What is the Significance of Experiencing Relaxation in Response to the First Use of Nicotine?

UMMS Affiliation

Department of Family Medicine and Community Health

Publication Date


Document Type



Nicotine; Tobacco Use Disorder; Smoking; Relaxation; Adolescent


Community Health | Preventive Medicine


Individuals who feel relaxed the first time they inhale from a cigarette are more likely to develop nicotine dependence. To determine if the relaxation response is associated only with specific aspects of dependence, a survey was administered to 1405 adolescents aged 14–18 years (mean 15.8 years) from four schools in Massachusetts. Nicotine dependence was measured with the Diagnostic and Statistical Manual (DSM-IV), and the loss of autonomy over tobacco was measured with the Hooked on Nicotine Checklist (HONC) and the Autonomy Over Smoking Scale. A feeling of relaxation was reported by 39.4% of 439 youth who had inhaled from a cigarette. Relaxation was associated with increased risk of current smoking (odds ratio (OR) = 5.7, p < 0.001), daily smoking (OR = 5.7, p < 0.001), a loss of autonomy on the HONC (OR = 5.0, p < 0.001), and a DSM-IV diagnosis (OR = 2.4, p < 0.02). In regression analyses, relaxation was not associated with psychological reliance on tobacco after controlling for nicotine withdrawal symptoms, and cue-induced craving. This study extends the literature by demonstrating that relaxation is associated with DSM-IV nicotine dependence, nicotine withdrawal, and aspects of cue-induced craving.

DOI of Published Version



Ursprung WWSA, Savageau JA, DiFranza JR. What is the Significance of Experiencing Relaxation in Response to the First Use of Nicotine? Addiction Research and Theory 2011;19(1):14-21. Link to article on publisher's website

Journal/Book/Conference Title

Addiction Research and Theory