6.9Predictors of nicotine dependence

Last updated: January 2018

Suggested citation: Christensen, D. 6.9 Predictors of nicotine dependence. In Scollo, MM and Winstanley, MH [editors]. Tobacco in Australia: Facts and issues. Melbourne: Cancer Council Victoria; 2018. Available from http://www.tobaccoinaustralia.org.au/chapter-6-addiction/6-9-predictors-of-nicotine-dependence

Several factors are thought to predict or increase the chance of developing nicotine dependence. For example, people who start smoking at an early age are more likely to become dependent smokers than those who start later in life.1 Dependence is also more likely among some ethnicities.2

Individuals may vary in genetic vulnerability for developing nicotine dependence. For instance, individual variation in the CYP2A6 enzyme responsible for metabolising nicotine correlates with smoking rates,3 while dependence on other drugs is also highly correlated with nicotine dependence.4 In addition, mood, anxiety, and personality disorders are also associated with significantly increased risk of nicotine dependence.5, 6 One US study of smokers found that nicotine dependence is more likely for women, adults younger than 65 years, those with less education, or unmarried adults.7


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1. Institute of Medicine. Growing up tobacco free: Preventing nicotine addiction in children and youths. Washington, DC 1994. Available from: https://www.ncbi.nlm.nih.gov/books/NBK236763/.

2. Lawrence D, Fagan P, Backinger C, Gibson J, and Hartman A. Cigarette smoking patterns among young adults aged 18-24 years in the United States. Nicotine & Tobacco Research, 2007; 9:687–97. Available from: https://www.ncbi.nlm.nih.gov/pubmed/17558826

3. Malaiyandi V, Sellers EM, and Tyndale RF. Implications of cyp2a6 genetic variation for smoking behaviors and nicotine dependence. Clinical Pharmacology and Therapeutics, 2005; 77(3):145–58. Available from: https://www.ncbi.nlm.nih.gov/pubmed/15735609

4. Frandsen M, Thorpe M, Shiffman S, and Ferguson S. A clinical overview of nicotine dependence and withdrawal, in Negative affective states and cognitive impairments in nicotine dependence.  Hall S, Young JW, and Der-Avakian A, Editors. San Diego: Academic Press; 2017.

5. Kollins S, McClernon F, and Fuemmeler B. Association between smoking and attention-deficit/hyperactivity disorder symptoms in a population-based sample of young adults. Archives of General Psychiatry, 2005; 62:1142–7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/16203959

6. Hu M, Davies M, and Kandel D. Epidemiology and correlates of daily smoking and nicotine dependence among young adults in the United States. American Journal of Public Health, 2006; 96:299–308. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1470478/

7. Goodwin R, Pagura J, Spiwak R, Lemeshow A, and Sareen J. Predictors of persistent nicotine dependence among adults in the United States. Drug and Alcohol Dependence, 2011; 118:127–33. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3337717/