Special Groups

Tobacco dependence does not discriminate. Regardless of demographics and personal characteristics, everyone is vulnerable to nicotine addiction. Tobacco researchers are invested in understanding which characteristics contribute to the onset of addiction, paying close attention to the role of age, sex, socioeconomic status, and mental health states in this process. The below section identifies some groups of smokers that appear to experience tobacco withdrawal differently than others.

Most of these findings have still yet to be applied to clinical interventions. However, you, as a supporter of cessation, can start by acknowledging the unique qualities of your friend or loved one. Then, check out our page of cessation resources to connect with someone who can help keep him/her tobacco free!


One popular field of research examines which factors might increase the likelihood that an adolescent would start smoking. We know that they can face unique social pressure from media and cultural influences to smoke, and that they experience differences, compared to adults, in brain development that can influence decision making and risk assessment. Because an adolescent’s brain is still developing, nicotine exposure has been found to take a greater toll, with potential to increase the risk of development of psychiatric disorders and cognitive impairment later in life. Adolescents who are dependent on nicotine are more likely to use e-cigarettes rather than combustible cigarettes. While it appears that these vaporizers are less harmful than conventional combustible cigarettes, they have become the focus of concerned public health professionals. E-cigarette marketers have recently been forced to dial back their advertisement campaigns that target young users. However, this new phenomenon of low-risk adolescents beginning to vape remains a serious issue. As a supporter, in addition to encouraging your adolescent friend or loved one to quit, stay informed of e-cigarette product trends and keep an eye out for new findings on risk and effective interventions.

Socioeconomic status and ethnicity

Research has found that individuals of low socioeconomic status and racial/ethnic minority groups experience varying genetic and environmental factors that appear to elevate their risk of tobacco dependence. For example, research has identified that certain racial/ethnic groups experience worse changes in mood during tobacco withdrawal. Furthermore, it appears as though some factors associated with living in a lower-income home (e.g. overcrowding, limited access to non-drug recreational activities) could reveal why tobacco dependence is a greater public health burden for some groups. Additionally, these groups often experience great difficulty accessing healthcare—a well-validated resource for individuals wanting to quit. As researchers come to a better understanding for which factors (genetic and environmental) contribute to these issues, consider the notion that some of these groups are disadvantaged in the fight against tobacco dependence, and strive to connect them to specialized care.


Although men smokers outnumber women smokers, tobacco dependence in women is a unique issue, considering some key biological differences. It appears tobacco withdrawal severity is associated with hormonal levels for some women. Furthermore, some women who smoke desire to get pregnant. Women smokers are less likely to get pregnant than women who do not smoke. Additionally, smoking during pregnancy increases the likelihood of a miscarriage, placenta detachment (posing a risk to both mother and baby), premature birth, sudden infant death syndrome, and various birth defects. Understanding risks specific to women can help you identify ways to support.

Interested in learning more about women and smoking? Take a look at what the Center for Disease Control has to say on the topic.

Older Adults

Adults who smoke later in their life face elevated risk for developing other age-related diseases. In addition to facing the effects of natural aging, these older smokers have often smoked for more time, and the prolonged exposure to tobacco often leads to health complications. Older smokers are also at risk for developing other age-related health issues like hearing deficits, impaired mobility and vision, decreased ability to smell and taste, and cognitive issues like dementia. As you encourage your older friend or loved one to quit smoking, consider the unique ways they experience tobacco dependence as you develop a plan to support.