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Neglect of alternative pleasures could be fulfilled by endorsing the item, "Do you find that you are spending more of your free time trying to get cigarettes?" The criterion of use despite harm could be fulfilled by answering affirmatively the question "Has a doctor or nurse told you that you should quit smoking because it was damaging your health?" Consequently, a participant who smoked two cigarette per week (but had planned on smoking only one), spent more time trying to get these two cigarettes than when he used to smoke only one per week and was told by the school nurse that smoking was bad for his health would earn in this study an ICD diagnosis of tobacco dependence

Skin aging Smoking affects collagen and elastin, which are elastic fibers that keep the skin plump and firm

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