Hardcore smokers: What do we know?

Audrey Darville, Ellen J. Hahn

Research output: Contribution to journalReview articlepeer-review

34 Scopus citations


Aims: The existence of smokers who are resistant to smoking cessation treatment has long been noted in the literature. There has been ongoing debate as to whether the proportion of these smokers is increasing as smoking prevalence rates stagnate. Studies define hardcore smokers inconsistently and within the context of specific illnesses, addiction, population, and/or theoretical paradigms. This review examines the existing literature related to hardcore smokers to develop a better understanding of what is known and not known about this group to guide smoking cessation treatment. Methods: PubMed MESH search and review of research publications from 1998 to 2012 (N= 61). Results: Inconsistent definitions of hardcore smoking make it difficult to estimate prevalence rates and to identify specific characteristics of persistent smokers. Generally, persistent smokers have higher levels of nicotine dependence, are disproportionately from lower socioeconomic groups, start smoking at an earlier age, and are more likely to have a psychological co-morbidity. Discussion: Defining some smokers as hardcore is limiting. Targeted and tailored interventions for smoking cessation for persistent smoking have demonstrated effectiveness in a small number of studies. Treatment access barriers need to be addressed to improve the reach and effectiveness of cessation with persistent smokers. Efforts to limit early age initiation of tobacco use are a critical element in averting persistent smoking.

Original languageEnglish
Pages (from-to)1706-1712
Number of pages7
JournalAddictive Behaviors
Issue number12
StatePublished - Dec 2014


  • Hardcore smokers
  • Smoking cessation
  • Tobacco dependence

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Clinical Psychology
  • Toxicology
  • Psychiatry and Mental health


Dive into the research topics of 'Hardcore smokers: What do we know?'. Together they form a unique fingerprint.

Cite this