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Consult a healthcare provider if: You smoke more than 20 cigarettes daily or have smoked for 10+ years (high nicotine dependence) You've attempted to quit multiple times without success and need structured support You experience severe withdrawal symptoms (extreme anxiety, depression, inability to function) that interfere with daily activities You have co-existing health conditions (heart disease, diabetes, respiratory problems) requiring monitored cessation You want guidance on NRT dosing, prescription medications, or combination therapy approaches You need accountability, counseling, or behavioral therapy to address psychological dependence beyond physical nicotine addiction For comprehensive smoking cessation support and guidance during Ramadan, please visit the Primary Care clinic at Johns Hopkins Aramco Healthcare

As a result, Halpern-Felsher says there's a higher possibility of addiction during adolescence than if the user had started using the product as an adult