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Memo to infrequent puffers: It's still smoking

/ Source: contributor

Maria Hynes doesn’t think of herself as a smoker, even though she often lights up with friends. Real smokers are people who can’t make it through a day without their cigarettes, Hynes says.

“I don’t crave nicotine,” explains the 42-year-old nurse from Bridgeton, N.J. “I’ve never been one to have a cigarette while watching TV or reading the paper. When I was pregnant, it was no big deal to quit. So I’ve always checked nonsmoker on medical forms.”

While smoking has been declining for the past decade in the United States, the number of “social smokers” like Hynes is on the rise, according to a new study. Between 1996 and 2001, the rate of nondaily smoking jumped from 16 percent to 24 percent of smokers. And it has continued to climb since then. In California, for example, the percentage of smokers who light up only occasionally went from 26 percent in 1992 to 30 percent in 2005, state health figures show.

And that’s exactly the way cigarette companies planned it, says Dr. Rebecca Schane, a researcher at the Center for Tobacco Control Research and Education at the University of California at San Francisco. She's a lead author on a new study published in the August issue of the American Journal of Preventive Medicine. The study aims to turn tobacco company research on its head, using industry data to help find ways to help social smokers quit.

In the 1970s and 80s — as the health risks of smoking became increasingly apparent — the tobacco industry spent millions studying social smokers to figure out what made them tick, Shane says.

Social smokers are defined as those who tend not to smoke alone; who restrict their use to social situations, such as parties, bars or nightclubs; and who swear to friends and health care workers that they're not real smokers after all.

Tobacco firms targeted social smokers

The tobacco makers hired anthropologists and psychologists to help design advertising campaigns that would make cigarettes more alluring to people who weren’t wired to become addicted to nicotine. The idea was to show that cigarettes could be a social lubricant, a necessary addition to any social gathering.

Shane and her co-author turned up the new information while searching through reams of tobacco industry documents that were released as part of a settlement in one of the landmark state suits against big tobacco.

Tobacco companies worked hard to develop an image of smokers as “cool,” Schane says. Brown & Williamson, for example, came up with “Kim,” a brand that appealed to people who were “style conscious”  and read magazines like Cosmopolitan and Glamour. RJ Reynolds developed its “Bright” brand for people “who enjoy the ritual of smoking, but who really don’t enjoy the tobacco taste," the study showed.

The challenge, Schane says, is to counter that alluring image and to find a way to get occasional puffers to acknowledge that they truly are smokers, too. Until experts figure out a way to do that, there won’t be much progress in getting social smokers to quit, says Dr. Antoine Douaihy, an associate professor of psychiatry and medical director of Addiction Medicine Services at the University of Pittsburgh School of Medicine.

“Conventional anti-smoking campaigns will fail to reach them,” Douaihy says. “We’re going to need to be creative and come up with different messages targeted directly to them.”

Because social smokers appear to be susceptible to peer pressure, it may help to emphasize the damage done by second-hand smoke, says Dr. Arthur Brody, a professor at the University of California, Los Angeles, and director of the Smoking Cessation Program at the federal Veterans Affairs West Los Angeles Healthcare Center. Another approach would be to emphasize the fact that even infrequent smoking may damage your health, he adds.

“No amount of smoking is good for you,” Brody says. "And while smoking one or two a day might not be as bad as a pack a day it’s still not good for you.”

I do know better.’

There are times when this message gets through to Hynes, who says she can go days and even weeks without picking up a cigarette.

“I do know better,” she says. “I’ve seen what lung cancer can do. And there is some guilt involved, especially after a heavy night of smoking when I wake up coughing up a lung and feel like crap. I wonder, why do I do this when I’m not even addicted? Why do I do this to my body? And then I kind of forget about it till the next time.”

The biggest challenge may be in getting social smokers to admit that they do, in fact, smoke. Shane suggests that doctors might get more truthful answers if their forms simply asked if the patient had a cigarette recently rather than attempting to categorize a person as a smoker or a nonsmoker.

Hynes isn’t particularly hopeful since she and other social smokers don’t see their habit as being dangerous. Besides, she says, they feel like they’re in control because they’re not technically addicted. Theoretically, they could quit at any time.

But even without an addiction to nicotine, the link between cigarettes and a good time can be tough to break. If Hynes gets a good friend on the phone or sits down for a visit, the urge for a cigarette adds to the feeling of closeness, she says.

“I look at myself as a lost cause,” Hynes says. “Somewhere in my brain it’s wired that I need to smoke to relax and enjoy myself. The cherry on top is the cigarette.”