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August 30, 2006

Smoking: Getting Worse

A new study shows that the amount of nicotine in cigarettes has increased by a full 10 percent in the last six years, making the damn things easier to get hooked on, harder to quit, and more destructive to your body. And for some brands, that understates the increase. Kool cigarettes, a top brand for African-American smokers, has boosted their nicotine by a full 20 percent. And light brands, by the way, show no significant difference in nicotine.

Quick rant: Like most nonsmokers, I've no interest in berating my friends for lighting up, even though I find the sight wrenching. As someone who follows health care data, a stunning percentage of the studies that flit across my screen show enhanced harm from smoking. The damn things literally kill you, accelerating an almost unimaginable number of terminal illnesses to a degree we'd not known even a decade ago. The data is so chilling that I'd be genuinely unable to seriously date a smoker. Folks can do what they want -- the libertarians are right about that -- but it's terrible to watch.

August 30, 2006 | Permalink

Comments

>>The data is so chilling that I'd be genuinely unable to seriously date a smoker.<<

I said that too. Then I married one. You never know who you're going to fall for. It took him years and several failed attempts to finally quit but he's smoke free now.

Posted by: fiat lux | Aug 30, 2006 11:13:33 AM

I'm banking on psychoneuroimmunology.

Posted by: Brian Cook | Aug 30, 2006 11:22:10 AM

The fundamental problem with the anti-smoking campaign is that smoking is cool. I am an occasional "drinking smoker" and I'm always amazed at how much cooler I am when I"m doing it. Your wonkery and communist fear-mongering are powerless against cig chic

Posted by: publius | Aug 30, 2006 11:24:57 AM

I have friends who call themselves nonsmokers but are in that "smoke when drinking" category. I tell them they are smokers b/c as one friend said "do you buy cigarettes? If so you are a smoker." Their argument is they don't smoke during the day at work.

It was annoying that on Match several guys would check the "Smoking - NO WAY!" box but then when you met up for a drink the truth came out.

I've dated 2 smokers and with one it was added to the list of things we fought about - sitting in the smoking section vs nonsmoking section.

Anyway - what I've noticed is for every friend that tries to quit its so difficult when there's at least one other person in the group who is smoking. I'm really happy my sister quit again even though her husband smokes - really thought it wouldn't happen until he quit b/c too much tempation having that access to the cigarettes.

Posted by: JenM | Aug 30, 2006 11:39:31 AM

What I find frustrating in these studies is that the ones I see are all on regular smokers (pack a day being most prevalent). What are the effects on the drinking smoker, who will have 2 a week, or even 1 a month?

Cigar and pipe smokers moderate their usage (mostly), and though it's not as common, so can cigarette smokers.

It's the whole "looking at a cigarette will give you teh cancer!!1!" thing that ticks me off about the anti-smoking campaign. Stop the "just say no" style anti-cig campaign and give us the straight dope.

Posted by: verplanck colvin | Aug 30, 2006 11:56:33 AM

I shun my smoker friends (berate might be a strong word.) I also would never date a smoker...how could I ever want to kiss her? Its digusting. Habitual smoking turns a person into someone other than they would be if they didn't smoke. Its one thing to light up a cigerette (or any other smokable item :) ) occasionally, but those who make a habit of it make it define them, and thats just sad.

Posted by: Adrock | Aug 30, 2006 11:57:58 AM

fiat lux, it's pretty easy to avoid seriously dating or marrying smokers if one avoids dating them casually as well. Personally, I find it easy because smokers aren't exactly easy on the olfactory glands-- I'm one of those sensitive-to-smells (not allergic or prone to physical reactions; I just register smells more easily than some others) types who picks up on it in others' skin, clothes, etc. Call me nitpicky, but I wouldn't get involved with a smoker any more than I would someone who only bathed a couple of times a week-- of course, YMMV.

Plus I'm increasingly militant because it killed my mom in her early fifties... but even as a kid I bitched at her about the smell, so my aversion isn't just philosophical.

Posted by: latts | Aug 30, 2006 12:00:19 PM

Verplanck, thats likely because it contains a highly addictive additive, nicotine, and so the campaigns errs on the side of caution. I do know some people who only bum cigarettes off people when they are in the bars occasionally. My guess, their healthrisks are only slightly elevated.

There is one bar that we sometimes go to that still allows smoking and I feel like shit when I leave there.

Posted by: Adrock | Aug 30, 2006 12:02:25 PM

Yeah, Nancy Reagan decided to err on the side of caution, too. All we got out of that were some unintentionally funny "this is your brain on drugs" commercials.

Everyone deserves the truth. Not the truth, erring on the side of caution.

Posted by: verplanck colvin | Aug 30, 2006 12:22:43 PM

I know everyone says it, but I don't get the whole "I also would never date a smoker...how could I ever want to kiss her? Its digusting" thing. I've dated smokers when I was a nonsmoker, and we kissed, and it was fine. A little...smoky, but whatever. I've kissed nonsmokers who tasted a lot worse.

On a related note: unlike regular cigarettes, kreteks (you know, cloves) actually smell pretty good. And the fiberglass thing is just an urban legend.

Posted by: Christopher M | Aug 30, 2006 12:30:32 PM

What I find frustrating in these studies is that the ones I see are all on regular smokers (pack a day being most prevalent). What are the effects on the drinking smoker, who will have 2 a week, or even 1 a month?

Cigar and pipe smokers moderate their usage (mostly), and though it's not as common, so can cigarette smokers.

It's the whole "looking at a cigarette will give you teh cancer!!1!" thing that ticks me off about the anti-smoking campaign. Stop the "just say no" style anti-cig campaign and give us the straight dope.

It's really quite simple - if you smoke very moderately, say 15 (at most) or less cigs per month - you will likely have no related problems. It doesn't take a study to figure that out. They focus the studies on average smokers - who smoke a pack a day, or slightly less. It is a very small percentage of smokers who smoke moderately like that, because the tobacco is so damned addictive. And I question your belief that pipe and cigar smokers don't smoek so much. Pipe smokers probably get a bit less but cigar smokers generaly smoke, on average as much tobacco as I do - they just smoke it less frequently in higher quantity.

Ezra - it is really nice to see someone posting about the disgusting nature of smoking. It is such a ridiculous drug and so easy to start - especialy when your young. Mine is a stupid tale of starting to smoke because so many of my friends did and I was actually allergic to it. A close buddy told me that if I lit up myself it wouldn't be such a bother to me - he was right, now 16 years later I'm having a smoke as I type (I'm outside a cafe` - haven't had a smoke inside in 4 years). The shit of it is that I have seven siblings, from 6 to twenty three years older than myself who warned me for years (five of them smoked) never to start. Several of them have a different mother, who died of emphazima a year after I started smoking. I damned well knew better than to do it - but when we're kids we think we're invincible - certainly something as innocuous as smoking can't control us. . .

Posted by: DuWayne | Aug 30, 2006 12:47:58 PM

I'm another moderate smoker myself. A pack a week is not unheard-of for me, but noticeably more than average. It's genetic, I guess. I'm told both my parents smoked until they decided to have kids and it was much easier for my dad to quit than for my mom, so I must have got his nicotine metabolism gene or whatever. DuWayne, I'm sorry to hear about that, and if you try to quit (or try again), I wish you the best of luck.

I reason that I won't really worry about it unless I do get addicted. (The obvious response being, at that point it's too late. But anyways.) A few months ago I didn't smoke for three weeks just because I didn't get around to buying another pack. As long as it remains that easy, I allow myself this one bit of stupid behavior.

Still though, I know it's very addictive to some people. Verplanck, I think your argument makes more sense applied to marijuana or some other drugs than cigarettes.

Posted by: Cyrus | Aug 30, 2006 1:18:04 PM

Exquisite Rant - You can't afford to smoke. 5 cartons a month is $250 a month or more in some states. Double for the smoking couple. A 25-year-old will pay $30 a month extra for health insurance. A 55-year-old may pay $150 a month for the smoking premium. By the time the 25 year old is 55 this extra smoking charge will be unaffordable. Lets add up the cost for a 55 year old smoking couple. $500/mo for the cancer sticks and $300/mo extra smoking premium. $800 a month is a lot and it will go up in the next 10 years before being Medicare age.

7-Eleven's first tax free MSA smoked in 1997 and paid the extra smoking premium for him and his wife. He had a heart attack at 52 and both he and his wife quit smoking so his premiums dropped $200 per month. Now he could light up a smoke and party because once the smoking premium is removed it can never come back.

To have the extra smoking premium removed you must answer the question: Did you light up ONE time in the last 12 months?

Posted by: Ron Greiner | Aug 30, 2006 1:39:32 PM

I enjoy the occasional cigarrette. I used to smoke about 10 a week, back when I drank a lot more. Now, maybe 5 or 6 a month. I've never been addicted to them, and scaling back when I'm starting to smoke too much has never been difficult. Just lucky, I guess.

And it is annoying that few studies address my particular habit to tell me how much damage I'm doing to myself.

Posted by: spike | Aug 30, 2006 1:41:52 PM

I've worked in a few different restaurants for the last two years and am amazed at the number of people who work in them who smoke. It's worse in upstate New York, where I go to school, but it's still pretty bad on Long Island, where my home is. I just wonder what it is about them that make people smoke. I guess I started wondering that last year, when people started talking about how much fat was in the food we serve, but would then go to the back to smoke.

Posted by: Brian | Aug 30, 2006 2:23:13 PM

At a social work symposium a few years ago, I heard a presentation by psychiatrist who specializes in addictions. The upshot was that therapy that combines nicotine replacement and antidepressants over a much longer period of time than typically prescribed for smoking cessation can increase the likelihood of success, especially in women with a history of depression.

I smoked for 12 years, about a pack a day, and had quit cold turkey twice -- once for a month, once for two. When I was ready to try again, I looked him up. He put me on wellbutrin about six weeks before my quit date, and had me wear a patch AND keep nicotine gum handy in the event of a severe craving. It's been six months and I'm still on a low dose of wellbutrin and wearing the lowest level patch -- I'm scheduled to taper off both in the next few months. I have been completely successful so far, and the experience has been much less painful than my other two attempts.

My primary care physician is horrified that I'm still on the nicotine. All I could tell her was that I'd rather expose myself to the risks of uninhaled nicotine for several months than have another failed attempt and wind up actually smoking again.

I think this approach falls in the category of harm reduction -- the idea being that it's less harmful to absorb 7 mgs of nictotine through my skin than it is to smoke 20 cigarettes a day. Would it be better to go cold turkey? Absolutely. But given my previous attempts and my daily exposure to triggers (my boyfriend and many of my friends and family members smoke) this seemed worth trying and I am so glad I did.

Anyone born in the 70s or later grew up knowing that smoking is deadly, so to the many health care providers who have, over the years, warned me that smoking causes cancer, I say: no shit! Being scolded about the dangers of smoking never made me want to quit -- it made me want to smoke more, out of spite, and shame. So I think it's wise not to berate smokers too much.

Posted by: Erin | Aug 30, 2006 2:30:32 PM

Good luck to you, Erin. I agree that the scolding was just annoying. It always made me want to smoke more, too. It was a serious physical addiction for me, and I would fall into really bad depressions when I tried to quit cold turkey. I quit with the patch, too, but the Wellbutrin sounds as if it would have been helpful.

I quit four years ago now, and after the first year, I allowed myself to have maybe two or three cigarettes a year.

Ezra, I always joke that "I'll never seriously date a smoker" should be on the list of dangerous phrases, right there with "What could go wrong?" and "I'll just go see what that noise is."

Both my very serious college boyfriend and my husband said the same. The boyfriend and I still made it six years, and my husband and I have been together for eight. He married me when I was still a smoker.

Posted by: Magenta | Aug 30, 2006 2:53:14 PM

My basic problem is that smoking is an acquired taste. It's not like sugary junk food, where it's easy to like. You find it gross at first, and you have to actually work to develop a cigarette habit. Overall, it just seems to be a waste of effort. I'll kill myself with greasy Trader Joe's gyoza fried in peanut oil, saturated fat-filled chocolate bars, and high-fructose corn syrup laden soft drinks, thank you very much.

Posted by: Julian Elson | Aug 30, 2006 3:17:14 PM

Anyone born in the 70s or later grew up knowing that smoking is deadly, so to the many health care providers who have, over the years, warned me that smoking causes cancer, I say: no shit! Being scolded about the dangers of smoking never made me want to quit -- it made me want to smoke more, out of spite, and shame. So I think it's wise not to berate smokers too much.

Yeah, ditto. While I was in college there were two attempts to get me to stop. One spring my girlfriend at the time tried, with puppy-dog eyes and a story about how her great aunt died of lung cancer or something. That made me think about it, but I didn't actually throw away my pack until I spent a week in the summer visiting some friends who did smoke about the average amount. I kept up with them for a while, until near the end of the week it made me feel sick and I said "you know, she's right". The week with heavier smokers might not have made me quit without the guilt trip, but the guilt trip definitely wouldn't have made me quit without the week.

I didn't start smoking again until about 10 months after that, in the stress and late nights and everything of finals season. The following September, a friend of mine with a, let's say, physical sense of humor, promised me that if I stopped smoking, she would stop threatening/pretending to kick me in the nuts. 20 minutes later, we had an agreement which lasted even longer than the previous time.

And the moral of this story is...
hell, anyone who would take a general lesson from it doesn't need the encouragement.

Posted by: Cyrus | Aug 30, 2006 3:33:31 PM

My problem with cigarettes is the smell. You're not going to get me to quite drinking a little too much on occasion; I don't spill on myself. But sheesh, the stink of your clothes around smoke! My favorite laws are the no-smoking-in-bar/restaurant laws. Like night and day.

FD: former smoker, never serious, so found it easy to quit

Posted by: wcw | Aug 30, 2006 3:50:38 PM

I'd say the smoking is far more dangerous than the nicotine itself. In fact, in past years I've read articles on studies which show that smokers have significantly lower levels of colon cancer(it stimulates the digestive tract to keep things moving) and much lower incidence of pancreatic cancer. Also, I believe Alzeimer's onset is lessened in people who smoke or chew. The trick is to get the nicotine without smoking it.

Posted by: Steve Mudge | Aug 30, 2006 4:13:29 PM

Steve, I seem to remember that nicotine is at least somewhat beneficial to Parkinson's patients as well.

Going back to the example of my mom, though, the irony is that she was statistically at higher risk (at her age) for both pancreatic cancer (type 2 diabetic) and colon cancer (colitis) than for lung cancer, but that's what got her. Wonder if that's all interrelated.

Posted by: latts | Aug 30, 2006 4:45:45 PM

Malcolm Gladwell makes a fairly convincing argument in The Tipping Point that reducing the amount of nicotine in cigarettes by a small amount would greatly decrease smoking addiction. Of course, no tobacco company will agree to this voluntary, but it would be a useful regulation.

Posted by: Minipundit | Aug 30, 2006 4:48:08 PM

My favorite laws are the no-smoking-in-bar/restaurant laws.

Why? Doesn't your area already have bars that disallow smoking? Why shouldn't the owner of the resteraunt or bar make that decision? I am all about not infringing on the rights of non-smokers to breathe clean air - I go out of my way to limit my second hand smoke to myself and other smokers. But it is the right of a business owner to allow smoking in their establishment. Just like non-smokers have the right not to frequent such places.

Malcolm Gladwell makes a fairly convincing argument in The Tipping Point that reducing the amount of nicotine in cigarettes by a small amount would greatly decrease smoking addiction. Of course, no tobacco company will agree to this voluntary, but it would be a useful regulation.

Purely anecdotal but I, and a number of my friends smoke ciggarettes that have no added chemicals and I see no difference between my tobacco addiction and anyone else's. Smoking carries a number of addictive qualities that it would be hard for many non-smokers to understand.

Posted by: DuWayne | Aug 30, 2006 6:46:28 PM

You find it gross at first, and you have to actually work to develop a cigarette habit.

Not necessarily. I *loved* my first cigarette, and second, and third....and oddly, I remained a light smoker, peaking at about a pack a week.

Another weird thing about me is that i like the smell--not the smell of stale smoke in clothes, furniture (although that doesn't bother me much) but the smell of the actual smoke. I loved visiting the homes of relatives who smoke for that reason.

Posted by: djw | Aug 30, 2006 7:01:54 PM

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