A Smoking Gun

American Fitness, Sept, 1999 by Stefanie A. Doebler

The daunting task of giving cigarette smoking can yield a wide array of health benefits.

Liz Danzico began smoking when she was only 14 years old. She vividly remembers hanging out at an arcade near her home in Scranton, Pennsylvania, where a friend's brother gave them their first cigarettes. Back then, she thought it was cool to smoke occasionally. Today, 25-year-old Danzico smiles sheepishly when she admits to her pack-a-day smoking habit.

"I did quit once in college," insists Danzico, as if to reassure herself that she could do it again. When her mother came to visit for a week, she stopped smoking to avoid having to confess her vice. After the visit, she managed to stay nicotine-free for almost six months but finally broke down during finals and started smoking regularly again. "I still haven't told my parents I smoke," she says. "I know I'm going to quit soon, so it just hasn't been worth it to upset them."

Like most smokers, Danzico is already well aware of the risks of cigarette smoking, which is the single leading preventable cause of death in the United States. Tobacco kills more than 400,000 Americans each year--more people than AIDS, car accidents, alcohol, homicides, illegal drugs, suicides and fires combined.

Statistics from the American Cancer Society regarding female smokers are chilling. The cancer death rate for female smokers is 67 percent higher than for non-smokers. Lung cancer is the leading cause of cancer death among women--ahead of breast cancer. Women who smoke are 300 percent more likely to develop bronchitis or emphysema than those who don't smoke. Smokers are also at greater risk for heart disease, strokes and blood clots. Women who smoke during pregnancy are more likely to have low birthweight babies, who are 20 times more likely to die than babies of normal weight.

So why, considering the staggering health risks of smoking, are women still lighting up? Today, 25.2 percent of women ages 18 to 24 and 27.8 percent of women ages 25 to 44 smoke--and these numbers are increasing. Dr. Larry Laufman, assistant professor at the Center for Cancer Control Research of Baylor College of Medicine, attributes the prevalence of young women who smoke to the recent rise in teen smokers.

Although the overall number of smokers in the United States has remained between 20 percent and 25 percent of the population over the past 10 years, the rate of teen smoking has increased at an alarming rate. According to the Centers for Disease Control and Prevention, the prevalence of cigarette smoking among U.S. high school students increased from 27.5 percent in 1991 to 36.4 percent in 1997--a 23 percent increase in only six years. Because today's young women were yesterday's teenagers, the rate of smoking among women has consequently risen proportionately.

This increase in teen smoking is particularly worrisome because CDC studies have shown most people begin to smoke as teens. In fact, 82 percent of adults who smoke (or smoked in the past) had their first cigarette by the time they were 18, and more than half had become regular smokers by that time. Furthermore, people who have not tried cigarettes by the time they graduate from college are unlikely to ever start smoking.

While there has been much debate regarding whether cigarette companies target teenagers in their advertising, these companies readily admit they target young adults, according to Dr. Laufman. "Unfortunately, teens model themselves on young adults, so the advertising affects teenagers regardless of whom the tobacco companies officially market to."

Once women are hooked on smoking, they are more likely than men to try to quit but are also less successful. It takes the average female smoker at least three tries before she is finally able to stop smoking permanently. One reason women have so much trouble quitting is that many smoke for weight control, says Dr. Ross C. Brownson, director of the Prevention Research Center at St. Louis University. Because nicotine acts as an appetite suppressant, many women gain five to 10 pounds when they stop smoking. "Weight is a big issue in smoking cessation," says Dr. Brownson. "However, the benefits of weighing a few pounds less pale in comparison to the other health problems connected to smoking."

Danzico says she isn't as worried about gaining weight as she is about losing the sense of identity she's come to associate with smoking. "There are certain times during each day when ! smoke," she says. "I just can't imagine not having a cigarette after dinner or between classes. It's become part of who I am."

Dr. Laufman says Danzico's fears are not uncommon. Because smoking can become such an integral part of a person's self-image, it's not unusual for an ex-smoker to feel as if he/she's lost her best friend. A person who smokes four to five cigarettes a day probably isn't going to have a particularly hard time dealing with nicotine withdrawal after he/she quits. However, if they're used to smoking at parties, they may have come to associate smoking and parties as one activity. To overcome the desire to smoke, they'll probably need to develop a substitute behavior during the next party--sucking on mints or playing with a pencil, for example. "Smoking and addiction are psychological as well as physiological processes," says Dr. Laufman. "Many people try to quit by changing their physical habits, but the ones who succeed are those who work on their psychological attachment to smoking as well."