Hey, you. Yeah, you, hanging around 50 feet or more from the door of your workplace on a breezy spring afternoon, striking a match, firing up a cigarette. Not exactly Jean-Paul Belmondo in Breathless, is it? But ah, that first drag-long, slow, highly satisfying, followed by a blue cloud of smoke when you exhale. It’s an indulgent ritual, an escape from routine, a treat for whatever accomplishment has been achieved.
You know you shouldn’t smoke.
It’s bad for your health in about a million ways. But you do it anyway. And you’ve got plenty of company.
According to the Centers for Disease Control and Prevention’s 2011 Behavioral Risk Factor Surveillance System, 27 percent of Arkansans smoke.
The highest rates are in Cleburne and Miller counties-35 percent and 36 percent, respectively. The national percentage is 21.2.
A recent study on health levels in the state by the Robert Wood Johnson Foundation listed Benton County as the healthiest and put counties in the Delta and other areas with uninsured and low-income populations at the bottom. Among the biggest health concerns in those low-ranking counties is tobacco use, which increases the risk of coronary heart disease, stroke, lung cancer and and other diseases.
Oh, enough already. Everybody knows smoking is injurious, and expensive, and frowned upon by nonsmokers, and practically impossible to do in public spaces without breaking some law or other. So here’s the big question: Why do it?
Because smoking cigarettes is what German philosopher Immanuel Kant would call “a negative pleasure,” alternately attractive and repellent.
“Cigarettes, though harmful to health, are a great and beautiful civilizing tool and one of America’s proudest contributions to the world,” writes Richard Klein in his 1993 book Cigarettes are Sublime. “Seen in this light, the act of giving up cigarettes should perhaps be approached not only as an affirmation of life but, because life is not merely existing, as an occasion for mourning.”
Before anyone starts shrieking that Klein is glorifying cigarette consumption, please know that his motives for writing Cigarettes are Sublime-“a languorous meditation on humanity’s most futile and wasteful habit,” wrote the late Christopher Hitchens in The Independent on Sunday-“had their origin in my urgent desire to stop smoking.”
The book title, explains Klein, can be traced to Kant, who identifies “sublime” as “that aesthetic satisfaction which includes as one of its moments a negative experience, a shock, a blockage, an intimation of mortality.”
Klein’s opinions are predated by Austrian-American psychologist and marketing whiz Ernest Dichter in his 1947 book The Psychology of Everyday Living. “Smoking introduces a holiday spirit into everyday living,” writes Dichter. “Smoking, for many of us … became a substitute for our early habit of following the whims of the moment; it becomes a legitimate excuse for interrupting work and snatching a moment of pleasure.”
Smoking is a reward, Dichter continues. “When we have done anything well, we can congratulate ourselves with a cigarette … The first and last cigarette in the day are especially significant rewards.”
The problem with rewarding yourself in this way is that cigarettes contain nicotine, which is physically addictive. What starts out as a sort of fun rebellion against American puritanism, an easily identified posture of modernity, turns into a craving that can’t be satisfied with safer substitutes. Physical addictions are considerably harder to get rid of than, say, giving up a subscription to HBO.
According to the National Institute on Drug Abuse, nicotine activities reward pathways, the brain circuitry that regulates feelings of pleasure. Nicotine withdrawal symptoms can include irritability, craving, depression, anxiety, cognitive and attention deficits, sleep disturbances and increased appetite.
People who try to quit start to experience these symptoms within a few hours of their last cigarette. Symptoms peak within the first few days of giving up smoking and usually subside within a few weeks. For some smokers, symptoms may continue for months.
Get it? It’s not easy to leave cigarettes behind. So let’s be honest here. Smoking cessation programs, like other efforts to treat addictions, aren’t exactly chart-toppers in terms of success rates. According to the American Cancer Society, only about 4 percent to 7 percent of people are able to quit smoking on any given attempt without medicines or other help. Studies in medical journals report that about 25 percent of smokers who use medicines can stay smoke-free for over six months-better than the cold-turkey route, but still not great.
That doesn’t mean quit-smoking programs are not worthwhile. “Your own success in quitting and staying that way is what really counts, and you have some control over that,” says the Cancer Society website. “Even if you don’t succeed the first few times, keep trying. You can learn from your mistakes so that you will be ready for those pitfalls the next time.”
The first step in kicking the habit is admitting that you have one. Then you have to decide that you’re ready to let it go.
Most likely to succeed at quitting, says Dr. Gary Wheeler, interim director of the Arkansas Department of Health’s Tobacco Prevention and Cessation Program, “is a smoker who wants to quit and has good family support.” Least likely to succeed: “A smoker who’s depressed, has other abuse issues, lacks family support, and has low educational attainment.” The No. 1 reason people fail, he says, “is having other family members who smoke.”
Among the cessation program’s weapons, Wheeler says, are:
-Promotion of a smoking cessation quit line at 800-QUITNOW (800-784-8669) that provides 24-hour access to so-called Quit Coaches, online support from those who successfully broke their smoking habits, and free nicotine replacement therapy medications
-Community education grants distributed in counties with high smoking rates
-Localized education campaigns in barber shops and hair salons
-Targeted minority education.
There’s a media campaign as well: A new Tips From Former Smokers television campaign from the national CDC and Arkansas’ Big Pitch Film Festival, which invites students in middle, junior and high schools to produce TV commercials promoting a tobacco-free lifestyle.
Wheeler says the Stamp Out Smoking media and public education campaign, begun in 2002 as part of the Tobacco Prevention and Cessation Program, has shown a significant drop in smoking rates for kids from 34.7 percent in 2001 to 18.2 percent in 2011. You can find out more at stampoutsmoking.com.
But statistics aren’t of much use if you’re struggling to set yourself free. Wheeler’s best advice on how to succeed at controlling a craving for cigarettes: Get ready to quit before you try. Get help. And don’t give up-try, try and try again.
Perspective, Pages 72 on 04/07/2013