Quitting is Hard, But Worth It

Three separate studies published in 2008 found that genetic variations on chromosome 15 could intensify a smoker's addiction, raise his or her risk of getting lung cancer or peripheral artery disease, and make it harder for affected smokers to quit. One of the lead researcher from one of the studies called this genetic difference a “double whammy,” affecting both the likelihood a person would smoke and the likelihood that person would suffer ill health effects from it. There seem to be some gender differences as well, although not all studies show them. In some research, nicotine replacement therapies were less effective for women than for men. As one theory goes, women are less sensitive to nicotine's effects and more responsible to the social and behavioral aspects that go along with the habit. This could explain why nicotine replacement is somewhat less effective for women. It also suggests that they might benefit more from counseling and group support to change their behavioral cues and social habits. LESS

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Women may be more susceptible than men to environmental cues to smoking, such as smoking with specific friends or smoking associated with specific moods. They also show signs of being more responsive to smoking-related cues and images. One study of women smokers scanned the subjects' brains when they viewed smoking-related images. Those who had higher reactivity in the brain regions having to do with emotion and planning and execution were more likely to slip up and smoke after attempting to quit. Behavioral interventions, such as therapy and counseling, often include planning alternate activities and thought patterns to replace smoking when environmental cues test a quitter's resolve. LESS

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“The tobacco industry is extremely clever,” says Steven Schroeder, M.D., Director of the Smoke Cessation Leadership Center at the University of California, San Francisco. “Pharmacies sell cigarettes. Pharmacies! And there is disproportionate saturation of marketing in lower-income areas, where smoking is more prevalent. Magazines still run tobacco ads. And funds for countermarketing efforts, such as the Truth.com campaign, are running out.”

Does tobacco advertising really work to recruit new smokers? Well, the three most heavily advertised brands—Marlboro, Newport and Camel—are the top three brands preferred by middle-school students. Among these rookie smokers, 43% prefer Marlboro, 26% choose Newports and 9% prefer Camels. Because their advertising venues are limited and closely regulated, cigarette companies have become more creative in their marketing. Some sponsor events, parties and cultural events tied to specific ethnic groups. Pushing menthol cigarettes to African Americans at hip-hop and holiday festivals, marketing of themed brands such as Rio and Dorado to Hispanics and American Spirits to Native Americans—Big Tobacco's efforts to keep at-risk populations interested in their products are transparent and somewhat effective.

By perpetuating such false notions as “light” and “low-tar” cigarettes being more healthful, tobacco companies convince smokers that they can reduce the health effects without quitting. “Smokers of 'light,' 'slim,' or 'low-tar' cigarettes believe that their cigarettes are less harmful, but this is false,” says Michael D. Stein, M.D., Professor of Medicine and Community Health at Brown University. “Those who smoke gold, silver or purple cigarettes—or menthols—share this false belief. All of these cigarettes have the same health risks as all other cigarettes. The names are misleading, and should be removed from all packaging.” LESS

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