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| Smoking: psychological and social influences |
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Written by Dr Sheila Bonas, lecturer
in health psychology, Coventry University
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As more of us become aware of the dangers of smoking, the
percentage of smokers in the UK has fallen from around 50 per cent of the
population in the 1950s to 25 per cent in 2003.
Even with this fall in the number of smokers, it's estimated
that cigarettes were responsible for more than 1.2 million deaths in 2000 in
the European region of the World Health Organisation. In the UK, smoking is
responsible for around one in five deaths.
The illnesses caused by smoking extend beyond the well-reported
links with cancer, heart disease and respiratory illnesses. Smoking can cause
impotence, ulcers and fertility problems and it's doesn't just harm
smokers.
Passive smoking causes lung cancer and is linked to cot death,
glue ear and asthma in children. However, the decline in smoking in the
population has levelled off and the percentage of people smoking in the last 10
years seems to have remained at around 25 per cent.
The good news is that about 70 per cent of smokers say they want
to quit. Yet success rates for quit attempts are between 10 and 20 per cent.
This article looks at some of the psychological and social barriers that
smokers face.
The problem starts in childhood
Most smokers first start experimenting with cigarettes in their
teens: in the UK only 1 per cent of 11 year olds smoke regularly. By the age of
15, this number has risen to 22 per cent, with girls more likely to smoke than
boys.
There are many reasons why children start to smoke:
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Children whose parents smoke are twice as likely to start
compared to those with non-smoking parents.
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A Scottish study of teenage girls found that smoking was part
of an image cultivated by the girls who were seen as leaders of their groups.
Smoking went along with wearing short skirts, jewellery and make-up.
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In contrast, a study by the World Health Organisation found
that the 11 to 15 year olds who were most likely to be smokers were lonely, had
difficulty talking to parents, had problems at school and had started drinking
alcohol.
How we learn to smoke
Health psychology looks at the complex array of biological,
social and psychological factors that influence our health and illness-related
behaviour.
Smoking is a biological addiction, with nicotine as addictive as
cocaine and heroin. However, there is more to being hooked on cigarettes than
the
physical addiction to
nicotine. When people want to quit, they also have a psychological habit
to break.
Social learning theory describes how we learn by example from
others. We are strongly influenced by our parents, and other people we look up
to, such as peers, actors and pop stars. This can lead us to emulate their
behaviour and try smoking.
There is an almost immediate effect on our brains with those
first cigarettes, so we keep smoking to get this reward.
Later we learn to associate smoking with other activities such
as drinking coffee, going to the pub, etc.
We can become conditioned so just the thought of the activity
triggers the need for a cigarette, just like Pavlov's dogs learned to drool at
the sound of a bell. These psychological associations remain when smokers try
to quit.
Finally, you learn to keep smoking, because if you try to quit
you are punished by withdrawal symptoms - irritability, snappiness, lack of
concentration.
Having a cigarette gets rid of these symptoms, negatively
reinforcing the desire to carry on smoking.
Such conditioning keeps you hooked on smoking because the reward
when you smoke is instant, whereas it takes years before you become aware of
the damage in terms of your health.
Similarly, when you try to quit, the 'punishment' of withdrawal
symptoms comes quickly, whereas the benefits of better health take longer to
realise.
Attitudes to smoking and risk taking
Health promotion campaigns often use warnings and shocking
images to try and motivate people to quit smoking.
While these adverts are powerful for non-smokers, they may have
little effect on people who are more willing to engage in risky
behaviour.
Coping with stress
Giving up cigarettes can be very stressful. People who are
trying to quit have to put up with cravings, change their habits, and resist
the temptation to have or buy cigarettes.
If smoking is used as a strategy for coping with other sources
of stress, such as work stress, smokers suffer a double blow: their prop for
dealing with stress is taken away and their stress levels rise as a result of
trying to quit.
Social influences
Peer pressure can be hard for anyone to resist, no matter what
your age.
Smoking can play an important role in friendships, while
offering a cigarette or asking for a light can be ice-breakers to start a
conversation.
It can create a bond between smokers, for example the huddled
groups who smoke outside offices.
If your friends smoke, deciding to quit can be awkward because
they may see it as an implicit criticism of their habit.
Cultural influences
Over the years television shows and films have effectively
built up associations between smoking and glamour, sex and
risk-taking.
From classic movies with Humphrey Bogart to Uma Thurman in Pulp
Fiction, cultural images involving cigarettes are strong, and generally
positive about smoking.
In addition, we are still subject to advertising that
deliberately promotes smoking and makes positive associations with
brands.
The tobacco industry denies targeting young people, but the
result of sponsoring exciting, risky, macho sports, is that it attracts the
attention of young boys.
A study found that boys who were fans of motor racing, which is
heavily sponsored by the tobacco industry, were more likely to smoke than those
who weren't.
What these images don't convey are the negatives of smoking,
from the yellow stains on your fingers and the stench of your breath, or the
long-term serious consequences from smoking.
What are your issues?
There are many psychological and social pressures on smokers,
and on those who are trying to quit. But this doesn't mean it's impossible to
quit, or that you'll find it difficult.
Some people quit first time, some take more attempts, but if you
don't try, you can't become one of the 11 million ex-smokers in the
UK.
Understanding your
habit is the first step in overcoming these obstacles - the next is to
come up with
strategies to tackle
them.
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References
1. Prevalence of cigarette smoking by sex and age: 1974 to
2003: General Household Survey 2003, Office for National Statistics,
2004.
2. Peto, R et al. Mortality from smoking in developed
countries 1950-2000 (2nd edition) .
3. Smoking-related behaviour and attitudes, ONS Omnibus
Survey, Department of Health, 2003
4. Denscombe M, Smoking cessation among young people. Health
Education Journal, 60 (3) 221-231, 2001.
5. Leventhal H, & Cleary P, The smoking problem: a
review of the research and theory in behavioral risk reduction. Psychological
Bulletin, 88: 370-405, 1980.
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Last updated 17.05.2005
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