An Unofficial Apology to Smokers

The antismoking crusade was ready to grasp anything that could demonize smoking, and in 1988 the US Surgeon General declared on his own authority that smoking was an enslaving addiction and that nicotine was a drug of abuse equal to crack cocaine. On its face the statement was and is preposterous, but the media loved its capacity to conjure anxieties and to foster allegations of dark conspiracies.… No official apology or change-of-mind admissions are likely to be forthcoming, as they should.

Gio Batta Gori, Virtually Safe Cigarettes

Smoking always was a bit of a hassle: you had to remember to take your cigarettes with you wherever you went, you had to make sure you had a light, and you had to have money on you to buy cigarettes. But at least you could smoke pretty much wherever you wanted. Things have changed. You’ve been run out of society, like a leper. Tough break. Modern-day smoking—in a society of closeted hedonists disguised as puritans—has become a game of hide-and-seek in which you, the smoker, are hunted down and corralled into a designated “smoking preserve” by guilt-tripping public health crusades. While Gio Batta Gori, the Health Policy Center epidemiologist and former tobacco-industry consultant quoted above, appears to call for an apology to the tobacco industry, we feel that the only apology necessary is owed to you, the smoker. This is an offer of apology to you. We feel that you have been treated unfairly, and we wish to make amends.

Remembering the First Casualties of Antismoking Crusades

It is ironic that we know so precisely how Western smoking got its start: “On 6 November 1492, two members of Columbus’s crew returned from their adventures in the interior Cuba. They reported an encounter with the natives in which they had smoked dried leaves” (Gilman and Xun 2004, 9). We know the names of these first two Western smokers: Luis de Torres and Rodrigo de Xerez. We know what happened to at least one of them:

Rodrigo de Xerex packed some tobacco for the return voyage…and by the time he set foot again in his hometown of Ayamonte, in southwestern Spain, he was hooked.… As the only man in town, and probably on the entire European landmass, so addicted, he was [an] offensive…sight to his friends and neighbors.… The Spaniards could not understand what had happened to dear old Rodrigo on that voyage to the Indies.… They decided after a while…de Xerex had become possessed by the devil on his journey.… The citizens of Ayamonte discussed the matter among themselves and decided there was but one course to take: report the evildoer to the Inquisition.… The Inquisitors, as was their way, showed little mercy” (Burns 2007, 19).

As you can see, the antismoking crusades are as old as Western smoking itself.  So, let us take a moment to remember Rodrigo de Xerex, the first documented casualty of misunderstanding around smoking. And while we are at it, let us also remember countless smokers all around the world who suffered for their coping choices. Let us remember Russian smokers, who, under seventeenth-century Czar Michael Fedorovich, were “whipped with leather thongs until bloody,” had their noses slit, and were either exiled or beheaded (ibid., 41). Let us pay tribute to Turkish smokers, who were hunted down and beheaded on the spot in sting operations by seventeenth-century health zealot Murad the Cruel (Burns 2007). Let us bow our heads to the smokers in China and Japan who were similarly executed or had their property confiscated. Let us atone for the Hindustan smokers, under Mogul Jahangir, who had “their lips slit so that a pipe would never again rest comfortably between them” (ibid., 42), and for Middle East smokers, who, under Shah Abbas, had molten lead poured down their throats for smoking in public. Let us, once and for all, recognize that smoking crusades achieve nothing but extremism, social stigmatization, and cruelty. We apologize for this unfortunate history of punishing fellow human beings who happened to make different coping choices than we did.

Thank You for Your Tax Support

In the book Tobacco and Smoking: Opposing Viewpoints, A. O. Kime (2008, 85) notes: “[S]tates are infringing on human rights by singling out a minority for higher taxes. Flush with victory over the tobacco companies, the states then began another attack, this time on the smokers themselves, by increasing taxes on tobacco to a punishing degree.” As a smoker, you have been financially scapegoated. You see, “the states have turned smokers into taxpaying captives,” and in case you didn’t realize, this kind of “unequal taxation amounts to subjugation” (ibid., 87). Indeed, “…smokers in some states pay more in taxes on cigarettes than in state income taxes, which is a polite way of saying smokers are forced to pay twice as much in state taxes as nonsmokers” (Bast 2008, 95). With all this in mind, we’d like to apologize on behalf of the country for this financial persecution of your personal coping choice.

Yes, You Have the Right to Smoke

Constitutionally, you have the right to smoke. Smoking is but one of an infinite number of ways in which a human mind tries to take care of itself. Thus, smoking is but one way to pursue well-being. In the United States you happen to have a constitutional right to do so. Just because smoking is hazardous to your physical health doesn’t mean it should be illegal. David Hudson Jr., author of Smoking Bans, aptly writes (2004, 47), “Many legal activities in society are dangerous, including riding a motorcycle, skydiving, eating fatty foods, and even working too hard.… Some people believe that state restrictions on smoking amount to a form of ‘legal paternalism’ that infringes on the fundamental right to liberty enshrined in the Declaration of Independence.” We apologize for our society’s continued attempts at prohibition-style public health policies. We apologize for these misguided and myopic attempts to take away your personal freedom.

You Are Not a Menace to Nonsmokers

John Stuart Mill wrote in 1859 (21–22): “The only purpose for which power can be rightfully exercised over any member of a civilized community against his will is to prevent harm to others. His own good, either physical or moral, is not a sufficient warrant.” What this means is that you are entirely well within your communal rights to do whatever you wish to your own health as long as it doesn’t harm the health of others. This point, of course, brings the issue of so-called secondhand smoke into focus. In case you didn’t know, experts don’t agree on the issue of secondhand smoke. For example, David Hudson Jr. (2004, 47) writes: “The EPA study on secondhand smoke is questionable.… The case against secondhand smoke…has been questionable. Some studies have found little, if any, statistical association between secondhand smoke and lung cancer. A federal judge ruled the Environmental Protection Agency’s 1993 report classifying secondhand smoke as a carcinogen was deeply flawed.” Hudson concludes: “[T]he push for smoking bans infringes on individual freedom of choice.” Whether or not secondhand smoke is dangerous, one thing is clear: society has crossed the line in suggesting that you are a menace to society. So, once again, we apologize: in your attempt at self-care, you never meant to hurt anyone, and it is simply inappropriate for us, as a society, to keep harassing you as if you were evil. You aren’t.

No, of Course, You Are Not a Child

We also wish to apologize to you for the patronizing way in which the antismoking crusade tried to squeeze “big tobacco” at your psychological expense. You see, in an attempt to make big tobacco pay, the litigators and public health wonks tried to blame inanimate tobacco for your smoking habit. In his online article “Smoking Right and Responsibility,” Jeffrey Schaler (1997) writes: “Tobacco caused them to smoke, they claim, as if tobacco had a will of its own… This doublespeak contradicts the scientific evidence: smokers quit all the time—when it is important for them to do so.” Elsewhere he adds: “The price of one’s freedom in a free society is responsibility for the consequences of one’s actions.… We cannot increase freedom by decreasing personal responsibility. That’s the road to serfdom.”

You see, using the disease model, antismoking crusaders have psychologically sold you out by suggesting that you are not responsible for your smoking habit. By convincing judges and juries, TV audiences, and smokers themselves that tobacco made you do it, these misguided do-gooders have belittled your sense of autonomy and doubted your capacity for self-determination. Of course, you aren’t a child; you can read warning labels, so you know perfectly well that smoking is dangerous to your health. Of course, nobody holds a gun to your head and demands that you smoke. So, we apologize for all this patronizing silliness: it is you who developed a smoking habit, and it will have to be you who quits this habit. You know it, we know it, big tobacco knows it, and every reasonable mind knows it. We, once again, apologize to you for yet another misguided attempt to rope you in as exhibit A of collateral damage. We are sorry that both the culture at large and the treatment community tried to sell you on the idea that you are a powerless child who is incapable of self-determination. You gave us way too much benefit of the doubt when we asked you to surrender your will (with our half-baked disease-model conceptualizations). You were never powerless in the first place.

You Are Not Irrational

Finally, we would like to apologize for treating you like an idiot. To see what we mean, consider the following opening paragraph by none other than the former surgeon general, Dr. C. Everett Koop, in the foreword of 7 Steps to a Smoke-Free Life (1998, v), by Edwin Fisher Jr.: “When you think about it, smoking is a strange habit: setting fire to something you then put in your mouth, breathing into your lungs the pungent smoke from chopped-up brown leaves, smoke that makes you and your house smell bad, smoke that will eventually shorten your life. It doesn’t seem to be something that most thoughtful adults would choose to do.” How’s that for a first-page welcome from the former surgeon general? Dr. Koop seems to think that you are a thoughtless child (as opposed to a “thoughtful adult”) who plays dangerous games with fire and stinks up his home. Nice bedside manner, Doc!

Just because Dr. Koop doesn’t get it doesn’t mean you are a kook. The same disrespectful tone jumps out of every other book. The authors of The Smoking Puzzle (Sloan, Smith, and Taylor 2003, 25) make essentially the same point but with slightly more finesse: “Smoking is an especially hard choice to align with rational behavior.” The message here is: smoking is irrational, and so are you, the smoker. What is irrational is the failure to understand the most basic axiom of human behavior: if a behavior is chosen, it is because there is a perceived benefit, which is the very rationale behind it. A behavior with a rationale behind it is a rational behavior; is it not?

So, once again, we wish to apologize to you, the smoker, for society’s continued failure to appreciate the very real reasons behind your smoking. You are not an idiot, and we are sorry that we, as a culture and a treatment community, insinuated that you were. Just because you haven’t yet developed reasons to quit smoking doesn’t mean that you didn’t have your reasons to start smoking and that you don’t have your reasons to continue smoking. Our cultural failure to see that is what’s irrational.

Quit to Stand Up for Yourself

One thing is painfully clear: there will be no official apology, neither from the despicable “big tobacco” nor the righteously zealous “big recovery.” The reality is that, as a smoker, you are a member of the new underclass. Unfortunately, antismoking crusades have become antismoker crusades, and it is highly unlikely that this psychologically toxic cultural climate will change anytime soon. What this means is that you will continue to overpay taxes, you will continue to pay the salaries of public health wonks who built political careers by demonizing your coping choices, and you will continue to be constitutionally disenfranchised. As we see it, your best option to stand up for yourself is to quit smoking, thus removing yourself from this artificially constructed underclass.

[P. Somov & M. Somova]

Resources: Smoking as Such - Psychology of Smoking

Smoking As Such

Smoking Is Chemical Coping

Nicotine is a paradoxical drug. Smoking both excites and calms. This habit has been shown to improve performance, reaction time, and information processing, while simultaneously stabilizing a person’s emotional tone, which is apparently due to “a periodic pattern of arousal and alertness during smoking, followed by calming and tension reduction after smoking” (Antonuccio and Boutilier 2000, 238).

What this means is that smokers smoke to regulate how they feel, that is, to cope. Coping comes in two broad flavors (and, no, we’re not talking “regular” and “menthol”). You can cope internally (through breathing, meditation, self-talk), or you can outsource coping using chemicals. When you drink alcohol or take prescription psychiatric medications (although some people certainly need the latter), you are coping through chemistry. It’s the same with smoking: it’s nothing other than chemically assisted emotional self-regulation, that is, a way to use chemicals to feel better, less stressed, more energetic, and so on.

Smoking as a Rational Pursuit of Well-Being

As a form of coping, smoking is the pursuit of well-being. Any coping is. The point of coping is to feel better. Thus, smoking is a form of self-help, that is, a form of self-care. As such, smoking is entirely rational. Any notion that smoking is self-destructive or irrational is an utter misunderstanding of the psychology of smoking. Case in point, it’s Monday; you feel stressed out, so you step out for a smoke break, for a “breather” of sorts, to get away from whatever it is that’s bumming you out, so you can relax and feel better. On some level you know it’s not good for your body in the long run. True, but that doesn’t negate the fact that your motive to smoke is to help yourself feel better now. And now is where it’s at. “Now” isn’t just a word; it’s your entire life. The authors of The Smoking Puzzle: Information, Risk Perception, and Choice write (Sloan, Smith, and Taylor 2003, 25): “For some, cigarettes provide a ‘comfort,’ a ‘friend’ in times of stress, and a benefit that outweighs all other consequences.” The bottom line is that the motivation behind smoking is self-care, and there’s nothing irrational about trying to cope.

Smoking as a Tactical Gain with a Strategic Cost

Tactical (short-term) behavior aims to change something immediately, whereas strategic (long-term) behavior, by definition, has a longer view of change. For example, going to the movies tonight will help you feel better tonight, in the shorter term. Enrolling in college today will help you get a better job in the distant future, years from now, in the longer term. Get this: all coping is tactical behavior. All coping is designed to reduce your immediate distress. All coping is motivated by the prospect of short-term gains. But, of course, not all coping is created equal. Some self-help coping behavior, such as smoking, comes at great strategic cost. Indeed, you feel bummed out, so you decide to solve this problem by lighting up. The cost of this coping solution is the price of the cigarette and seven minutes off your life expectancy (Mackay, Eriksen, and Shafey 2006). Is this too great of a strategic cost? Can you afford this kind of solution? The answer depends entirely on your priorities and the psychological resources at hand. If it takes a cigarette to keep you off the ledge, then wasting seven minutes of your life expectancy may save you years. Cope with what you’ve got until you’ve had a chance to systematically upgrade your coping software.

Smoking as an Expression of Mind-over-Body Values

As a smoker, you probably haven’t thought of yourself as a health nut, but in a way, you are. Let us explain. One way of looking at ourselves is to say that we are a combination of body and mind. Both are equally important halves of one human whole, right? In theory, yes. In practice, no. People differ in terms of what they value more. Some value physical health more than mental health. Others place mental health over physical health. Both sets of priorities are existentially valid. Indeed, who is arrogant enough to definitively proclaim that you’d do better with an unhealthy mind in a healthy body than with a healthy mind in an unhealthy body? It’s a classic existential dilemma, and whatever you decide is okay by us. We are clinical libertarians who feel that it’s simply nobody’s business to tell you what you should value more in your life, your body or your mind.

Thus, as a form of coping, smoking is an expression of mind-over-body values. Indeed, when you choose to cope (which is mind business), you are paying for your emotional well-being with your body as the coin. In other words, just like your classic body-focused health nut who gets up at dawn to run a 5K or drive to a yoga session, you, too, are going to extremes to maintain your health—the health of your mind, that is.

As such, smoking is a coping extreme in which the mind’s short-term well-being is obtained at potentially grave long-term risks to the body. But guess what? This kind of extreme coping at the expense of the body is common. Take extreme sports, for example. People risk body health and even life itself just to get a mental kick by climbing cliffs and jumping out of planes. Whether you join the military, become a cop, or go on a humanitarian-relief mission in a war zone, you are essentially chasing mind health, a fix of existential meaning at potentially life-threatening costs. After all, pride, honor, and a sense of accomplishment are all just forms of mental well-being. And, as a society, we generally see nothing wrong with paying dearly for this kind of psychological health with the voucher of the body. So coping by smoking is nothing other than a choice of psychological self-care at the expense of the body. Are there other ways of coping? Of course. But that’s not the point—at least not yet. The point is that as a smoker who is paying for emotional well-being with the body, there is no need for you to second-guess your sanity. You are doing what all of us are doing, in one form or another. The only issue is that you are overpaying: buying a moment of emotional well-being at too great of an expense to your body.

Smoking as Consciousness Modifier

People smoke tobacco because nicotine is a psychoactive drug. Psychoactive drugs activate your psyche, that is, alter your mind. That’s “better living through chemistry,” and as we see it, there is fundamentally nothing wrong with that. After all, we do it all the time when we drink coffee, eat chocolate, or take a pill to reduce anxiety or alleviate depression. Smoking, as a coping behavior, works because it changes your state of mind. And that’s the whole point of coping. All coping is designed to alter the mind, to reactivate the psyche in the direction of pleasure, significance, and well-being. In other words, all coping is psychoactive, mind altering, and consciousness modifying by design—even the kind of coping that involves inhaling nothing more than unfiltered air. Speaking of which…

Smoking as Breath-Focused Coping

Smoking, as we see it, isn’t just about inhalation of tobacco. It’s also about the process of inhalation and exhalation itself. Indeed, smoking is indistinguishable from your run-of-the-mill deep-breathing exercise, except that you are inhaling junk air rather than unfiltered Mother-Nature air. Did you know that much of what makes deep breathing relaxing is the prolonged exhalation phase of breathing? For breathing relaxation to be most effective, it helps to slow down your breathing rate to extend the amount of time that it takes for you to exhale the air out of your lungs—which is pretty much what happens when you smoke: you inhale, you hold, and then you slowly exhale. And voila: you feel relaxed. Our guess is that much of what you enjoy about smoking isn’t tobacco itself, but the relaxing subtleties of the slow-smoking behavior, that is, the inherent relaxation of the breath work itself.

Smoking as a Platform for Meditation

Edward Bulwer-Lytton (quoted in Kuntz 1997, 82) once said, “The [person] who smokes thinks like a sage.” Exactly, for there is more to smoking than meets the eye. What you have, in fact, developed is an excellent platform of breath-focused, contemplative coping. Indeed, like a devoted monk, for years, you have been breaking away from the rat race of the daily grind into brief and effective meditative retreats. While you have been certainly poisoning yourself with the junk tobacco air, at the same time, you have taken time to cope. Indeed, you have developed what we see as an invaluable habit: “dosing” yourself with “paced” contemplative, breath-focused self-care.

Nonsmokers aren’t generally so attuned to their coping needs. They mostly plow through the day, and if they are conscientious about psychological self-care, they might sit down to meditate at some point. You, however, have chosen a different path, a path that makes a lot of sense: you’ve been coping on demand. You have mastered an important existential skill, that of putting life on hold and taking the exit ramp for a few minutes of coping solitude, reassuring yourself that life can wait for a few minutes until you catch your breath.

The problem, of course, is that you’ve been breathing junk. What we’re suggesting, if you want to quit smoking, is to kick the tobacco but keep the actual habit of dosed, breath-focused self-care. In other words, the trick is to ditch the smoke but keep the smoke break, and to learn to smoke air. And that’s entirely doable; you’ve been practicing breath awareness for years. We’ll help you rebuild a smoke-free body on the breath-focused platform that you have built with the help of your smoking. You haven’t smoked in vain!

Smoking as Coping through Ritual

Smoking, like any repetitive behavior, is a ritual. Rituals are emotionally stabilizing because they provide a sense of predictability. When you participate in a familiar routine, you have a feeling that you know what’s going on, so you begin to calm down and relax. Life is uncertain, and we escape into rituals to create illusions of simple predictability. That’s normal. So, smoking, as a ritual, is just another psychological oasis, a behavioral sequence that cues the mind to relax. With time and repetition, not only does the smoking behavior go on autopilot but so does your own internal reaction to it. Relaxation becomes conditioned and automatic. You invest seven minutes of the body’s health in return for about as much time in your mind’s well-being. It would seem like an ideal exchange, except for such existentially and financially cheaper coping rituals as just breathing.

[P. Somov & M. Somova, Smoke-Free Smoke Break]

Against Doctors' Orders

Yet smoking may engender changes in the brain that make smokers resistant to the very antismoking messages Andrews and her colleagues promote, according to a paper in press in Nature Neuroscience by Baylor College of Medicine neuroscientist Read Montague, PhD. His findings suggest that smokers don't learn from mistakes as well as nonsmokers.

In his research, Montague used fMRI to measure the brain activity of smokers and nonsmokers while they played an investment game with predetermined outcomes. The researchers specifically looked for two brain activity patterns known to be important to learning: experiential and fictive learning signals. Experiential learning takes place when investors adjust their behavior when their earning expectations don't match their actual earnings. Fictive learning occurs when investors compare what they actually earned with what they hypothetically would have earned had they invested differently. Together, these signals help guide decision-making in most people.

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Nicotine Impairs Brain's Ability to Tell When Stomach is Full

Source:  APA Monitor

Ex-smokers may gain weight after kicking the habit because nicotine permanently impairs the brain's ability to signal when the stomach is full, says a study at Yale University. The researchers found that in addition to attaching itself to addiction-causing neuronal sites such as dopamine receptors, nicotine also attaches itself to a receptor on neurons in the hypothalamus, which helps regulate appetite. Mouse studies show that this receptor comes to rely on nicotine for normal functioning, so when nicotine is no longer present, the hypothalamus is left with a reduced ability to regulate appetite properly. Some antismoking drugs, like the drug cytisine, which isn't sold in the U.S., contain nicotine-like compounds that target this receptor, which might prevent post-cessation weight gain, researchers say. (Science, June 10, 2011)

Should We Pay People to Quit Smoking?

Why don't Medicaid smokers quit in response to policies that are effective for others? One reason is that investing in preventive health care is difficult when you live month-to-month. But an indulgence the poor really can't afford is cigarettes. Smoking is expensive. A pack-a-day smoker could save more than $2,000 per year by quitting.

How would the proposed incentive system work? Smokers on Medicaid would receive small payments in return for quitting or getting cessation counseling as a step toward quitting. Participants would have to hold up their end of the bargain. They would get paid only if medical claims data indicated that they were getting counseling or they tested to be smoke-free. Tests can easily be conducted using breathalyzers to measure carbon monoxide levels.

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