Two factors which contribute to the recruitment of new smokers are "peer pressure and parental smoking" (Guttman, 1995, p. 27). A ninth grader in Santa Monica, California admits that "Once they pressure you, you start. And it's kind of hard to stop" (Guttman, 1995, p. 27). Most kids long for acceptance, to be regarded as "cool", so they give in to an image. Despite all of the negative health information we receive o a daily basis, smoking is seen as tough and rebellious, and that is what kids want to be. It is an attempt to demonstrate to your elders that you are indeed one of them and nothing less. Combine the philosophy of the young of heart with the reinforcing effects from seeing parents, friends, and idols smoking and they are dead in the water.
It takes a person of epic morality and self-confidence to resist smoking and endure the ridicule of their peers.
Nicotine causes the heart to beat faster and the blood vessels to constrict because it "...is chemically similar to a nerve chemical called acetyleholine and thus it can grab hold and activate the same spots, or receptors, on nerve cells that are activated by acetylcholine" (Bishop, 1995, p. B3). More importantly, nicotine was found, by Dr. Lorna Role, to affect the limbic system. The limbic system is responsible for reinforcing behaviors important for survival and for some reason nicotine is something that the limbic system reinforces (Bishop, 1995, p. B3). This means that your brain is reinforcing something that is actually killing the rest of the body. The brain is, in a way, being tricked by the chemical. Based on these facts nicotine is said to be as addictive as heroin. Other internal selling points for nicotine include calmed nerves, eased muscles, and reduced appetite (Greenhalgh, 1992, p. 64). Furthermore, according to Bishop (1995) nicotine assists short-term memory, enhances attentiveness, and makes people more alert (p. 83).
There are some scientists who argue that nicotine is not addictive. They even claim to be working independently of the tobacco companies. Robert Cloniger, a psychiatry professor at Washington University in St. Louis, stands firmly on the notion that an addiction to smoking is in the head of the smoker. They are not actually addicted. He bases this on the facts that nicotine is not intoxicating and that his sons quit without any problems (Hwang & Ono, 1995, p. B1). I do not place much emphasis on Mr. Cloniger's theory because nicotine does intoxicate you mildly and for a brief period of time, that is why you need to smoke so many damn cigarettes in a day. He also fails to acknowledge the habit theory. Even if they are not addicted physically, which they are, they are psychologically addicted to the motion and the act of smoking. They are addicted because of that repeated action of bringing the cigarette to their lips. An act the average smoker performs countless times a day. On a side note, there was a time when a more famous psychiatrist thought that cocaine was not addictive. Sigmond Freud prescribed and used cocaine until he realized that it was manipulating his thinking. The bottom line is that smoking does take hold over an individual and to dismiss it in Mr. Cloniger's fashion is naive. I know numerous cases of people who want to quit, but can not, and it is not because they like waking up with aching lungs or spending hours trying to alleviate migraine headaches. They are addicted in one way or the other.
Smoking attacks our lungs by inactivating the antiproteases that protect structural lung tissue (Pennisi, 1992, p. 127). In addition to destroying valuable lung tissue and leading to lung cancer and emphysema, smoking also leads to heart disease and strokes. It has also been strongly linked to various other cancers including cancer of the mouth, throat, kidneys, esophagus, and bladder (Greenhalgh, 1992, p. 64).
Behnegar (1993) has stated, "Cigarettes will kill one of five people now alive in developed countries" (p. 11). He continued on to state that one-third of all smokers die from it. These statistics were based on a study of one million Americans from 1982 to 1988 (Behnegar, 1993, p. 11). These statistics hit home because they suggest that one of the people currently living in my house will die from a smoking induced disease. That is a scary fact!
The average cigarette shortens life by seven minutes and smoking takes six years off the average life. One fifth of all smokers die in middle age, a startling twenty-five years before they should (Greenhalgh, 1992, p. 64). The minor benefits from smoking, the effects responsible for part of the addiction, just are not worth the health risks. Health risks which are very often fatal. Yellow fingernails and bad breath are the least of the smoker's worries. People need to fully understand that they are not exempt from the apparent death sentence that smoking truly is.
A smoker could try hypnosis, patches, gums, nasal sprays, pills, and inhalers. At present, only the nicotine patch has received any real publicity. The patch has been mildly successful with about a 20% success rate and it sells for about $120 a month (Newport, 1993, p. 103). It has a drawback in the fact that it takes four hours to reach peak strength, all the while the smoker is not satisfied (Shapiro, 1993, p. B1). The other methods are still undergoing testing to determine effectiveness. In one notable study, several British researchers found that 26% of their sample quit smoking after using a nicotine nasal spray (Shapiro, 1993, p. B1). Researchers believe that the spray will be more effective than the patch because it delivers the nicotine more quickly.
Hypnosis by a licensed psychologist costs around $125 per visit; however, according to William Hoffman, the executive vice president of the American Society of Clinical Hypnosis, hypnosis will not eliminate your lust for cigarettes, only help dilute it (Newport, 1993, p. 105). In addition to hypnosis and the aforementioned treatments there is a couple at MIT trying to develop an anti-obesity drug to combat the weight gain and mood swings associated with quitting (Shapiro, 1993, p. B1). There are also health clinics geared to help people overcome their addictions for around $350 for a five day stay, these clinics have minimal results (Newport, 1993, P. 105).
Despite all of the various cures that have been tossed around, nothing can work without the total dedication from the individual. Saul Schiffman, a professor of Psychiatry at the University of Pittsburgh, said he does not think "...even a pill will work without significant effort and commitment from the smoker" (Shapiro, 1993, p. B1). The best way to kick the habit is to throw away your cigarettes, feel terrible, and refuse to purchase another pack (Newport, 1993, p. 103). If a smoker can realize that the ability to quit will come only from inside he/she has a chance and the health risks begin to fade within three days of quitting (Greenhalgh, 1992, p. 64).
I think this is a good idea for attacking that tobacco demon. Smoking is obviously extremely addictive and most of us do not have the will power to conquer it alone. I think a persuasive attempt by someone near and dear is one of the best ways to alter the smoker's mind set.
Specifically, healthy influence might work because we have been friends since the seventh grade and we respect each other and we respect each other's views. He is very aware of the health risks involved with long-term cigarette smoking and if I can manipulate a couple of our persuasive methods adequately, I can help him quit. He wants to, but he lacks the proper motivation because he can not see the pot of gold or even the rainbow that comes before it. He needs to realize that life is valuable, especially his own.
Current practice is not working because young adults do not want to listen to the government. It is hard to believe that the greedy people in power actually care about our health. We are stubborn and want to do things our own way. We seem to resent authority and have a difficult time relating to their ideals. My friend is no exception; therefore, I'm going to step in and try to help him realize that he does actually want to live a long and healthy life. He does, he just does not know it yet.
My main plan of attack is to implement the attribution theory. I want him to know that he is doing something to better the quality of his existence. This, for me, is the obvious choice of attack because it is effective in maintaining the behavior that it elicits. My friend lives at home, in New Jersey, so I have to communicate with him through letters and phone calls until Spring Break. The idea is for me to throw in subtle remarks about how intelligent and reasonable he is. I want to convince him that he is a worthwhile individual who does not need the crutch of cigarettes. He always says how they make him feel more comfortable in social situations so I am going to tell him that I think he is one of the friendliest, most sociable people I know, and I live in a town of socialites. I also want to play on his ability to deter himself from the booze. I have already told him many times how proud I am of him for his success with that dilemma, but I think a few more jabs of admiration would help this cause. If he gets it into his head that he is a smart sociable person who is capable of forgetting whichever vice he may have, I have a very good chance of getting him on the patch. After three or four of these uplifting conversations I am going to write him a detailed letter about a mutual friend. In which I am going to inform him of how our friend got on the patch and has not smoked since. My friend at home knows very well that he is more intelligent than our friend who went on the patch. I am hoping that I can play on his ego somewhat and make him realize that he can do it too, without saying it outright. In the letter I am going to inform him that I too have been nicotine free for a week at that point and that I am focused on continued success. I truthfully only quit recently; however, he is in New Jersey and is not aware of this fact. I know, I know, I am a weak weak man!
Attribution theory is fully supported by the study of the school kids and the garbage. The students who were told that they are clean and neat individuals made internal attributions about their cleanliness and 80% of them threw away their trash and continued to do so in a later post test. The significance is that this 80% maintained the behavior after the conditioning while the persuasion and control groups did not. I want my friend to be able to remain cigarette free after the patch treatment is over. I am sure he would want to also after spending serious money on the patch.
My back-up plan is a form of the inoculation theory. If attribution fails then I am going to bet him $50 over Spring Break that he can not smoke three packs of cigarettes in one day. Of course he will take the bet because $50 is $50. He will feel so lousy the next day that he will never want to see another cigarette, at least for a couple hours. During those couple of hours I am going to attack his weak held beliefs for why he smokes. He will not be satisfied in leaving it at him just being weak. He will get angry about this inadequacy. I will hit him with the patch idea to alleviate his anger. It would be a solution he should be willing to try.
I like the Inoculation theory because it worked so well for a moral less Bill Clinton. I know it is not a study, but it is a demonstration of the potential of this theory. Clinton won the election because he maintained a wholesome image by telling the population that he had marital problems, but he and his wife were now happy and very much in love. He even had her come on television with him just to convince the public even further that the rumors we would hear later were not factual. Whether they were factual or not, the public ate it up and voted for him on election day.
Once he received my letter he called me. He started getting all excited and said he was pretty gung-ho about trying the patch out himself. He said he never tried it before because he did not know much about it and the two or three people he knew who had tried it said it was no good. But now he was feeling good about himself and felt like he could do whatever he set his mind to and I reassured him that I thought he could also. He was hesitant because of the price of the patch. The clinician told him it would cost $120 a month, but that he could stop anytime he felt like he did not need the patches anymore. He decided that a healthy body was more important than the money. He is now totally committed to leaving nicotine and cigarettes in his past.
I never needed to implement my inoculation theory, but I was curious what would have happened. After my friend got on the patch I told him, not of this project, but that I had an idea to help him quit if would have wanted to try it. So I told him the idea and he said that he would have gone for the bet; however, he did not believe that he would have given in to that idea. In other words, he thought he would have continued smoking after a situation like that. He said he was glad that he decided to quit on his own because that way he is doing something for himself. I am glad that he is doing something for himself too.
He has been on the patch for just over two weeks and he has not touched a cigarette. He is still receiving a nicotine dosage equivalent to a pack a day; however, the level of nicotine will slowly decrease until he can function without any in his system and without any irritable side-effects. He is very optimistic about his chances for success, in fact, he says that he has already quit. The key to his success was that he believes that he made the decision to help himself. He knows that he is worthy of having a better life and that he needed to make the first step and that was helping his health. Since he is a high watt thinker he was able to make internal attributions about himself. The internal attributions were the key to his success. He believes he is a good person without cigarettes and belief is fact when you talk about positive self-concept
Another thing I would like to try in a future healthy influence attempt with someone else would be performing the influence entirely in person. It was too difficult for me to persuade any of my friends in this town because none of them think they can live without their vices as soon as test time rolls around. I figured it would be a good idea to try it on my friend; however, I wish that I could have been in his environment while I was doing it.
In conclusion of everything, I would like to say that this is a very admirable project that you have instituted into the curriculum. I am glad that I was a part of it and I hope that there are many future successes because if we do not look out for one another who will?
Note from SBB: References omitted by me
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