Tag Archives: addictive behavoirs

Parental Warning: Second-Hand Smoke May Trigger Nicotine Dependence in Kids

New study from Canadian researchers published in Addictive Behaviors

Parents who smoke cigarettes around their kids in cars and homes beware – second-hand smoke may trigger symptoms of nicotine dependence in children.

The findings are published in the September edition of the journal Addictive Behaviors in a joint study from nine Canadian institutions.

“Increased exposure to second-hand smoke, both in cars and homes, was associated with an increased likelihood of children reporting nicotine dependence symptoms, even though these children had never smoked,” says Dr. Jennifer O’Loughlin, senior author of the study, a professor at the Université de Montréal’s Department of Social and Preventive Medicine and a researcher at the Centre Hospitalier de l’Université de Montréal.

“These findings support the need for public health interventions that promote non-smoking in the presence of children, and uphold policies to restrict smoking in vehicles when children are present,” adds Dr. O’Loughlin, who collaborated with researchers from the Université de Sherbrooke, the Université de Moncton, the University of British Columbia, McGill University, Concordia University and the Institut national de santé publique du Québec.

Study participants were recruited from 29 Quebec schools as part of AdoQuest, a cohort investigation that measures tobacco use and other health-compromising behaviours. Some 1,800 children aged 10 to 12 years old, from all socioeconomic levels, were asked to complete questionnaires on their health and behaviours. Researchers also asked questions about symptoms of nicotine dependence and exposure to second-hand smoke.

Second Hand Smoke and Children“According to conventional understanding, a person who does not smoke cannot experience nicotine dependence,” says Mathieu Bélanger, the study’s lead author and the new research director of the Centre de Formation Médicale du Nouveau-Brunswick of the Université de Moncton and Université de Sherbrooke. “Our study found that 5 percent of children who had never smoked a cigarette, but who were exposed to secondhand smoke in cars or their homes, reported symptoms of nicotine dependence.”

Dr. O’Loughlin added that this inter-university investigation builds on previous findings: “Exposure to second-hand smoke among non-smokers may cause symptoms that seem to reflect several nicotine withdrawal symptoms: depressed mood, trouble sleeping, irritability, anxiety, restlessness, trouble concentrating and increased appetite.”

About University of Montreal Study on Second Hand Smoke

Contact: Sylvain-Jacques Desjardins
University of Montreal

About the study:

“Nicotine dependence symptoms among young never smokers exposed to secondhand tobacco smoke,” from Addictive Behaviors, was authored by Mathieu Bélanger (Université de Sherbrooke and Université de Moncton), Jennifer O’Loughlin (Université de Montréal and Centre Hospitalier de l’Université de Montréal), Louise Guyon (Institut national de santé publique du Québec), André Gervais (Direction de santé publique de Montréal), Jennifer J. McGrath (Concordia University), Chizimuzo T.C. Okoli (University of British Columbia) and Maninder Setia (McGill University).

On the Web:

Is Fear of Gaining Weight Keeping Many Women from Trying to Quit Smoking?

[UMHS-Press Release]

Women and Smoking

Smokers are more likely to have unrealistic body image & eating problems, and women who had weight problems as girls are more likely to start smoking early.

Is a fear of getting fatter partly to blame for the fact that nearly one in five American women still smokes, and many don’t try to quit?

Although there are many possible reasons for the stubborn persistence of smoking, fear of weight gain is high on the list for many women, says a University of Michigan Health System researcher who has devoted much of her career to studying this issue.

Although there are many possible reasons for the stubborn persistence of smoking, fear of weight gain is high on the list for many women, says a University of Michigan Health System researcher who has devoted much of her career to studying this issue.

weight.jpgSeveral years ago, she and her team reported that 75 percent of all women smokers say they would be unwilling to gain more than five pounds if they were to quit smoking, and nearly half said they would not tolerate any weight gain. In fact, many women started smoking in the first place because they thought it might help them stay slim.

Now, new U-M research findings published in the October issue of Addictive Behaviors show that women who smoke tend to be further from their ideal body image, and more prone to dieting and binging, than those who don’t smoke.

Cigarettes are well known to suppress appetite and weight, says Cindy Pomerleau, Ph.D., director of the U-M Nicotine Research Laboratory. “So it’s hardly surprising that women who have trouble managing their weight or are dissatisfied with their bodies are drawn to smoking,” she says.

In another recent study, published in August, the U-M team found that overweight women smokers who were overweight as children were far more likely to have started smoking in their early teens than women whose weight problems started later in life. They also had worse withdrawal symptoms when they tried to quit.

Once they make a serious attempt to quit, evidence suggests that most weight-concerned smokers can be just as successful in kicking the habit as others.

“The problem here is getting women who are concerned about their weight to be willing to try to make a quit attempt,” says Pomerleau, “and then helping them gain a sense of control over their weight.”

Women who are highly concerned about weight tend to be concerned about other aspects of their appearance as well, she notes. What they need to understand, she says, is that smoking has an impact on many aspects of appearance and attractiveness. Among other things, it causes wrinkled skin, thinning hair, cracked fingernails, yellowed teeth and terrible breath.

Pomerleau, a research professor of psychiatry, is working on a book about women, smoking and weight loss that will draw together research findings, helpful tips and real-life examples of women who quit tobacco while also containing their weight.

Some beliefs about smoking and weight are true, she says. For instance, nicotine suppresses the appetite and increases resting metabolic rate. Smokers on average weigh less than people who have never smoked, and that smokers who quit tend to gain weight. Adding to these perceptions are tobacco advertisements that portray female smokers as slim and successful.

Even so, the effect of quitting on weight is often less dramatic than many women fear, Pomerleau says. A rough rule of thumb is that one in four women who quit smoking will gain less than five pounds, and another two out of four will gain five to 15 pounds. Only one in four women who quit will gain 15 pounds or more.

But Pomerleau’s own research suggests that many women smokers start out with an unrealistic image of how they would like their bodies to look. This may make their dread of gaining weight even worse.

In her paper in Addictive Behaviors, she reports the results of a study of 587 women between the ages of 18 and 55, including 420 smokers and 167 women who had never smoked. An equal proportion of both groups was overweight or obese, with a body mass index of 25 or more.

In the study, the smokers and non-smokers were asked to look at silhouette pictures of 10 different body types, ranging from thinnest to fattest, and to choose which one their current body type was closest to, and which one they wanted to look most like. They were also asked questions about their self-image and their eating habits, about how concerned they were about gaining weight if they quit smoking, and about how sure they were that they could stay off cigarettes even if they gained weight.

The smokers chose an ideal body shape that was slimmer than the non-smokers chose, and further from how they perceived themselves as looking. They also had more problems with limiting their eating. Smokers who were overweight were especially doubtful about their ability to stay off tobacco if they started to gain weight.

This study, Pomerleau says, suggests that if women smokers are to succeed in quitting, they may need extra help in achieving a more realistic body image and paying attention to unhealthful eating patterns, particularly if they are already overweight.

At the same time, Pomerleau and her team have found that the earlier in life a weight problem starts, the more likely a woman is to start smoking.

In a study of 89 overweight women smokers, those who remembered being overweight before they reached junior high school reported that they had started experimenting with smoking at around age 13 – compared with women whose weight problems didn’t start until junior high or after, who hadn’t tried smoking till they reached age 15.

The women who were overweight as children also reported more nicotine-withdrawal symptoms when they tried to quit smoking, especially symptoms like anger, irritability and trouble concentrating. The study was published in the August issue of Eating Behaviors.

These studies, and others that the U-M team have done, all point to the importance of finding new strategies to help women quit smoking without losing control of their weight. Although severe dieting during a smoking cessation attempt has not been shown to be helpful in either quitting smoking or controlling weight, it may be unrealistic to expect women with strong weight concerns to put these concerns on hold for several weeks or months while they try to quit tobacco.

“What we would like to work for is a kind of compromise strategy, where the focus is on the smoking cessation, but women can also take some passive and active measures to control their weight,” Pomerleau says.

Passive measures include things like nicotine patches and gum, and medicines like bupropion, which can help in controlling weight gain while keeping nicotine withdrawal symptoms at bay.

Another option for women is to launch their stop-smoking effort early in their menstrual cycle, so that the bloating that can happen soon after they snuff out their last cigarette won’t be compounded by the bloating that comes along right before their period begins.

Finally, although strenuous dieting is not recommended, Pomerleau says, women can start immediately to rebalance the energy-in/energy-out equation by not substituting eating for smoking, and by increasing their physical activity. Even brief bouts of exercise, such as stretching or walking, can be effective in distracting a woman when the urge to smoke strikes, she says, and they burn a few calories too.

Facts About Smoking and Health

  • Smoking damages a woman’s hair, skin, nails, teeth, voice and more.
  • Smoking causes lung problems, including lung cancer, which kills far more women than any other form of cancer including breast cancer.
  • Smoking increases the chance of heart disease and stroke, the number one and number three killers of women.
  • Smoking can reduce a woman’s fertility, making it harder to get pregnant.
  • Smoking can cause abnormal growth of cells in the cervix, a condition known as cervical dysplasia that can lead to cervical cancer.
  • Smoking during pregnancy increases the chance that a woman will miscarry or experience pregnancy problems, and increases the chance that her baby will suffer problems.
  • Quitting smoking often leads to weight gain, but three-quarters of women who quit will gain 15 pounds or less.
  • Quitting smoking is one of the most important things a person can do to improve their health now and in the future. Once a smoker has quit, the harm that smoking has done to their body will stop and even start to reverse. In fact, within 15 years of quitting smoking, death rates for ex-smokers are the same as for people of the same age who have never smoked.

U-M Health Minute: Today’s top health issues and medical research
Written by Kara Gavin

Learn more on the web or by phone at:
The American Lung Association: Freedom from SmokingAmerican Cancer Society Stop-smoking help, and information on the Nov. 15 Great American Smokeout, or call 1-800-ACS-2345

Smokefree.gov:
A web site for Americans who want to quit smoking, from the National Cancer Institute or call 800-QUITNOW   Hearing impaired: TTY 1-800-332-8615

U-M Nicotine Research Laboratory

Study references:
Addictive Behaviors, Volume 32, Issue 10, October 2007, pp. 2329-2334
Eating Behaviors, Volume 8, Issue 3, August 2007, pp. 418-422

The Secret Smoker

He would, he says, never cheat on his wife.

But each time he smokes a Camel Light, it feels like an infidelity.

He promised to quit before they married.

He stubbed out his cigarette, washed his face with scented soap and for two months he abstained.

He said his wedding vows, toasted her with champagne and honeymooned at a resort, all without a cigarette.

Back in Charlotte, as he faced work again, he felt an irresistible urge to smoke.

Cigarette SmokerHe opened his desk drawer and there it was, a pack of Camel Lights he had hidden. He reached in. With more desire than regret, he got up and returned to his old haunt, an alcove behind his office where he knew he would find the other smokers standing around a terra cotta flowerpot.

The first couple of puffs tasted bitter the way he remembers his first cigarette in junior high.

Then a familiar heady adrenaline rush kicked in, and he was hooked all over again.

The Closet Smoker

He is The Closet Smoker, and that pack of Camel Lights in his desk is his dirty little secret.

You may know someone like him: an alcoholic perhaps, or a gambler or drug abuser. The pleasure they get from their addictions makes them do things they would not ordinarily do: indulge in risky behavior and lie about it.

The Closet Smoker knows better. In so many other ways he takes care of himself and the people around him. He lifts weights, takes a multivitamin and avoids fast food. He enjoys a good bottle of wine and an occasional sushi dinner out, but he’s not extravagant. If his car needs an oil change or tire rotation, he does it himself.

He’s not yet 40, a professional in Charlotte. His boss says she’s impressed by his savvy and creativity, and by the little things he does to help around the office, such as cleaning up the kitchen.

Most evenings, he cooks dinner for his wife. He phones his mother every day, or sends an instant message. Weekends, he might take his daughter golfing or to Carowinds. On Sundays, you’ll find him in church. His best friends know his secret. Everybody at work knows. But not the people who mean the most to him, his wife, his mother and his daughter.

He’s embarrassed to admit he lies to them. He says he wouldn’t lie for any other reason. He feels guilty, ashamed that he’s capable of deceiving the three most important people in his life for a cigarette. He worries what will happen if they find out.

They’re right, and he knows it. He shouldn’t smoke. It’s bad for him. He researched smoking for a science project in eighth grade and discovered that a few drops of nicotine in liquid form can kill you.

Years of smoking, he knows, might kill him, too.

The Nature of Cigarette Addiction

The Closet Smoker is sensible about most things. Yet his compulsion to smoke overpowers his common sense. That’s the nature of addiction.

It’s part of being human. Our brains are wired to reinforce behaviors we need to survive. Eating, drinking, sex. These behaviors stimulate pleasure circuits in the brain. Nicotine over-stimulates the circuits. It floods the brain with a neurotransmitter called dopamine that makes us feel good. Cocaine and heroin act in similar ways.

One reason nicotine and these other drugs are so addictive is they work on the same brain circuitry we use for survival.

Our brains become hijacked. We have to have more.

Scientists have turned to brain imaging to learn about addiction. They discovered that the decision-making part of an addict’s brain, the region that controls judgment, is no longer as effective. That could help explain why we become hooked on things when we know we shouldn’t.

  • Nicotine
  • Cocaine
  • Alcohol
  • Steroids
  • Gambling
  • Shoplifting
  • Caffeine
  • Sugar
  • Work
  • Sex

We’re all capable of addictive behavior.

Anything to look cool

The Closet Smoker’s initiation came in middle school. His older brother smoked, and The Closet Smoker occasionally sneaked one.

He wanted to like cigarettes. He wanted to look grown-up like his brother.

But what he remembers most from those early attempts is a burning sensation on the tip of his tongue and in his chest, followed by a fit of coughing.

He bought his first pack freshman year in high school. He was 15. State law then as now said no one under 18 could buy cigarettes, and for a while he bummed off older friends. Then he learned about a convenience store on the way to school where the clerk didn’t check IDs.

He asked for Marlboros. Everybody he knew smoked Marlboro’s, the cowboy’s brand, America’s favorite cigarette. He wanted to be like everybody. He paid for that first pack with money he earned bagging groceries at the Winn-Dixie.

He tucked the little red and white box in his backpack and headed off to school, a member of a new fraternity.

He ignored the taste. It was more important to him to be like everybody than to actually enjoy smoking. And it didn’t take too many cigarettes before the taste grew on him like the taste of another adult pleasure he had learned to like, black coffee.

He says most students smoked. The fortunes of their town, like so many towns in North Carolina, were built on tobacco. It was still the state’s biggest cash crop when he was in school, and even now brings in $400 million a year.

Of course, teenagers smoked.

Many of their parents did, too. The Closet Smoker’s dad smoked three packs a day for 30 years before giving it up.

High school students could smoke between classes, at recess and at lunch with a parent’s permission. The Closet Smoker’s parents didn’t approve, but he says he got so he could get in a smoke in 45 seconds and no one ever caught him.

He remembers the night of a basketball game, hanging out in the parking lot with friends, most of them sneaking beer, then one person asked if anyone had a cigarette and another person wanted one, too, and then another. He was the only one with a pack, and he passed it around.

That night, he was The Man.

Loved Ones Worry

His first wife, he says, hated his smoking. Before they married, he was up to a pack and a half a day. Thirty cigarettes every day.

He says she complained about the smell, and the taste when they kissed, and the stale odor of his clothes, and the butts in the flowerpot on the deck.

Most of all, he says, she hated what smoking might do to him: the heart disease and bronchitis, asthma, emphysema, lung cancer and other cancers.

Everyone knows smoking kills. Half of all Americans who smoke will die because of it, about 400,000 people every year, twice as many people as die from alcohol, drugs, fires, car accidents, homicide, suicide and AIDS combined.

Kids in preschool know smoking kills. Yet more than 46 million people in our country smoke. The Closet Smoker, like many addicts, assumes it won’t happen to him.

He Tried To Quit

He really did, he says, and once he almost succeeded.

He went without a cigarette for several months after college and he felt much better. He had more stamina. He no longer had that nagging smoker’s cough.

Then he took a job at a company where most employees smoked. They stopped working every day at 10 a.m. and 3 p.m. for 15 minutes of smoking and socializing.

Within two weeks, he was in there with them.

He tried to hide his habit after his daughter was born, but when she was 4 she caught him.

He had sneaked out to the patio like a teenager. She went looking for him. She opened the door and there stood her father, a cigarette dangling between his lips.

Daddy, that’s nasty!

He felt ashamed. He snuffed out the butt between his fingers and flushed it down the toilet. But he didn’t quit. From that day on, he just made sure he never again smoked around her.

He doesn’t want his daughter to smoke.

His parents didn’t want him to.

His dad once offered him $1,000 if he would quit.

The Closet Smokers Deception

The Closet Smoker thinks he’s fooling his new wife.

He smokes his last cigarette at work around 4:30 most afternoons, then washes away the smell from his face with scented soap. He drives home, car windows open, chewing gum or sucking mints. He chews gum on weekends just so she won’t wonder why he’s always chewing gum when he gets home from work.

He doesn’t smoke in his car. He doesn’t smoke on Saturdays or Sundays. He sometimes smokes when he’s out to lunch, but mostly he confines his smoking to the alcove behind his office.

He and two co-workers knock on each other’s doors on their way out, four or five times a day, more on bad days. The Closet Smoker says he enjoys the socializing as much as the smoking. If he didn’t smoke, how could he justify taking so many breaks?

They stand in the alcove in 104-degree heat. They’re out there in freezing rain. They can’t be picky. Finding a place to smoke is not easy any more.

You certainly can’t smoke at school. In your office? Few businesses allow it. Even outdoors in many places, you’re a pariah; no one wants to breathe your secondhand smoke.

As bare and ugly as the alcove is, The Closet Smoker looks forward to being there every Monday morning.

What Happens Inside

Every Monday morning, after two days without nicotine, his first cigarette gives him a kick more powerful than any he’ll get all week.He balances the Camel Light between his lips, then cuffs his hands around his lighter. A flame shoots up. The tip of the cigarette burns. He inhales, drawing smoke deep inside. Particles of tar, the same stuff used to pave highways, carry the nicotine through his windpipe, then down his left and right bronchi and into his lungs.

He holds onto the smoke for a few seconds before exhaling.

The nicotine flows through small tubes in his lungs called bronchioles and into millions of tiny air sacs that puff up every time he inhales. From there, it enters his bloodstream.

It takes about eight seconds to reach his brain.

Before he can take another puff, he feels the effects of the first. The gratification is immediate and that’s one reason nicotine is so addictive.

He feels a lift of energy. His heart beats faster, his blood pressure rises. He is focused, more attentive. He feels ready to tackle work again.

What he doesn’t feel are the poisons circulating through his body:

Cyanide, benzene, formaldehyde, methanol and acetylene, ammonia, carbon monoxide and nitrogen oxide, more than 4,000 chemicals in each cigarette, the same chemicals used to kill rats, make gasoline and nail polish, and embalm dead bodies.

The nicotine is what hooked him; it’s the chemicals in cigarettes that may kill him.

They’re the reason this summer he couldn’t swim underwater from one end of his apartment pool and back again without coming up for air.

He says his wife blamed his lack of stamina on years of smoking, not knowing he is still at it.

A Partial Confession

Since they married, he says she has confronted him a few times about the smell of cigarettes.

His heart beat faster, his blood pressure rose, but not in a pleasant way. He says he confessed. Sort of. He says he told her each time that, yes, he smoked that day. He didn’t tell her he smokes every day at work.

He says she hates the smell and the taste and, most of all, she hates what cigarettes might do to him. How could he promise to be with her forever, when he shortens forever by several minutes or more with every cigarette?

He says he had every intention of quitting. He’s had every intention of quitting every time he’s tried. Most smokers want to quit, but it usually takes several tries. The Closet Smoker says he has tried 15 to 20 times.

What the Secret Smokers Tells Himself

Maybe he can’t quit. So he gives himself permission, the way addicts do: “I firmly believe that a lot of lung cancer that’s smoking related is because people sit inside and continuously breathe in the smoke. I don’t smoke inside.”

He rationalizes, the way addicts do, that his smoking doesn’t affect his family because he doesn’t smoke in front of them.

But The Closet Smoker is a smart guy and when he hears what he’s just said, he knows it doesn’t make sense. “Now that I’ve said it out loud, I guess it’s a little short-sighted of me because I don’t see it as directly affecting them. Long-sighted, my health and my early demise will affect them.”

Most of all, he says, he hates deceiving the people he loves.

Smoking Kills, Yet We Light Up

One in 20 middle school students in North Carolina smokes cigarettes, according to the American Lung Association. By high school, one in five students in the state smokes, and the percentage grows slightly among adults. They smoke despite evidence that smoking is responsible for nearly one in five deaths in the United States. Consider these statistics from the CDC:

  1. Smoking causes 90 percent of lung cancer deaths in women, and nearly 80 percent in men, and many other types of cancer.
  2. If you smoke, you’re two to four times as likely to develop coronary heart disease, the leading cause of death in the United States.
  3. Smoking doubles a person’s risk for stroke.

    Smokers in the Closet

    More than 46 million people in the United States smoke, according to the Centers for Disease Control and Prevention.

    No one knows how many are closet smokers. After news reports that ABC News anchor Peter Jennings, a former smoker, had lung cancer, New York magazine polled 100 smokers; one-third said they hid their habit from parents, bosses, children or spouses.

    Want to Quit Smoking?

    Call toll-free in North and South Carolina, 1-800-Quit-Now.

    American Lung Association’s “Quit Smoking Cessation Plan”

    Tobacco prevention in North Carolina

    Teens can get help at NCNot.com


    How We Reported the Story

    Elizabeth Leland interviewed Professor Steven Childers of Wake Forest University School of Medicine, who studies the effect of drug addiction on the brain, and Dr. Cindy Miner, a deputy director at the National Institute on Drug Abuse. Leland also researched addiction and nicotine through publications such as “Psychology Today” and on Web sites of the National Institute on Drug Abuse, Stanford University, Harvard University and others. She read about the history and economics of tobacco, and got data from the N.C. Department of Agriculture and the American Cancer Society. She interviewed The Closet Smoker and his boss. He agreed to be the subject of a story on condition that she not reveal his identity.

    Source: Elizabeth Leland, Charlotte Observer