Who Smokes in United states?


New member
Oct 3, 2012
In the United States, there are an estimated 47 million smokers, nearly 25% of the population. Over 3 million teenagers smoke. Smoking is highest in younger age groups (under 44 years of age) and among lower education levels and incomes. Nicotine Addiction Nicotine is an extremely addicting drug, as addictive as heroin or cocaine. Cigarettes deliver nicotine to the brain in only a few seconds, increasing its addictive power. After only a few cigarettes, most people become addicted to nicotine and need more to prevent the cravings for nicotine. How dependent are you? Other than the number of cigarettes you smoke each day, one simple sign of a highly dependent smoker is how soon after awaking you smoke the first cigarette. If you smoke within 5 or 10 minutes of waking up, you are highly dependent on nicotine. If the physical addiction to nicotine were not enough, there is also a strong learned addiction as well. Over years of smoking, you develop “conditioned cues” for smoking, triggers that are associated with smoking. A pack a day smoker puffs on a cigarette over 7000 times each year. Each puff is associated with situations where you typically smoke (in the car, leaving the office, talking on the phone, after a meal) or an emotional state (feeling sad, tired, bored, irritated). Each time that situation occurs again, it triggers the desire for a cigarette. How to quit smoking? There are a number of methods for quitting smoking, and you need to find the way that best suits you. There are three dimensions to consider when choosing a quit strategy. Medications vs. Non-medication (Behavioral) approaches. Medication approaches include nicotine replacement therapies such as nicotine gum and non-nicotine medications such as bupropion. Behavioral strategies include methods to break the associations to smoking (e.g. scheduled smoking, stimulus control), coping strategies (e.g. relaxation) and relapse prevention strategies. Both types of approaches are equally effective. Since nicotine addiction has both physical and learned components, it is not surprising that a combined approach of medications and behavioral support has often been found to be better than either alone. However, you may want to lean toward behavioral approaches if you are pregnant, under age 18, have a medical condition which would be made worse by a smoking cessation medication, or take a medication which would interact with nicotine replacement or bupropion. On the other hand, you may want to lean toward medication approaches if you aren’t willing to put some work into breaking your dependence on nicotine since behavioral approaches take substantial commitment and effort on your part. Self-help vs. professionally assisted. Most smokers try to quit on their own and tend to prefer doing it themselves instead of asking for help. However, the more intensive the quit smoking approach and the more social support available, the greater the chance of quitting. Therefore, a multi-session, group smoking cessation program offered by a health professional experienced in smoking cessation has the best chance of success. Choose the most intensive program that: a) is available to you, b) affordable, and c) fits with how you would like to quit. Unfortunately, many smokers have difficulty finding a smoking cessation program that is available, affordable, and fits their needs. Fortunately, self-help programs are available to assist smokers trying to quit on their own. Medication approaches such as nicotine gum and patch are available over-the-counter. Booklets and tapes are available from various agencies (e.g. American Lung Association, American Heart Association), and computerized self-help programs such as LifeSign also are available. Regardless of what self-help program you choose, be sure to increase the social support available to you by letting those close to you know that you are attempting to quit smoking. Ask for their support. Cold turkey vs. gradual quitting. A majority of smokers prefer to quit abruptly, commonly referred to as “cold turkey.” A number of smoking cessation treatments encourage quitting cold turkey and focus primarily on preparing you to quit, reducing the withdrawal during a cold turkey quit (e.g. nicotine gum) and/or helping you remain quit (e.g. relapse prevention). If you prefer to “get it over with” or are a light smoker (less than a pack a day), a cold turkey approach may be best for you. If instead you want to stop smoking gradually or are a heavy smoker (more than a pack a day), a gradual reduction approach may be best for you. Recent research has shown that a scheduled gradual reduction (SGR) approach in which you smoke cigarettes on a specified schedule not only helps you reduce your nicotine use gradually but also helps you disrupt your triggers or “conditioned cues” for smoking. This approach is more effective than simply reducing your cigarettes by selectively eliminating the easier ones first. The LifeSign program is an example of a scheduled gradual reduction approach. The table below provides examples of smoking cessation strategies along these three dimensions:
Medication Behavioral Cold Turkey Self-help Nicotine Gum Nicotine Patch ALA Freedom From Smoking Professionally Assisted Nicotine Inhalers Most Smoking Cessation Clinics (e.g.SmokeStoppers) Gradual Reduction Self-help LifeSign Professionally Assisted Bupropion Scheduled Gradual Reduction Program
Handling a Relapse Most smoking cessation experts will tell you that quitting is easy,staying quit is hard. Nearly every smoker can quit for a few hours or even a day, but to stay quit requires developing skills to handle possible relapses and the motivation and dedication to remain quit regardless of your cravings. After quitting, here are some tips to help you remain quit. Remind yourself that the worst of the withdrawal symptoms subside in a couple of days. Most relapses occur in the first few days after quitting. Set goals for 3, 7, and 21 days of remaining abstinent from cigarettes and reward yourself for making these goals. Review all of the situations (both external triggers and internal mood states) that are most likely to produce a relapse. Either avoid these situations for as long as you can (e.g. don’t go out of the office through the designated smoking area at work) or come up with a plan to handle these situations (e.g. when I’m feeling bored, I’ll read a magazine). If you slip and smoke a cigarette, don’t get down on yourself. Feeling guilty or down only increases the likelihood that you will smoke another. Instead, step back from the situation, consider what you will do in the future when this relapse situation arises and commit to remaining a nonsmoker again. Special Issues: Smokeless Tobacco Use:  Although the rate of smoking in adults has decreased over the last two decades, the use of moist snuff and chewing tobacco have increased. There are over 5 million smokeless tobacco users in the United States and 3/4 of a million teenagers are smokeless tobacco users. Smokeless tobacco use causes oral cancer, gum disease, and cardiovascular disease. Since smokeless tobacco use tends to begin at an earlier age than smoking, such use often leads to smoking as well. Unfortunately, there are less proven approaches for the cessation of smokeless tobacco use than smoking. Medication approaches such as nicotine gum and patches generally have not been found to be effective in helping people quit smokeless tobacco use. Since dentists are among the first health professionals to notice the negative health effects of smokeless tobacco use, some dental professionals have received training in how to assist their patients in quitting. Researchers at the Oregon Research Institute have developed a booklet for smokeless tobacco cessation (“Enough Snuff”) and are developing a CD ROM program using behavioral principles to help people quit smokeless tobacco use. LifeSign also has a program for smokeless tobacco users that has been found effective in helping smokeless tobacco users quit gradually. Teen Smokers: Although there has been a great deal of research focus on preventing smoking in youth, there has been very little research on helping teen smokers stop.
Medication approaches are not approved for use under age 18, and initial studies of their efficacy with teen smokers have been disappointing. Because teen smokers are not typically interested in professionally-assisted or school sponsored cessation programs, self-help programs, particularly computerized programs such as the LifeSign for Teens and a PC-based program from the University of Rhode Island have been recently developed and evaluated. Pregnant Smokers:   If you are pregnant, smoking not only affects you but also your baby. Among other effects, the carbon monoxide from smoking interferes with the oxygen supply to the fetus causing premature deliveries, low birth weight babies, and a higher likelihood of spontaneous abortions and sudden infant death syndrome. After delivery, continued smoking by the mother is associated with higher rates of bronchitis and other respiratory problems in their children. Despite this, approximately 20% of pregnant women smoke during their pregnancy. If you are a pregnant smoker, it is never too late to quit; the risks from smoking increase during the course of pregnancy. If you are smoking, talk to your doctor about ways to quit.