Some call them devil weed. Cancer sticks. Or coffin nails.
But others, curiously enough, think of cigarettes as friends.
Cigarettes are always there to help smokers cope "in any emotional situation," explained Debbie Mahood, director of smoking education for the American Lung Assn. of Orange County. "When they quit, there's something missing in their lives, and they can only describe it as a friend."
"The hardest patients I ever worked with were people who smoked a long time and lived alone," added Nina Schneider, a research psychologist at UCLA who has studied smokers for 14 years. "They had no one when they let go of their cigarettes."
Nonsmokers urging their smoking friends to quit on the Great American Smokeout Day today might find this hard to understand in light of what appears to be an airtight case against cigarettes. According to the surgeon general, smoking kills an estimated 350,000 people a year through lung and other cancers, heart disease, emphysema, bronchitis and allied conditions. When pregnant women smoke, their babies may be harmed, born prematurely or have a low birth weight.
Nevertheless, smoking researchers say grief over losing one's "best friend" is one of the intense withdrawal symptoms of the mind and body that keep a quarter of all Californians and one-third of all Americans hooked--even though surveys show the vast majority want to quit.
More than a behavior, many researchers now consider smoking to be a dependency as strong as addictions to heroin or alcohol. Only 30% of all those who try to control their alcohol, heroin or tobacco consumption will succeed, according to Dr. Joseph Herskovic, a psychologist and nicotine researcher at the VA Medical Center and UCLA School of Medicine.
In fact, diagnostic manuals of the American Psychiatric Assn. and the World Health Assn. have recently added the term "tobacco dependence disorder" as an official syndrome that can be listed as cause of death on a death certificate.
What is it about cigarettes that make people continue to smoke them when they don't want to? What could possibly make people confuse burning sticks of flaked tobacco with friends?
Smoking researchers believe that it is nicotine, the natural psychoactive alkaloid found in the tobacco plant. A poison that is harmful in much larger doses, nicotine increases the heart rate and blood pressure, raises skin temperature and causes changes in the peripheral nervous system, researchers say. And those changes foster such pleasant mental states that if it weren't for its side effects, nicotine would be an "excellent psychological tool," Herskovic said.
A 'Phenomenal Illusion'
Propelled by smoke, nicotine hits the brain within a short and gratifying seven seconds of each puff. Smokers are either instantly stimulated or sedated, depending on how they smoke, he said. With short puffs, smokers can raise their spirits; with deep puffs, they can tranquilize themselves.
Nicotine, one researcher said, provides a "phenomenal illusion" of emotional control.
Cigarettes tend to calm introverts and stimulate extroverts; they also help increase concentration and improve work performance, Herskovic said.
He said he tries to persuade smokers who regard cigarettes as friends that while cigarettes may appear friendly, they are really "back-stabbing enemies." While scientific studies are as yet inconclusive, nicotine is highly suspect as the addicting agent in cigarettes, he said.
And regardless of whether nicotine itself is harmful, it is apparently dependence on nicotine that causes smokers to continue to expose themselves to the carcinogens produced in the combustion process, researchers say.
Suits Against Tobacco Firms
"Nicotine addiction" is a controversial term, Herskovic said, due to lawsuits against tobacco companies. The suits basically claim that people who have died as a result of smoking were unable to control their smoking and were improperly warned of potential dependency. The first case went to trial this month in Santa Barbara.
Historically, officials have been warning the public against tobacco since 1604, about 100 years after Christopher Columbus introduced tobacco from American Indians to Europe. That year, King James I of England issued "A Counterblaste to Tobacco."
But no one is known to have abstained until April 5, 1679, when the Sheriff of Turku, Finland, Johan Kastu, wrote in his diary: "I quit smoking tobacco," according to the Guinness Book of World Records. It is unknown what method he used or whether he succeeded, because he died one month later.