Only 27% of adult Americans now smoke, a group that falls predominantly into a "hard-core" class of smokers for whom cigarettes are less a pleasure than they are an important psychological part of their daily routines.
Researchers at the St. Helena Health Center in Northern California have come up with a profile of these puff-a-holics, which include a large number of high-energy professionals on one extreme and blue-collar working-class people on the other.
"We've seen fewer and fewer casual smokers," said Hap Stump, a psychologist at the center which runs an intensive five-day stop-smoking program boasting a 37% success rate. "Quitting is now more of a health issue than a social issue."
A recent survey taken by the national Center for Disease Control in Atlanta showed that 26.5% of adult Americans now smoke, a decrease of nearly 4% from a 1985 survey and down nearly 14 points since 1964, the year warning labels were put on cigarettes by the U.S. Surgeon General.
More Public Awareness
The poll showed that 43 million adult Americans have kicked the cigarette habit in the past 25 years, while 86 million others have never smoked. That still leaves some 47 million people who still light up.
Dr. Ron Davis of the disease control center's U.S. Office on Smoking and Health said he believes the decline in smoking is because of a growing public awareness that it is a dangerous addiction.
"I believe that people are now beginning to realize that smoking is not just a minor health hazard," Davis said. "It's actually the most important preventable cause of death in our society."
Stump said most of the people who quit have done so "cold-turkey" or without professional help, although statistics show it usually takes three serious efforts to stop before being successful. He said many so-called "casual" smokers were induced to quit because of social pressures, such as the proliferation of no-smoking sections in restaurants, public conveyances and work areas.
"For many of these casual smokers, it became so painful to keep smoking that they quit," said Stump, adding that additional pressures have come recently from non-smokers who for health and aesthetic reasons don't want to inhale the fumes of nearby cigarettes.
Stump said the 17-year program at St. Helena used to help a wide range of smokers to quit, but that more recently those entering the regimen fall mostly into the "hard-core" category. These people, he said, often have the following traits that have prevented them from quitting:
--A cross-addiction to caffeine.
--Heavy alcohol consumption.
--Emotionally reserved but not shy.
--Afraid of losing social understanding from friends who still smoke.
--Low self-esteem because of trying to quit and failing.
--A strong resentment of the pressures to quit.
Stump said groups most likely to include hard-core smokers are clergymen, doctors, lawyers, stockbrokers and executives who put in long hours and whose only breaks--and relief from pressure--often come by stopping their work to light up. Blue-collar workers in occupations where smoking isn't a social stigma are also among the hard-core, he said.
"For many people, cigarette breaks are an important part of their daily functioning," said Stump. "On a short-term basis, smoking has worked for them. If they quit, they'll have a flat-out grieving process, denial and anger."