Second-Class Citizens? : 54 Million Americans Cling to Their Cigarettes

SAN FRANCISCO —  There are 54 million Americans who haven’t “kicked the habit,” preferring to enjoy a leisurely smoke rather than go through the anxiety and behavioral changes needed to quit cigarettes.

Cigarettes, psychologists say, are often used for companionship, to relieve stress, to repress anger and to enjoy good times by the 30% of the population still puffing.

Statistics show that 32 million people are ex-smokers, most of them quitting “cold turkey” because of health concerns and societal pressures--particularly the emphasis on nonsmoking rules on public transit, in work places, in restaurants and at recreational events.

Second-Class Citizenship

However, people who enjoy cigarettes say they have rights too, and many are angry at the national trend toward treating them as second-class citizens.

Dave Christian, 54, a former Navy jet pilot now jockeying a statistics desk with the federal government in San Francisco, said he has smoked since junior high school, quitting once for seven months at age 18 because of a wager.

“I really don’t think much about quitting,” said Christian, saying he especially enjoys lighting up after his morning coffee, when sipping a martini and after the evening meal.

“I figure there are worse things I could be doing,” Christian said. “If you have to go, you might as well go doing something you enjoy.”

Christian said he occasionally gets irked at nonsmokers who ask him to extinguish a cigarette, particularly if it is somewhere he is used to lighting up. Once on jury duty, he said, he found a seat beside a floor ashtray in a hall and lit up when a man sat down beside him and asked him to put the cigarette out.

“I told him there were no non-smoking signs, that I was there first and that he could (expletive deleted),” Christian said. “I have some rights too.”

Another smoker for 46 years said he quit once, for a month, and found it was easy “except for my head. I couldn’t stop thinking about cigarettes.”

Joyce Gertler, who heads a smoking cessation program with a 42% success rate--twice the national average--at the Merritt Peralta Medical Center in Oakland, said addiction to cigarettes is mostly behavioral and psychological, not physical.

“The smoking habit is an elaborate complex behavior that reaches into many aspects of the smoker’s life,” Gertler said. “The habit becomes part of the smokers’ way of coping with stress, suppressing emotion and defining their self-image.

“It is very hard for a person to quit unless they consider the behaviors which are connected with smoking and find substitutes for the habit in these settings.”

A small Florida-based organization called PUFFS--People United For Friendly Smoking--has started a membership drive and publishes a newsletter to keep smokers informed on laws and regulations that might affect their right to light up.

“We really are not pro-smoking,” said Dean Overall, who recently started the group with her husband, Sidney, a nonsmoker. “We’re concerned with the rights of smokers who choose to smoke. It’s a legitimate habit.”

The Overalls, who run a public relations firm on St. Simons Island, said they quickly formed a mailing list of 10,000 people who have contacted them for information.

Stand Up and Be Counted

“Smokers are in the minority, but we’re saying don’t eliminate us from the face of the Earth,” said Overall, a smoker. “We really think it’s time that smokers stand up and be counted.”

She said PUFFS was chosen as an acronym for the organization because it stresses that smokers should be courteous, friendly and respect the rights of nonsmokers. The group was started, she said, after seeing a newspaper ad that read “No smokers need apply.”

“An employer can say don’t smoke on the job, but they should give the person a chance to have the job,” she said. “We’re trying to alert people to the dangers that might occur if these things aren’t challenged. We’re coming dangerously close to the next Prohibition.”

Her husband’s favorite phrase, she said, was: “Don’t throw out the civil rights with the cigarette butts.”

Psychologists say although 54 million people smoke, many of them have tried or considered quitting, particularly because of the well-known physical hazards of long-term use: lung cancer, birth defects, emphysema, heart disease and vocal cord damage.

Gertler said when a person quits it takes only 48 to 72 hours for nicotine to leave the body and that physical cravings for a smoke last on the average only 60 seconds. Carbon monoxide levels in the blood drop to normal and oxygen increases to normal within eight hours, breathing becomes easier and lung capacity increases.

Larry Woolf, president of Caesars Tahoe casino in Lake Tahoe, said he had trouble extinguishing the habit because he was told that he looked good with a cigarette in his mouth.

“I tried to quit several times, but it wasn’t until I decided that I didn’t want to be a bad influence on my son that I finally quit,” Woolf said.

The casino is cooperating with the American Lung Assn. in offering a series of smoking cessation clinics for employees, 30 of whom smashed ashtrays recently in a gesture symbolizing their commitment to quit.

At Stanford University Medical Center, an experimental do-it-yourself stop-smoking program has enrolled 1,100 volunteers, all of whom had to agree to quit for 48 hours to participate. They are then assigned randomly to one of several eight-week programs.

“It’s a self-help program for people who don’t want to join an ongoing support group” program director Barbara Newman said. “We’re testing things that people can use to strengthen their chances of staying off cigarettes on their own.”

Some participants receive weekly educational materials, called modules, designed to help them stay off cigarettes. Others receive either nicotine chewing gum or a placebo gum containing inert substances. One group receives both gum and modules. Researchers said they will collect follow-up information on the volunteers for two years.

“Studies have shown that 95% of Americans who have quit have done so on their own,” said Dr. Stephen Fortmann, assistant director of medicine and head of the federally funded project. “What we’re trying to do is help that independent process along a bit.”

Joe Walsh, a Sunnyvale engineer, said he chose the Stanford program because he did not have to attend meetings.

“I don’t like tying myself up every evening to be indoctrinated on all the evils of smoking,” said Walsh, who had a 30-year, three-pack-a-day habit before joining the program last February. He said nicotine gum gave him the support he needed to kick the powerful craving.

“I won’t go back to cigarettes,” he said. “It was too hard to quit.”

Newman said that nicotine addiction is strong and that withdrawal can lead to irritability, anxiety and sleep disturbances. However, she said, the hardest part of quitting is “breaking the habit” of lifting a cigarette to the lips 200 or more times a day, usually in connection with such things as answering the telephone or sipping a drink.

33% of Males Smoke

Surveys by the American Cancer Society show that in general men with college educations, white-collar occupations and high-income levels are less likely to smoke than high-school graduates, blue-collar workers and men with low incomes. Statistically, 33% of the male population smokes.

Twenty-eight percent of the female population smokes, although in absolute numbers more women are smoking than in the past, causing lung cancer to surpass breast cancer as the No. 1 cancer killer among women. The disease claimed the lives of an estimated 41,000 women in 1985, nearly double the 22,000 deaths in 1976.

Surveys show that women who work outside the home are more likely to smoke than housewives and women in households with a low family income. Smoking is also more likely if separated or divorced, or, in contrast to men, if employed in the $25,000-plus income bracket.