Why do people smoke? All of know that smoking is a dangerous, even potentially lethal habit - and one moreover that now carries an increasing weight of social stigma. And yet still people do it. There must therefore be compelling reasons why people should endanger their health to such a degree and the most obvious of these reasons is the one that smokers themselves offer up the most often: Smoking is simply pleasurable. This paper examines why people smoke cigarettes and especially how young people (who have been aware of the dangers of smoking their entire lives) begin their love affair with nicotine.
When it comes to the issue of smoking and young people, it seems that despite numerous advertising campaigns to quell the use of tobacco in those under the age of eighteen, the reality is that these tactics have been highly ineffective. While the use of tobacco amongst North Americans is, overall, on the decline, the number of teens using tobacco continues to increase steadily each year. Given this reality, we may assume that as these smoking teens enter young adulthood, their attitudes toward smoking will be more lenient than that of older adults, although this is probably only true if those older adults did not themselves smoke when they were teenagers.
Such research is important because smoking is known to cause a wide range of health problems for the person smoking as well as a somewhat reduced health risk for those who are exposed on a second-hand smoke. Moreover, there is a general overall cost to society.
The first study considered for this investigation was an empirical study in which researchers considered tobacco smoking beliefs and risk awareness of university students in 23 countries. Steptoe etal (2002) designed a study to determine:
the prevalence of current tobacco smoking, associations with beliefs about the health benefits of not smoking and the awareness of risks for lung cancer and heart disease in university students sampled from 23 countries (p. 1561).
Additionally the investigation utilized the World Health Organization's (WTO) model of tobacco epidemic to understand variances in tobacco usage among different countries.
Employing an anonymous questionnaire survey, 19,292 university students (8,482 men and 19,816 women) aged 17-30 studying non-health related disciplines were surveyed from 23 different countries. The researchers used the following instruments: the measure of smoking (which asked the participant to rate their tobacco use based on the number of times the individual has used tobacco); the importance of not smoking as it pertains to health (a Likert-type questionnaire that ranked the participants responses from 1 [low] to 10 [very great] in regard to importance; and risk awareness (questions posed in a yes/no format). Belief ratings for adults and their attitudes concerning smoking were extrapolated for 11 countries to determine if correlations between adult and young adult smoking patterns existed.
The findings of the study indicate that the prevalence of smoking in university students from developed countries such as Europe and the United States was much higher than rates in developing countries such as Thailand and South Africa. Overall health beliefs were strongly associated with prevalence; meaning that the less risk the individual believed smoking posed to overall health, the higher the incidence rate of smoking. In addition, the researchers found that, on the whole, university students were largely uneducated about the health risks associated with tobacco use.
Statistical methods utilized for the interpretation of the data included STATA 6 and SPSS 10.0.5. The researchers found that when correlating data, there were some correlations between smoking patterns and age. To correct the statistics for this problem, STATA 6 results were age- adjusted based on the data produced. Furthermore, Steptoe, et al., found that education levels also had an impact on beliefs and risk awareness. However, this variable could not be corrected in the final presentation of the data.
Using the age-adjusted data, researchers found significantly different attitudes toward smoking between men and women. Overall, more female smokers demonstrated an interest in reducing smoking behavior (70%), while more men had taken up the practice in developing countries.
In a more tightly focused study, Onal, Tumerdum and Ozel (2002) examined smoking addiction patterns among university students in Istanbul. The researchers believe that this study is especially pertinent because of the high rate of smoking in Turkey: While four million individuals die from smoking related causes worldwide each year, in Turkey this number is 100,000, which is more than the combined total of Turkish deaths from traffic and industrial accidents.
For the purposes of this study a randomized sampling method was employed. A questionnaire on smoking addition was administered to groups of 10-30 participants utilizing by means of responding under observation. "Smoking addiction was defined as, smoking more than 100 cigarettes life-long or smoking one or more cigarettes a day" (p. 398). A total of 236 participant responses were utilized out of 250 potential respondents. Logistic regression analysis of the data was utilized to calculate p values: any p value greater than 0.05 was considered significant.
The results of the study indicate that of the total population surveyed, 36% (41.3% males and 26.7% females) were addicted to cigarette smoking. The median age for smokers was 24.0 +2.9 years. Utilizing the Mann-Whitney U-test, the researchers found that males smoked significantly higher numbers of cigarettes per day than females. Upon final analysis of the data the researchers do note that there are a number of intrinsic variables that cannot be accounted for when considering the prevalence of smoking among university students:
Studies relevant to smoking addiction in the young population showed that social status, income and educational levels, as well as age and gender play an important role in smoking attitudes (p. 400).
The article concludes by considering the research findings within the context of alcohol addiction. According to the authors, similar research findings in other studies have shown that smoking additions closely correlate to alcohol addictions; suggesting that there is some inherent component in addition, whether it is to tobacco or alcohol. Finally, the authors are able to demonstrate that students in the study that derived most of their income from their parents were more likely to smoke simply because they could afford to do so. Individuals that were responsible for their own incomes had lower tobacco usage rates. This suggests that income plays a significant role in the development of smoking behaviors.
In a well-focused article, Biasco and Hartnett (2002) attempted to assess American college students' attitudes toward smoking Biasco and Hartnett (2002) surveyed 81 students (one-tenth of the student population) of a northwest Florida university. According to the authors the respondents for the survey were chosen randomly after being stratified for gender and race: 40% of the population was male, 60% female, 78% white, 10% African-American, 5% Asian, 4% Hispanic and 3% "other." The measurement instrument was a 19 question, 3-point Likert-like survey which asked subjects to rate their responses based on agree, uncertain or disagree options.
The results of the study indicate that although most college students viewed smoking as a bad habit and dangerous to one's health a majority felt that individuals should retain the right to smoke (94%). Further, most students agreed that others should not be harmed by an individual's choice to smoke:
the majority of college students believe others should not be injured by their smoking; for example, by smoking in an enclosed area. In addition, students said that people should be advised about the harmful effects of smoking and prohibited from smoking near pregnant women or near children. They also believed that second-hand smoke could cause health problems (p. 446).
According to the researchers the results of the study are commensurate with what other investigators have found on the subject. Overall, it seems that while college students acknowledge that there are health risks associated with tobacco use and further that these risks can affect non-smokers, many believe that their choice to smoke is their own right.
Choosing to Die
One of the great ironies for people born in the 20th and now the 21st century is the fact that many of us will die of diseases that are preventable. Of course, one could argue that this was always true: That people in the 15th century did not need to die of leprosy or cholera because death from these diseases is also preventable if only people will use antibiotics and ensure a clean water supply. However, there is a clear difference in a person of the 15th century dying of cholera and a person of the 21st dying of smoking; a doctor practicing in that century did not know about bacteria or the connection between clean water and cholera outbreaks while today both patients and doctors are aware that smoking has a number of terrible health consequences, including the real possibility of death.
It remains, true, of course, that many people continue to die in our own century of diseases that we do not understand well and have no clear remedy to,…