Cigarettes uncool on campus

It has been about four months since signs went up all over Northeastern University announcing a smoking ban on school property. The new rule, which puts Northeastern on a growing list of schools including Salem State, the University of Massachusetts, Amherst, and Boston University’s Medical Campus that have taken a no-tolerance stance toward cigarettes, has forced the smokers among Northeastern’s student body to walk out to Huntington Avenue before lighting up.

And while there’s no official punishment associated with violating the rule, the fact that students — a lot of them, at least — are following it anyway is plainly obvious as you walk past groups of huddled puffers along the campus perimeter. Sometimes fellow students “look at us strangely,” says Xing Long Xiong, a 23-year-old Northeastern student from China’s Hunan province, as he stands on Huntington with three fellow smokers.

Though no one has been explicitly rude to him, he says, he does feel that nonsmokers see him differently when they learn of his habit. And one of his friends says, “My girlfriend doesn’t like me to smoke.” Being a smoker is an increasingly lonely path in America, and particularly on college campuses.

Almost 50 years after the release of a landmark Surgeon General’s Report revealed to the wider public that cigarettes cause lung cancer, emphysema, and heart disease, policy makers are going to ever-greater lengths to discourage people from smoking, with taxes pushing the average cost of a pack of cigarettes to about $9 in Massachusetts and almost $15 in New York, and bans not just in restaurants, bars, and office buildings, but in outdoor spaces, too. (Late last month, the Boston City Council voted to impose a $250 fine on anyone caught smoking in the city’s public parks.)

The anti-tobacco message seems to be sinking in: Though 1 in 5 American deaths every year still result from cigarette smoking, adult smoking rates have fallen dramatically, from around 42 percent of the population in 1965 to slightly less than 25 percent in 1997 to about 18 percent in 2012, according to the Centers for Disease Control and Prevention.

And the numbers for teens are dropping as well, with a recent report by the University of Michigan’s Institute for Social Research showing that the percentage of high school sophomores who were daily smokers was down from 18 percent in the mid-1990s, when it peaked, to just 5 percent in 2012. On college campuses, according to an ongoing University of Michigan study, daily cigarette use plummeted from a high of 19 percent in 1999 to just 5 percent last year, while among non-college students one to four years out of high school, the rate is close to 19 percent.

For all that progress, the fact remains that some of the smartest young people in the country are still smoking. In addition to the 5 percent, which represents 650,000 students, there’s also a growing number of so-called social smokers, who indulge only occasionally and only in certain contexts, like when they’re partying. As someone who kicked the habit only a few years after starting to smoke in college, I wanted to find out what had changed on America’s campuses — both in terms of why smoking rates had fallen so far and why those who still do it insist on hanging on.

According to the Americans for Nonsmokers’ Rights Foundation, the number of campuses in the United States that have enacted total smoking bans, both indoors and out, has grown from slightly fewer than 600 two years ago to more than 1,100 today. Though it’s arguably a somewhat inflated number — the group counts four schools at Harvard separately — the smoke-free campus movement is clearly gaining momentum.
Driving this is the idea that college students are a population that’s especially vulnerable to the temptations of tobacco and that historically they’ve been a high-priority target for tobacco companies’ marketing departments.

Though there seems to be some disagreement on this today, a 1998 study published in the Journal of the American Medical Association that is still cited by researchers reported that 28 percent of college kids who smoked regularly didn’t pick up the habit until after they finished high school.

That makes sense to me: I started buying cigarettes in the opening weeks of my freshman year, and I have long believed, perhaps for self-serving reasons, that college and smoking go together — that there is something about the mind of an 18-year-old living in a new place and surrounded by new people that makes cigarettes incredibly attractive.

And while smoking rates among young adults who aren’t in school are higher than they are for college students, it’s nevertheless true that college is the time in your life when you’re most likely to be trying on new identities — wondering what kind of person you want to be now that your parents can’t tell you what to do, even making decisions you know are not in your long-term interests because there’s a buffer of several years protecting the young, invincible creature you are from the responsible adult you’ll need to become once you graduate.

College is also the time when you spend the majority of your days and nights either stressed out about work, trying to impress strangers, or drinking heavily (or doing all three at once). Under those circumstances, a person can be drawn to cigarettes not in spite of the well-known health risks but because of them — which is why persuading young people not to smoke can be such hard work. After all, when a behavior is appealing precisely because it is transgressive, telling them they shouldn’t do it, even instituting a ban that tells them they’re not allowed to, would seem to carry the risk of making it that much more alluring.

And yet the ground is clearly shifting. Walking in Cambridge recently, a 20-year-old student named Mike Harrison from MassArt recalls a time he and his friends went out for a cigarette while attending a party at MIT. The reaction was unequivocal, Harrison says: “Someone was like, ‘Who even smokes cigarettes anymore?’ ”

I am 28 years old I grew up thinking smoking was the coolest thing in the world and wanted very badly to do it starting at an early age. As a third-grader I bought packs of fake cigarettes at a joke shop that also sold hand buzzers and disappearing ink. They looked just like regular cigarettes, down to their glossy red tinfoil tips, and on the inside they were full of chalk dust, so that when you put one to your lips and gently exhaled, a cloud of rather realistic smoke would form in front of your face.

Walking around with these things, holding them between my fingers with practiced casualness, I felt like a star, and every time I took a puff, I narrowed my eyes and imagined how awesome I must look in profile. One day my best friend’s mom called my house and reported that a neighbor had seen me with a cigarette while she was driving by in her car. My parents were, of course, horrified. For my part, I was just proud of how convincing my performance had been.

I didn’t start really smoking till I arrived at Harvard, having spent the previous summer flirting with the habit by bumming the occasional late-night cigarette from girls I had crushes on. When I got to school, I found myself repeatedly standing around at social functions with no one to talk to; I believe it was after an ice cream social that I entered a CVS and bought a pack of Marlboro Lights. After that, I stood around with purpose and style, and eventually I made friends with other people who did the same.

Being a smoker felt great. I loved it despite knowing all too well what it was doing to my insides. In my mind, it gave me the aura of a complicated man with his hands firmly on the steering wheel of his destiny and the windows rolled all the way down: someone with a tantalizing inner life and interesting flaws.

It also allowed me to have something in common with all kinds of people I thought were cool: the glamorous ragamuffins who hung out on the steps of the Harvard Lampoon building, the two sophomore guys who played in a dance-punk band, the blond girl from Seattle who was into the Pixies. As far as this freshman was concerned, the fact that we were all smokers meant we shared some bond — that, unlike all the dullards in our midst who had gotten into college by never doing anything they weren’t supposed to, we lived by our own rules and didn’t follow anyone’s advice.

While it’s undeniably true that by the end of my four years I felt more and more as if my friends and I were being judged by our nonsmoking classmates for our nasty habit, the truth is I liked feeling as though others saw me as a fearless off-putting outsider.

I remember lighting up a cigarette at graduation, wearing my black robe, and being rather pleased with myself as the people around me looked with eyes that asked, “Is nothing sacred?” But not long after I left school, the romance started to fade. By my mid-20s, I was no longer smoking, and neither were most of my college friends. This year, the last two remaining holdouts switched to e-cigarettes.

If you ask Michael Siegel, a professor at Boston University’s School of Public Health who studies tobacco policy, he’ll tell you that there’s nothing essentially, or inherently, cool about smoking. In Siegel’s view, the fact that I and so many others have those associations is the direct result of decades-long marketing efforts by tobacco companies, which have spent billions of dollars selling young people on the idea that smoking is a good way to channel their oppositional instincts.

“Individualism, rebelliousness, autonomy, these are core values that resonate with young adults who are looking for ways to exert their freedom from their parents and from being told what to do,” Siegel says. “But there are a lot of different things you can do to rebel. And the point of tobacco industry advertising,” he says, is to “make cigarettes the product everyone’s using to [do it].”

Of course, tobacco companies have been severely restricted in their marketing efforts since the 1970s, when Congress banned the advertising of cigarettes on television and radio, and even more so since 1998, when the Tobacco Master Settlement Agreement put an end to promotions that targeted young people.

But smoking still appears in lots of movies. According to the Center for Tobacco Control Research and Education at the University of California, San Francisco, “tobacco incidents” in youth-accessible movies actually jumped by 54 percent in 2012 compared with the year before. And while Mad Men makes smoking look sexy and elegant, it takes pains to remind viewers of how stupid it is.

“Obviously there’s, like, this romanticized notion of smoking that kind of exists in movies,” says Jonathan Mendoza, a 24-year-old grad student at MIT. But Mendoza mocks the idea that anyone would ever see him smoking and think he was cool as a result. “I’m not trying to project anything,” he says. “I’m just trying to get nicotine into my lungs.”

Whether Mendoza’s attitude is representative of all students is hard to say, because the reasons people start smoking, and the prevalence of people who do, vary so much and depend on factors like socioeconomic status, race, and gender. And while overall smoking rates are down, there are some communities and subcultures in the United States where it remains relatively common.

“Smoking is getting concentrated in little enclaves,” says Dr. Pamela Ling, an associate professor at the University of California, San Francisco School of Medicine who studies tobacco marketing. “The prevalence in California is approaching 10 percent, but if you go to bars in certain neighborhoods in San Francisco, you’ll see that half the people are smokers, not 10 percent. If you’re hanging out with hipsters in the Mission District, smoking amongst that group still seems pretty cool, because a lot of people still smoke.”

Most of the students interviewed for this story said their main motivation for smoking is to relieve stress, not to look or feel cool. “This pack of cigarettes I wasn’t planning on buying, and then I had just, like, a stressful conversation, and I went and bought a pack,” says Kaitlin, a 23-year-old pursuing a public health degree at Boston University who did not want her last name used.

Like many Boston-area young people, Kaitlin says she feels others look at her differently when they find out she’s a smoker: “There’s definitely a sense of judgment. I don’t think it’s socially acceptable to smoke anymore.” Others report feeling like pariahs when they walk around campus with a cigarette, with classmates visibly turning their heads away or pulling their scarves over their mouths to avoid breathing in the contaminated air.

One important effect of this perceived persecution is that smokers who do get a rush of rebellious energy from maintaining their habit feel it all the more strongly. Samuel Newmark, a shaggy-haired senior at Harvard, says there’s a disproportionate number of smokers affiliated with The Advocate, Harvard’s literary magazine, as well as Record Hospital, the hard-core and punk department of the university’s student-run radio station, where he works.

“Kids in my department smoke because they think of it as a slightly self-destructive thing,” Newmark says. “We always like to be the kids who say ‘[Screw] you’ to everything. And I think one way of saying ‘[Screw] you’ to a lot of things is smoking. . . . Part of it is knowing what the health risk is, and part of its knowing that you’re able to create your own horrible cloud of smoke that pushes other people away.”

What will it take to get through to these last young people who are drawn to smoking? According to Bonnie Halpern-Felsher, a University of California, San Francisco professor who has studied smoking and attitudes around smoking among adolescents for more than 15 years, one thing that worked extremely well is the “Truth” ad campaign, which tries to persuade teens that by smoking cigarettes, they aren’t rebelling against anyone so much as succumbing to the efforts of big corporations to manipulate them.

Michael Siegel at BU believes there needs to be more such advertising: “We in public health need to have counter-advertising campaigns where we show smoking . . . takes away your freedom and makes you addicted,” he says, “which essentially means you lose your independence.”

One of the college friends I used to smoke cigarettes with recently shared a different theory: that smoking will lose its counter cultural cachet on its own. As he sees it, smoking cigarettes in spite of the health risks at this point implies a breathtakingly stubborn refusal to accept scientific fact — a stubbornness that no longer puts smokers on the side of rebels and rock stars, but instead aligns them with climate-change deniers and folks who don’t believe in evolution.

His prediction is that young people will embrace an alternative to smoking that has become a billion-dollar business since we graduated from college: vaping — using e-cigarettes — which appeals not to the users’ self-destructive impulses, but to their much more au courant desire to be an early adopter.

That e-cigarettes, which deliver nicotine vapors to the user but don’t actually burn like tobacco does, are poised to become increasingly widespread is consistent with recent findings from the CDC about the growing popularity of “alternative tobacco products” among college-age students, like Snus, smokeless tobacco packets people stuff behind their upper lip, and hookahs, which they smoke at specialty bars.

Halpern-Felsher says she’s particularly worried about e-cigarettes, which are being marketed in ways highly reminiscent of the bad old days of big tobacco advertising. (For a great example, see the NJOY spot in which Courtney Love tells off a stuffy old broad after she tries to forbid her from puffing on her e-cig inside.)

And while it’s true that e-cigarettes don’t contain the carcinogenic tar that real cigarettes do, most do contain nicotine, which has its own negative effects. And while the jury is still out on whether people who would have never started smoking otherwise are getting addicted to nicotine by using them, it’s a fact that manufacturers of e-cigarettes are making a concerted, aggressive push toward portraying their products as “cool” in a way real cigarettes can never be again.

At the cutting edge of this dubious effort is the Henley Vaporium in New York, one of the first stores in the United States to specialize exclusively in vaping paraphernalia. When I visited on a recent weekend, a sign outside called on people to “START VAPING TODAY,” and another promised “TRILL VIBES.” Inside, there was a menu with dozens of flavors of nicotine-infused “e-juice” cartridges, including frozen lime drop, strawberry fuzz, and a caramel-vanilla offering called Swagger, as well as an assortment of vaporizers, including one made in the shape of a Star Wars light saber.

Michael Carbone, a tattooed 21-year-old store clerk who didn’t finish college, tells me he started “vaping” five months earlier after he realized he was the last of his friends who was still smoking cigarettes. I ask Carbone if he gets the same thing out of vaping that he used to get out of cigarettes.

He says he does. “I mean, I like smoking,” he says. “I guess my body’s in it for the nicotine, but I’m in it to smoke. I’m in it to, like, look cool and have swagger. That’s why I picked up cigarettes when I was in high school. Cigarettes made you look cool. I mean, that’s just fact.” Vaping, he thinks, makes him look even cooler.

When I ask Sam Newmark, the Harvard senior, what he thinks about vaping, he tells me about going to a concert the night before with his friend who had recently switched to electronic cigarettes. “He was smoking it indoors, and I just thought it looked kind of sad,” he says. “It doesn’t look cool to me.” But younger people he knows? They’re all about e-cigarettes.

By Leon Neyfakh Boston Globe


Research: rapid recovery after kicking the butts

Within a few days you will probably begin to notice some remarkable changes in your body. Your sense of smell and taste may improve. You will breathe easier, and your smoker’s hack will begin to disappear, although you may notice that you will continue to cough for a while. And you will be free from the mess, smell, inconvenience, expense, and dependence of cigarette smoking.

It is important to understand that the long range after-effects of quitting are only temporary and signal the beginning of a healthier life. Now that you’ve quit, you’ve added a number of healthy productive days to each year of your life. Most important, you’ve greatly improved your chances for a longer life. You have significantly reduced your risk of death from heart disease, stroke, chronic bronchitis, emphysema, and several kinds of cancer not just lung cancer.

Cigarette smoking is responsible every year for approximately 130,000 deaths from cancer, 170,000 deaths from heart disease, and 50,000 deaths from lung disease.
20 minutes
– Blood pressure drops to normal
– Pulse rate drops to normal
– Body temperature of hands and feet increases to normal
8 hours
– Carbon monoxide level in blood drops to normal
– Oxygen level in blood increases to normal
24 hours
– Chance of heart attack decreases
48 hours
– Nerve endings start regrowing
– Ability to smell and taste is enhanced
2 weeks to 3 months
– Circulation improves
– Walking becomes easier
– Lung function increases up to 30%
1 to 9 months
– Coughing, sinus congestion, fatigue, and shortness of breath decrease
– Cilia regrows in lungs, increasing ability to handle mucus, clean the lungs, and reduce infection
– Body’s overall energy increases
1 year
– Excess risk of coronary heart disease is half that of a smoker
5 years
– Lung cancer death rate for average smoker (one pack a day) decreases by almost half
– Stroke risk is reduced to that of a nonsmoker 5-15 years after quitting
– Risk of cancer of the mouth, throat and esophagus is half that of a smoker’s
10 years
– Lung cancer death rate similar to that of nonsmokers
– Precancerous cells are replaced
– Risk of cancer of the mouth, throat, esophagus, bladder, kidney and pancreas decreases
15 years
Risk of coronary heart disease is that of a nonsmoker

Research: 90.6% smoke-free success rate

Of 43 consecutive patients undergoing this smoking cessation treatment protocol, 39 reported remaining abstinent at follow-up (6 months to 3 years post-treatment). This represents a 90.6% success rate using hypnosis. (Int J Clin Exp Hypn. 2001 Jul;49(3):257-66.Barber J.)