Hooked on the Myth of Instantly Addictive Cigarettes


Digging through a pile of medical journals, New York Times health reporter Jane Brody discovers that cigarettes are instantly addictive:

Dire warning to all adolescents: You can get "hooked from the first cigarette."

Brody is quoting an article (available for $10) from the December Journal of Family Practice in which tobacco researcher Joseph R. DiFranza warns that "one cigarette may be all it takes to get hooked." But DiFranza immediately back-pedals:

Hooked from the first cigarette?

You bet.

Very soon after that first cigarette, adolescents can experience a loss of autonomy over tobacco, and recent research indicates that this loss of autonomy may play a key role in nicotine addiction.

Notice how the claim of instant addiction quickly becomes a claim that some time after the first cigarette (possibly after the 10th or 100th?) smokers may begin to experience "loss of autonomy," which ultimately could play a role in addiction. And how is this "loss of autonomy" measured? With a 10-point checklist:

1. Have you ever tried to quit smoking, but couldn't?
2. Do you smoke now because it is really hard to quit?
3. Have you ever felt like you were addicted to tobacco?
4. Do you ever have strong cravings to smoke?
5. Have you ever felt like you really needed a cigarette?
6. Is it hard to keep from smoking in places where you are not supposed to, like school?

When you tried to stop smoking (or, when you haven't used tobacco for a while):

7. Did you find it hard to concentrate because you couldn't smoke?
8. Did you feel more irritable because you couldn't smoke?
9. Did you feel a strong need or urge to smoke?
10. Did you feel nervous, restless, or anxious because you couldn't smoke?

If you answer yes to one or more of these questions, according to DiFranza, you have experienced "loss of autonomy" and are well on your way to a cigarette habit that will give you lung cancer when you're 65. In a sentence that Brody quotes, DiFranza says "three New Zealand national surveys involving 25,722 adolescent smokers who used this checklist revealed a loss of autonomy in 25% to 30% of young people who had smoked their one and only cigarette during the preceding month." How plausible is it that someone who has smoked exactly one cigarette in his life has tried to quit smoking but couldn't, or feels strong cravings for a cigarette, or gets irritable and has trouble concentrating when he can't smoke? Maybe teenagers who have tried cigarettes sometimes say such things because they believe that's what a smoker would say, and they are experimenting with that identity. Or maybe they are just screwing with the people conducting the survey.

Neither DiFranza nor Brody considers these possibilities. Brody is so eager to believe in the overwhelming power of nicotine that she does not even notice how she contradicts herself. After quoting a tobacco researcher who notes that "the vast majority of teenagers who try one or two cigarettes don't go on to become smokers," Brody blithely asserts that "smoking by youngsters…typically leads to a lifetime of smoking."

This sort of misrepresentation reinforces the myth that nicotine is irresistible and inescapable, which is counterproductive for at least two reasons that DiFranza and Brody should be able to appreciate. Teenagers who experiment with tobacco or observe peers who do so will quickly discover that addiction takes more than a single cigarette. Having seen through the scare tactics aimed at stopping them from taking that first puff, they may be inclined to dismiss better-grounded concerns about, say, the long-term health consequences of a pack-a-day habit or the difficulty of giving up cigarettes once you've come to depend on them as a way of relieving stress. And if they do eventually become regular smokers, exaggerating the enslaving power of nicotine will discourage them from trying to quit and from persisting in the attempt.  

I commented on earlier attempts to portray cigarettes as instantly addictive here and here