Who they are and why they can’t quit?
A home-invasion robbery at his South Side residence foiled Keith Shannon’s attempt to quit smoking.
“After getting hit across the head with a gun,” he said, “I needed a cigarette.”
The stressful event brought a return to his old habit — but not a happy return. The 29-year-old valet at a downtown hotel faces the same scary thought each time he puts a cigarette to his lips.
“It helps calm my nerves,” he said, “but it will also kill me.”
Shannon has company. Despite recent laws that further limit where they can smoke, despite tax hikes that have made Chicago the second-most expensive place to smoke in the U.S., despite unyielding pressure from friends and family to quit, a sizable chunk of the population keeps lighting up.
In Illinois, adult men are more likely to smoke than women, while high school girls are more likely to smoke than boys. African-Americans smoke at the highest rate among ethnic groups, while Asian-Americans smoke at the lowest rate. The poor and less educated smoke at higher rates as well.
The group that smokes the most? The mentally ill. According to studies, people with mental illness smoke at nearly twice the rate as those without such disorders.
Studies have identified a common genetic vulnerability to both mental illness and nicotine addiction, said Brian Hitsman, an assistant professor of preventive medicine at Northwestern University who researches tobacco use among psychiatric patients.
Beyond the physical addiction, smokers repeatedly pointed to the stress relief that smoking provides.
“Cigarettes are just adult pacifiers,” said three-pack-a-day smoker Deborah Israel, 56, of Chicago. “You stick ‘em in your mouth when you get stressed.”
But the habit isn’t all that calming. For heavy smokers who can’t get their fix, withdrawal symptoms including nervousness, irritability and restlessness can develop in as little as two hours, Hitsman said.
Like Shannon, Israel said she has made multiple attempts to quit. So have many others.
A state Health Department study in 2005 found that 62 percent of smokers in suburban Cook County had quit for at least one day; in Chicago, 58 percent had. By 2007, a follow-up study found the numbers had risen, to 67 percent of suburban smokers and 62 percent in the city.
That shows that most smokers want to quit, said Joel Africk, president and CEO of Respiratory Health Association of Metropolitan Chicago. In national studies, younger smokers have been found to be significantly more likely to try to quit than older smokers, and more likely to succeed.
But most efforts to quit, for young or older smokers, fail. Why?
Africk said government funding for smoking cessation programs has declined dramatically.
In 2001, Illinois allocated $25 million from a landmark settlement with tobacco companies to smoking prevention and cessation programs, he said. In 2002, funding for the programs jumped to $46 million.
But in 2003, the funding got whacked to just less than $10 million and has stayed there ever since, Africk said. Programs started during the lush budget times got cut or dramatically downsized, he said.
“When it comes to making a big investment in smoking prevention and helping people quit, it’s been a patchwork approach,” he said.
Israel said she was frustrated to learn that her employer’s health insurance policy doesn’t pay for prescription drugs that can help people quit. Out of pocket, the drugs cost more than $100 a month, money she said isn’t in her budget.
And the rising cost of her habit isn’t enough to force her to cut herself off.
“I’m addicted,” she said. “I can’t quit. So I just try to wean myself, smoke less, keep costs under control.”
Copyright © 2009, Chicago Tribune
