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=> Pathetic Tobacco-addicts need hand-holding to help them quit <= just like lil' babies!
=> Pathetic Tobacco-addicts need hand-holding to help them quit <= just like lil' babies!
Study Finds Big Social Factor in Quitting Smoking
By GINA KOLATA
For years, smokers have been exhorted to take the initiative and quit: use a
nicotine patch, chew nicotine gum, take a prescription medication that can help,
call a help line, just say no. But a new study finds that stopping is seldom an
individual decision.
Smokers tend to quit in groups, the study finds, which means smoking cessation
programs should work best if they focus on groups rather than individuals. It
also means that people may help many more than just themselves by quitting:
quitting can have a ripple effect prompting an entire social network to break
the habit.
The study, by Dr. Nicholas Christakis of Harvard Medical School and James Fowler
of the University of California, San Diego, followed thousands of smokers and
nonsmokers for 32 years, from 1971 until 2003, studying them as part of a large
network of relatives, co-workers, neighbors, friends and friends of friends.
It was a time when the percentage of adult smokers in the United States fell to
21 percent from 45 percent. As the investigators watched the smokers and their
social networks, they saw what they said was a striking effect — smokers had
formed little social clusters and, as the years went by, entire clusters of
smokers were stopping en masse. So were clusters of clusters that were only
loosely connected.
Dr. Christakis described watching the vanishing clusters as like lying on your
back in a field, looking up at stars that were burning out. “It’s not like one
little star turning off at a time,” he said. “Whole constellations are blinking
off at once.”
As cluster after cluster of smokers disappeared, those that remained were pushed
to the margins of society, isolated, with fewer friends, fewer social
connections. “Smokers used to be the center of the party,” Dr. Fowler said, “but
now they’ve become wallflowers.”
“We’ve known smoking was bad for your physical health,” he said. “But this shows
it also is bad for your social health.”
Smokers, he said, “are likely to drive friends away.”
Their paper is to be published Thursday in The New England Journal of Medicine.
“There is an essential public health message,” said Richard Suzman, director of
the office of behavioral and social research at the National Institute on Aging,
which financed the study.
“Obviously, people have to take responsibility for their behavior,” Mr. Suzman
said. But a social environment, he added, “can just overpower free will.”
With smoking, that can be a good thing, researchers noted.
But there also is a sad side. As Dr. Steven Schroeder of the University of
California, San Francisco, pointed out in an editorial accompanying the paper,
“a risk of the marginalization of smoking is that it further isolates the group
of people with the highest rate of smoking — persons with mental illness,
problems with substance abuse, or both.”
These are people, Dr. Schroeder notes, who already suffer from being
stigmatized.
It is not clear how to resolve that problem, Dr. Fowler said. “What we are
seeing is that there is a fundamental trade-off to having a campaign to really
change people’s behavior,” he said.
Dr. Christakis and Dr. Fowler published a similar study last year on obesity,
asking about the rise of a health problem.
The new study also looked at smoking initiation but, because many more adults
were stopping smoking than starting in the years of the study, its main focus
was on cessation. Still, Dr. Christakis said, smoking initiation followed the
same patterns as cessation: people started and stopped smoking in groups.
Such studies of social networks and behavior like smoking are extremely
difficult because what is needed is detailed information on people’s behavior
and the behavior of their family, their relatives, their neighbors and
co-workers, their friends and their friends of friends. Dr. Christakis and Dr.
Fowler discovered one data set that had what they needed but, they and others
say, there may not be any others.
The data were from the federal Framingham Heart Study. It was initiated after
World War II to follow the population of Framingham, Mass., in order to
understand the causes and consequences of heart disease. Researchers regularly
examined the study participants, weighing them, doing medical exams, asking them
whether they smoked. In order to keep track of the subjects over the years, even
if they moved away, the investigators asked for the names and contact
information of close friends, co-workers and neighbors.
That meant, though, that the data set also contained all the information that
would be needed for an analysis of social networks and the spread of obesity or,
in this case, for an analysis of social networks and the decline in smoking, Dr.
Christakis and Dr. Fowler realized.
The researchers focused on 5,124 people in the Framingham study who had 53,228
friends, relatives and neighbors as part of their social networks.
They noticed that, on average, smokers clustered in groups of three. Over the
years, as fewer and fewer Americans smoked, the number of clusters declined but
the clusters that remained stayed the same size, which meant that smokers were
not stopping smoking one by one. They were stopping in groups.
Education also played a role. Those with more education were more highly
influenced by their friends, and their friends were more likely to influence
them. And some social contacts were more influential than others. A spouse’s
quitting was more powerful than a friend’s, and a friend’s quitting was more
powerful than a sibling’s. If someone you name as a friend quits, that has more
of an effect than if someone who names you as their friend quits. Co-workers had
an influence only in small firms where everyone knew one another. The effects
were greater among casual smokers than heavy smokers.
The study and the obesity study that preceded it, said Duncan Watts, principal
research scientist at Yahoo! Research in New York, provide a new view of
society.
“We tend to think of individuals as atomized units, and we think of policies as
good or bad for individuals,” Dr. Watts said. “This reminds us that we are all
connected to each other, and when we do something to one person, there are
spillover effects.”
And, he added, when the same sort of effects show up in the spread of obesity as
in the decline of smoking, that should be a signal.
“Something very powerful is going on here,” Dr. Watts said.
Study Finds Big Social Factor in Quitting Smoking
By GINA KOLATA
For years, smokers have been exhorted to take the initiative and quit: use a
nicotine patch, chew nicotine gum, take a prescription medication that can help,
call a help line, just say no. But a new study finds that stopping is seldom an
individual decision.
Smokers tend to quit in groups, the study finds, which means smoking cessation
programs should work best if they focus on groups rather than individuals. It
also means that people may help many more than just themselves by quitting:
quitting can have a ripple effect prompting an entire social network to break
the habit.
The study, by Dr. Nicholas Christakis of Harvard Medical School and James Fowler
of the University of California, San Diego, followed thousands of smokers and
nonsmokers for 32 years, from 1971 until 2003, studying them as part of a large
network of relatives, co-workers, neighbors, friends and friends of friends.
It was a time when the percentage of adult smokers in the United States fell to
21 percent from 45 percent. As the investigators watched the smokers and their
social networks, they saw what they said was a striking effect — smokers had
formed little social clusters and, as the years went by, entire clusters of
smokers were stopping en masse. So were clusters of clusters that were only
loosely connected.
Dr. Christakis described watching the vanishing clusters as like lying on your
back in a field, looking up at stars that were burning out. “It’s not like one
little star turning off at a time,” he said. “Whole constellations are blinking
off at once.”
As cluster after cluster of smokers disappeared, those that remained were pushed
to the margins of society, isolated, with fewer friends, fewer social
connections. “Smokers used to be the center of the party,” Dr. Fowler said, “but
now they’ve become wallflowers.”
“We’ve known smoking was bad for your physical health,” he said. “But this shows
it also is bad for your social health.”
Smokers, he said, “are likely to drive friends away.”
Their paper is to be published Thursday in The New England Journal of Medicine.
“There is an essential public health message,” said Richard Suzman, director of
the office of behavioral and social research at the National Institute on Aging,
which financed the study.
“Obviously, people have to take responsibility for their behavior,” Mr. Suzman
said. But a social environment, he added, “can just overpower free will.”
With smoking, that can be a good thing, researchers noted.
But there also is a sad side. As Dr. Steven Schroeder of the University of
California, San Francisco, pointed out in an editorial accompanying the paper,
“a risk of the marginalization of smoking is that it further isolates the group
of people with the highest rate of smoking — persons with mental illness,
problems with substance abuse, or both.”
These are people, Dr. Schroeder notes, who already suffer from being
stigmatized.
It is not clear how to resolve that problem, Dr. Fowler said. “What we are
seeing is that there is a fundamental trade-off to having a campaign to really
change people’s behavior,” he said.
Dr. Christakis and Dr. Fowler published a similar study last year on obesity,
asking about the rise of a health problem.
The new study also looked at smoking initiation but, because many more adults
were stopping smoking than starting in the years of the study, its main focus
was on cessation. Still, Dr. Christakis said, smoking initiation followed the
same patterns as cessation: people started and stopped smoking in groups.
Such studies of social networks and behavior like smoking are extremely
difficult because what is needed is detailed information on people’s behavior
and the behavior of their family, their relatives, their neighbors and
co-workers, their friends and their friends of friends. Dr. Christakis and Dr.
Fowler discovered one data set that had what they needed but, they and others
say, there may not be any others.
The data were from the federal Framingham Heart Study. It was initiated after
World War II to follow the population of Framingham, Mass., in order to
understand the causes and consequences of heart disease. Researchers regularly
examined the study participants, weighing them, doing medical exams, asking them
whether they smoked. In order to keep track of the subjects over the years, even
if they moved away, the investigators asked for the names and contact
information of close friends, co-workers and neighbors.
That meant, though, that the data set also contained all the information that
would be needed for an analysis of social networks and the spread of obesity or,
in this case, for an analysis of social networks and the decline in smoking, Dr.
Christakis and Dr. Fowler realized.
The researchers focused on 5,124 people in the Framingham study who had 53,228
friends, relatives and neighbors as part of their social networks.
They noticed that, on average, smokers clustered in groups of three. Over the
years, as fewer and fewer Americans smoked, the number of clusters declined but
the clusters that remained stayed the same size, which meant that smokers were
not stopping smoking one by one. They were stopping in groups.
Education also played a role. Those with more education were more highly
influenced by their friends, and their friends were more likely to influence
them. And some social contacts were more influential than others. A spouse’s
quitting was more powerful than a friend’s, and a friend’s quitting was more
powerful than a sibling’s. If someone you name as a friend quits, that has more
of an effect than if someone who names you as their friend quits. Co-workers had
an influence only in small firms where everyone knew one another. The effects
were greater among casual smokers than heavy smokers.
The study and the obesity study that preceded it, said Duncan Watts, principal
research scientist at Yahoo! Research in New York, provide a new view of
society.
“We tend to think of individuals as atomized units, and we think of policies as
good or bad for individuals,” Dr. Watts said. “This reminds us that we are all
connected to each other, and when we do something to one person, there are
spillover effects.”
And, he added, when the same sort of effects show up in the spread of obesity as
in the decline of smoking, that should be a signal.
“Something very powerful is going on here,” Dr. Watts said.
