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Home / Lifestyle

10 myths about smoking that will not die

By Simon Chapman
Other·
14 Mar, 2016 10:53 PM9 mins to read

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Cutting down rather than quitting shows no reduction in harm. Photo / Getty

Cutting down rather than quitting shows no reduction in harm. Photo / Getty

Across forty years I've come to recognise many factoid-driven myths about smoking that just won't die. If I asked for a dollar each time I had to refute these statements, I'd have accumulated a small fortune.

Their persistence owes much to their being a vehicle for those who utter them to express unvoiced but clear sub-texts that reflect deeply held beliefs about women, the disadvantaged, mental illness, government health campaigns and the "natural".

Let's drive a stake through the heart of ten of the most common myths.

1. Women and girls smoke more than men and boys

Women have never smoked more than men. Occasionally, a survey will show one age band where it's the other way around, but from the earliest mass uptake of smoking in the first decades of last century, men streaked out way ahead of women.

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In 1945 in Australia, 72 per cent of men and 26 per cent of women smoked. By 1976, men had fallen to 43 per cent and women had risen to 33 per cent.

As a result, men's tobacco-caused death rates have always been much higher than those of women. Women's lung cancer rates, for example, seem unlikely to reach even half the peak rates that we saw among men in the 1970s.

Currently in Australia, 15 per cent of men and 12 per cent of women smoke daily.

But what about all the "young girls" you can see smoking, I'm always being told. In 2014, 13 per cent of 17-year-old male high school students and 11 per cent of females smoked. In two younger age bands, girls smoked more (by a single percentage point).

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Those who keep on insisting girls smoke more are probably just letting their sexist outrage show about noticing girls' smoking than their ignorance about the data.

2. Quit campaigns don't work on low socioeconomic smokers

In Australia, 11 per cent of those in the highest quintile of economic advantage smoke, compared with 27.6 per cent in the lowest quintile. More than double.

So does this mean that our quit campaigns "don't work" on the least well-off?

Smoking prevalence data reflect two things: the proportion of people who ever smoked, and the proportion who quit.

If we look at the most disadvantaged group, we find that a far higher proportion take up smoking than in their more well-to-do counterparts. Only 39.5 per cent have never smoked compared with 50.4 per cent of the most advantaged - see table 9.2.6).

When it comes to quitting, 46 per cent of the most disadvantaged have quit compared to 66 per cent of the least disadvantaged (see table 9.2.9).

There is a higher percentage of the disadvantaged who smoke mainly because more take it up, not because disadvantaged smokers can't or won't quit. With 27.6 per cent of the most disadvantaged smoking today, the good news is that nearly three-quarters don't. Smoking and disadvantage are hardly inseparable.

3. Scare campaigns 'don't work'

Countless studies have asked ex-smokers why they stopped and current smokers about why they are trying to stop. I have never seen such a study when there was not daylight between the first reason cited (worry about health consequences) and the second most nominated reason (usually cost).

For example, this national US study covering 13 years showed "concern for your own current or future health" was nominated by 91.6 per cent of ex-smokers as the main reason they quit, compared with 58.7 per cent naming expense and 55.7 per cent being concerned about the impact of their smoking on others.

If information and warnings about the dire consequences of smoking "don't work", then from where do all these ex-smokers ever get these top-of-mind concerns? They don't pop into their heads by magic. They encounter them via anti-smoking campaigns, pack warnings, news stories about research and personal experiences with dying family and friends. The scare campaigns work.

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4. Roll-your-own tobacco is more 'natural' than factory made

People who smoke rollies often look you in the eye and tell you that factory made cigarettes are full of chemical additives, while roll-your-own tobacco is "natural" - it's just tobacco. The reasoning here that we are supposed to understand is that it's these chemicals that are the problem, while the tobacco, being "natural", is somehow OK.

This myth was first turned very unceremoniously on its head when New Zealand authorities ordered the tobacco companies to provide them with data on the total weight of additives in factory made cigarettes, roll-your-own and pipe tobacco.

For example, data from 1991 supplied by WD & HO Wills showed that in 879,219kg of cigarettes, there was 1,803kg of additives (0.2%). While in 366,036kg of roll-your-own tobacco, there was 82,456kg of additives (22.5%)!

Roll-your-own tobacco is pickled in flavouring and humectant chemicals, the latter being used to keep the tobacco from drying out when smokers expose the tobacco to the air 20 or more times a day when they remove tobacco to roll up a cigarette.

5. Nearly all people with schizophrenia smoke

It's true that people with mental health problems are much more likely to smoke than those without diagnosed mental health conditions. A meta-analysis of 42 studies on tobacco smoking by those with schizophrenia found an average 62 per cent smoking prevalence (range 14 per cent-88 per cent). But guess which study in these 42 gets cited and quoted far more than any of the others?

If you said the one reporting 88 per cent smoking prevalence you'd be correct. This small 1986 US study of just 277 outpatients with schizophrenia has today been cited a remarkable 1,135 times. With colleagues, I investigated this flagrant example of citation bias (where startling but atypical results stand out in literature searches and get high citations - "wow! This one's got a high number, let's quote that one!").

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By googling "How many schizophrenics smoke", we showed how this percolates into the community via media reports where figures are rounded up in statements such as, "As many as 90 per cent of schizophrenic patients smoke."

Endlessly repeating that "90 per cent" of those with schizophrenia smoke does these people a real disservice. We would not tolerate such inaccuracy about any other group.

6. Everyone knows the risks of smoking

Knowledge about the risks of smoking can exist at four levels:

  • Level 1: having heard that smoking increases health risks.

  • Level 2: being aware that specific diseases are caused by smoking.

  • Level 3: accurately appreciating the meaning, severity, and probabilities of developing tobacco related diseases.

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