The lies ‘social smokers’ tell themselves – and how to give up

Social smokers beware: the health risks you think you’re avoiding are closer than you think. Photo / 123rf

Occasional smokers think the health warnings don’t apply to them, but the odd cigarette is more damaging than you think

Social, casual, non-daily … Whatever you call it, the scourge of the safe smoking fallacy is on the rise – and I’m one of the many in denial.

Smoking on and off since the age of 15, I can go weeks without a cigarette and even when I’m ‘on’ the fags, I mainly smoke when I’m out; this makes it very easy to kid myself that the scary stats and gory pictures don’t apply to a non-regular smoker like me.

But non-regular smoking carries serious risks, prompting researchers at University College London to draw our urgent attention to the unexpected findings of a major UK-wide study. The research was carried out over a 10-year period and reveals that while smoking prevalence in the UK has decreased (good news), the number of non-daily smokers has nearly tripled. But not just that – these casual smokers have no intention of quitting.

“Cigarette smoking is hugely harmful, even for those who don’t smoke every day,” says Dr Sarah Jackson of University College London’s Institute of Epidemiology and Health Care, who is also lead author in the study. “But the trouble is that non-daily smokers hugely underestimate the risks.” Crucially, casual smokers are “uniquely good at spinning stories to justify their habit”, adds Hazel Cheeseman, the chief executive of Action on Smoking and Health (ASH).

I’m an English teacher and ex-journalist so narratives are my stock in trade and oh my goodness, the ones I make up around my smoking habits could be best-sellers. Luckily, I have the scientists to scoff at my sorry little stories.

The story: I can go for months without smoking, so I don’t need help to quit

The truth: “Statistics show that unsupported quit attempts among all types of smokers are the least successful,” Jackson says. I have never considered going to my GP or using a stop-smoking service because of an arrogant belief that they are only for “proper” smokers and that I can give up whenever I want. But if that were the case, why do I always go back?

“Smoking is uniquely addictive and, as with other addictions, external support massively boosts your chances of giving up for good,” Jackson says. She reminds me of the wide range of support available (but in my case ignored). I’m especially interested in varenicline, a daily pill that binds to nicotine receptors in the brain and stops cravings in their tracks; it has just become available through the GP and is being hailed as the “Ozempic for smoking”. Otherwise, there are various nicotine replacement therapies (NRTs) available on prescription, as well as smoking support services that can help you overcome the behavioural challenges associated with smoking.

Non-daily smokers inhale more deeply, making each cigarette more harmful than they realise. Photo / 123rf

The story: I’m in a different category to regular smokers

The truth: Because I smoke occasionally and believe myself to be in control of my smoking, it’s easy to kid myself that I’m not a real smoker and that the number of cigarettes I smoke is insignificant compared to regular smokers. “But casual smokers always smoke more than they think,” says Robert West, a professor emeritus of health psychology at University College London. “And the nicotine and tar intake of non-daily smokers significantly overlaps with daily smokers.”

In addition, non-daily smokers are champions when it comes to what Cheeseman calls compensatory smoking: “All smokers have an established level of nicotine addiction, so when irregular smokers smoke, they do it more efficiently, drawing more out of each cigarette,” she says. Given the first cigarette (after a pause in smoking) “poses the highest risk”, this means that danger for casual smokers is compounded, not curtailed, by their “occasional” habit. For a brief moment, this feels like a licence to smoke every day. And that’s of course when I realise: I’m a smoker. I need to call myself a smoker – nothing casual about it - and seek help accordingly.

Smoking is the leading preventable cause of death worldwide, killing two out of three long-term users. Photo / 123rf

The story: I smoke less, therefore there’s less risk to my health

The truth: All the experts I spoke to pointed out that lungs are “fragile organs” and smoking is “uniquely harmful”. While there is some very small consolation for lighter smokers that cancer risks are dose-dependent, “the risk correlations for cardiovascular and respiratory diseases are non-linear and vary far less between heavy and casual smokers”, according to West.

On top of that, the life expectancy stats for smokers apply to both regular and light users: “There is no other legal product that, when used as intended, will prematurely kill two out of three lifelong users,” says Jackson. “And a user does not have to smoke 20 a day.” If that’s not sobering enough, Jackson points out: “It’s not the decade at the very end of your life that you lose; it’s years off the good bit, since smoking compresses the period of your life that is lived in good health.” Somebody pass me the nicotine patch.

Non-daily smokers are less likely to seek support for quitting, falsely believing they’re not truly addicted. Photo / 123rf

The story: The odd cigarette won’t kill me

The truth: Whether it’s the one that makes it impossible to quit or the one which gives you a stroke, it turns out that each and every cigarette is its own tobacco-stuffed tyrant. “When you inhale, particulate matter enters and thickens the bloodstream, so there’s an acute risk there and then,” explains West, “irrespective of whether you’re a daily or non-daily smoker.”

On a slightly less catastrophic note (though not really), “you never know which cigarette is going to be the one that makes it impossible to quit”, according to Cheeseman. “This is especially true in relation to part-time smokers.” Like me, she says, “they might return to smoking after a period of abstinence, thinking they’ll be able to stop again, but given the highly addictive nature of nicotine, they probably won’t.”

The story: I’m healthy in other respects, so smoking won’t have as much impact

The truth: “It’s great to be healthy in as many aspects as you can,” says Cheeseman, “but smoking poses such a significant risk factor that most smokers, by the time they’re 50, have acquired some sort of harm.” The most common symptom is a cough which people often rationalise as part of getting older, but in fact can be an early sign of chronic obstructive pulmonary disease (COPD). You can live with COPD – but it can also kill you. If you experience a persistent cough, ask your GP for a lung check. And if you do identify as being healthy, then upping your exercise goals can help you quit as smoking becomes a hindrance.

Nicotine replacement therapies (NRTs) are up to twice as effective when paired with behavioural support. Photo / 123rf

The story: Smoking is cool, it’s part of who I am

The truth: Unlike some smokers, I’m not ashamed of my filthy habit. I look forward to that smoke with a pint on a Friday, or the mid-morning cigarette consumed with a coffee when (and only when) on holiday.

But if you like who you are as a smoker, it’s harder to give it up, according to West – and that seems to be the problem with all those non-daily smokers who, according to the research, admit they’re not interested in quitting. Perhaps it’s a little bit of pleasure when times are tough.

In any case we social smokers might think there’s genuine pleasure in the anticipation and smoking of a cigarette, however occasional, but it’s actually the addiction talking. “Such is the power of nicotine that it feels like it’s making you happy,” Jackson says. Instead we’re simply feeding the beast. “All the science proves that people enjoy better mental health when they’re not smoking,” Jackson adds.

In short, whatever stories we non-daily smokers are telling ourselves, they’re all lies. Lies that mask a serious and profound addiction to a substance that we never anticipated, when we started smoking all those years ago, would become a life-long nemesis. So for anyone who puts a cigarette in their mouth and lights it, there’s only one thing to tell yourself: it’s time to stop.

Tips to stop smoking

Seek help to stop smoking and your chances of quitting will increase

• Information about stop smoking services is available on smokefree.org.nz and quit.org.nz
• Book an appointment with your GP to enquire about support services
• Some pharmacists can provide funded Nicotine Replacement Therapy without a prescription
• Know when you’re tempted to smoke (ie on social occasions) and have a strategy, whether it’s an e-cigarette, gum or a simple ‘rule’ that you can invoke, like ‘not a puff’.
• Vapes and e-cigarettes aren’t perfect but they’re ‘far, far less harmful’ than smoking, the experts say. If you’re new to vaping, find one that uses nicotine salts, as the nicotine is coated like it is in cigarettes (albeit in cigarettes it’s coated in toxic chemicals), making it less harsh on your throat.