Women Smokers -- Gambling With Their Lives

Young women and a deadly habit. Can they finally quit smoking?

Deadly Trend

A dozen twentysomethings gathered in a Manhattan bar. Two were med students, another a PhD candidate at an Ivy League university, and the rest young professionals making their way in the big city. They were the image of health and fitness, except for one thing -- 10 of the 12 were smokers.

Young people are lighting up in large numbers, especially those 18 to 24. One in five women in this age group nationwide is a smoker, a figure that has held fairly steady for the past few years. Some blame the billions that cigarette companies spend on marketing each year ($13 billion in '05), including promotions geared toward young adults. Girls are especially influenced by the glamorous images of smokers in movies and shows like Sex and the City, and many of them have heard that smoking can keep them thin. A 2002 CDC study found that high school girls who were trying to lose weight were 40 percent more likely to smoke than their peers who weren't.

And teenage girls who start dieting are nearly twice as likely to start smoking as those who aren't trying to slim down, according to a 2007 study.

Girls are also swayed by celebrities and models who smoke to stay thin. Smoking among female lead characters in movies nearly tripled from the 1960s to the late 1990s, and tabloids run candid shots of A-listers puffing away. Supermodel Naomi Campbell once told a reporter, "I never diet. I smoke." Actress Cheryl Ladd admits she smoked for 23 years to stay thin, and it was reported Gisele Bündchen gained 15 pounds when she quit.

Add to this the invincibility factor. Every day, about 4,000 young people take their first puff, and, as 24-year-old Katie Laster did, some 1,300 become daily smokers. They know the health risks, but they just don't care.

"When you're young, you think nothing bad is going to happen to you," says Laster, who started smoking when she was 19. She's trying to quit, but it's not about health. "It's horrible, but I'm more concerned about my looks," she says. "It's not so much 'I'm going to get cancer.' It's more or less 'I'm going to get wrinkles.' I need to quit because this is really affecting my appearance."

Laster, who does freelance promotions and marketing work in Los Angeles, smoked up to half a pack a day yet never considered herself a smoker. On her MySpace page, in response to the question "Do you smoke?" Laster says no. "I say no because everyone does it, but no one likes to admit they do. It's really not attractive.

"I know this is not good for me, and it doesn't make me feel good," she admits. "I wake up in the morning and I feel gross. Every time I smoke, I think, This will be my last one." But it never is, and she doesn't think her habit is bad enough to warrant a nicotine patch or prescription drugs.

Part-Time Habit

Laster's experience is all too familiar, says Tom Glynn, PhD, director of the Cancer Science and Trends division of the American Cancer Society. "Over the past decade, we don't see as much daily smoking as we used to. What we're seeing is more sporadic smokers. They don't define themselves as smokers, because they only smoke on the weekends or when they go to a bar. Young smokers say, 'I know you can get cancer and heart disease, but those are things older people get, and I'm not going to be smoking when I'm older, so I don't have to worry.'"

The problem with that, says Glynn, is twofold: Quitting isn't as easy as they think it will be, even for social smokers. And there are health effects that show up early. Young people who smoke, and women especially, are more susceptible to respiratory ailments such as bronchitis and emphysema. And they'll feel the effects of these problems sooner than they'll realize the potential for cancer or heart disease.

Today's young smokers aren't ignorant or naive about the effects of nicotine. "Sometimes I wish I were more of an idiot," says 29-year-old Victoria Tucker, an administrative specialist for a management consulting company in Atlanta. "I'm smart enough to know all the bad things smoking does to me, but still I do it." She notices an effect on her health (recently, after a day of heavy smoking, she lost her voice) but isn't always willing to admit it's due to her habit. "I can always find another thing that's a contributing factor." There's the beer she drank, her asthma and stress, to name a few.

Tucker had her first cigarette at a party when she was 16. A week later, she had another, and even though she swore she'd never become a smoker, that was the start of her pack-a-day habit. "You know all along that you need to quit," she says. She came close last year; with the help of a new drug, she was down to one cigarette a day. "But the minute you say, 'I'm not going to smoke anymore—this is killing me,' you start freaking out."

Fear Factor
In the past few years, Tucker lost her father, aunt and uncle, all to heart-related illnesses. "The mortality of my family has become very clear to me. Almost no one in my family has made it past 56 years old. We're dropping like flies, and I basically have about 25 years left to live if we're going by their numbers. I don't even know if I want to get married, but I want the shot."

So she's given herself a deadline: "I want to celebrate my 30th birthday and not smoke a cigarette on that day—or ever again." To do that, she's going back on the drug. But she'll do whatever else it takes: "If I had the opportunity, I'd go down to the morgue and look at the lungs of a smoker so I could see what mine look like. I am scaring myself into this."

Fear does play a role in quitting. "It's like the angel and the devil on your shoulder, and one of them's up there puffing away," Tucker says. "Your body is saying, 'What else is going to make you feel good like that?'"

For many, that search for something else leads to weight gain. Some people end up stuffing themselves with food to replace the cigarettes. "Many young women smoke because they want to maintain a certain body image or are afraid to stop because they'll gain weight," says Tom Glynn. The average weight gain for quitters, though, is less than ten pounds. "You don't want to gain five pounds, but you'd have to gain a whole lot more to make the weight gain do the same damage that continuing to smoke will do," he says.

Tucker recently lost 25 pounds, and while she would never have thought about the weight issue a few years ago, "now I'm terrified to quit, because if all the weight comes back in four weeks, I'm going to be really upset."

Mind Games

Alex Leo, a 25-year-old editor in New York City, started smoking during the summer she spent in France when she was 14.

"Everybody smoked. It was just a habit I picked up," she says. By the end of the year, she was up to a pack a day and continued to puff away for the next ten years. But her reason for quitting is more psychological. "Smoking is a way of removing yourself from the reality of a situation. You don't really take care of yourself as a smoker," she says. "You're always waiting for your next cigarette. My apartment was smoky, so I never cooked, and I'd sit around and smoke as opposed to joining that guitar class or dance class I'd always wanted to take."

Leo has tried to quit "dozens and dozens of times." This time, she's also cutting out alcohol, since the two are intertwined for her. "I realize now how much of my life has been dictated by smoking. You have to arrange your schedule to make sure you have cigarettes and that you can be in a place where you can smoke."

Quitting isn't really about her health. "It's always there in the background, but it's harder to quit for a negative reason," she says. She's going cold turkey, as she has in the past. "I've gone a month or two without smoking, but I always knew I was going to start again, like when I quit before I ran the New York City Marathon. I told myself I just had to stop for a while, which made it easy, because I knew I wasn't giving it up forever."

She's trying not to focus on the possibility of weight gain. "I read in Allen Carr's Easy Way to Stop Smoking that when you see quitting as a deprivation, you're going to want to replace it with something, like food. If you don't, you won't," she says. So she's staying positive: "I see it not as something I'm denying myself but as something I'm giving myself. It's much easier to quit when you realize there's something hopeful in the future," says Leo. "And the hope for me is having a better life."

Progress Report
When she was interviewed for this article, Katie Laster had gone a week without smoking. But three weeks later, she'd fallen off track. She's still trying to quit. Victoria Tucker went back on the prescription drug, and two weeks before her 30th birthday deadline, she was down to one cigarette a day, and none on some days. And Alex Leo had been smoke-free for a few weeks, but she slipped only weeks later, "just falling back into old patterns," as she says. "It's hard to form your life without cigarettes when you started smoking at age 14." But at press time, Leo had been smoke-free for three weeks and remains determined. While it's a tough road ahead, all three women are confident they'll succeed.

Success Story
Jessica Rowbotham's nine-year habit came to a screeching halt last year when she learned she was having a baby. "Being a nurse," says the 29-year-old from Verona, New Jersey, "I knew the health ramifications. But it was still appealing. I was nervous about weight gain, and I truly enjoyed smoking."

Still, she always made mental quit dates: when she finished nursing school, when she took her boards, when she got married and the one that worked: pregnancy. "I'm doing it more for the baby than for me, but I would love not to go back to smoking," she says.

Her daughter was born on October 2, and a month later, Rowbotham was still smoke-free. "I've been too busy to smoke," she says. "If I have a free second, I'd rather eat, sleep or go to the bathroom."

Advice on Quitting Smoking

Quitting Time
Kicking the habit cold turkey is hard and doesn't work for most people. But quitting is possible. "Remember, if you slip -- and most people do -- it's not a failure. It's just part of the process," says Tom Glynn, PhD, of the American Cancer Society. Examine the reason it happened (you were out with friends, you were drinking) and eliminate it.

Glynn's Tips on How to Quit
l. Pick a quit date, at least two to four weeks in advance.

2. Ask your doctor whether drugs could help. There are seven FDA-approved meds, from patches and gums that replace the nicotine to pills that reduce the high.

3. Clean house. Get rid of all your smoking paraphernalia: matches, ashtrays, etc.

4. Tell friends and family you're doing this and that you may be grouchy. Ask for their support and that they not smoke around you for a bit.

5. Smoke your last cigarette. Within 20 minutes, heart rate and blood pressure decrease. In 12 hours, the carbon monoxide in your blood goes back to normal. And within a week, your senses of smell and taste improve.

Print a Customizable Quit Smoking Plan

Visit cancer.org for more tips.