Why Can’t We Quit?
Have you all been watching AMC's Mad Men
, the TV series about a Madison Avenue advertising firm in 1960? The premise explores the lofty question of how we create truth — and sell falsehood. We follow the power of sex, ethnicity and money through each episode. The women wear bullet bras, and the men swill bourbon from bottles kept in their desks.
But what struck me from the beginning is how much they all smoke.
I grew up a decade later and a coast away from the world depicted in Mad Men, but I remember the prevalence of tobacco. Both my parents were smokers, and our house was filled with ashtrays of lipsticked cigarette butts. The one thing I remember about a favorite babysitter is that she always had candy cigarettes for my sister and me. In hindsight, I realize that the red splotch at the end of each sugar stick was meant to be the burning end. As a kid, I thought it was my lipstick mark, a sign of grown-up sophistication.
Today is the American Cancer Society's Great American Smokeout, a challenge to all U.S. residents to quit smoking. Do people really still smoke? We rarely see smoking represented in popular culture these days; that's why the Mad Men set is so striking.
Apparently though, we do still smoke. I saw two news items last week that each became more interesting in light of the other.
- The number of U.S. smokers has remained steady over the past 2 years at around 21%.
- Oregon voters defeated a tobacco tax that would have paid for insurance coverage for 100,000 uninsured children who don't qualify for Medicaid.
The November 9 issue of Morbidity and Mortality Weekly reports that smokers don't seem to be quitting. After a drop in smoking rates between 1997 and 2004, the prevalence didn't change significantly from 2004 to 2006, with 80% of smokers reporting that they smoke every day.
And the day after last week's elections, BusinessWeek reported that the Oregon bill was being defeated with 60% of voters against the tobacco tax and 40% in favor. The proposal would have added 84.5 cents to the price of a pack of cigarettes, raising it to $2.02, one of the highest rates in the United States, according to BusinessWeek. It would also have raised about $150 million in the first year and a half for nonsmokers' health care.
No one knows whether the nay votes were smokers, but Gov. Ted Kulongoski attributed the defeat to a $12 million ad campaign rolled out by cigarette manufacturers. Of course, voters may simply have objected to paying part of the costs of health insurance for children whose families make between $41,000 and $62,000 annually — after all, even on Mad Men some of the young copywriters truly backed Nixon over Kennedy.
ADVANCE subscribers who are interested in helping patients quit smoking can check out these recent articles:
Real Solutions for Real Life. Smoking Cessation in Today's Busy Practice Settings.
Smoking Cessation. A Protocol for Adolescents.