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Smokers misinformed about smoking's link to cancer

November 02, 2005

Fear, worry, and guilt plague female smokers

Women who smoke are more concerned about their habit and their ability to quit than men, yet both genders appear misinformed about smoking and its link to cancer. In a new study presented at CHEST 2005, the 71st annual international scientific assembly of the American College of Chest Physicians (ACCP), the majority of smokers mistakenly believed nicotine causes cancer, leading many to smoke "light" cigarettes because they believed them to be less harmful. Women also were more likely than men to have feelings of guilt, fear, and worry associated with tobacco use and quitting the habit.

"Men who smoke spend little time thinking about their habit and the harmful effects of smoking, especially if they have few physical side effects," said lead author Virginia Reichert, NP, director of the Center for Tobacco Control, North Shore-Long Island Jewish (LIJ) Health System, Great Neck, NY. "Women who smoke seem to have a great deal of anxiety about smoking. They are worried about their health, feel guilty about not quitting, and believe that cigarettes are controlling their lives."

Researchers from North Shore-LIJ surveyed 1,139 smoking patients (482 males and 657 females) involved in a tobacco cessation program to evaluate smoking perceptions between genders. Of the patients questioned, 71.9 percent of women and 59.4 percent of men believed nicotine causes cancer, while 75 percent of women and 64.5 percent of men admitted to worrying that smoking may give them cancer. More women (71.9 percent) than men (63.1 percent) reported smoking "light cigarettes," believing them to be less harmful.

"People smoke to get the addictive drug, nicotine, but the drug alone does not cause cancer. The delivery system, a cigarette full of hundreds of toxic chemicals that are inhaled along with nicotine, does," said Ms. Reichert. "This misinformation leads many smokers to smoke 'light' cigarettes, thinking they will inhale less nicotine. In reality, smokers tend to smoke more light cigarettes and inhale more deeply to get nicotine from light cigarettes, resulting in a significant amount of harmful chemicals being inhaled."

More women than men reported feeling guilty about their smoking habit, 77.2 percent vs 61.7 percent, respectively. In regard to quitting smoking, 41.1 percent of women and 14.6 percent of men reported a "fear of gaining weight," while 17.5 percent of women and 10.7 percent of men reported "fear of failure" at quitting smoking. In addition, 63.1 percent of women and 55 percent of men reported being "worried about managing their stress without cigarettes."

On average, men smoked more "pack years" than women, 33 years vs 27.5 years, respectively, yet showed no difference in nicotine dependence scores. Researchers also found no difference in quit attempts (two for each gender) or in quit rates between genders. Researchers stress that quit success is based on how much a smoker wants to quit the habit and how comfortable the smoker believes he or she will be during the quit process.

"The majority of smokers worry about how they will manage their stress without cigarettes, and many women who smoke worry that they will gain weight if they quit," said Ms. Reichert. "Through a comprehensive, medically supervised quit program that involves behavior modification, pharmacotherapies, and a healthy diet, most smokers who quit can expect to avoid withdrawal symptoms and minimize weight gain."

"Smoking is the number one cause of lung cancer and is a risk factor for numerous other health conditions," said W. Michael Alberts, MD, FCCP, President of the American College of Chest Physicians. "As health-care providers, it is our responsibility to encourage our smoking patients to quit, and when they are ready to quit, refer them to smoking cessation programs that provide comprehensive care."

American College of Chest Physicians