Understanding Psychology (10th Ed)

 Module 
44 
Psychological Aspects of Illness and Well-Being 
489
FIGURE 2 
Although smoking among teenagers is lower than it was 20 years ago, a 
signifi cant number still report smoking regularly. What factors might account for the 
continued high use of tobacco by teenagers despite the increase in antismoking advertising? 
(Source: Johnston et al., 2009.)
Percent
’76 ’78 ’80 ’82 ’84 ’86 ’88’90 ’92’94’96 ’98 ’00 ’02 ’04 ’06 ’08
Year
100
80
60
40
20
0
8th Grade
10th Grade
12th Grade
quitters can fall off the wagon: About 10% relapse after more than year of avoiding 
cigarettes (Grady & Altman, 2008) .
Among the most effective tools for ending the smoking habit are drugs that 
replace the nicotine found in cigarettes. Whether in the form of gum, patches, nasal 
sprays, or inhalers, these products provide a dose of nicotine that reduces depen-
dence on cigarettes. Another approach is exemplifi ed by the drugs Zyban and Chant-
rix; rather than replacing nicotine, they reduce the pleasure from smoking and 
suppress withdrawal symptoms that smokers experience when they try to stop (Gar-
wood & Potts, 2007; Shiffman, 2007; Brody, 2008). 
Behavioral strategies, which view smoking as a learned habit and concentrate on 
changing the smoking response, can also be effective. Initial “cure” rates of 60% have 
been reported, and one year after treatment more than half of those who quit have 
not resumed smoking. Individual or group counseling also increases the rate of suc-
cess in breaking the habit. The best treatment seems to be a combination of nicotine 
replacement and counseling. What doesn’t work? Going it alone: Only 5% of smok-
ers who quit cold-turkey on their own are successful (Noble, 1999; Rock, 1999; Wood-
ruff, Conway, & Edwards, 2007). 
In the long term, the most effective means of reducing smoking may be changes 
in societal norms and attitudes toward the habit. For instance, many cities and towns 
have made smoking in public places illegal; legislation based on strong popular 
sentiment that bans smoking in places such as college classrooms and buildings is 
being passed with increasing frequency. In addition, smokers are more likely to quit 
when their friends are quitting, so the social support of others quitting is helpful 
(Hamilton, Biener, & Brennan, 2007; Christakis & Fowler, 2008). 
The long-term effect of the barrage of information regarding the negative 
consequences of smoking on people’s health has been substantial; overall, smoking 
has declined over the last two decades, particularly among males. Still, more than 
one-fourth of students enrolled in high school are active smokers by the time they 
graduate, and there is evidence that the decline in smoking is leveling off. Among 
these students, around 10% become active smokers as early as the eighth grade 
(see Figure 2 ; Johnston, O’Malley, & Bachman, 2009; Fichtenberg & Glantz, 2006). 
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