Life After Cigarettes - An Interview With Author Cindy Pomerleau

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Image Courtesy of Cindy Pomerleau

It used to be that smoking was a pastime reserved for men, and the diseases that follow tobacco use were theirs to shoulder as well. Most women didn't smoke, and in fact, women who did smoke were considered to be "naughty" or "racy"...not good girls, certainly.

That all changed in the early 1900's when tobacco companies realized that with a bit of carefully crafted marketing targeted at women, they could coax a lot more revenue out of the population.

Tobacco executives knew that nicotine had two properties that could be nicely matched to concerns common to many women: weight control and mood enhancement.

Clever ad campaigns touting cigarettes as appetite suppressants and anti-depressants were suddenly everywhere, and before long, Big Tobacco had plenty of new customers. After that, women started sharing the burden of smoking-related diseases with men, and death by tobacco became an equal-opportunity killer.

Life After Cigarettes

Dr. Cynthia Pomerleau is the Director of the University of Michigan's Nicotine Research Laboratory, and has been involved in the unique issues that plague women smokers for decades. Her work has led to a book that offers valuable insight into nicotine addiction and how it affects women specifically.

Dr. Pomerleau begins her book, Life After Cigarettes with a historical view into the psychological manipulation tobacco companies have used on women over the years...successfully ingraining misconceptions on the female smoker's psyche so strong they affect women even today.

She goes on to discuss the links between tobacco use and depression, as well as the book's primary topic, smoking cessation and how it can affect a woman's weight.

I recently had the opportunity to ask Dr. Pomerleau a few questions over email about her research and the book that came out of it.

If you could, please give readers some background about how you came to work in the field of nicotine/smoking research.

Dr. Pomerleau: Oddly (or perhaps not so oddly), I first became interested in nicotine addiction and smoking cessation because my husband was (and still is) a leading researcher in the field. He was very work-involved at the time, and I figured if I wanted to see anything of him, I’d better be able to talk about what he was doing. Very quickly, however, I became “hooked” on nicotine research for its own sake. It’s hard to imagine a topic with broader ramifications, ranging from its value as a brain probe to its utility as a model addiction to its devastating consequences for the public health. And because I came to the field with a strong interest in women’s issues independent of smoking (I had coedited a book of oral histories of women physicians, for example), it was natural for me to be attracted to the special problems women face when they attempt to quit.

What do you feel are the major issues women in particular face in overcoming nicotine addiction successfully?

Dr. Pomerleau: Most researchers agree that hard as it is for men to quit, it’s even more difficult for women.

That’s probably because in addition to everything that’s involved in overcoming dependence processes, women are also more prone to depression, disordered eating, and concerns about weight – problems that smoking may hold in check and that can be unmasked by quitting. My main impetus for writing Life After Cigarettes was to focus directly on these issues and help women find effective ways to deal with them.

How have the tobacco companies manipulated women smokers over the years?

Dr. Pomerleau: How much time do you have? :) Here are a couple of outstanding examples of famous (or notorious) ad campaigns.

The tobacco industry has a long tradition of using the twin themes of weight control and women’s emancipation to market their products and attract women to smoking. (You might not see concerns about appearance as going hand-in-hand with freedom and nonconformity, but the tobacco industry has repeatedly shown it can have it both ways.) As early as the 1920s, women were urged to “Reach for a Lucky instead of a sweet.”

The pages of women’s magazines were filled with ads showing a woman (and the occasional man) in front of the shadow of a much stouter person and warned to “Avoid that future shadow.” Lucky Strike also enjoyed remarkable success in expanding the women’s market by persuading a group of fashionable young women to smoke at the 1929 New York Easter Parade, lending a new air of respectability to smoking in public.

Virginia Slims, introduced by Phillip Morris in 1968 just as the second wave of women's liberation was getting into gear, was similarly branded as the cigarette smoked by strong, successful, and slim women. Even those who weren’t around at the time are familiar with the catchy slogan, “You’ve come a long way, baby” – and later, “It’s a woman thing.”

For a more recent example, consider Camel No. 9, with its pretty pink packaging, a name that sounds more like a perfume than a cigarette, and the claim that the product is “light and luscious.” (Excuse me?!) The R.J. Reynolds people say they are trying to persuade women to switch brands. In fact, it’s likely they are also trying (with their aggressive women’s-night-out style promotional activities) to convert occasional (weekend) smokers into dependent daily smokers, to seduce teenagers into smoking, and to capture the attention of little girls who like to totter around in their mothers’ high-heels. (Joe Camel got bad press and a legal spanking for marketing to children, and now he’s history; Camel No. 9 shows that you don’t need cartoon characters to appeal to kids.)

What advice would you give women who are afraid to quit smoking because they don't want to gain weight?

Dr. Pomerleau: As I indicate in Life After Cigarettes, even though many women state that they don’t want to gain even a pound (who does?), I believe the real, bedrock fear is not of putting on a few pounds but of weight spiraling out of control. These fears are fueled by the fact that post-cessation weight gain often starts very shortly after quitting; fortunately, it generally levels off quickly.

If a woman can keep her weight gain within 5-10 pounds, most of her clothes will still fit and her BMI will go up by only a unit or so. This is a very realistic goal and is in fact where the vast majority of quitters end up. Those who substantially exceed these limits may have other problems, such as binge-eating, that emerge when they quit and may require additional help in their own right.

A few women fail to gain weight because they become depressed. Depression can have differing effects on appetite, often increasing it but occasionally suppressing it. If you don’t gain weight because you’re too depressed to eat, that’s a poor trade off. Again, serious depression requires additional help in its own right.

It is possible to gain no weight but that will require dropping a few calories per day in a context where most people tend to add a few calories per day and/or increasing the amount of exercise you get. These are positive goals and if they can be achieved, so much the better.

What perspectives can you share to help women change their relationship to smoking and embrace a life that is truly free of any desire to smoke?

Dr. Pomerleau: The short-term goal is to become an ex-smoker – someone who used to smoke but doesn’t anymore. The long-term goal is to become a non-smoker – someone whose life is not controlled, even for a moment, by thoughts and feelings about smoking.

How to make this transition? Be prepared to give it some time. When you first quit, you are acutely aware of missing and craving cigarettes. You may have mood swings, flashes of anger, and hunger attacks. These start to subside after a few days (though unfortunately for the weight-conscious woman, increased appetite is one of the more persistent withdrawal effects). Eventually they fade into the background so that you can go for increasingly longer periods of time without thinking about cigarettes.

How long it takes to reach that point varies from person to person, as does the occurrence of setbacks triggered by stress or exposure to smoking cues (e.g., people or events associated with smoking in the past). You can ease things along by developing your own personal set of tricks and techniques for keeping intrusive thoughts at bay, managing your weight, and jollying yourself up when you feel blue. A brief bout of exercise, a single piece of dark chocolate, or a side-splitting movie, well timed, can do wonders. Experiment to find what works for you.

Eventually, with time and practice, you’ll find yourself focusing not on what you’ve lost, not even on what you’ve gained, but on your life here and now. You’ll experience the joy of long walks without half your mind planning your next smoke; of coffee breaks spent sharing confidences, not cigarettes; of precious moments with your child or grandchild, fully attentive and undistracted by a vague “something else” tugging at your consciousness. That is what I refer to in Life After Cigarettes as “the chic of quitting.” It’s a good feeling.

From About.com Smoking Cessation expert, Terry Martin:

As a woman who lost more than one quit attempt due to smoking cessation-related weight gain, I know how much putting on weight can hurt a person's motivation to stay smoke-free.

Cynthia Pomerleau's insightful book not only educates us about the issues women face with nicotine addiction, it lights a fire under our desire to free ourselves from the shackles tobacco keeps us in.

If You Want to Change Your Life, Change Your Mind

You can abstain from smoking for years, but if you never change the relationship you have with cigarettes, nicotine addiction will continue to hold you tight. Change the way you think and you can free yourself in an instant. You'll still have to do the work to undo the years of habit of course, but once you free your mind, you are on your way.

Dr. Pomerleau's gem of a book should be required reading for any woman who wants to find her way to a permanent change of mindset about smoking. It lays the groundwork for successful smoking cessation through education, sound advice and positive support.

Most importantly, this book shows us that indeed there is a life worth living after cigarettes, one that is achievable for each and every one of us.

If you're still smoking, pick up a copy of Cynthia's book today, and start reading. It will change your mind, and from there...your life.

Full Disclosure from Terry Martin: Cynthia uses several quotes from my quit story -- and those of other women who have quit smoking successfully -- in the last section of her book.

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