Smokers quit in groups
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When smokers decide to kick the habit, odds are they are not alone in making that decision. New research shows that social ties play a key role in smoking behavior and if a close associate or relative, or even a distant one, stops smoking, a person’s odds of quitting increase.
“We’ve found that when you analyze large social networks, entire pockets of people who might not know each other all quit smoking at once,” Dr. Nicholas A. Christakis, from Harvard Medical School in Boston, who was involved in the study, said in a statement.
There has been a marked drop in smoking prevalence in the US and “network phenomena” are likely to be involved in this trend, Christakis and co-investigator Dr. James H. Fowler of the University of California, San Diego, note a report in Thursday’s issue of The New England Journal of Medicine.
The researchers analyzed changes in smoking behavior over the past three decades within a large interconnected social network of more than 12,000 people from the Framingham Heart Study.
They identified clusters of smokers and nonsmokers within the network and found that they extended to three degrees of separation. Although smoking prevalence fell in the overall population, the size of “smoking clusters” changed little, suggesting that groups of people were quitting together.
When a husband or wife quit, it decreased the odds of their spouse smoking by 67 percent. When a sibling quit, it reduced the chance of smoking by 25 percent among their brothers and sisters. A friend quitting decreased the chance of smoking by 36 percent among their friends.
In small businesses, smoking cessation by a coworker decreased a person’s odds of smoking by 34 percent.
“Interestingly, geography did not appear to play a role because smoking behaviors spread between contacts living miles apart and in separate households,” Christakis said. “Rather, the closeness of the relationship in the network was key to the spread of smoking behaviors.”
The study findings also provide evidence that smokers are increasingly marginalized socially. “In the early 1970s,” Fowler noted in a statement, “it was completely irrelevant if you smoked. You could be central in your circle and be connected to lots of other people who were similarly central. You could be popular, in other words. By the 2000s, it had become highly relevant: If you smoked, you would, in some sense, be shunned.”
In a statement, Dr. Richard Suzman, director of the National Institute on Aging’s Division of Behavioral and Social Research said: “This study has an essential public health message—that no one is an island—our health is partially determined by our social networks and those around us. The decision to quit smoking cascaded throughout the web, indicating that some form of collective decision-making was taking place.”
The results,” said Suzman, “suggest new and probably more powerful approaches to changing health behaviors, such as smoking, by careful targeting of small peer groups as well as single individuals.”
SOURCE: The New England Journal of Medicine, May 22, 2008.
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