'Chippers' Challenge Concepts Of Smoking Addiction

A number of surveys show that a substantial proportion of U.S. smokers don't smoke every day. And their ranks appear to be growing. Up to 15 million U.S. smokers say they don't light up on a daily basis. Many of them say they are trying to quit.

But many light smokers — called intermittent smokers, or chippers — have no wish to quit. These are people who smoke no more than a couple of cigarettes a day, says Saul Shiffman, a professor at the University of Pittsburgh's Department of Psychology.

Defining Chippers

Until recently, not much was known about them. Most research focused on heavy smokers, people who had between 10 and 20 cigarettes a day. These are people who Shiffman says smoke anywhere they can — "when they are stressed, when they are happy, when they're eating, when they're not eating, when they're working, when they are relaxing."

Chippers are different; they have particular situations and places where they smoke, Shiffman says. Some, but not all, are social smokers.

"For some people, it may be that social setting of drinking at a bar with friends who are also smoking. For someone else, it may be with coffee by themselves in the morning," Shiffman says. That may be what keeps smoking from pervading their whole lives, and limits how much they smoke.

With the current restraints on smoking, he sees intermittent smoking becoming the dominant pattern of smoking. Light and intermittent smokers are most prevalent in states with the strongest tobacco-control policies.

What's Normal?

It's also quite possible that the nondaily, occasional smoker is the normal pattern.

In developing countries, occasional smoking appears to be the dominant pattern. For example, a World Health Organization study of Central American countries found that two-thirds of smokers there are nondaily smokers. People in poor countries, Shiffman points out, can't afford to smoke every day.

Light smokers also challenge concepts of addiction, because they can go for extended periods of time without a cigarette and not experience withdrawal symptoms. "If you ask the stereotypical regular smoker not to smoke for two hours or 12 days," Shiffman says, "they get anxious, have trouble concentrating, and will — if you will — be dying for a cigarette." Occasional smokers are not addicted in that way.

Others are not so sure. Dr. Joseph Difranza is a professor of family health at the University of Massachusetts' Medical School in Worcester, Mass. "If people have no craving for cigarettes outside that special situation where they're drinking in a bar, and they can go weeks without a cigarette and it doesn't interrupt their thoughts that they need a cigarette," he says, "then they probably have no addiction."

Signs Of An Addict

But Difranza works with a lot of patients who want to quit smoking and can't. They come in all stripes, from people who smoke once a week to those who go through three packs a day.

"Most of the nondaily smokers are daily smokers who have cut back and they keep cutting back, and that's as far as they can get. They haven't been able to give it up completely," Difranza says.

The number of cigarettes a person smokes in a day or a week is no indication of how difficult it will be for them to quit smoking. If you want to kick the habit and can't, that's a sure sign for Difranza that you are addicted to nicotine.

MRIs of the brains of smokers show that nicotine activates billions of receptors, releasing chemicals such as serotonin, dopamine and dozens of other chemicals that fire up other nerves, creating a cascading effect.

That is why Difranza thinks that true nonaddicted smokers make up a fraction of people who smoke — about 5 percent. The brain is changed by nicotine, he says, and harbors memories of the smoking experience.

"You also have the heat of the smoke, you have the taste, you have the physical component of taking a deep breath and holding it in and letting it out," Difranza says. "And all these other physical aspects of taking in the nicotine with the cigarette help stimulate the brain also. Because maybe over thousands of repetitions of smoking, the cigarette has been paired or coupled with these physical sensations of the smoke."

It is the overall smoking experience that explains why nicotine in the form of gum, patches or pills is not entirely effective in getting smokers to quit. People lapse many times when they try to quit completely. It can take up to three months for the mind to settle down and the cravings for nicotine to go away.

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