The power of choice

Ever wondered how people make a conscious decision to take up a maladaptive habit that is severely counterintuitive to being healthy? Studies reveal that most cigarette smokers scored lower on conscientiousness and agreeableness, with a higher score on extraversion, writes Rashikkha Ra Iyer

Often considered to be typical of the “cool kids’ club”, teenagers most often resort to smoking to conform to peer pressure or what’s limned as glamorous. However, is that even as cogent as one might think? A study by John S Seiter et al. (2010) examined people’s perception of smokers, in terms of specific attributes such as attractiveness, likeability, cleanliness, health and credibility. This study yielded results that meant, smokers were perceived in a less favourable image in all categories, except for credibility. One might wonder, do you have to be a smoker to perceive a smoker as someone who is attractive?

A study by John R Beech and James Whittaker (2001), indicated that participants who were smokers themselves rated smoking models as attractive and likeable while the non-smoking participants rated the smoking models as less intelligent and less attractive in comparison to the non-smoking models. Yet there remains a significant number of existing smokers and new ones who pick up a penchant for it every day.

Our bones throughout the body receive intense scaffolding and support by bone tissues which act as the main catalyst in the repair, restoration, and recuperation of any damage to the skeleton. Coupled with that, bone tissues also support the regulation of phosphorous and calcium throughout the body. Smoking has a direct effect on bone tissue.

Bone metabolism is maintained by osteogenesis and angiogenesis. Nicotine has an inhibitory effect on both these processes which can consequently lead to cell death. All these are also linked to bone density. Lots of studies point to confounding factors which exacerbate these risks. This establishes that activities performed in conjunction with smoking furthers the risks associated with bone health. For instance, most smokers also have a co-occurring dependence on alcohol. Consumption of more than four glasses of alcohol in a day increases the risk of fracture. Smokers also tend to perform less physical exercise and dietary intakes may not include optimal levels of dietary calcium.

With more studies and results being published, one might wonder, how do people still smoke? How do they still make a conscious choice to take up a maladaptive habit that is severely counterintuitive to being healthy? Even the cigarette packaging has some saddening gut-wrenching images of how smoking can degrade the body. How does this not serve as a deterrent? Here’s where the good old discussion about personality traits and their influence on lifestyle choices comes into context.

Data from the Survey of Health, Ageing and Retirement in Europe (SHARE), which spans a sample population from 11 European countries and older adults, indicates results that are food for thought. Most cigarette smokers scored lower on conscientiousness and agreeableness, with a higher score on extraversion. This means that cigarette smokers enjoy the immediate effects of smoking, which feeds their sense of impulse and social acceptedness, whilst less focused on the long-term health effects. Contrarily, cigar smokers scored higher in openness and lower in neuroticism, which could mean viewing smoking as a symbol of social sophistication. This not only indicates that smoking is related to personality traits but also that personality traits are intricately intertwined with the choice of smoking.

This in turn would have important implications for the success of a smoking cessation programme.

This highlights the importance of why psycho-social interventions as a part of smoking cessation programmes should be imbued and tailor-made with specific service user’s psychological profiles.

(The author is a multidisciplinary professional who works in the UK.)