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Addicted to "Getting Normal"

"Who is likely to take up smoking at a time when its risks have been publicized as never before?" 

Where tobacco is concerned, I seem to meet only two sorts of people these days: the self-righteous and the surly. People once smoked everywhere—casually, undefensively, invisibly—but smoking is now, in my circles at least, a public and provocative act, loaded with overtones. What a shame. For whether one sees smoking as sexy or merely macho, daring or stupidly risky, individualistic or compulsive, "this nothing activity, so slight it's hardly there" holds in it the seeds of a rich conversation that could change the way we think about addiction and human behavior.

In this complicated political and social climate, David Krogh's clearheaded exploration of who smokes and why comes as a relief and a stimulus (exactly the qualities, by the way, for which people turn to nicotine). Smoking: The Artificial Passion manages to lay out the current research on smoking without a trace of the condescension that infuriates the 50 million smokers who make up roughly a quarter of American adults. In fact, so intelligent, witty, and compassionate is his description of the nicotine addiction that I was still asking myself at book's end if Krogh, an editor and science writer who works for the University of California, might once himself have smoked.

I wouldn't be surprised, because—for reasons Krogh methodically explores—a lot of writers do smoke. One of the most appealing qualities of this substance—an acrid weed, after all, whose taste and harshness tobacco companies spend millions to disguise—is that it appears to enhance one's ability to concentrate and to process information over a prolonged period. Among those who sit at a typewriter hour after hour—as among factory workers and truck drivers and data processors—nicotine actually seems to improve job performance, returning them to normal from states as various as boredom, depression, anxiety, and stress. These positive effects are compounded by the physical routines of smoking—the tiny habitual acts of lighting up, dragging, stubbing out the butt—which substitute for distracting activities toward which the worker might otherwise wander. Unlike any other psychoactive drug except caffeine, tobacco commands a powerful and positive position in the workplace. But unlike caffeine (probably the world's most popular drug), nicotine is wildly addictive.

Moreover, as everybody knows by now, smoking kills you. David Krogh does not grind this point home with images of blackened lungs and weakened hearts; he merely reminds us that more Americans die daily from the effects of smoking than from any other drug, accident, or crime. His principal purpose, however, is to explore why people use nicotine—and from there he turns to the more encompassing and fascinating question of drug addiction itself. The urge to use tobacco, Krogh argues, is equal to the strongest of other substance addictions, partly because of the overwhelming number of behaviors smokers associate it with, and partly for complex neurobiological reasons that may link all drug addictions in the pleasurable effects they produce. In the end this book is as much about the ways psychology and biology combine to form addiction as it is about the particular "enslaving weed" itself.

People use "workplace drugs" like tobacco, Valium, and caffeine, Krogh says, not so much to induce an exotic sensation as to deal with the stresses and strains that make us less ourselves—not to get high, that is, but to "get normal." What is particularly startling about nicotine is its ability to moderate states of mind and body on both ends of the scale: it relaxes you if you're tense, mildly stimulates you if you're below par. Cigarettes are useful in other ways, too: they can signal erotic availability, hostility, or any number of other states one might want to advertise. Smoking keeps one's weight down, partly by increasing metabolic activity; smokers weigh about seven pounds less, on average, than nonsmokers. And it feels good, once you get used to it—not only the nicotine's physical effects but the sensual suck at the lips, the pleasurable scratch in the airways, the satisfying feel of something held in the fingers, "doing nothing while still doing something," as Krogh puts it. Who wouldn't get attached to such a drug, cheap and legal as it is? Who wouldn't mourn it like a lost love when the time comes to quit?

Krogh answers these questions by sorting through the studies of who smokes, when they start, and what happens when they try to stop. Although smoking is steadily on the decline in the United States (from 40 percent of adults in 1964 to 27 percent today), it remains fairly constant across age groups and impervious to economic and emotional changes. Most smokers start in adolescence or young adulthood, work up to a tolerance level of about a pack a day, and hold that pattern for years or even a lifetime. Seventy-five percent of quitters relapse within a year, the same rate as for heroin addicts and alcoholics. The figures hold so steady, Krogh reminds us, because nicotine creates a physical dependence; smokers who cut down on the number of cigarettes with compensate by increasing the number of drags they take on each. (Many smokers of "low-tar, low-nicotine" cigarettes habitually block the air holes in the filters, intensifying the nicotine they get to the point that they might as well be smoking Camels.) Withdrawal symptoms are intense and immediate, and even when the hardest first few days are over, the ex-smoker faces years of intermittent cravings to smoke. Obviously, the most effective line of attack against smoking in our society is to persuade people not to start.

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