Smoking is now such a well-known health risk80 that it is disconcerting to hear it asserted that some people’s lives are such that smoking is a necessity. The health consequences seem to be discounted because they only accrue in the long term.
14 A lot of people have the “It won’t happen to me” way of looking at things, so I suppose they will be the same about their health. Most of them are living lives where they have to smoke, it’s the only pleasure that they get. They are all living for today, they have enough to worry about for the day, never mind the future. They don’t view things in the long term at all. (Council services)
One respondent implied that all the publicity about the harmful effects of smoking might be being overpowered by all the publicity about the ever multiplying cures at the disposal of doctors. Otherwise it would be hard to make sense of this kind of behaviour.
21 ‘Healthy’ is what you are unless you are ill. They don’t think about who is responsible for health, but I would expect that if you were to ask them, it would be up to the doctor. I reckon the doctors are not entirely without blame; the medicalization of everything has encouraged that kind of attitude. They want a cure for everything, they go demanding something for their asthma and light a fag as soon as they get out. They expect the doctor to do something and there is a lot of anger if they don’t, or if they put the responsibility firmly back on to them. (Youth worker)
Some respondents reportedly had the long-term consequences of smoking demonstrating themselves in front of their eyes, in the form of older family members with smoking-related disease, but still found themselves unable to shake off the addiction.
32 My dad has serious lung problems, so he has had to stop smoking, the doctors have told him that his lungs will collapse if he doesn’t. Everyone in my dad’s family have lung problems, my uncle has had a bit of his lung removed from cancer. I’ve smoked since I was about nine or ten, at Primary school anyway. Everyone that I know smokes, my friends all did and my family. I suppose in the first place I did it to look good, now I do it because I can’t stop. I don’t smoke much though, maybe 10-15 a day. I wish I could give up, for the money. Nothing I could do would make any difference to my health, I don’t think, lung problems seem to be in my family. (Single parent, 20)
One health consequence that could manifest itself very quickly in the smoker’s environment was children’s asthma. Again, at least in the following case, the health beliefs about the connection between the two could bear investigation. If the belief that smoking ‘helps’ asthma is as widely diffused as the belief that dentists don’t like to see young children, some targeted health promotion work may be in order.
33 Her [baby, 18 months] asthma is still pretty bad, it isn’t affected by smoking I don’t think, because everyone smokes in this house and not everyone has asthma. Well, my big sister has it, but she doesn’t live here and [sister #2] and [sister #3] have it and they don’t live here now, so I don’t think it can be that. Mum has it; her chest is pretty bad, she can’t walk to [sister #3’s] any more, she has to get a taxi, but it’s not so easy to give up, you know. The doctor has told her about it and to lose weight, but that’s all very well for him to say. She has lost weight, she used to be about 17 stone, she’s lost 3 stone in the last few years. She’s trying to get her weight down for her lungs.
I smoked when I was younger, but I gave up when I was pregnant with [daughter, 3]. I used to smoke a lot when I was really depressed, my mum and [sister 3] do it to help their asthma. I don’t have the money now. I’m needing all I’ve got for my messages tomorrow. I get fags every day. Sometimes, I’ll share a packet with mum, if we’re really hard up. (Married mother, 19]
38 Being healthy? I don’t know really, smoking and that sort of stuff. We’ve tried to cut down the fags, we only have about 15 a day now. He [partner] had asthma as a baby, so it doesn’t surprise me that [son, 7months] has got it. (single parent, 19]
One professional explored the question of how people viewed their responsibility for their health and that of their children, but in doing so admitted that he was one of the addicted.
4 People fail to see that they have a responsibility for themselves. You see it with health. Well most folk don’t see their health, but people might bother for their kids. I try to be more careful since I feel a sense of responsibility to [daughter] and [son]. But I still smoke, I suppose I feel inadequate if I admit that I am addicted, so it’s easier all round if I pretend that I actually want to do it. It’s a trade off. “At least I’m not as bad as…” I’ve heard so many people describe their health in that way. They don’t seem to realize that it doesn’t matter what others are doing, but people can always justify their own behaviour. (social worker)
Given nicotine’s addictive property, not everyone can give up when they are pregnant.
35 We both smoke, but not in the living room, we smoke in the kitchen to be away from him [son, 2]. I leave the door open a bit, so I can see what he’s up to. All [partner’s] family smoke, his mum and dad and his dad’s wife – his parents are divorced and his dad married again recently. I couldn’t give up when I was pregnant, I’d smoked since I was 15 or 16, but I cut right down to 5 or 6 a day. I don’t smoke much now, maybe 10 or 15. (married mother, 20)
Being a young starter seems to be highly associated with having older smokers in the family81.
31 I started smoking about two years ago [at age 15]. I was bored I suppose. I don’t really know why I took it up, but my mum and dad both smoke. I wish now that I could give up. (Single mother, 17)
42 Parents don’t seem to take the upper hand with their kids, to prevent their dangerous behaviour. It starts with children picking up bad habits when they are really young. You hear kids swearing or mimicking their parents smoking and everybody laughs. They are all saying “What’s he like!!” (Police officer)
This 16 year old was actually an extremely young starter; however, at an age when, ‘older and wiser’, she needed less reinforcement for her self-image, the family norm of non-smoking asserted itself and she gave it up.
23 I did smoke in primary, for the look of it. Everybody I mucked about with tried it to look good82. I didn’t inhale though. I always hid it from my dad, he would go mad if he knew. Nobody in our family smoked, I would have got into serious trouble. I gave up for a while and then I started again in 3rd year. I only did it for a couple of months and then I stopped. I haven’t smoked since. I began to realize that I didn’t have to pretend to be something that I’m not. I asked myself and my pals, What does it do for you? Nothing. So there was no point. It wasn’t a big deal to give up. The people I went around with, I had different friends, they didn’t smoke and I didn’t need to pretend to be like them. I suppose I just got older and wiser.
Even a group of school-age mothers did not take up the offer of help in giving up smoking, despite the fact that it came at the same time as it became all but impossible to smoke in their daytime environment.
20 Recently we’ve had to bring in the no smoking policy that has come from higher up. It used to be that they could stand outside and have a fag, but they can’t even do that now. Most of them have been really good about it. We’ve offered them support to give up, but that’s not what they want. They will just make up for what they miss later on at night or whatever. (Education service)
One local observer put smoking into a psycho-social context of people with lots of time and little motivation to be active about filling it, which lack of motivation we have seen elsewhere he attributed to poverty and lack of education. The telly filled the mind and smoking satisfied the body.
41 There is this lack of motivation. They sit about, just sit about and smoke and watch telly. There is this lethargy about life. (Minister of religion)
