subscribe | advertise | about | contact | home

Smoke Screen
by Roberta Greenwood

Christie Driskell speaks with a distinctive, slightly raspy voice. “I was playing the best tennis of my life when I was diagnosed with tongue cancer,” she says softly. “Even when my mother was diagnosed with a smoking-related illness, I didn’t stop. Neither did she. She’d remove her oxygen mask to smoke and I smoked right along with her.”

The irony of her mother’s death and her own cancer diagnosis five years ago isn’t lost on Driskell. A smoker since the age of 13, she’s a Seattle therapist, active in promoting smoking cessation programs throughout the state. Driskell always believed that if her smoking caused any health problems, she’d simply quit. A highly competitive athlete for over 40 years, Driskell didn’t suffer from the typical respiratory illnesses that afflict most smokers, so she believed she’d beaten the odds.

She hadn’t. Diagnosed with tongue cancer during her mother’s illness, Driskell quit smoking for the last time the night before her first visit to her oncologist. “I finally quit because it was such a done thing; I knew the terror I was facing. I quit because if I didn’t, I was going to die.” Driskell joined the growing number of women who deal with the horrific effects of smoking – numbers that are increasing even as the total number of smokers in the U.S. has declined. This shocking increase in women smokers has medical experts concerned and Driskell says it’s time to do something radical.

“If we took the over 4,000 chemicals, toxins and poisons contained in cigarettes, rolled them into a bomb and dropped it on a major U.S. city – wiping out almost five million people – there would be an uprising of tremendous proportions,” Driskell points out. “That’s what smoking has done, day by day in this country. Women are now dying in staggering numbers, and our children are being subjected to illness and disease as never before.”

Driskell, who helped start a smoking cessation program at Verbena Health in Seattle, isn’t overstating the facts. Lung cancer currently kills more women each year than breast, ovarian and uterine cancers combined. There’s a biological connection that’s just beginning to be understood: As lung cancer cells bind with estrogen, they produce a protein that encourages tumor growth. Laboratory data indicate that due to higher levels of estrogen circulating in their bodies, women are at a higher risk. According to the Cancer Prevention Center at the University of Texas, tobacco smoke accounts for 30 percent of all cancer deaths; for women, there is mounting research that indicates smoking and second-hand smoke is even more risky than was previously understood.

And that’s not the only disturbing news; it’s also more difficult for women to stop smoking once they’ve started. Driskell explains there’s emerging evidence that a genetic predisposition to tobacco addiction exists in women due to two genes that are activated by nicotine that men don’t share. A recent study at the School of Public Health in Washington D.C. also confirms that women are more susceptible to the effects of tobacco smoke due to the smaller size of their lungs and the concentration of smoke in the smaller airways. The U.S. Department of Health estimates that more than 179,000 women will die of smoke-related illness in 2006.

But, not only do women harm themselves through smoking, they’re doing incredible damage to their children, according to the American Lung Association. Cigarette smoking during pregnancy can cause serious and lasting health problems for both mother and child, such as problems conceiving, pregnancy complications, premature birth, low-birth weight and stillbirths. The ALA asserts that smoking during pregnancy accounts for 20 to 30 percent of low-birth weight babies and 10 percent of all infant deaths. Additionally, maternal smoking (and the smoking habits of additional caretakers) has been linked to asthma, colds, bronchitis and other respiratory diseases.

So, with all of these troubling facts and heartbreaking statistics facing us, why do women continue to smoke? Driskell is adamant in her position: Women (particularly those in the 18- to 24-year age bracket) have been targeted by huge tobacco advertising campaigns waged over the past few decades. “Advertising, the media, Hollywood – they all combine to sell a picture of what’s glamorous in America. There’s such stress to look a certain way, be a certain thing. Our young women don’t stand a chance,” she says. The American Cancer Association claims women have been “extensively targeted” by tobacco-marketing firms that feature ads with slim, attractive and athletic models. Is it any wonder, questions Driskell, that teenage girls consistently say being overweight is worse than smoking?

That overwhelming need to “fit in” prompted Driskell to participate in the start-up of the “Out to Quit” program at Verbena Health. There, members of the lesbian, gay, bisexual and transgender (LGBT) community receive support in a unique smoking cessation program. Offered in a safe and open environment, the program includes peer support groups and structured multi-week sessions. Driskell explains that members of the LGBT community may feel tremendous anxiety as they’re oftentimes alienated from society due to external and internal homophobic pressures. They strive desperately to belong to a group – even at the risk of their health and well-being. “These young women face tremendous pressures, high anxiety, and may have an internalized lack of self-regard,” she says. The Verbena program focuses on understanding the reasons behind the decision to smoke, coupled with behavioral changes that are introduced over time. Clients are guided through a series of steps to recognize what Driskell calls the “dialogue of addiction” and learn techniques to calm themselves without the use of nicotine.

“There are basically three patterns of smoking,” she explains. “The habitual smoker lights up at specific times during the day – first thing in the morning, when they get into the car, after dinner. The emotional smoker uses tobacco to deal with feelings of anger, loneliness, or boredom. The addicted smoker can’t imagine life without smoking – it’s the way they deal with stress or anxiety and they don’t believe they can stop.” Driskell says that once the smoker identifies their unique pattern, they can be taught to recognize the internal dialogue that takes place, isolate it and then stop it.

Stopping that dialogue is rarely easy – especially for women. ACA studies report that most smokers attempt to stop at least eight times before they’re successful, and that women relapse far more frequently than men. Research shows that nicotine withdrawal produces feelings of anxiety, depression and irritability, and women often feel these symptoms more strongly than men. According to the Center for Disease Control, smoking cessation programs are increasing but reach only a fraction of women smokers; it’s even more difficult for women of color to quit as almost 75 percent of black women smokers don’t have access to effective smoking cessation programs.

Driskell believes this lack of support puts the lives of young women in America at risk. “Girls are targets!” she exclaims. “The tobacco industry is after them; they need youngsters to start smoking and keep smoking. Right now, one out of five teenage girls smoke – and the numbers are growing.” Although it’s true that since 1997 youth smoking has declined nationally, in Washington, 11,700 kids under 18 become new daily smokers each year, and the annual health care cost directly attributed to smoking is nearly $2 billion dollars. Just as smoking in public places has been banned due to the effects of second-hand smoke, there are some who want to take the next step – make it a criminal act to smoke around kids as well.
KATU News in Oregon reports that Dr. Chris Covert-Bowlds, the physician behind Washington’s anti-smoking law for public places, wants to protect kids from smoking parents.

Both Washington and Oregon currently restrict foster parents from subjecting kids to second-hand smoke and Covert-Bowlds sees no reason that all parents can’t be held to the same level of accountability. “Children are even more susceptible than adults to second-hand smoke,” says Covert-Bowlds. “We know it’s even more deadly for them as their lungs are developing.”

Ready to kick the habit?

Smokers don’t have to face quitting on their own; there are numerous programs available, many offered at no charge. The American Lung Association, The American Cancer Association, The Black Woman’s Health Imperative, Verbena Health and even the State of Washington offer smoking cessation programs. Some suggest using the “Four D’s” as the first step to halt tobacco cravings:

• Drink water: Water distracts you and flushes nicotine from the system;
• Delay: Wait a few minutes to see if the urge to smoke passes;
• Deep breathe: Take five deep breaths and wait five minutes; the urge to light up may pass;
• Do something else: Take a walk, meditate, chew gum, spend time with people who don’t smoke.

While Driskell supports these programs as effective and helpful, she thinks more can be done to reach the youngest of smokers. “We need to get into the heads of our young female smokers,” Driskell declares. “These girls need to be reached on a level that they understand. We’ve got to demonstrate that smoking will have devastating effects on their looks, their health, and ultimately their future.” Driskell hopes to develop a program directed at pre-teens that will graphically illustrate the horrific effects of long-term smoking while offering healthier ways to deal with the underlying emotional issues she believes causes girls to smoke in the first place. “I honestly don’t think smokers will quit until they face their emotions; people self-medicate with cigarettes,” she says quietly. “In all my years, I’ve never met a long-term smoker who was healthy.”

Roberta Greenwood is a frequent contributor to Seattle Woman.

©2006 Caliope Publishing Company