Federal officials considering new regulations on tobacco products should give more weight to the fact that a majority of smokers are unhappy about feeling addicted to cigarettes, and should put less emphasis on the theory that smokers who quit are losing "pleasure" in their lives, according to a recent study by the School of Public Health at Georgia State University.
Researchers at the school's Tobacco Center of Regulatory Science (TCORS) analyzed data from 1,284 adult smokers in the United States and found more than 80 percent expressed discontent about their inability to quit, felt they were addicted to cigarettes and regretted they started smoking.
The Food and Drug Administration (FDA) is required to perform an economic cost-benefit analysis of proposed regulations. The agency has included a measure of the "lost pleasure" of smoking in its analysis of regulations on cigarettes, such as proposals to require visually graphic warning labels similar to those required in many other countries. Some researchers have questioned whether smokers enjoy the habit and whether a focus on "lost pleasure" overstates the economic burden on smokers of regulations designed to encourage them to quit and to prevent others from taking up the habit.
Results of the study are published in an article titled "Reassessing the importance of 'lost pleasure' associated with smoking cessation: Implications for social welfare and policy," in the journal Tobacco Control.
The authors said their findings support measures of "reduction in smokers' discontent and an improvement in subjective well-being" in the cost-benefit analysis of proposed regulations. When smokers in the study were asked to offer the first thought that came to mind when they heard the word "cigarette," common responses included: cancer, addictive, nasty, stinky, expensive, dangerous and stupid.
The study used data from the 2015 Tobacco Products and Risk Perceptions Survey conducted by Georgia State's TCORS. The researchers found levels of discontent among smokers "did not vary significantly by sex, age, race/ethnicity, education or income."
"This study found that most smokers feel deep regret about their habit and say that if they could do things over again, they never would have started smoking," said Dr. Terry Pechacek, professor of health management and policy and the lead author of the paper. "Many also spend time worrying about their risk of developing lung cancer and other debilitating diseases. These people are not continuing to smoke because they derive pleasure from their habit. As smokers themselves state it, they are addicted and wish they could quit."
The study's other authors are Dr. Scott Weaver, assistant professor of epidemiology and biostatistics; Dr. Jidong Huang, associate professor of health management and Policy and Dean Michael Eriksen, all of the School of Public Health at Georgia State; Dr. Pratibha Nayak of Battelle Memorial Institute; and Dr. Paul Slovic of Decision Research and the University of Oregon.
TCORS, established at Georgia State in 2013, takes a multi-disciplinary approach to understanding human and economic factors that contribute to tobacco use. The center conducts research designed to inform the regulation of tobacco products to protect public health.
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Terry Frank Pechacek et al, Reassessing the importance of 'lost pleasure' associated with smoking cessation: implications for social welfare and policy, Tobacco Control (2017). DOI: 10.1136/tobaccocontrol-2017-053734