Support-Seeking Smokers Take a Drag on the Internet

Ignored as never before, smokers are seeking solace from one another, often on the Internet. “I want a baby. I have to quit,” one smoker writes. “I have already tried and failed. . . . I am OK for the first 48 hours but then turn into some kind of junkie, looking for old butts to smoke, just about anywhere.”

In recent years, as the debate concerning cigarettes has escalated, the more than 40 million Americans who continue to smoke have found themselves isolated from a society seeking to blame, ostracize and sometimes even punish them for their addiction.

“Smokers are outsiders now and we only have each other,” said Ro Malacria, a 59-year-old former three-pack-a-day smoker from Santee, Calif. Malacria runs Nosmoke, one of several Internet-support groups for those who want to quit.

No longer welcome inside many restaurants and workplaces, huddled outside in office doorways throughout the country to grab a smoke, they also are facing slights in public policy.

* In the debate over a national tobacco bill, Congress and the White House focused not on smokers but on the more politically and socially appealing issue of keeping children away from cigarettes. The only attention paid to smokers in the bill, which failed, was an effort to raise the cigarette tax by at least $1.10 a pack.

* Despite numerous studies showing the cost-effectiveness of investing in smoking-cessation programs, both public and private health insurers have been reluctant to do so, creating financial obstacles for smokers who want to stop puffing.

“The demonization of smokers is one of the most remarkable ethical changes in American society in the 20th century,” said Art Caplan, director of the center for bioethics at the University of Pennsylvania. “It has transformed what was once a bad habit into an outright sin.”

“Smokers feel very alone,” agreed Blair William Price, 45, a Canadian who quit after 25 years with the help of the nicotine patch and the support of others he met on the World Wide Web. “They feel like they aren’t getting any support from their spouses, their co-workers or their kids because [nonsmokers] don’t know what it’s like.”

He estimated that as many as 1,000 people visit his site daily. “They come to a page like mine because they can feel free to say anything,” Price said.

Malacria found the support she needed to quit after 43 years of smoking from Smoke-free, an Internet list. She stopped cold turkey in 1995, but said she couldn’t have done it without the support of the group--one reason she now runs a similar list.

“Other people [nonsmokers] simply don’t understand,” she said. “What the people on the list did for me was make me realize that I wasn’t alone.”

Stopping isn’t possible for everyone; science is beginning to discover that, as with other addictions, nicotine exerts a pull that can differ in strength from one smoker to another.

Recently, a Canadian study showed that some people carry a gene variant that may contribute toward protecting them from the addictive properties of nicotine, which might help explain why some have an easier time quitting.

“Nicotine dependence is every bit as much a dependence as cocaine or heroin,” said Dr. John Slade, who heads the committee on nicotine dependence of the American Society of Addiction Medicine.

John Renkiewicz, 42, of Burke, Va., has been smoking since he was 17 and has tried numerous times to quit--without success. He is unhappy that his insurer does not include smoking cessation as a covered health benefit.

“You would think that insurance would take a more proactive approach in helping smokers quit, considering the big health care costs down the road for smokers,” he said.

Dr. Jack Henningfield, a nicotine-addiction specialist at Johns Hopkins University in Baltimore, agreed. “The bottom line is that treating the addiction is more cost-effective than treating the consequences of the addiction.”

But one reason insurance companies hesitate to fund smoking-cessation programs is that so many people change jobs, and insurers, regularly. The long-term payoff for helping a patient quit may accrue not to their books, but to the bottom line of another company.