The most incisive guide to issues facing the American family today . . . An invaluable resource for anyone wishing to stay on the cutting edge of research on family trends.

-W. Bradford Wilcox
Associate Professor of Sociology, University of Virginia 

A Wedding Ring: Better Than a Nicotine Patch?

Bryce J. Christensen and Robert W. Patterson

Public-health officials strive very hard to find ways to help smokers quit the habit—targeting poor smokers particularly, because poor men and women are more likely to light up than are men and women of higher economic status (though they suffer more relative economic deprivation as a result of the costly habit than do their more affluent smokers), and because poor smokers cannot pay for the expensive therapies that can make quitting easier. But readers of an Australian study of community-based organizations that work with poor smokers may wonder if officials should consider strategies for reinforcing wedlock. For this study indicates clearly that even among the poor, married men and women are distinctively resistant to the appeals of tobacco merchants.

To analyze smoking among Australia’s poor and to assess their likelihood of quitting smoking, researchers from the University of Newcastle examined data collected in 2010 from 383 men and women working with social-service organizations, identified as “non-government, not-for-profit organisations that provide welfare services to disadvantaged individuals.” These data indicate: “Disadvantaged smokers have a desire to quit smoking that is comparable to the general population.”

Unfortunately, these data also indicate that “a relatively small proportion” of the smokers surveyed had used “strategies known to increase quit[ting] success, including using nicotine replacement therapy and behavioural support.” Highlighting a particularly underutilized form of behavioral support, the researchers lamented that few of the smokers surveyed had “contacted the telephone Quitline, and few showed interest in receiving this type of support.” Indeed, the researchers find it unsettling that over a third of the smokers they surveyed expressed a desire “to access acupuncture and hypnosis, despite there being no evidence of the effectiveness of these types of support.” To counter this kind of thinking, the researchers call for “strategies to increase engagement of disadvantaged smokers with evidence-based cessation interventions.”

“Evidence-based” thinking about smoking among the poor, however, might involve considerations other than just nicotine patches or help hotlines. The researchers report that among the disadvantaged Australians surveyed, marital status emerged as a significant statistical predictor of tobacco use. Compared to married peers, the researchers conclude, those who were “never married or single . . . were . . . significantly more likely to smoke” (p<0.01).

This finding, predictably, harmonizes with a body of American research finding that marriage fosters better health habits by inculcating a sense of responsibility and obligation. At a time when public officials around the world are seeking ways to hold medical costs in check, the distinctive resistance of married individuals to the health-destroying tobacco habit deserves attention.

(Jamie Bryant, Billie Bonevski, and Christine Paul, “A Survey of Smoking Prevalence and Interest in Quitting among Social and Community Service Organisation Clients in Australia: A Unique Opportunity for Reaching the Disadvantaged,” BMC Public Health 11 [October 26, 2011]: 827.)