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:an;eIika Wetterer Jurben von Troschke Smoker Motivation A Review of Contemporary Literature With 29 Figures and 16 Tables Sptinger-Verlag Berlin Heidelberg NewYork London Paris Tokyo 2060440412

C.IIAPTF.R I Trends in Cigarette Consumption and Ilfe Sociodemogruphic Slruclure of Ille Smoking I'opula(ion in Developed Industrial Countries Infnrmalion on Ihe developnwm of cignrelte cnnnumplioo and nrr changes in Ihe sociodemographic slruclnre nf smoking ptpulalmus cunstilule a majnr elnuenl in Ilw desnil9iun und unalysis M'smoking lxhavame Ikmevm, thc enlleclion ul irliaMe, fulfmiwnly delaikd dam an Ihis subject is he,c1 with dirlicullics. Nol rwly .ht we frlul differences in survey melluals:md definilions hclweeu Ihe various uuun- Iries, hul there is also a Iack of apreemenl on these issncs evcn wilhin eulividual rnuntries. Forex:mrPle.lhere are severul dcfinilimis of nrc c'utrgory "irgtAar.nwker' and many differenl methods of delermining aclual cigarette cunsunqalot~''1 he prot+lems increase if we mlcmp to idenlify intern+nion:d Irends. InMed, dmrr eo utnircrliunn of a(plarenlly idemkrd funs crqcerning Ihe "IyPical smaker" revcd. Ilun Ilse d:na are in reality highly helerogn/eous and thal il is in m:ury c:uc, iml•usildc to make nnernmwmal comparisnns! After all, •'/he dinc¢n1 Iradiliunr, ecnrwnna ealdilinru and snetoeuBural backgrmmds,lugetlnr with lh< sy.lnn ur u.cixl eplur, whir.~h varies from country lo country ... (nrakc) a direct rnnyuui,an nl linrpug..' even more prnMcnu+lie (Mcrsdorr N al, 1982 p 9)- In view of Ilrtse prohkms - which +re deah wilh more fully in ('luqner 12 il qlenled F<n/iMe lo eonfille our imefnnlinnal enrllPar/Ym1 of thC deveh,lmu9n tdelgartlle eonsumPlion to Cases where Ihe 6gnres wcrc nmspalihlr. In thc 11,1 loacuwc this na:mn restricting mu sludy to Ihc highly drvclnlxal indu.uiai nalimu In.:wu ordy in these cnnnlrins is a mmaningful crornparisun of ecnnnmic :mA ukirKUltur.A fmrurs pa.sihle. We Onlber limited Ihe smlx of our survey Io Ihe UtiA nn.l cn.mIries within dw Euro)uan Co/omunily hec:rusc the dula available are bmh mclh.ul ologically reliaMe and fnrrn a good Iwsis fiu amlluuiWUr Finally, in urdcr le auaiu u differenlial<d breakdown nhhe snciedcmogmpbic feauues of Ihc amnkiug Iwrpu WiMI we deCirlerl ln foncenlrate /Nn n/lenlinn on nOG cournry WaSt (i2nndnr 7his wnn nerrssury as Ilw rarimn inlcrnalimud diffcrencrx in Ibc Jclinilmn al .urlrI usiodenugraphie f.ltlors as class urucmre ru edncarirutal Icvcl siwply rvcludc I eomP%rrisun.'Tlw Inlemq 1. creme a single cmnowu dnwminatur wnuld, in Ilu II, ou, have disloded the fatls.

le 7.em/.t in I'iWCpe ('r.wnnp14m1 lao ro A to sn M ID- ln lY U- ® I4.yw.Y vlv/ O Secwhay rtNM..neyl LLNp41-kArly fnM(ek fMn'nm/r.clvN.IMI O Sr1wl.haagu.Mrtak .M~141vMhOVw~9 eeIl9f.YFf/Lly lIR.1.1. Ikedbwwnfhwdttl^'ll^I+Ikwattn/falslneblexiwA WIx 55 I O W4 MMnf 5n p v.nw,nan. t5 e1 eD I h" nl IS I 15 ~II / NnnMyy,lLM fkw~nY~Y41rM SNb.b)XhM 51MYIewYy .'In na/Y..xY nuul xlvrtnM2uMSNeye. 4n.r'y kw+qcnMNple w.erMr kk I. N. INak anll fswk umdm n a Lulxxlirvn nf IuW Lry.Fwion x vrlliry IxMrar:mM I The Slh'i1We.MIgly+hk.51rue1Mre nf Ille SnedinF ISqw6ywvl M wr4 f w Nn.Nly 1 t tiat helween amokiug alul edutalion is shown nNrce prmkely io Yig L In, a hich in IlieMa the perceMUge of male aaJ female snwkers xcnn611g tn edmatiun.d +lalus. It is clear from Illese Jatu Ilmt wamen wi10 u higher levcl nf nlNeution mm tnuc h4r ly losmoke dum Iexs-ellncaleJ wmnen. Anlong Inen lhe converse iarua; mcn w'nh fewer cAuc:NimlN qualifiraimis ue mme likely to vwnke. An exmuinatioll of daily eigareue eou5nmlqion ucturdinK to cJuealiuual oucgn ries does not rev<al any signifrcum AiRerences helwecn own and wmucn with Ihc smne eJucalilwui alntos. htyures 1.11 a ..11, 11 b clmfilnl olke Iwuc Ilcu Alily cigarellc conaumplinn is hlglar ammng men titan wnnn:N. i fknnw/Y ul'M IML.A ..<n1.nM NOYw/ 1 I' 1 1- 1' 1 1 o a xn w m w w m m f9x.1.111. Aeernle c•xIw./1Yh1i1+1 •f frmak I,Iwken.x.rN~kllf,la e•lulaiinl.~l awl~. rkanby xlyd r11vM.otdkxi InWy__._.. kY'nnioy uWW ./ah .xel.>w Nnwy Snd~d.Y YIpM •nNnJ xl.p.ho+y win+a4 Se(ptlyY LMA...M v1.NIm.ay U. W'cMe ec.M¢.Ywnfiy 1 9[y I~MIY~.xL ISIyI•MrY~>II~.1•n.nei.4~a (" 1 ' 0 10 .\1 ]I/ l0 `p (U N hl 'x/ •xi Fk. 1.141, AYC.aK ttvnn~nryli•m M elnk anmrn. xrniAiup m ahhalun.~l 4.m~.

4 1'rcn,ls In ('ifemle (-maxnywAxl 1 r.wh M ('rearcue ('IxnxMlai,M t ~~ rr.,,x. ...,... xi m 5a Sa w XI- q 1 I ~ ~ ~ h ~ h l i • rqfp t'165 xl/ll t4l'. N/" Fk.1.y. ("haryn M arxmet enn.mmprea d ritmmin per penm lafed it ytara nr nlder) in rFe IISA helwern /v6J arxl 1911. /.IrrcJ un IhplW d Ai^cdbee anal IISA mawrqAinn rerkn: S. Iar.a.l nn I~akral Tr.,k ('rwai..kn d,nrrcak n.rsumryian snkr. J. haad nn 1h(a. d A=rkvb sare eM.ueule emrswrqatm eerlee: 4. /wsnl an Meewek Repan'a Aane4k awr.ny,lien eMex /SrnFnxr C,enceMl Rel'^rl 1919 Al9renr6el 7.kk 1.2. Namher d mxden a. . I,eraxmnfe d Ilw Wak p,yralal:xr in 1'A' wen,lrer uwMrip,19M/-1Ylr.lMenA,dat al. 14121 19N1 19tt1 19" An.anwlrn 41gv. 437% WI% Mvk.xar4en htwn yk.11X N.tM IwenakarrWen 21m5 19U% Jnnx fk.l..t. N.mherdsnrakeraaaaPVa.+nupedlheparminlanwlirplxrywlnl,wmw'rqucnn.n,y fnwx IWA1 {n Illtl tMernMxf n al. IVa?I 7altr L1 Ikd> eiEwrne eonswuryMn IKr xwder 6r Ll' anur.rie. b.nn IMana 1419 UlernLnl el al. 1Wt11 NundYrNnpn,ene.e Iw,n 1416% 19111 IY1[ (Vn/ Cemlany 11.1 146 ~ I l l ---19 6~-~ Fr+nce 11.2 115 11 ] I41u Iraty 74 11¢NcIM1erlux/a 119 Irl 14 ! Ia5 lXlgiarn/IUSemMw.e lal Hr2 1!1 Cre:alhiWn 154 159 IV= 20 8 Irel:axl NI1 241, Ikr,xlarl 1t6 119 14J Il,r, fil'MMaI 11.5 161 . Ing hchaviour it is nececcury rxR only In eaamilre the lalenlial smoking population hnt alsn Ihe prrrpulion nf the ryrlrulalion wlm actually xmuke. As can he secn fronl T'ahk 1.2. dllring the same period wllen eigareRe rnrlsumqion in the EC canariea rose by 19%li. e. 19fA-1979) the proportion rlf smokess wilhin the pmenlial smok- ing population fell fran just under N% lo a litlle over 39%. The two main fealures nf this development can be seen in Fg.13, which illus. vules trends in Wc.sl Cennuny. There is a clear decline in the proportion of mak emokeq and this has been accompanied by a continual, although less substantial, increase in Ihe lunlxnti(m of walu'n umders. lhis phenanenas is not peculiar In the C(' cuumries hul also typifies Ireals in the USA.s llle lals.sihk rcasuns for the diRerenl Ireak in Ihe snusking hehaviour d men und wnmen will he discussed at a larer slage. At Ihis point attention should be given {' In the fact that during Ihe period in which total dgarelle eonsumplion increased,lhe , nnnlher nf amtkers -:n a proprnion of the laal populalion - aHUally declined. ihis colrftrnlHhe suspicirm that an ioerease in the intensity of smokinR i. e. per aa- , pita eomrunftlinn, was resfwuKihle for the increase in oreull cigarelle consurnp. 1 lion. T:rhle LJ deaonslales Ihis innclsc in rigarclle eon.uapti,.n pci naukcl lie 1-Iwecrl 19m1 arW 1979. At llw sunu: time ils per cnpila dgareNe cnnsumptinn auraug Ilw Lvla•nti:d elnnk, ing (i.e. aduhl Pupulation inereased in the enmmi.. uf Ih< b.lnulk.nl ("nmm. k muy by almoet 29%, it is upparenl fronl T:dAe I.) thal the d:rig cun.mnMinn nl .undr/. rose by alryxoxinulely N%./ The trend Inw:ud. a r'mnimmlly dcac:uiug prrqun Ikln of srllokers whn smuke an increasing rnnnher nf r'igaallu. iKr he:,d I. a.o eeident in the USA. Table 1.4 itluar.uus Ih:rl Ille prulxrninu uf Smukcl. whu auwke L_mrsre Ihan 25 cig:rrelles a clay grew slcadily Imtrocml I W,5 alul 177n. J.1.J Aardr in Cim.vmnlukrn xilh Rrgnrrlrn ncr Afurl /invunv/ Ii1x•a nl t'ry(mrnr lhrnughounbis presenl discussion we haae sinqdy rcfcrad lu amukers witbam dl. ' linguishinghelweerscigarellesnrokersaldllaxewhncunuua:tohaaauuuif nlher finm. llle fa.Y Ilml it sterlls alnecess:rry tn nlakesneh a di.lincliun shaw• Ih.n ng.l

12 Tren.l( in('iE.rAk(YalwnMirn rn Lft u M u 1 . su A 9 97 1 N n 7 fJrwu / 7 N fwxder fk f -1 .-r.-1-.r-.r--r.-t 1 . . ma n s 1. a•xl~•wwsnaw,a~fixgm.rr A b nl b m A tl 9a loa .xddxgyeun.xnplioq kiuly-eigln perccln nfmale smoken srlmke mnre Ihan Mcigurnles rb8y. Siuri- larly as slwwn in Yig.1.7, the Inuryrnimi nf wolrlerl within each ealegory (i. e. Ilrc .nnu levd rrt nnnlmry+lion) Jecrcasen as the mlmher of eignrclles nawmrcll rises. Nm mlly nrc Illcm more nWle srmrkers Ihlm wsnln:n slmlkerx, but mcm ulca srlnrke nlore. lJI AgrlHUrihulnm . Ilnwcver, if we look a1111c age distrihulion rdsmoken as depianl in fig. kk il Iw. wwues clear Iha/ the Jiffelern.'ca in sourking M:Imvinur ald eollunrynion ae less pronounced xmmlg the pmnger g<Ilerulinns. Ahhongh thcrc Ilre fewer femak unoken than male vnoken, Ihe Jiscrerylncy is mnh smalkr than in oWer age grorqrs.'fhe nrves in Ihe u(yler parl rrf Fig.1.g - which are plnllal aeeording /n the age didlrlhelirwl ydllm entire population - serve In emphnsim Ihe sve of the gap be. Iwcen the /nopnrlion nf olrkr mak amlrken uml their fenmle mulnerpans. Whereas the dixlribuliun of older malc slmrken roughly corresponds wBh their rqrresenlalism whhin the pnpulmion as a whrlk, in the age groulu whcre.women are InnMminnnl Ilmre is, in facl, a dist,ro(xMinnnlely snlatl ryercentage of srmlkers. Tnhle 1.9 rttinrmces Ihis ryrinl. In the age grmlp N-19 yean Ihere is vinunlly Ihe mme proportion uf nlaM aul fcm:rk smukerx. lhe age gronr, 20-29 year okls corh Inins Ihe highesl ImymrlisW of snurktrz in both seses. Tire proponioll of male sumders declines slcudily from mre nge group lu Ihe lual, where:rs Ihe prolwninn or slrmkers drops Jral"ls:Aly umorlg wnmen aged I0 yexn and older. As we klww frmn nthcr researdl Gndings Ihal wrnlrcn generally fiad il rnrne diI1L coll lo cease snloking Ilwn Inen (see Siegrixl 19g/, p.16). we earnuN allrNxne the high Prnpmkm uf older mm-slnoken almmg wmrxNl to Ihe prescnce rrl' a large IM 4^irxkaxjv;aArK ilranarc nfllw tinnklnf 11qn~l.nvn ,A wt•1Caerianry hi - h+ 0 1 11 IN r AM I MI 19 I rll (N I 41 "!1 1 1/~ ra ~ nn..A.4n/ Ila.l.a. A(c ,Y4rihnlLw rd MNal IMNn1.nMn .rn1l .xuninF IxN`~~Lxnm hn,ik• .nnl I.ni.~h./ Ix. Ib, apc Ji4rihalinn d xMal MN•alaabn: lx. :h. xFC.L•mh~xeq ~tl •m~dn~F Pq~ul.enn 1^ p+k.: --_ frxuk.l ~ 'faMe1.N. Makw,ifrmakam.lrr...ans'Irc~naFcr'frXvnnFcFnwNw All Mnk --- Irnylv saxncn uo-a<n +nno.ri. I! 19rcals !u 1v yc:x. Ix r: 51 e-s 4±m. .W 11yrw. 41 t': JxJ+. ' N.1-- NI Kye+rx 15.11: .6 T: !y 5^. w+I r.: .r 1-. IF r-. W Myrars nl:. 11Y:. In!-: sr•: Aye.r.mr*kr 11-a+: +.Ie-t mnuber of es-smokrrs. II is puhahle Ihal aoxrng Ilx oldcr geucrniun. Icwrl wum tn adopled Um IWl.il.l he hu1111a1 tlu•Ie .rc ahnna :m m+ny ynungn lemn/c awnk ers us men illlticnles thal srmrking hehnvhnn rwt nnly Jifl'ns brbreen Ihc x•eaiul ulsll hclween Ji/fcrem genernliuns. l.l.f k'JueNG»aJSmmt llwdiarilmliunrJ'xnmkaxnccurJinglnnhnan..l/nl4rlnliliaaliun.Il ig 141/••un ilarlnlhalnflhepnpnlaliurlasawlwlcP'IhisaVl`hce wilhcan"iiucxlvnuan. Inlwlh nmk mul fem:de.wul.ken.l he pereanL~ge al"aninken whu:nlcudvd clamcn lury xchsAl a1W havc nu x1An nprean Itaining or apprnni.c.hip is cnmidcumy hrch- er xlnmlg fclnales 1/mn malcz'Ihis is Imrlly accomucd fo/ by the 6ugr1 uuodrn ul wnmen whn leuve elenlenlnry scluml mnl dn me aacivc uny uatniug 1` I Iru..mch

CIIMTEn 2 Why Do Smokers Smoke? A Survey of the Various Approaches to the Question of Smoker Motivation (7 <) l 71em are at least as mauy amwers In the quesuon,Vhy do smukcn-%mo_laT as Ihere are sckruific Aiscifdincs cnncerned with IN, subjecl. 11 is nnl aurpriilng Ih:n the replies differ. IMlysicians and phannacotogias anphaciic biochnnlcnl md physiobgkal facloa, while fxcydlolog'r.sls seek an amwn in Ixrsondiq strrnvucs Of the ilkrNifxution pmcess which occurs during Infancy. Naurally, ntwial Inyrhul- ogi.sls and edueationulisls curw•entrale an patterns of Inaming within the family, at schnnl or M the peer group, whereas sociologists crnxtidcr she signific:uree nf snkixl norms and changn in the "soci;d suppxl syslnn of smokinF'. Tha1 smoking should he of interest to such a wide range of discipliues is In a I:u fc esleM {rounded in the fan that smoking most he regarded within a varkly of cun- lexls. For examFle, while it has quite defrnite physiological effecls, smoking also fulfils spcciGe, yet varied, fnydldogical ard srwhipsydwhrgic:d fmrclions. timuk- ins is learnl within a social eonlexl and is Ihus part of o set al'norms and ndos whidr are rysniallj unwrulen. but also codified. Corrsequunly, even Ihe most divcue ap. Frwches to estahlishing srl explnnaliml for smnking shnuhf nul he reg:mkd as nw. hmlly exelusive.7he aMnccuiorr of several disciplines Is, in fncl, n re0ccliml of Ilm many aspects ofsmokint and in snnnw respects relates to Ilre dilli•rcnl pha.es of rlre smoking career. Nonelheless, the cluim Uon individual studies lervc.YichkA moq than a I*ulial explanation of cenain aspects of smuking is quile conmwn. indecd, the clairn it, have discovered an explanation for snmkhrg is equally I+revalcnl, rh•.Irile the facl that usually only speciGe aspects or smoking or parlicul:v chmaclaisliav :uuuug smdren have been descrihed. An aceurale description Of both smoking hchavinur mxt lypieal gnnqr. of smuk. ersis,ofcourse,es.venlialslmplyinordertorklincllwureaofsludyil.clf Ilnwevcr, resenrch work which that regar<h this desnilnlnn as an cxplmmnimr in its uwn riplu should be viewed with smplicism. We should he similarly duhirnn nf sunlio which, for example, provide valunhle empirical infucrnalion no Idrysiolugir.d aspecls Of srroking and Ilrtn proceed to eluim (eilher expliridy or indicilly) In have eeplninc.l srnoking. In this survey or the main yquoaeLes to he qucstion uf slnnking ruulirunun we willlherefore ask I. each rase whal the l+wiculer aplunach actu:ery• explama lhi, musl also embrace the queslion as to whal is not explained. Frequcnlly tlre mushled Ihcoredarl or methodological slrnalures clmaen for indiviAu+d xludin anmnwllically exclude cerlain posalble eiplanaliems and predetermine resnlls, llms nra. • jor Intportrtvlce is ulpxhed In the following que>rinns: Wlmr is the oa1Nc of snmking, or more precisely, what lype of hehaviour are we observing? ('ould •nmk

6 tlerxl.in('iNrrnuCamuqaHln l:Me /A. 14rcnqage „f Icyular unn6erx irl llw USA wha smoAe a.vs Ihan 23rqa- relles Ilaily (1963 /91A4151nKna Gcnerrl's Rehm 111Y A19nndsl IMM1S IMIn 1974 191ff ANUmeen I9.9% ]l,l% 2(.1% 23.1% Maksmolcr. 24 5% 716% m.l% ll/#% I'ealnksruMen O7% 111.1% 11,116 M 19a% • Saakip InMwlaliw He.l ]o yena wd ever, aN arMr fqwe. lrxnl an srmding fM,Iw1i11M1 agnl I/ yta/e nad aYe1 1'fMe I.3. Rltak,6/wa nf she sanlllln/ fWIMIIYIkaI la /:fc erlmllrler XfMlhng MI frann af smldmk I1979f IMrrrcharH d. I91tI 15ge ('igws/ ('1Nar1MVC ('Ifwenes wnl(kr,aany Iln( ..1% »s% Fr..ce Ro% 140% 16 V/. Raly 11M1o% 'IM NnhcA:x.h 3.1% 15.7% p.(% Rdj/MA/I.nreMdnWr/ un.nrw.kl Is.7% n.7% e3.m IrcRmA 7.3% 2.3% Mlll% Ikmnart 17.1% 111W 2oR 329% • 14o%ciryNrlydMw }ILeAI eknMYf rellc amuking has hecnme the drnninam form of tobacco eolllumfMion. ihis is rcin- ftnttd by the frgures fnr E(7 coulntfes shown in Talde 1.5. ~ As we can see in the e.19e or Denmark, tradhion tolslinues lo be a major fador in mainlailling aptcifre fwms or luhaao consumplion. Nonelheless, it is quite clear that the Irend it, llfe nlunlrics of the Guropean ColnmunHy is similar lo Iha1 ill Ihe USA, where "cigarettes account for about 95% of the tobacco used' (Griu 19g), _r.2m). Similarities between Eurrqle and Ilu USA can also be seen with regard to (he Freference ffu cerlaiu qpes orcigaatle. Fiiler cigarettes, in Iranicular, have rapidly gained in LMndarity This trend is demonarafed in Fig. IA- between )95tl and 19110 Ihe market share af liller eigarelles in the USA rnse frmn 0.5% In 92.5%. In 1979 filter cigarelle9 mcounlesl furbelween 61% (in France) and 92% (in Great 1lrilain) or the Imnkel h• the European CnmmunNy (Mcadrxf el al. 1982, pp.63, Table 2.5.2). Filter cigarelles ifnYeased in ppulariy and achieved a markd shure of afryunxinunely MI%evcn in caufNties where non-tipped clgalelles were Iradidonally fnvoured. Ahhlmgh this is far below Ihe level reached In the USA it still represcnls a considerable increase in saks helwecn 1960 and 1979. A second mnjnr Ircnd in the IyRe'd cigarelle smaked wn he scnl In Ihe increas, Ing popularity of 1he so-enlled "low mr" cigarene, which yields a Inwer k.el uf rylr- licldnle Inmmr. As sM/wn in Fig. 1.3. /hese "milder" eigarenes have enjoyed an in- creaaisgly grlalrr alwre nf the markel in Great lirilain since the early uveMits. 9rS pl 1 r9 r UI ]U9 --IAn~~ 1919 IM Q Cgnm.. ".r rwe. Q rrr, cp.mr. 1 na /99 vl ne c V I] 110, 1.4. fMtr lip.han nr/,Xal nwnlfannred rly:unlen in Iln I ISA. NM mwl ll lna' ivsll 'Ia4k1A. tilwrly,.9hare n(Na:,) alnlwfxlu.Iripnlh, n, IM 1:(' cvwMriet, IMMI IM19.1/.(crnhaf rl al. IvX!1 N en 19" IMc,.e wew (:nawny 6x +. ee% . Nn: I'I:rnrc 1_" ( 61% /Ma: INly 11 % gux r ips: 11. Nrlhnwvk I7 es 62% 1 wu Ik1FivWL.rcn,lnn,rg Nr s Nns /str.. 0. Ilr/lrln 16 % MI% 4 1L:: ImL,N /m .: ps I/F: /knnurl 1M ': M1I'r 111': A sintilar trend ean be ohserved in Ihe IISA. hl 1967 olJy ?".+ ul' ul:uwlarmrrd cigarelles yiehkd i$ mg (or laxs) lnt eonlenL Ily I'1Sl Ihi. applicA Iu c.nnc 65•.: ul'.dl munuradured cigareuei Low lur cig:ocnes are palicul:uly Fupular in Wca Ucr muny, where Ihey accounl fnr gg% nf saks, hnwevcr in Italy Ilxil mada sh:uc i. only 2l1%(Adverlising mul Cigarcllc ('unvufnlNiun 193), p. S) Ite.calch 11.11 Ihn./.u heen unahle 10 eapiain Ihesa mn+idcrahle nalional dilfeufKca. Sunilnrly, Ihac i~ still nu mnwer lo /irc qneslion whether the rcdlmliun ill laf nlul mef ninc Icrck i. Ic simnsihfe fur Ihe ilu:ream in consumption Fer.muker. Ahhrmgh it seefn.:ul ,s Lvi mis m/klusiml Io draw, research hns not yul eelabli,lwd whedar the Icdu.cA ince Iiru: enmem has led to an increase in dse numlur .d cigarerlc..moked pcr, IfezJ "Sludies of changes in cigarelle canvunpirm ummng tlune wlnl vnluin.udY switched 10 lower Inr and nkuline cigarettes haye yielded eqoivrlr:d re.ull., unh

In 'rrn,dsinl"ryarcaeCnnxanrye/nal m w ro fnwm vrosns - IMae fn»ns . 1119 9 7r1-A Yl.yl rUe9 SN.YI rA.69 lnvaltln fy.Lh AscAiurdxnMwr:fnwkaadreravksaarlenaca.rGrrEmAWAl19MIauANvrdaN9M) I Makwx,l<narxtndNrynrNmAa 7 MakmuierxacundryMrAWA 3 YeMnk vairn amx,Nllg In A W A 4 IEnek smAas wxw•Nn{ ur I/w,6 of the pnpulalimt Whercaa AlknsMvch (AWA 19g4, 1915) employed a random samide of indivWuads selecled by a qumu prrrfednre ~ the linrda sample was based nn addresses. The defmition of Ihe various cueRories is also prohahly an imporlanl faelot VA rkhrren nn average rLtily nussumqhsn of I- Illdgaretles as'low", I I aM ahove ns "rnedimn •. and 21 or nuxc as "high". Iturda adups a scuk of 1-9, 1U-19, 211-29 and )II m mme per day, while A WA usn a xrale of less than 10, 10-211 and mnre than 20cigarclres daily. Ak IU rn 20eigarelles alnrear lo rcpreseM srrrne kimd of.wh- jeclive lurrier nr °rrlilrnorle" when slnokers as.scsx their own smnking intmnNy,"r it Is by nn nreuns frrekv:un wlxvlscr a persrm who claims In snake Itlaigarelles a day is clasvlied as a light ur medium snwker. The rery fad Ih:n the various slrnlica us< different smnker calegories emidsasixes Ihe irulnl lhal a csunis:uison of scrcmi srudies can he highly PmMemalie.'fherc are ulur differences in the household hscvnrle and professional status cmegories used lo ' delermine srn:iode/nr9tmf+hic classifrcalion.rr In Nct, even Ihe numh<r of categories employed differa. For eaample, lhe Allenshach sludy which we examined did not . contain infmmmion rsn academic achieremenl or personal Inenme. 'ffN: ahsdtce of the ealegMy "Irersrrnal IlMnlne- frilrg5 In Itl another problem , which is iihrNralerl lryrnhersrmges Ihal will he n.nsisknvl at a hner stage. Virlnally all of Ila:m iln/lcalt major differences in the snwking hehariour of nrcn mld wonr. 7he.LrciwknopraNhk 51r.11nK nf rhe $n,nlinf ITIwUIVn ur Wcq rK:many I I en.rr Consequendy, h is imlrrutaru 10 allow for differenccs belween Ure sesr. when analysing the ennposilims of the smoker pnpulalinn. Unfunumnely, in Nosv sm- veys willr que.Uious based on hrwrelmhl innenr•h is dilGcnh la diaingui.h Mlreccn the mms's and the woman's respective irmumes uldess Ihe¢ is a qneslinn alwut Irr snnndilleome. This weakness is aggravated by Ihe fact Ilml in ordrr nr ol.rhh.h prn• fession m occupation the subject is usually asked about Ihe prufeasimr uf Ihe 111.0 of 1he houselmld- As Ihis is nearly always tlrc hushand, llw mdy rneans nf rklvmdn- ing the socindenographic status of Ilse vmmatl snmker is necording to edncaliun.d SlalaS. INre Io Ihe prohkm: fmaed Ny cump:rring a raddY uf slurlles we rkuirkd lu u•c jusl au rcpresenlalive survey in order m delennilt<Ihe akirwlemograldtic sundnle uf Ihe slrroker fmqdmisas. Aher carehd amnirkraliun we dlnse Ihe sludy cnmmi.sinned by Ilnrdu u71kJ Tppr~gierGr IYilnnh<, niunl<M1UuMxcn Yrnrhlclsl, uhkh wus puMished in 19g4. l.ike Ihe A W A 19g4 aud 19g5 r9pnns Ihis sludy cnnlain. ull the lalesl data, hul it is preferalde for snn prurysses hecaine it indurks a glealcr numher of eategmtts which ve furlher broken down, Ilws Mmdtting a hnler in- siglu into the diRerermes h<Iwecn Ihe seaes. "Uu: I:ddcs and fignres which fnlluw alc Ihercfine based on data presensed by Ilnrda. Un.knlMcdly Ihu cusn.mmy pmndureofroundingofffiguresw1111nrveledlocenaininacuuncis~.Asarconll aod tyueially in view of the uncwi prohkms inrd.ed by suuh snrvcys nnoe ul' the finskngs emr, hbe regNrdnl as deliuilire, bm they are .ccumlc cnuuph:n lea+l Iu priul to a few generW trends or cmrcius/oln. ' ' 1.3 The Sociodemugraphic Slnlelurc of Ihe Slnoking Pnpulzliou of We51 Gerlllallr f.l.f Avenrg< Consunyu8ar • , According In llse gunla survey findings, 12% af all \Vesl fkmuun agud nver 14 yean nrc smnkers, M1I%of/he smnkirg furymlalnm arc men and )MS am wnmm~ Table Lg iMlicaleslhearerag<daily dgartlle ameumiuiun. htuel wnmcn:nc fwd as light or meskum smokem mW only a minoriry snmke nwre rhan 91 cugamuvs o day." Alqwosirnalely half of all nsal< smokers hehmg to dre a:ucgmy "hcxry snruker-. . LNe LL. A.errFe,bYf aw.wnqxi,m M nok nnJ rrnd<nnmAm N:xrrherof sifarcrm AN sax,em Malr .,mkns Inu.Ae .nx.lar. I-1 111-/9 20 29 Nrnmlx.Me IW.: Vla tlx hA 11% NA: 7A: 11;: 24, 19T. }!:: AX Ilal%• IIMn4• IlaM ~~~- - •TMald,nwxalr.y.equaIllNMaahPmsaarwnxlvAulf -

/e 'Im.h in l'iearMr ('Iqwwy;rMxt 1. fA fhY'IrIMIM+X lln: ylnwhm wlnlller the snwkcr pllpululirM Ji/l'ers in srntinrlemngral+hk nxnqniti/m frorn the req nf the pupuhtlinn musl uhn he examin<J in the Nglll of hNorcma- IiIM on occulmlirMal Nnhls. kignre 1.12, which depicls Ihe IxoryMian of lninees/ xlynenikR enrydnyett penmm, unemployed uml retired persrMS, etc. within Ihe smnker Itn1111In11rM, slx/ws IhM FIInIkeR /kl mlt rMMilllme 11 srreclhC soewx1e1m4 gmphk griMp anl Me hlenikal in Illcsc tcrnls lo the resl of Ilw Mrynrlalion. 71w mw e11ce111irM - lhc relatively low numhaM"retirM Irervlurs in 111e smr.kcrryrylrJ:uilm - rqn he hnequcled as n resnh rlf the llte dislriM1mion of slmders and does nm imli- ' ewe n"sltecil-u: strwker characteristic.lhe Iw`e nundwr nf wmmcn willmul a slal- cd rlarnlralilur - aune ) I% of female snmkers - enmfvareJ wilh mJy 2% of m:rlc suMkers uudoulqedly rnfhtYS Ihe fxY that hmnewivcn slig rqrtesenl the largest grlMp wilhin Ihis category. AtMlher fetNnfe IM 11411 Gml.kycd wltltR9 snmkerA Icrnl In nm+ke nnM Ih.Nll wMn- en who are mp elnl>loynl. Wlrercus.ll%rd'Ihc total femak pofxtlalhM are nnploy- M anll lv%nrc rla em111r.yM, llle propmtims of femak smukers who are emrloycd' (511%1 is higher Ihun IMwc willnwl emplnyment (.11%).w lhe Jala urailahle to us Jhl nm permit a Imwe detailed unulysis of Ihe smoker IMpulalimr accorrNng m sprcifie ocenpalhw rn profession. As previorlsly men- Ihnmk inyuiriex almul enlployrnenl w<re eslnessal as a question ah<wl the ncrnfva- linn or pmfesulnk of Ihe hcarl or the hmischnhl. Tlris has meam that data which qwkk pctfialx. have prnvhkd a hellcr insigM into Ihe IRlferelsces between nmk Mlrl fernak snMlars was atl ardlecled-11 would, fen exumple, have heen imeresling IMC Wr<imdcllnqrpA+c Grrimexf the Sm,Ah.r ISNw4luxt nf wrv (irnnan/ I I lu rNscover whelher IIW Ji.erKntl IrutMs in snmking hvhavhun a/nutlg nlen .InJ wrMwn whh tlx smne edtrcalhual smms is uhu rellcclnl in men :Ind xomen wuh elevuleJ IxnfeSSinnul slalas. lu shon, whctlter wmmn willr inllwrtanl i+A+• ala lume 6ke1y1nsnwkelhannteninsimilarlxnitianwM.lendmsmuke Inc IlwJialibnlirm of snwkers aeennliug In varimis oeeap:aional calegnrien eunllun, nur m ipiu:J curxenlirw Ihi11Wn nunlMSilirm nf Iltt smnkcr Iwpul:ainn is rilulally iJrnrir.J lu Ilr:u of Ilw Inqlrllnlimr as a wlwlc- Tlre diRerenrcx nre .n ntinnr Ihal Owy cannd llc re6•tukrl us 7Pically charurteriNic of Ihe srnl.kinF Iwpulatina° 1 fJ f lnrrmre Pigure 1.1) slwws Ilro prnpmion of nlale aarl I'nnale amakcrs wllhin Ihr un'l pup ulalirM xrtnding lu Ixnlsehnld innmre cnep.rie>. I~iB•'Ic 1.14 slwwz a b1c.Alhneu nl'Ilw suuderpryMlalhm mxordingln Iwrsonal iucuuw. Ilolll fleulcs /cva:d sVll.uo JilTerclten hclwttn male wxl felmlle smakers. C.I+acially iu Ibe c.ne ul Iron.ehulJ inelMw, which is regardcd us ml indieathm of livinK+land.ud, il i. eri.l<nl Ih:a Ihe proqMlmt of wmnen wlm smnke is higher in Ihe nlrynr incmnc r.ncgolica rhun ia Ihc lower inamre culcgodcs. Among nun Jx rry+pmira Irciul r:ul lie ub.ervrJ. Ar presnM we r1n rn11 have sulrrcinn Jau Inesplain uhy Jli.lirllliug il nnt rclx•:rt+11 in Ihe rerVnlal inernnc GNIey.UriCn. ' l..kn S'nnlnnlrY SlaliUlenl fmhnh's ml tremlx in cigarette cmm..lmNiml, JK eonlpo.iliao +dIhe srm+ker fnyndaliwr. llw JiOcrcnres betwcen mm., auJ womrn amukcls In unlcol Ihe difkrentts belween snwkcrs nnd rwn-snwkcrs prnvide linlc uwrc Ih.m a ycu- 0 ll ® M.w..n un+.r. 0 I n.Mm•r Inv.n O uesry<e Iwrv.n I 1 I Il L-A lyf nv~ nlnl Ilrl }<n Tl YAI Ynl Ilrrl n11+ t! ,ni..i kle.l.ll. kl:nemMkm+ks++.Aer<u..Ivqn.l:x1,A1L<nw.l IwNw4uw,n.nnv,ln+pe+n+,mn,h hn.vFnLl in<.mn lin lic/nlm m.uk<I . O 1M...YNw11,.Ynf .lix/al/xv..xn IkL11. tlmvk+bwnMa,.dnl.rwA.n:x.wnn.nnnWwvwMint k II

A 1 remh In ('ifarnte ('ronumnl4m . A('rirical Lwd In Avail:rMe Iblu nn Ihe Gw:xklrx~y al•hia Snxrln+e 11 51 aj ° rnri -» r xA '-z r~>rPa..~,;so . sl,.i}..y_+._- fIR•LM1~ Mxr\n.Iwer~fM.1+Ya'y,arenesin(wrx111/iuil,If22-Itk).IAr1.vrliJrya+W('iExene ('~m.wntNi.N+ IVI111 • Nri ermrrp Ih r1N lat rrnnenl sulne mnnkrrs reporting increased ttnlsumpthm, mmny srmikers reprxling rm aimnge. amt Nill ahers tcrnnhK x alecrease' (5urgeun Generul-s Rellnn 1979. Ap- ~ /xlir, p. A-ZII). 1.1.4 Sur+umur Thr trnxh fo cigarette ameunnMMn In tlre USA uml in Ihe memher couMlks or the liurupeau ('ommunity errhlhil a nunnccr IJsimilarilks: - Sirtce 19fA1 cilearelle cwm/mplhm has increased (in ahsolu/e lerms) in every cnnmry. - At lhe .ulne Ume rhe tmmhrr nf snmkeN (as a prnlxlnion of Um p°tnxiul snmk• ing rylpnl:niw+) has declined - rkslMe °n increase in Ihe numher of fenwle smnlo CM. - The daily crmsumpiun of cisartlles per wluker n coltsiderahly Frea/er Ihan i/ was in 1/M12. - 1hesr ch:rnge.s in cigurelle cmismnruion ndnchkJ with a tapid inerease in the popularity nl'filter and low lar eiparclles. AlJxm f.h Ilx.e develnpnlenls lcnJ to confirm a certain mcrull Irelxl, il wau W he incnrma to make swceping generaliiwliwls or to apply these findinEs universally. llle IminholnNneJ here fw Ilro European ('mnmrmNy eawlqrics are by IHm menln identical. Nalim:lf differences dn esiN which ahonhl ul least modify any general cnndusions Ihal might he rwuk. l here :xe ulsrl a numhtr of Mller raul°rx - such as un irx.ranr in Inh:rrn+dolv nr rMail nrke.:n well ua Ihe role nl°ved hv Ihe "anli- snwkin¢ h>tilry" - whicll aeenunl f~n snional dil'fcrenees. Fiually, lhrrr alv a Ic.n m JKiIlmblha/61Me1htnllth.N.•YCn1/e3lheilMrl^JRe111e/nxu1111Hxn11N:1]IllnkCl nrle jol'the nxnl signiftcarn nelxls nfihe lasl few decuden may anHnlly hr Icerllfng u1f -nr cYtn rkclI1111r1R il1(Mnr ct1I1111Y1e5. ~ Tlmse re'.1CrYa1/w15 aklM IaJkt 11 CIlar 111:1/ dM r++NHldlhl/l rlt 11+1('I IlAlinllill Ilrrl~l~ o° dre basis of evidellee clJlecYed in various ruunlries awulJ lac vicwcd euunwi.lv • even where, as in this case, tlnl ctxm/ries nmurkrcd luwe a ninrvlar s+x:iawcnnonu. mul tullur.d charaalcr. Inlemalumal cn°llxlrisrnl. arc vuli.l, hul nxlir/n.J ucu:l. shmdd nut he mlJercslinulcA, P:rnipdmly whnl thr ilnenll°n i.In pra•vnt an c. i rilan:llhm nf luharinur rather Ih:m a descrilNive aludy. 1.2 A C'rilicnl l.onk al-Avail:lhle 17a1:1 °n Ihc Suriudemugr•lphie tiuurlme nfthe Snlakilrg I'optdnlinn in Wnl (F:nnaoy The Jiffindlin asnxialnl whh nlakinR immrlalion:J wmpari.un. uf ua•nJa in viy+~ rcim nxlsunlptiam have alreaaly Lcrn dixusrJ. tiinlilar pnddcul.:°r IH+•ed by Ihc c.mp.lrulivc un:dysic of Jaul eullerled willlin inAiriduul eminn ir+ 0... prra•al . ua- cern is Io illuslraro wlly slu:h J:ua camun Im n.cd unalilically, I hi± is Iwdlap.IHa ach/crnl by taking West f icnnany us an csanqdc i° nrJ<r to Imin1 uul aruw; uf Ilm Iy111cJ1 fH,Jtkmi A4({KIatCJ wnh d1C rFalalntllm tlt aYmlah/r d.+t:+ Tlu arlnlyses nf Ihe Wea Cierman urhatt'o puxlucl madel dl:n wr h+ve cml.id- ernl are hased wl SeYeral relxetienr:4iMe HNYeyY: 11nweYer, a CIHIII+AIwtl IcaaV h Iha111/ese fr/xlinKs arc nflen highly incnnsislenl. Txhk 1.7 Ihls samlr nf Iln: frndings frsnn surveys cunduclcd Jm ing 19%J :mJ IuSc II IS nPlewMltly Ilml even the IMNI IIIIIIIhe1 Of SIIIHkcI> reclHalCtl Jitlcl, hv owrc Ilum rmr alxl,r balf millinn. IAscaiuuH:ies nf Ihis wuu-Ic ca° nruhably Iw alluhuleJ lollx'JilfernnrnMluxlsu. •JlnesU:+lml:uchmnWlici:d~a+rernux~inal:niau'. Ilr rurious Nwhes Ihus asnume a slrhWanlially Jilfnem ImlHdalton Ier.e. (nrLnlsi4encits are aWl lu l+e funrxl in Ihe l+rcakdown uf Ihc snn.t.cr IN qHdulren (in terms nf pcrcenlages). IriPne 1.6 (see p. III) iiluslrales Illc varialkms iu Ihr liud~ ings of Ilurda nnel the Allensbacher WcdmuJFenmalyee (A WAI x'llll reslrccl to Jlr age Jislrihwiun of nw/e a1M fentak snmkers" We ean nnly speculul° on 111c rrusuns Rn such dilferenrb I he puua•Jwr ut ran alnln sxnmding mxy, in some cuses, lcad lu an ovennprescni:rlHm nf cellain xauun. lahkC/. INf&¢m'otMweenlhefmJerMrAGwrrelxe.rxlNne.w•<rixr~nxJU~~ I•RVL'lutl Swree \xu~pir I•qxnxl:x+lx+w lipa.nrc -~Maky Imn..k. inwlnlNxn sNwtm (11Vfun .,L n~NnxN. .. Nxllxx+. . /INXxarlil,rl,kn _ "' Itur.laNX( Mnr e°22 ` 12 1524 •1 1?a ~1 { . AWA WM Mtx 49011 )i 14,15 ir/ Y 12 !n l/,i AWA IVXS TVI! • M.Un 4/0.73 Il V Is Is ) 11 VAM°S 10767 4s.12 ly IM1Vi. 42 eLI 2'+ /al