Quiting together works better,

When smokers kick the habit, odds are they are not alone in making the move. The decision to quit smoking often cascades through social networks, with entire clusters of spouses, friends, siblings and co-workers giving up the habit roughly in tandem, according to a new study New England Journal of Medicine.  The study was sponsored by the National Institute on Aging (NIA).

Researchers analyzing changes in smoking behavior over the past three decades within a large social network found smokers quit in groups and not as isolated individuals. Those who continued to smoke also formed clusters that, over time, shifted from the center of the social network, where social connections are more numerous, to the periphery of the group.

“This study has an essential public health message—that no one is an island—our health is partially determined by our social networks and those around us,” said Richard Suzman, Ph.D. of the NIA “The decision to quit smoking cascaded throughout the web, indicating that some form of collective decision-making was taking place. The results suggest new and probably more powerful approaches to changing health behaviors, such as smoking, by careful targeting of small peer groups as well as single individuals.”
Researchers from Harvard Medical School and the University of California, San Diego, reviewed a large social network of 12,067 people participating in the Framingham Heart Study, a community-based study sponsored for 60 years by the National Heart, Lung and Blood Institute, collects comprehensive measures of cardiovascular health and risk factors among three generations of participants who are connected as family, friends and co-workers. Researchers analyzed data collected on the network’s smoking behaviors between 1971 and 2003. The group ranged in age from 21 to 70; individuals smoking one or more cigarettes a day were deemed smokers.

The researchers found that smoking rates among the FHS participants mirrored the national downward trend of the past three decades. In 1971, there were many more smokers and they tended to mix equally with nonsmokers. But by 2000, along with a drop in smoking rates, there was also a change in their social lives. Smokers and nonsmokers tended to form separate clusters, and gradually, the smokers were marginalized on the fringes of the social network.

“While smoking has declined significantly over the past 30 years in America, it remains a leading cause of preventable death,” said NIA Director Richard J. Hodes, M.D. “This study tells us that social relationships have a critical impact on health behaviors and decisions, and that people are strongly influenced by those in their social sphere.”

The researchers found the closer the relationship between contacts, the greater the influence when one person quit smoking. For example:

• When a husband or wife quit, it decreased the chance of their spouse smoking by 67 percent.
• When a sibling quit, it reduced the chance of smoking by 25 percent among their brothers and sisters.
• A friend quitting decreased the chance of smoking by 36 percent among their friends.
• In small firms, a co-worker quitting could decrease smoking among peers by 34 percent. In larger firms, the influence was insignificant.
• Neighbors did not seem to be influenced by each other’s smoking habits.

“Interestingly, geography did not appear to play a role because smoking behaviors spread between contacts living miles apart and in separate households,” said researchers. “Rather, the closeness of the relationship in the network was key to the spread of smoking behaviors.”

Source
New England Journal of Medicine
National Institute on Aging