The touchstone moment in each episode of the Netflix series "House of Cards" is the single cigarette that Washington power couple Claire and Francis Underwood share every night. It's what passes for intimacy between the two, but to some, it also glamorizes and legitimizes intermittent smoking, which makes up an increasing share of the habits of the nation's 45 million smokers.
"At the end of the day, they get together and they have their little social moment. They smoke a cigarette and they’re telling you it’s okay to smoke," said Robin
Joval, Koval, president and chief executive of the American Legacy Foundation, a leading anti-smoking group. "The fact is there is no such thing as social smoking. It’s smoking."
Research shows, however, that the reality is more complicated. Surveys reveal that a quarter to a third of adult smokers don't smoke every day, according to Saul Shiffman, a psychology professor at the University of Pittsburgh who has spent decades studying smoking habits. There are "chippers" like the Underwoods, who smoke one to five cigarettes a day, and intermittent smokers who may smoke more, but inconsistently. Contrary to common belief, neither group becomes dependent on nicotine, Shiffman said.
"Neither pattern of behavior is consistent with the nicotine-maintenance model," Shiffman said. "...Neither group is addicted, at least not in the traditional sense."
Let's be very clear that smoking is about the worst thing you can do for your health. A single cigarette is one more than you should ever smoke. And the physical harms are dose-dependent; the more you smoke, the more you expose yourself to heart disease, other cardiovascular problems and, of course, lung cancer, not to mention wrinkles and a reduced sense of smell, said Tom Glynn, director of cancer science and trends for the American Cancer Society.
When Shiffman and colleagues studied intermittent smokers for a paper published March 5 in the journal PLOS One, they determined that intermittent smokers' are more likely to light up as a result of "being away from home, being in a bar, drinking alcohol, socializing, being with friends and acquaintances" and being with other smokers. Daily smokers, by contrast, tended to smoke more as a result of their craving for nicotine.
"I’m increasingly of the mind that there are two threads or factors in addiction and we’ve tended to over-attend to one"--the model that says "you have to have it all the time, and when you don't, you suffer craving and withdrawal," he said.
In a separate 2012 study, Shiffman determined that intermittent smokers averaged 4.39 cigarettes a day and smoked 4.38 days a week. On average, they had smoked for 18 years and consumed 42,850 cigarettes. So they certainly aren't smoking newbies or youngsters experimenting with tobacco.
Where does this leave us in terms of prevention? In a 2009 assessment, Shiffman suggested that rising costs, workplace bans and other limits on where and when smokers can light up may be working, pushing more people to smoke occasionally. Indeed, in poorer countries, he said, intermittent smoking is the norm.
[Spoiler Alert! Stop reading here if you haven't finished "House of Cards."]
Now that Frank is president, it remains to be seen whether he and Claire will continue their nightly habit in the White House, or whether something will persuade them to skip that one daily smoke.