Dr. Michael Eriksen

Staff Photo by Gillian Bolsover James Riddle, stands outside his bar, The Hot Spot, in Dalton Friday. He said most of his customers are smokers but because of his ventilation system the bar can be filled with smokers and the bar doesn’t smell too smokey.

Tobacco use will continue, and may increase, even as the recession squeezes wallets, a Georgia State University researcher said.

“The bad economy is a risk factor for relapse,” said Dr. Michael Eriksen, director of Georgia State’s Institute of Public Health and co-author of “The Tobacco Atlas,” a recent global report on trends in tobacco use.

“We need to continually reinforce smoking cessation as the norm, (and) states need to fund their quit lines to help people who are quitting or relapsing,” he said.

wrong direction

Results from the most recent National Health Interview Survey, which tracks the health behaviors and health status of a representative sample of the U.S. adult population, seem to reflect the effect of the recession, he said. The survey showed a small but potentially worrisome increase in U.S. smoking rates in the first nine months of 2008, from 19.7 percent to 20.9 percent, Dr. Eriksen said.

“You have to be a little concerned that some of the increases in 2008, while not statistically significant, are going in the opposite direction of what has happened in the past,” he said.

Overall, the National Health Interview Survey has shown that adult smoking rates have declined fairly steadily from a rate of 24.7 percent in 1997.

Jay Collum, tobacco cessation coordinator for the Chattanooga-Hamilton County Health Department, said it is “absolutely true” that stress from financial woes can affect smoking rates.

“It is highly likely that, under additional stress of the recessionary pressures, many people are feeling they are likely to smoke more,” he said.

“In some cases, we do suggest people try not to quit in times of very high stress,” Mr. Collum said. “We’re talking about a reliable friend, an addiction (that a smoker is trying to give up.) That’s not the ideal time to quit.”

SOCIALLY ACCEPTABLE?

Legislation prohibiting smoking in most establishments passed in 2005 in Georgia and in 2007 in Tennessee, making the practice less socially acceptable, Dr. Eriksen said. Both laws prohibit smoking in most enclosed areas, except in establishments that always limit patrons by age, such as 21-and-older bars.

For smoker and Dalton, Ga., resident Jeff Stanley, the habit has been hard to break. Even after once quitting for three years, he started again after hanging around co-workers who were smoking, he said.

But he wondered if the economic recession would deter people from smoking cigarettes.

“It may make some people quit because they can’t afford them,” said Mr. Stanley, 45.

Dr. Eriksen said that’s a possibility, but he noted the correlation between lower incomes and higher smoking rates is a powerful one.

“The issue is going to be: Do those two cancel out? As prices go up (will) people have less money to spend on tobacco? Is that going to be a weaker or smaller (effect) than the change in social status?” he said.

In 2007, the Tennessee General Assembly voted to more than triple the cigarette tax from 20 cents to 62 cents per pack.

Georgia has one of the lowest cigarette taxes of all states at 37 cents, Dr. Eriksen said. A proposed $1 cigarette tax increase, which he said would raise $300 million, never made it out of committee in the state Legislature this year, he said.

Danise Birchfield, community education coordinator at Memorial Home Health in Chattanooga, is a core member of an anonymous support group for smokers trying to quit. Within the past few months, one member who had been tobacco-free for nearly five years started up the habit again, she said. Stress from the economic downturn was a contributor, Ms. Birchfield said.

A cigarette “makes you think that you can cope, emotionally,” she said. “We did lose a couple of people due to stress and starting back.”

Those trying to quit should not be discouraged if they fall off the wagon, said Amy Carroll, nurse manager at the Catoosa County Health Department.

It often takes multiple tries for a smoker to quit for good, and even taking the step to decide to quit is something to be proud of, she said.

“We know the more times they quit, the more success they will have” in eventually quitting permanently,” she said.