How to Make People Quit Smoking (Ep. 161)
Our latest Freakonomics Radio episode is called “How to Make People Quit Smoking.” (You can subscribe to the podcast at iTunes, get the RSS feed, or listen via the media player above. You can also read the transcript, which includes credits for the music you’ll hear in the episode.) The gist: the war on cigarettes has been fairly successful in some places. But 1 billion humans still smoke — so what comes next?
In the U.S., roughly 70 percent of smokers say they want to quit. But when they try, some 90 percent of them fail. So what does get people to smoke less? Something must be working: the smoking rate in the U.S. has fallen by more than half.
Kenneth Warner, an economist at the University of Michigan School of Public Health, has been doing tobacco-policy research since the 1970’s. One of the most powerful smoking deterrents, he says, is making cigarettes more expensive.
WARNER: The effects of tax and price are more well studied than any other area of tobacco control. We have a lot of data about that. What we know is that if you increase the price by 10% you will decrease total cigarette consumption by 3 to 4%.
The Vanderbilt economist Kip Viscusi agrees, calling price a “powerful tool” that doesn’t wear out. From a report called “The Economics of Tobacco Taxation,” by Frank J. Chaloupka, here is a good picture showing the relationship between price and cigarette sales:
So besides price and tax controls, what makes people quit smoking? In the podcast, you’ll hear from Jeffrey Harris, a physician and economist at M.I.T. who has studied tobacco control in Uruguay, which he calls “a pioneer” in smoking cessation. In his most recent paper on the topic — “Tobacco Control Campaign in Uruguay: Impact on Smoking Cessation during Pregnancy” (abstract; PDF) — he discusses the effect of cigarette packaging that includes graphic, grotesque imagery:
You’ll also hear about the upside of smoking — or at least of getting nicotine in your system. Paul Newhouse, an M.D. who runs the Center for Cognitive Medicine at Vanderbilt, is doing research to learn if nicotine (divorced from smoking, ideally) has strong medicinal efficacy:
NEWHOUSE: It appears to activate a class of what we call receptors, [which are] important for regulating a whole variety of brain functions. And so we think that nicotinic receptors are important for things like attention, for behavioral strategies, for what we call executive functioning, which is the ability to make decisions and evaluate information, we think it’s important for memory, and so that has led us to thinking about what particular disorders might be helped by stimulating nicotinic receptors with nicotine or with something else.
Among the disorders that Newhouse and others in his field think may benefit from nicotine therapy: schizophrenia, Parkinson’s disease, Alzheimer’s disease, anxiety, depression, and many others. If nicotine does indeed work as theorized, that may explain why so many people have such a hard time quitting smoking: they are self-medicating.
You’ll also hear about an early tobacco-control policy from the Ottoman Empire in the early 1600s. Trust us, you wouldn’t have wanted to be a smoker then.