Only Smoke When You Drink? You're Still a Smoker

If you're taking a couple of drags on a cigarette at a party — you do it only socially, of course, to unwind and get you into the flow of the night — there's something you probably ought to know.

You probably already know it.

You're smoking.

It's not "social" smoking, "party" smoking, "low-level" smoking, "non-daily" smoking, "intermittent" smoking or any other quote-unquote smoking. It may not be that two-pack-a-day habit that your Uncle Joe and those losers on the other side of the bar have. But it's smoking.

And that makes you a smoker. Just like Uncle Joe.

"It was a very common mantra that I heard, ‘Oh, I smoke but I'm not really a smoker. It's no big deal. I just smoke when I'm drinking,'" says Mimi Nichter, a medical anthropologist who spent a decade poring through hundreds of interviews with college smokers, detailed in her book, "Lighting Up: The Rise of Social Smoking on College Campuses." Nichter is a professor at the University of Arizona. "These kind of comments are potentially very harmful for the person who doesn't recognize what's happening."

Social smoking is a real, scientifically verifiable phenomenon, if not particularly well defined. And it's almost always paired, as anyone who has ever been to a party knows, with drinking. A recent study in the Journal of Neurochemistry offered up one reason: A smoke acts as a stimulant to ward off the sleepiness that comes with drinking too many brewskis.

But social smoking is more than just an accompaniment to a drink at a party. It is — because, let's point out again, it is smoking — a potentially dangerous, possibly deadly act.

Brian King, a deputy director in the Office on Smoking and Health at the Centers for Disease Control and Prevention in Atlanta, says that intermittent smoking, however many cigarettes per day or per weekend or per party you define it, is flat-out dangerous. For a lot of reasons.

"Several decades ago, the preponderance of smokers were actually daily smokers. But now we're seeing increases in the proportion of intermittent smokers and social, occasional smokers," King says. "We know that there's still significant health risks associated with intermittent smoking, as has been identified in several studies. Smoking just 1-4 cigarettes per day is going to double your risk of dying from heart disease. Heavy smokers who have reduced cigarette use by half still have a very high risk for early death."

But what about just a couple at a party every weekend? Or a few times a week? Or every other weekend?

"Even low levels of nicotine can still lead to addiction. It's a highly addictive agent. Some have said it's even more addictive than heroin or cocaine," King says. "Even intermittent use can still lead to addiction and sustained use over time, particularly among youth, who are particularly vulnerable to addiction."

It's not just the nicotine that'll get you. Other, nonmedical factors collude to further hook users, according to Nichter.

For one, smoking remains a major social outlet for many. Whining about the boss or the teacher during a smoke break. Sharing a cigarette while talking relationships at a party.

Then there's the marketing. Big tobacco is constantly pushing the message at young people that cigarettes are desirable and that smoking is cool.

Add all that to the common belief that light smoking isn't dangerous — "It's just a couple cigarettes now and then" — and you have the potential to be a future Uncle Joe.

"My work with young people has really told me it's not about the number [of cigarettes smoked]. It's really about social context," Nichter says. "And I think it's social context that moves you along a trajectory to higher levels of smoking, not necessarily the number."

It's a hard trajectory to break. Many of Nichter's subjects, interviewed early in their college careers, figured they would quit before they graduated. But somewhere around half of them had not by their senior year, and many began to wonder if they would, given the uncertainty of their futures and the need to remain social.

"I was really surprised to find that there were reasons why they wouldn't quit," Nichter says. "It was very ambiguous: ‘I know I shouldn't be smoking because it doesn't look good; it sends all kind of messages about who you are. ... but, yet, I'll probably continue to do it."

One of the biggest obstacles in getting part-time smokers to quit is getting them to admit that they are smokers in the first place. According to Nichter, more than 60 percent of young people who smoke, at whatever level, don't consider themselves smokers.

So, if they're not smokers, they don't need to consider the health implications of smoking. They don't even need to consider stopping — because, you know, they're not smokers anyway.

It is, both Nichter and King agree, a prime opportunity for some teaching and some straight talk.

"They need to know about low-level addiction, that they can become addicted to cigarettes at very low levels, and to some people, this process can happen very quickly," Nichter says. "Students need to recognize that. They need to beware of what they're doing."

Says King: "Every cigarette you smoke is doing you damage. We now have over 50 years of scientific evidence documenting that cigarette smoking harms nearly every organ of the body. Cigarette smoking, even a few puffs, is still dangerous to your health."

Something to think about the next time you're out socializing.