Goodwin, Keyes, and Hasin1 note that despite the decrease in cigarette smoking in the United States, there is evidence that nicotine dependence has increased among cigarette users in recent birth cohorts, especially among women cigarette users living in poverty, and nicotine dependence has not been reduced significantly within the overall population. The authors further note that the heaviest users of other substances, such as alcohol and cocaine, are not expected to quit on their own, whereas those who are nicotine dependent find that smoking cessation treatment is often difficult to obtain.
A bicyclist in the model greentown of Cuitiba, Brazil, safely crosses the town center in a designated bicycle lane. Photograph by Carlos Cazalis. Printed with permission of Corbis.
In light of this I was surprised to discover the lack of attention to a potential source of help in smoking cessation, Nicotine Anonymous (NicA), which is a 12-step program for people who are nicotine dependent.2 I recently became aware of NicA through my homelessness research3 and in searching for smoking cessation for homeless populations who are underserved for nicotine dependence. NicA has existed since 1985, yet there has been a dearth of research attention to it,4–6 which I believe has contributed to its overall lack of visibility. As an anthropologist, I find this lack of interest and lack of referrals to NicA, which is free and could be easily accessible, culturally interesting. Further, there is some recent evidence that some heavy smokers are interested in approaches to cessation that include a spiritual dimension.7 I believe that NicA should have the benefit of outcome research, after which we may find it appropriate to add to the current smoking cessation choices.
References
- 1.Goodwin RD, Keyes KM, Hasin DS. Changes in cigarette use and nicotine dependence in the United States: evidence from the 2001-2002 wave of the National Epidemiologic Survey of Alcoholism and Related Conditions. Am J Public Health 2009;99(8):1471–1477 [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Nicotine Anonymous Web site. Available at: http://www.nicotine-anonymous.org. Accessed May 9, 2009.
- 3.Glasser I, Zywiak WJ. Homelessness and substance use: a tale of two cities. Substance Use and Misuse 2003;38(3-6):553–578 [DOI] [PubMed] [Google Scholar]
- 4.Lichtenstein E. Nicotine Anonymous: community resource and research implications. Psychol Addict Behav 1999;13(1):60–68 [Google Scholar]
- 5.Martin JE, Calfas KJ, Patten CA, et al. Prospective evaluation of three smoking interventions in 205 recovering alcoholics: one-year results of Project SCRAP-Tobacco. J Consult Clin Psychol 1997;65:190–194 [DOI] [PubMed] [Google Scholar]
- 6.Humphreys K. Circles of Recovery: Self-Help Organizations for Addictions Cambridge, UK: Cambridge University Press; 2004:77–78, 106–107 [Google Scholar]
- 7.Gonzales D, Redtomahawk D, Pizacani B, et al. Support for spirituality in smoking cessation: results of pilot survey. Nicotine Tob Res 2007;9(2):299–303 [DOI] [PubMed] [Google Scholar]