Nondaily and Social Smoking

Abstract

Nondaily and social smoking (smoking primarily in social situations) are increasingly prevalent. Social smokers differ from daily smokers in their demographics, psychological profile, and degree of nicotine addiction. Current methods used to screen for tobacco dependence often miss social smokers, who tend to self-categorize as “nonsmokers.” The available, albeit limited, literature on whether social smokers exhibit nicotine dependence is controversial. While there are no data on the direct health risks associated with social smoking, data on light active smoking and passive smoking suggest that intermittent tobacco use carries health risks, particularly for cardiovascular disease. Because social smokers consume less and tend not to show signs of nicotine dependence, pharmacotherapies, which are designed to counter withdrawal symptoms, may not be relevant. However, social smokers may be more motivated to quit when educated on the dangers of their secondhand smoke. There is a need for new research on defining the health impact of nondaily and social smoking. While daily tobacco consumption in the United States is declining,1 nondaily smoking is increasing.2 Nondaily smoking (smoking on some days but not every day) is a distinct pattern of tobacco use that falls under the broader category of light (low-volume) or intermittent smoking. There is not a consensus on how to study nondaily smokers; some investigators have grouped nondaily smoking with other forms of light tobacco use, while others have studied it as a separate entity. Regardless of the precise definition, nondaily and social smokers are intermittent tobacco users who, alone with occasional, low-rate daily and very light smokers, are often not identified in clinical practice because they do not consider themselves smokers. Because nondaily smoking is increasing in prevalence, representing up to one-fourth of current tobacco users,2 there is a need to improve clinicians' ability to identify and treat these types of smokers. Current smoking cessation strategies were developed for established smokers who consume 1 or more packs of cigarettes per day, meet clinical criteria for nicotine addiction, and experience clear physical and psychological effects of tobacco. Nondaily smoking has not been a focus of cessation efforts, nor has it been incorporated into national clinical guidelines for treating tobacco dependence, partly because nondaily smoking has been considered a transient behavior associated with smoking initiation or quit attempts.3