Most people’s lists of life-changing books focus on great works of literature, philosophy, and religion. Prominent on mine is Sarah Susanka’s The Not So Big House. Susanka popularized the notion that when it comes to living spaces, bigger is not necessarily better, and showed the world how to put it into practice. She convinced us we didn’t need to duplicate functions or devote a lot of space to rooms that are almost never used. She suggested that we spend our housing budget on quality, not quantity. Calculate the amount of square footage you can afford, then spend the same amount of money on a smaller amount of space, making it as appealing to the eye and nourishing to the soul as you can.
It occurred to me that these principles for how we live could be adapted to how we eat, and that they might be especially relevant for people who have quit smoking or are about to do so. After all, smoking suppresses appetite; when nicotine is removed from your life, appetite increases. Although some of the typical increase in weight after quitting comes from changes in metabolism and blood volume, most of it comes from increases in food intake. So at a time when you probably need to eat a little less to maintain weight, you are likely to eat a little more instead. This isn’t a failure of the will, it’s the triumph of physiology.
Dieting doesn’t usually work; or it works for awhile and then it doesn’t, because it’s hard and unpleasant to live in a state of perpetual deprivation, especially at a time when you’re also absorbing the loss of your cigarettes.
But there’s a fair amount of wiggle room between dieting and supersizing – and even between dieting and eating till you’re “full,” as many of us have been taught to do. In nutrition, as in architecture, if we can improve the experience by using high quality ingredients and then taking time to savor the results, we can eat a little bit less and enjoy it more. We can leave a little on our plate and still feel satisfied. We can reframe our thinking about what constitutes “enough.”
As little as 100 fewer calories per day can make a difference. Here are a few clues that will tell you you’re on the right track with your food choices:
Too expensive? A few Americans are so close to the margin that there is no elasticity in their food budgets, but most of us can pay a little more for good food if that’s what we prioritize. Divert the money you used to spend on cigarettes to upgrading your fare and regard it as an investment in looking and feeling your best.
My diatribes about tobacco advertising often focus on its role in promoting nicotine’s weight-suppressing effects (and probably in encouraging our strong preference for slimness as well). Like all successful seducers, however, the tobacco industry has more than one arrow in its quiver. In this post I’d like to talk about smoking as a symbol of women’s rights and the way in which the purveyors of tobacco have capitalized on it.
When I accepted Smith College’s offer of admission in 1960, I don’t think I fully appreciated the company I’d be keeping. The ranks of my fellow alums include many illustrious advocates for and/or examples of female achievement—writers as diverse as Margaret (Gone with the Wind) Mitchell, tragic poet Sylvia Plath, and political humorist Molly Ivins; the redoubtable Julia Child; and feminist trailblazers Betty Friedan and Gloria Steinem, to name but a few.
I recently received the 100th anniversary issue of the Smith Alumnae Quarterly, featuring a decade-by-decade review of the college’s proud history of empowering women. Because of my interest in the history of tobacco use, I was particularly taken with an essay by Shirley Dlugasch Zussman of the Class of 1934. Zussman, a sex therapist living in New York, still active, still blogging at age 95, vividly evoked the heady sense of emancipation she and her classmates experienced: “World War I had brought women out of the house to work in offices and factories and given them a new freedom. The harsh sexual repression of the Victorian age had begun to subside…. [The] students relished the new freedom women had. Smoking was common, its dangers still unknown.”
The tobacco industry probably did not invent the connection between smoking and women’s emancipation, any more then it invented nicotine’s weight-suppressing effects, but it was similarly quick to turn the connection to its own advantage. Lucky Strike enjoyed remarkable success in expanding the women’s market by persuading a group of debutantes to smoke as they walked in the 1929 Easter Parade in New York, billing cigarettes as “torches of liberty” and lending a new air of respectability to smoking in public. By the time Shirley Zussman and her classmates arrived in Northampton, MA in the fall of 1930 to begin their freshman year, smoking among women had become commonplace on college campuses as well as in other settings.
In 1963 the so-called “second wave” of feminism was sparked by the publication of Betty Friedan’s The Feminine Mystique. Three years later the National Organization for Women (NOW) was formed, and in the early ‘70s, Gloria Steinem became the founding editor of Ms. magazine. It was during this era that the Virginia Slims brand was launched, using the same twin themes of liberation and weight control that had worked so well for Lucky Strikes in the ‘20s. Images of sleek, glamorous women succeeding in business and social settings were served up to the catchy tune of “You’ve come a long way, baby.”
One big difference from the college days of Shirley Zussman: By now the health hazards of smoking had been well publicized. You might think the women’s movement, committed as it was to protecting the health of women, would have confronted the tobacco industry—but you would be wrong. Sadly, by advertising in women’s magazines, contributing to women’s causes, and sponsoring women’s sports events, Big Tobacco was able to fend off most potential opposition, and by and large the risks of smoking were downplayed in the pages of Ms.
The introduction of “women’s cigarettes” saw an alarming uptick in smoking initiation by 14-17 year old girls, running counter to the steady overall decline in smoking in the U.S. beginning in the early ‘60s. Thus were excess numbers of young women in the generation just behind mine lured into tobacco addiction.
Emancipation? Liberation? Or clever manipulation by people who have their own bottom lines and not your best interests at heart? You be the judge.
You saw it on webmd.com – you know, the folks who pride themselves on “bring[ing] you the most objective, trustworthy, and accurate health information on the web. “ Cutting salt, shouts the headline, is “as good as quitting smoking.” “Half a teaspoon less salt a day,” they continue, “would prevent 92,000 deaths, 99,000 heart attacks, 66,000 strokes.”
Hmmm, you may be asking yourself, which is easier? Quit smoking, or eat a little less salt each day? Well, duh.
Because smoking is widely known as the single biggest preventable cause of morbidity and mortality, it seems to be the health hazard to beat if you want to make a splash in the news. (I recently blogged about obesity, another condition that has vied with smoking for the role of number one health villain.)
What is wrong with this picture? (And c’mon, deep down you know you can’t balance out the risks from smoking by blocking half the holes in your salt shaker.)
First of all, according to the article, the “benefits of reduced salt intake are on par with the benefits of population-wide reductions in tobacco use….” The operative words here are “population-wide reductions.” Most Americans consume excessive salt (mostly not from the salt shaker or in cooking; nearly 77% of the salt in the American diet comes from processed foods), whereas the risk of smoking is largely confined to the 20% of Americans who smoke. Population-based estimates average out your risk with that of your nonsmoking next-door neighbor, but in fact, most of the risk of smoking (apart from the lesser though not negligible risks of passive smoking) accrues to those who smoke.
Another catch: The study cited was based on cardiovascular risk. But smoking entails substantial other risks as well. For starters, it causes cancer, remember?
An editorial accompanying the scientific report advocates federal regulations to compel food manufacturers to reduce the salt in processed food. Michael Pollan, author of several bestselling books on nutrition, would urge you to eat less processed food. Either strategy—or ideally, both—would undoubtedly have a great impact on the public health.
But shame on you, webmd.com, for implying that cutting salt intake will produce health benefits comparable to smoking cessation without stating explicitly that this does not apply to the individual smoker.
I have read many explanations for the so-called “obesity epidemic” in the U.S. The phenomenon is undoubtedly multifactorial, with the success of anti-smoking public health campaigns and consequent postcessation weight gain numbering among the culprits. Other possible contributors include the aging population and ethnic shifts that increase the representation of groups that place less cultural emphasis on thinness, to name a couple. Overeating, however, is clearly key.
The big question is not why increases in caloric intake lead to increases in weight but why here and why now? What has happened to our food supply and the way it is marketed, and why are we so receptive? David Kessler’s latest book, The End of Overeating: Taking Control of the Insatiable American Appetite (Rodale Press, 2009), is a brilliant account of how food manufacturers, restaurants, and the advertising industry have conspired to manipulate the salt, fat, and sugar content of foods, mouth feel, portion size, appearance, etc. to maximize availability and palatability. These products — often not food in the conventional sense — are designed and tested to coopt brain reward mechanisms evolved to help us survive under very different conditions. The result is what Kessler calls “conditioned hypereating.” There may once have been an advantage in eating all the berries on the bush but not in the context of perpetual overabundance. It’s a setup for addiction that some can resist but many cannot.
Unfortunately Kessler’s proposed solution – essentially behavior modification based on a perceptual shift combined with showing the food industry the error of its ways – is less compelling than his analysis of the problem. Kessler, you may recall, devoted much of his career as FDA Commissioner to exposing the tobacco industry’s malevolence, which he documented in a book tellingly entitled A Question of Intent: A Great American Battle with a Deadly Industry. As a researcher on smoking/nicotine addiction and author of a book intended to help women smokers who struggle to control weight and keep depression at bay when they quit, I kept asking myself why Kessler is so willing to give the food industry a pass. Does he think the intent of the food industry is less diabolical and profit-driven, even though The End of Overeating is rife with evidence to the contrary? I hope he is right that re-educating them will have a big impact (maybe they have learned something from watching the travails of the tobacco industry), but pardon my skepticism.
Lest anyone think we Americans have brought our troubles upon ourselves through laziness and lack of discipline, there are already signs that the “obesity epidemic” is turning into a pandemic, and why should anyone be surprised? The laws of human biology are not suspended at national borders, and though the U.S. may be at the bleeding edge, we live in a global culture. One further point: In raising concerns about obesity it is not my intent (nor do I think it is Kessler’s) to endorse the socially-engineered preference for thinness that propels so many, especially women, to self-hatred and/or undernutrition. The issue is obesity as a health problem. You know something’s amiss when ads aimed at diabetics, peddling products that make diabetes look like fun, become mainstream.
Yep, that’s me, age 18 or so, working hard to become a smoker. (And in case you were wondering: No, that’s not my husband; this photo was taken long before I met him.)
I was luckier than the smokers we studied in the Nicotine Research Laboratory in that I never succeeded in learning to inhale. So I never took in enough nicotine to become addicted, and eventually I decided that uncontrollable coughing fits were not exactly the image I was trying to project. As I say, I was very lucky – and believe me, it was sheer luck. I was definitely giving it my best shot!
Most smokers start when they’re in their teens. To an adolescent, the hazards seem distant and remote; smoking seems cool or sexy and the tobacco industry is happy to reinforce those notions. And sadly, many girls are seduced by the belief that smoking will help them control their weight. Although smoking does suppress appetite, and although confirmed smokers tend to gain weight when they quit, smoking is really not a very good dieting tool. We have conducted several studies of college women and found no difference in weight between smokers and nonsmokers in this age group. Rather, the weight-suppressing effects of smoking primarily emerge over time, by reducing normal adult weight gain so that eventually adult smokers weigh about ten pounds less, on average, than their nonsmoking counterparts.
Conclusion: If you are a young woman and a light or occasional smoker, and you wish to gain as little weight as possible when you quit, now would be an excellent time to stop smoking. It is far easier to quit now than it will be later, when you’re a confirmed smoker, and when you’re more likely to gain weight after quitting.
Cynthia S. Pomerleau, Ph.D., is currently research professor emerita in the University of Michigan Department of Psychiatry. From 1985 to 2009 she served as director of the Nicotine Research Laboratory, where much of her research focused on the impact of smoking on women. She is the author of more than a hundred articles and book chapters on smoking and a contributor to the 2001 Surgeon General’s Report on Women and Smoking.