The Few 'Chippers' May Be OK -- But You Probably Aren't One

By Daniel DeNoon
WebMD Feature

Reviewed By Brunilda Nazario

Lots of people say they're just social smokers. Odds are, they're fooling themselves.

You've seen them at parties and in bars. They usually bum smokes from more serious cigarette addicts. Their excuse: They aren't really smokers -- they're just social smokers.

Is there really such a thing? The surprising answer is yes. Some people really do smoke just a few cigarettes a week. But if you think you're one of them, think again.

Chippers

Researchers call them "chippers." There's much to learn from this. The term is a slang word for heroin users who try to avoid addiction by infrequent use of small drug doses. It's not a strategy that often works -- for heroin, or for nicotine, says Elizabeth E. Lloyd-Richardson, PhD, assistant professor of psychiatry and health behavior at Brown University, Providence, R.I. She's an expert in adolescent and college-age smoking behavior.

"This is absolutely not a good thing to try," Lloyd-Richardson tells WebMD. "We certainly know the health risks associated with smoking. At this point we have not determined a safe amount of smoking. Research also suggests that particularly with adolescents, they often are kind of lulled into this sense they can smoke a little in social situations and then can quit when they go to college or get a job. And we don't actually see that happening that much. Overall, these smokers end up smoking for many, many more years than they intended to."

It's not entirely a bad thing for a person to try to smoke just a little instead of a lot, says Jack E. Henningfield, PhD, professor of psychiatry at Johns Hopkins Medical School.

"The good side is if a person is honest, and truly is only smoking in social situations -- and those are not daily situations -- that person is at a lower level of dependence," Henningfield tells WebMD. "If properly motivated, such people should be able to quit completely. And they should. A person wouldn't go out to their car four times a week and inhale exhaust fumes. But that is the health equivalent of smoking cigarettes four times a week."

Just like one shot of heroin, one cigarette leads to another. Well, not just like heroin. Cigarettes may be more addictive than heroin or cocaine. Two-thirds to three-fourths of current cocaine users, Henningfield notes, did not use the drug in the last month. But two-thirds of current cigarette smokers had a cigarette today.

"The other bad side of social smoking: Like a lot of people on the road to addiction, many of these people are flat-out denying they do have a problem," Henningfield says. "So people say, 'Oh, I only smoke when I drink socially' -- like in the bar -- but they find themselves going to the bar more often. And with cigarettes, soon they find themselves out on the street at 20 degrees below freezing with the other social smokers."

Do Social Smokers Exist?

John Bachman, PhD, assistant vice president for special projects at United Behavioral Health, San Francisco, helps people with serious nicotine addictions.

"The social smoker, I would say that type of person exists," Bachman tells WebMD. "The social smoker, who smokes once or twice a week or at a party, my guess is this is not a person who is smoking cigarette tobacco in order to self-administer nicotine. The people addicted to nicotine will smoke cigarettes, pipes, chew tobacco, put on skin patches, whatever they have to do to get the drug they crave. So I am distinguishing between the social smoker who may get high on the acute effect of carbon dioxide and nicotine, as contrasted with the nicotine-addicted smoker."

This extremely low level of smoking may not be as dangerous as heavier cigarette use.

"I think if a person is healthy, in the broad sense of the word, and smokes one or two cigarettes a week, something else will probably kill that person before cigarette smoking will," Bachman says.

That level of smoking appears to be very rare indeed. Henningfield notes that depending on state of residence, only 5%-15% of smokers have five or fewer cigarettes a day. And half of daily smokers, he says, die prematurely.

"The only thing that is relevant is this: If you smoke at all you are at increased risk of cancer and heart disease. Any smoking does that," he says. "So if people say, 'I only smoke occasionally,' or 'I never smoke more than 10 a day,' they have increased risk because this substance is so toxic."

Current Smokers Usually Can't Just Scale Down

Social smoking is likely less harmful than heavy smoking. But if you're already a smoker, it's very unlikely you can cut back to being a social smoker.

"What I counsel my patients is that, particularly with individuals who have smoked more regularly, it is very difficult to practice that harm reduction where you get down to smoking one or two cigarettes a day," Lloyd-Richardson says. "For someone who has been a regular smoker, it is hard to do that because the number of cigarettes smoked tends to creep up over time."

It's especially true for younger smokers. They feel they can smoke without getting addicted. In other words, they try to become social smokers.

"It is so tricky. College students really want to become social smokers, especially those who are more regular smokers and know they should quit, but still want to go out with friends and smoke and drink and not smoke during the week," Lloyd-Richardson says. "I have never seen any students be successful at trying to do that. It is really an all -or-none kind of thing when you're trying to quit. And that is really harder with younger people who feel invulnerable and think they can do anything and get away with it."

Published Nov. 18, 2003.

SOURCES: Elizabeth E. Lloyd-Richardson, PhD, assistant professor of psychiatry and health behavior at Brown University, Providence, R.I. Jack E. Henningfield, PhD, professor of psychiatry at Johns Hopkins Medical School. John Bachman, PhD, assistant vice president for special projects at United Behavioral Health, San Francisco.

Health Solutions From Our Sponsors