INTERVIEW WITH RACHEL PASTIVA
At the time she interviewed Dr. Pomerleau, Rachel Pastiva was the Bookstore Manager of the Crazy Wisdom Bookstore and Tearoom in Ann Arbor, Michigan. She is currently Director of the Friends of the Ann Arbor District Library.
Rachel Pastiva: On your website, it mentions that you served as the director of the Nicotine Research Laboratory at the University of Michigan from 1985 until your retirement last year. What attracted you to research this particular field?
Cynthia S. Pomerleau: Long before I became involved in research on smoking, I had an interest in women’s issues. I wrote my doctoral dissertation on autobiographies of English women in the seventeenth and eighteenth centuries and later served as director of an Oral History Project on Women Physicians, based in the Library of the Medical College of Pennsylvania (MCP! - historically a women’s institution that had recently begun accepting men). This project resulted in a book entitled In Her Own Words, which remained in print for many years and can still be readily obtained.
In the early 1980’s I entered a master’s program in psychology and began working in my husband’s laboratory. He was a psychologist doing research on addiction and regarded smoking as an ideal model for laboratory research because it is legal, has a short addiction cycle of around 30 minutes in highly dependent smokers, and doesn’t cause behavioral disruption such that it would be unsafe for participants to drive home after ingesting their drug of choice. At that time he was studying only men because their behavior was not “complicated” by cycling hormones. Studying women smokers was my contribution to the laboratory, and of course we had to start by studying the impact of the menstrual cycle on smoking. We then went on to study the effect of weight concerns and of various psychiatric disorders upon smoking and quitting. Studying women’s smoking turned out to be a wonderful career choice for me because the topic is both critically important to public health and fascinating in its own right.
RP: It's interesting that your book Life After Cigarettes: Why Women Smoke AND How to Quit, Look Great, and Manage Your Weight is geared specifically towards women. Do women face stressors that make them more susceptible to smoking than men?
CSP: Since the smoking rate in men and women is currently very similar – around 20% - it is probably not the case that women are more susceptible to smoking then men, although there is a fair amount of evidence that women find it a little harder to quit than men. In response to your implied question about my book being “geared specifically towards women,” however, the important thing to note is that factors that influence women to initiate and continue smoking differ from those that influence men, especially with respect to weight concerns and depression. Taking those special considerations into account and tailoring our prevention and intervention efforts to the special needs of women will increase our ability to help women become and remain smokefree.
RP: The subtitle of your book suggests that appearance and weight concerns are key issues for women who are trying to quit smoking. Can you elaborate on how these issues undermine their ability to quit?
CSP: Nicotine suppresses appetite and revs up metabolism, with the result that smokers typically weigh around ten pounds less than people who have never smoked. For some women – for example, women who “use” nicotine to manage a tendency towards binge-eating – the differential may be even greater. Most women have some degree of concern about or dissatisfaction with their body weight; for many women smokers, this concern is so intense that they will not even consider quitting smoking, or they will not make it beyond the first few days of abstinence as the needle on the scale begins to creep up.
Many so-called experts, mostly male, have a hard time relating to these concerns and either actively or implicitly “dis” women for putting them above concerns about health (as though men didn’t take unnecessary risks with their health!). My book, by contrast, makes clear that there is nothing wrong with wanting to be the most attractive “you” you can be, and to have the sense of well-being that goes with looking and feeling good. The problem is, smoking also has many negative effects on appearance as well as on health. My book’s message is that there are far better ways to take charge of weight and appearance.
RP: There are many books, cds, medications, etc. designed to help people quit smoking. What unique tools does your book offer women to help them quit for good?
CSP: I have never seen Life After Cigarettes as a quit-smoking book per se. (As you say, there are already lots of them, and though many are of questionable value or based on unsubstantiated methods, a few of them are pretty good.) You will notice that my book does not contain self-tests for smoking typology or step-by-step behavioral prescriptions for the reader to follow. It also does not try to scare the reader into quitting by telling her upfront about all the morbidity and mortality associated with smoking. In my original manuscript, in fact, information on quitting smoking was relegated to an Appendix, since I wanted to be sure the book would also appeal to former smokers who had already quit but wanted to go back and “get it right” with respect to weight and depression. When my publisher insisted that the subtitle must include the words “how to quit,” however, I decided that truth-in-advertising required me to add a chapter providing comprehensive, up-to-date information about approved behavioral and pharmacological interventions for smoking. I think this turned out to be a good addition to the book and hope anyone seeking guidance on how to quit smoking will find it helpful. But the unique contribution of my book is its focus on problems that often deter women from even trying to quit - in particular, concerns about weight and abstinence-emergent depression:
RP: What can women expect to learn from your book event at Crazy Wisdom?
CSP: Please note that my presentation will be framed to appeal to people with a general interest in women’s issues, not just smokers. The following topics will be covered:
Rachel Pastiva: On your website, it mentions that you served as the director of the Nicotine Research Laboratory at the University of Michigan from 1985 until your retirement last year. What attracted you to research this particular field?
Cynthia S. Pomerleau: Long before I became involved in research on smoking, I had an interest in women’s issues. I wrote my doctoral dissertation on autobiographies of English women in the seventeenth and eighteenth centuries and later served as director of an Oral History Project on Women Physicians, based in the Library of the Medical College of Pennsylvania (MCP! - historically a women’s institution that had recently begun accepting men). This project resulted in a book entitled In Her Own Words, which remained in print for many years and can still be readily obtained.
In the early 1980’s I entered a master’s program in psychology and began working in my husband’s laboratory. He was a psychologist doing research on addiction and regarded smoking as an ideal model for laboratory research because it is legal, has a short addiction cycle of around 30 minutes in highly dependent smokers, and doesn’t cause behavioral disruption such that it would be unsafe for participants to drive home after ingesting their drug of choice. At that time he was studying only men because their behavior was not “complicated” by cycling hormones. Studying women smokers was my contribution to the laboratory, and of course we had to start by studying the impact of the menstrual cycle on smoking. We then went on to study the effect of weight concerns and of various psychiatric disorders upon smoking and quitting. Studying women’s smoking turned out to be a wonderful career choice for me because the topic is both critically important to public health and fascinating in its own right.
RP: It's interesting that your book Life After Cigarettes: Why Women Smoke AND How to Quit, Look Great, and Manage Your Weight is geared specifically towards women. Do women face stressors that make them more susceptible to smoking than men?
CSP: Since the smoking rate in men and women is currently very similar – around 20% - it is probably not the case that women are more susceptible to smoking then men, although there is a fair amount of evidence that women find it a little harder to quit than men. In response to your implied question about my book being “geared specifically towards women,” however, the important thing to note is that factors that influence women to initiate and continue smoking differ from those that influence men, especially with respect to weight concerns and depression. Taking those special considerations into account and tailoring our prevention and intervention efforts to the special needs of women will increase our ability to help women become and remain smokefree.
RP: The subtitle of your book suggests that appearance and weight concerns are key issues for women who are trying to quit smoking. Can you elaborate on how these issues undermine their ability to quit?
CSP: Nicotine suppresses appetite and revs up metabolism, with the result that smokers typically weigh around ten pounds less than people who have never smoked. For some women – for example, women who “use” nicotine to manage a tendency towards binge-eating – the differential may be even greater. Most women have some degree of concern about or dissatisfaction with their body weight; for many women smokers, this concern is so intense that they will not even consider quitting smoking, or they will not make it beyond the first few days of abstinence as the needle on the scale begins to creep up.
Many so-called experts, mostly male, have a hard time relating to these concerns and either actively or implicitly “dis” women for putting them above concerns about health (as though men didn’t take unnecessary risks with their health!). My book, by contrast, makes clear that there is nothing wrong with wanting to be the most attractive “you” you can be, and to have the sense of well-being that goes with looking and feeling good. The problem is, smoking also has many negative effects on appearance as well as on health. My book’s message is that there are far better ways to take charge of weight and appearance.
RP: There are many books, cds, medications, etc. designed to help people quit smoking. What unique tools does your book offer women to help them quit for good?
CSP: I have never seen Life After Cigarettes as a quit-smoking book per se. (As you say, there are already lots of them, and though many are of questionable value or based on unsubstantiated methods, a few of them are pretty good.) You will notice that my book does not contain self-tests for smoking typology or step-by-step behavioral prescriptions for the reader to follow. It also does not try to scare the reader into quitting by telling her upfront about all the morbidity and mortality associated with smoking. In my original manuscript, in fact, information on quitting smoking was relegated to an Appendix, since I wanted to be sure the book would also appeal to former smokers who had already quit but wanted to go back and “get it right” with respect to weight and depression. When my publisher insisted that the subtitle must include the words “how to quit,” however, I decided that truth-in-advertising required me to add a chapter providing comprehensive, up-to-date information about approved behavioral and pharmacological interventions for smoking. I think this turned out to be a good addition to the book and hope anyone seeking guidance on how to quit smoking will find it helpful. But the unique contribution of my book is its focus on problems that often deter women from even trying to quit - in particular, concerns about weight and abstinence-emergent depression:
- Life After Cigarettes provides motivation to quit and stay quit based on realistic observations on about the likelihood of weight gain, encouragement to accept a modest weight gain, and evidence-based information on how to avoid large weight gain. The emphasis, for both quitting smoking and managing weight, is on finding the way that is right for the reader, the one she can and will carry out.
- Smoking is more common among people with a tendency towards depression, possibly because of nicotine’s antidepressant effects, and these people are particularly susceptible to experiencing depressed mood as a withdrawal symptom when they quit smoking. Because depression is around twice as common in women than in men, this aspect of smoking and quitting is particularly relevant to women. My book includes suggestions for coping with depressed mood after quitting and, in severe cases, encouragement to seek professional help.
RP: What can women expect to learn from your book event at Crazy Wisdom?
CSP: Please note that my presentation will be framed to appeal to people with a general interest in women’s issues, not just smokers. The following topics will be covered:
- How has the tobacco industry attempted to encourage women to initiate and maintain smoking, both in the US and globally?
- How does nicotine act on the body and why are its effects particularly relevant to the needs and concerns of many women?
- Is weight gain upon quitting smoking inevitable, and how can it be managed?
- What is the connection between smoking and depression?
- How can a women smoker become not just someone who no longer smokes cigarettes, but one who has actively embraced her nonsmoking status and feels good about herself and her world?