1. Have you smoked more than 100 cigarettes in your life?
2. Do you still smoke once in a while now as well, including at least one cigarette in the last 30 days?
3. Are you a smoker?
If your answers to the first two questions are "yes" and your third answer is "no," well, according to Wael K. Al-Delaimy and some of his colleagues at the University of California-San Diego School of Medicine, you've just failed.
You're not alone, at least. By analyzing a 2011 California smoking survey, Al-Delaimy recently estimated that there are almost 396,000 adult Californians—or more than 12 percent of the state's adult smoking population—who smoke on a measurable basis, sometimes daily, yet don't consider themselves smokers. Al-Delaimy calls them “non-identifying smokers.”
You've probably met a typical "non-identifying smoker" before, based on the study's characterization, even if you aren't this kind of smoker yourself. It's the 20-something who thinks cigarettes are gross but likes to puff on a few when buzzed, or the person who loves cigarettes but keeps them at bay except in times of stress. Or it's the former chain smoker who hasn't quite kicked the habit but is tired of putting up with the label.
"There is a risk for such smokers to continue to smoke and be adversely impacted by the tobacco they smoke, yet they do not seek any assistance nor do they plan to quit because they falsely believe they are not smokers."
Smoking is a controversial thing to do in a health-conscious society, and is often taken as a sign of someone's greater lifestyle and even values. Being a “non-identifying smoker" seems to walk a careful line: Looked at cynically, it’s self-delusion, but it also might be the best strategy for simply doing something you enjoy without having to take a stand in a public health debate.
Cultural speculation aside, though, there are real dangers to this trend, according to the researchers. For one, casual and heavy smokers share many of the same health risks. "There is no safe level of smoking," Al-Delaimy said in a UCSD press release. And smokers’ failure to self-identify in surveys could diminish efforts to reduce tobacco consumption by hiding significant chunks of affected populations.
"There is a risk for such smokers to continue to smoke and be adversely impacted by the tobacco they smoke, yet they do not seek any assistance nor do they plan to quit because they falsely believe they are not smokers," Al-Delaimy said. The journal that published his study, Tobacco Control, explicitly aims to curb what it calls the "global tobacco epidemic."
Al-Delaimy believes the field needs to design surveys that better account for how smokers perceive themselves. "This more complex issue of identity and self-perception of smokers in today's social environment will require further studies and understanding," he said.