Monday, June 9, 2008

Potent Social Forces Influence Smoking Behavior

From the desk of Julia....

Article is interesting in terms of the influence of others on changing health behaviors. We can make use of this type of data to emphasize the importance of modeling through patients and the ability to make use of community and online social networks for positive change.

Potent Social Forces Influence Smoking Behavior

Friends and family have a powerful influence on whether a person quits smoking, and the decision to stop smoking can "spread" from one person to another in a social network, new research suggests. The findings are from a detailed analysis of smoking behavior in more than 12,000 individuals who were followed for 32 years, from 1971 to 2003, as part of the Framingham Heart Study.

In 1971, the places smokers and nonsmokers held in the social network were indistinguishable. But three decades later, societal views of smoking have changed, and smokers are increasingly at the periphery of social networks and aligned largely with other smokers, according to results published in the May 22 New England Journal of Medicine.

The authors, Drs. Nicholas Christakis of Harvard Medical School and James Fowler of the University of California, San Diego, reported last year that social networks may strongly influence obesity. In the current study, the authors demonstrate that decisions to quit smoking often reflect changes made by groups of people connected to each other, both directly and indirectly. For example, when a spouse quit smoking, the partner's chances of smoking decreased by 67 percent; friends who quit smoking decreased one another's chance of smoking by 36 percent.

"People are connected, and so their health is connected," the researchers write, adding that "cessation of smoking in one person appears to be highly relevant to the smoking behavior of others nearby in the social network." They also suggest that the person-to-person spread of smoking cessation has been a factor in the significant decline in smoking seen in recent decades.

The network phenomenon could potentially be exploited to spread positive health behavior, the study concludes. Along these lines, collective interventions may be more effective than individual interventions, and public health strategies to encourage smoking cessation may be more cost-effective than initially thought, since health improvements in one person may well spread to others.

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