Stay in School, Live Longer

This article first appeared at Water, No Ice (www.waternoice.com).

I was in India on a business trip recently and some friends took me to a night club in Bandra. It was Friday evening, and while the place was relatively empty when we got there at 9 pm, it quickly filled up with young office workers in their twenties and thirties. Since smoking in bars is not prohibited in India (or at least not enforced), the entire place quickly acquired a thick haze of cigarette smoke. What was particularly striking was the number of women who were lighting up. Over the years, smoking seems to have become especially fashionable among young professionals in general, and women in particular. Anecdotally, smoking rates in general seem much higher there; I have few friends who smoke here in the US, but in India, I frequently ran into colleagues on their way out of the building for a smoke, or on their way back from one.

A recent New York Times article talks about the strong correlation between years spent in school and life expectancy. Interestingly, researchers have found much lower levels of correlation between race, or wealth, and longevity; education stands out as the single largest factor.

So what marks the difference between the more vs. the less educated? There is established research that shows that people with more education are better able to plan and to delay gratification. But the one statistic that jumped out at me was the % of people who smoke - 45% of people who never went to school, while just 10% of those with 16-18 or more years of education light up. This one factor showed the greatest difference between the two groups.

Frankly, the link between smoking and life expectancy is nothing new: just try getting life insurance and see what happens to your premium if you are a smoker. What was fascinating is that smoking is significantly lower among educated people, with a correspondingly higher life expectancy.

So back to my co-workers in India. These are folks who have at least a graduate degree, if not a Masters. Why don't they fit in with the pattern that the New York Times study found? To find out, I asked a few smoker friends what made them light up. It was fascinating to find that attitudes to smoking mirrored a 1947 study I found on the web.

They ranged from Fun or Reward on one end of the spectrum - people treat smoking as an adult substitute for the carefree enjoyment they knew as children, and as a reward that they could give themselves as often as they wished.

Some people spoke about cigarettes being a companion when they were alone, and brought back pleasant memories in the past (that were often also associated with smoking).

While few smokers will admit it, smoking is often a part of one's imagined or desired personality - the 'Coolness' factor. TV and Movies reinforce these images in the pop-culture.

At the other end of the spectrum, the most commonly quoted reason was that smoking was a stress-buster - "it helps me think" or helps me blow my troubles away.

Finally, almost everyone we know has tried to quit or reduce his / her smoking at some point. Everyone worries that they're smoking too much. Some can, others can't.

What made is easier for smokers (especially educated ones) in the US to quit? I think that here in the US, several difficult factors have made it more difficult to smoke and by corollary, easier to quit. Widespread awareness of the health effects of smoking, high prices of cigarettes due to high taxes, bans (that are enforced) on smoking in offices and public places, the easy availability of alternatives such as nicotine patches or gum, and a significant reduction in portrayal of smoking in the popular media, have helped reduce the incidence of smoking (among the more educated, at least).

India's begun to move in that direction, how quickly is still a matter of debate.