The image thing that drives women to smoke

But after research which suggests women find it even harder than men to give up, do girls need extra help? Barry Nelson investigates.

IT doesn't matter who you are, giving up smoking is a nightmare. It's not just the nicotine - many people become hooked on the feel of the cigarette in their hands and even the act of opening a new packet.

And if you do finally manage to take the healthy option and quit for a while, there's always the danger that you will slide back into the habit when things get stressful at work or when you're out drinking.

According to new research, it can be even harder for women than men to stub out the habit for good.

A team of scientists at the University of Minnesota monitored a group of smokers who were allowed to have as many cigarettes as they liked on some days and had to go without on others. The subjects were quizzed about their feelings on smoking and put through a series of mental agility tests.

The researchers found that the women experienced greater cravings than men and suffered more intense withdrawal symptoms. They also discovered that women were more likely to use cigarettes as an emotional 'prop' to help deal with daily crises. More teenage girls now smoke regularly than teenage boys, and if this latest evidence is to be believed, it seems they will also find it more difficult to quit later in life.

The research from America is no surprise to health officials on Wearside, which has some of the highest levels of smoking in a region which itself has higher than average levels of nicotine addiction.

Christine Jordan, tobacco control co-ordinator for Sunderland Teaching Primary Care Trust, says the trust's own research confirms that women smokers are more emotionally dependent on their cigarettes than men.

"Women tell us that they regard cigarettes as an emotional prop to their lives," says Christine, who backs plans to seek funding from the European Union to set up an office for tobacco control in the North-East.

If such an office is established - and regional health bosses are determined to press ahead even if European funds are not forthcoming - it could lead to the kind of bans on smoking in pubs, clubs and restaurants which have successfully halved smoking rates in the American state of California.

"It is also interesting that men and women said different things about the reasons they wanted to give up," adds Christine. "While both see the health risk, men tend to see giving up as a way of improving fitness. Women say they stop for the sake of their family, their children or if they are pregnant."

Christine is keen to point out that Wearside was one of the first areas in the North-East to set up specialist advisors to help pregnant women to quit, a service which is now widely available.

Other important gender differences surface when smokers are asked how they are going to stop. "Men tend to say they will rely on their own willpower, women are more likely to seek help from smoking cessation advisors," she says.

Stars such as Kate Moss, Anna Friel and Ruby Wax have all struggled with the deadly weed. Moss was photographed smoking when she was pregnant while Anna Friel was spotted shivering outside a showbiz party last year when she sneaked outside to have a cigarette. Ruby Wax gave up cigarettes - and then found it hard to stop chewing nicotine gum.

So why do women find it so hard to quit? Just how should they be fighting their battle to stub out for good?

Amanda Sandford, research manager with anti-smoking group Ash, says there is increasing evidence that women and men smoke for different reasons, and the seeds are usually sown very early on in life.

"There's been a fair amount of research now saying there may be gender differences. Women don't usually take up smoking - girls do. More teenage girls than boys are regular smokers, and that seems to be because of self esteem.

"Smoking can help them socially, because it makes them appear more mature. The image thing is an essential reason for starting to smoke."

Jean King, director of tobacco control at Cancer Research UK, agrees and thinks it is vital to stop smoking being seen as something free spirits do in order to discourage teenage girls from starting.

"As long as we have Hollywood stars willing to smoke on screen it's going to be very difficult to stop smoking being fashionable, but it really should not be seen as cool or glamorous. Maybe what we need is fashion accessory nicotine patches!"

Once women have started smoking, social factors also play an important role in keeping them at it, as well as the normal physiological addiction to nicotine.

"For women it could well be something they turn to in times of need," says Sandford. "It can be an emotional support to get them through the day."

"Women tend to depend far more on cigarettes than men," adds Ed Hudson of counselling service Quitline. "They are more likely to use them for comfort in stressful situations, and often identify them as their only source of pleasure during the day.

"The weight issue is another big one which comes up all the time. They think as soon as they stop smoking they will start piling on the pounds, and it definitely puts people off quitting."

So if women tend to have a particularly powerful psychological addiction to cigarettes as well as a physical one, what chance have they got of giving up?

"It's undoubtedly willpower that's the most important factor," says Sandford. "You have to be ready to quit, and unless you're ready to quit nothing's going to work. But if you rely solely on willpower most people will fail. They might get through day one, but on day two they weaken and start up again."

King says people hoping to overcome their addiction could try nicotine patches or nicotine gum, and in extreme cases drugs such as Zyban.

These kind of techniques have been shown significantly to increase the chances of quitting, while there is also some evidence that hypnotherapy and acupuncture can help.

"We want to use all the different strategies we can to help people and we're committed to research into these alternative therapies," says King.

However, as Hudson points out, giving up smoking is a very individual process.

"What will work for some won't work for others. The most important thing with quitting is to know why you want to do it, and plan ahead for difficult times. Pick a day about a week ahead as your quitting day, and then get information about the different treatments, and support from a doctor or our helpline.

"Doing those things will improve your chances considerably."

Certainly, with death rates in the North-East from lung cancer running at 66 per cent higher than the national average for women and 36 per cent higher for men there is room for improvement.

Quitline: (0800) 002200