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On the Runway

Her seat back and tray table were in the upright position. Her seat belt was securely fastened. She couldn't leave her seat, couldn't even recline her seat. Couldn't smoke.

As the plane taxied for take-off, she slipped a pad of yellow legal paper from her handbag and pulled a flight magazine out of the seat pocket in front of her. Using the magazine for a writing surface, she recorded a date and time on the top page of the legal pad. It was late in the morning of a late-summer day; she was flying home for her mother's funeral.

The woman wrote words she probably never expected or wanted another human being to read. She alluded to raising children now grown, to being divorced and remarried. She wrote of sacrificing to build a career, without mentioning what career that was. She wrote too about her mother, about her own daughter, and about her squabbles with both. She scrutinized herself and found herself lacking.

More than anything else, she wrote about smoking, about how it was an illness, a priority, an isolating factor. She wrote that she had used it to put distance between herself and those she loved. As the plane took off, she vowed to set things right by quitting smoking. She resolved to change her life, to feel more, to be kinder, more loving, more patient. She considered quitting before returning from the funeral, then added with ominous innocence that she still had a couple of packs of cigarettes she should finish first.

She apparently folded the notepaper and tucked it in the seat pocket along with the magazine. Later, as she left the plane, she left the pages behind. Maybe she just forgot them; maybe they had already served their purpose.

Not long afterward, an ex-smoker sat in that same seat on another flight. This second woman—my cousin—reached into the seat pocket to look for (no kidding) a barf bag to mail to a friend as a joke. She found, instead, the handwritten pages. She read them with easy comprehension; this was how she felt about smoking, too. Unable to return the pages to their anonymous author, she shared them with a couple of people close to her. She showed them to her husband, who confirmed that he too had felt the same way about smoking. She also sent them to me.

Thus these two women, my cousin, whom I know well, and the airline passenger I may never meet, unknowingly started this book eight years ago. I wish I could share those wrenching paragraphs with all who read this book, but they are not mine to share. They belong to the woman who wrote them. In their stead are the words of another smoker, an articulate and thoughtful young woman who once begged her grandfather to give up his pipe, and now hopes to give up her own cigarettes. The story of her life with and without tobacco forms the framework of this book.

To these three women I owe a sizable debt: Before I read the words from the discarded diary, I regarded smoking mostly in terms of nanograms per milliliter of nicotine metabolites in the bodily fluids of tobacco users. That's what I'd measured, in the quantification of tobacco exposure necessary for studying nicotine and tobacco. My training was in behavioral pharmacology, with occasional doses of brainwave research. I'd had little recent contact with the type of psychological research in which one considers meanings and symbols. I'd had plenty of contact with smokers, but I confess to not always allowing myself to see the whole of their behavior.

Smoking is more than a behavior, and more than a meta-message about our world and our times. Our vulnerability to and widespread acceptance of this practice points us toward the need to explore the complexity of tobacco use, and to search for synthesis in the wealth of scientific research about nicotine and tobacco.

And a wealth it is. Scientists have studied how we puff, how we inhale, how we absorb, how we develop physical tolerance, how nicotine affects our moods, how we start smoking, and how we stop smoking. Little about tobacco use has gone unnoticed, although much remains to be explored. To future historians and scientists a few millennia down the pike, tobacco may appear to be the major bafflement of our time. Even if we survive pollutions, deforestations, wars, rap music, and Windows 95, will enough of us survive our self-made tobacco pandemic? Will future explorers wonder, as many today have questioned—

Around the world, from Sweden to Australia, tobacco scientists spend their working days identifying patterns, contrasts, and logic in tobacco-related biology and behavior. The body of research they generate forms the groundwork for solutions to the worldwide tobacco problem. Although the information in this book is as current as today's news, I note with pleasure that every day this book's contents become increasingly dated. Daily, what researchers call "the field"—the state of the science, based on the most current publications and presentations—moves closer to understanding what keeps the woman on the airplane and her 1.1 billion worldwide counterparts using tobacco. Every day, we move closer to offering them better ways to quit.

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Copyright 1998 National Academy Press