Malcolm Gladwell - The Tipping Point

This is, if you think about it, a rather extraordinary finding. Most of us believe that we are like our parents because of some combination of genes and, more important, of nurture — that parents, to a large extent, raise us in their own image. But if that is the case, if nurture matters so much, then why did the adopted kids not resemble their adoptive parents at all? The Colorado study isn't saying that genes explain everything and that environment doesn't matter. On the contrary, all of the results strongly suggest that our environment plays as big — if not bigger — a role as heredity in shaping personality and intelligence. What it is saying is that whatever that environmental influence is, it doesn't have a lot to do with parents. It's something else, and what Judith Harris argues is that that something else is the influence of peers.

Why, Harris asks, do the children of recent immigrants almost never retain the accent of their parents? How it is the children of deaf parents manage to learn how to speak as well and as quickly as children whose parents speak to them from the day they were born? The answer has always been that language is a skill acquired laterally — that what children pick up from other children is as, or more, important in the acquisition of language as what they pick up at home. What Harris argues is that this is also true more generally, that the environmental influence that helps children become who they are — that shapes their character and personality — is their peer group.

This argument has, understandably, sparked a great deal of controversy in the popular press. There are legitimate arguments about where — and how far — it can be applied. But there's no question that it has a great deal of relevance to the teenage smoking issue. The children of smokers are more than twice as likely to smoke as the children of nonsmokers. That's a well-known fact. But — to follow Harris's logic — that does not mean that parents who smoke around their children set an example that their kids follow. It simply means that smokers' children have inherited genes from their parents that predispose them toward nicotine addiction. Indeed studies of adopted children have shown that those raised by smokers are no more likely to end up as smokers themselves than those raised by nonsmokers. "In other words, effects of rearing variation (e.g. parents' lighting up or not, or having cigarettes in the home or not) were essentially nil by the time the children reached adulthood," the psychologist David Rowe writes in his 1994 book summarizing research on the question. The Limits of Family Influence. "The role of parents is a passive one — providing a set of genes at loci relevant to smoking risk, but not socially influencing their offspring."

To Rowe and Harris, the process by which teens get infected with the smoking habit is entirely bound up in the peer group. It's not about mimicking adult behavior, which is why teenage smoking is rising at a time when adult smoking is falling. Teenage smoking is about being a teenager, about sharing in the emotional experience and expressive language and rituals of adolescence, which are as impenetrable and irrational to outsiders as the rituals of adolescent suicide in Micronesia. How, under the circumstances, can we expect any adult intervention to make an impact?

"Telling teenagers about the health risks of smoking — it will make you wrinkled! It will make you impotent! It will make you dead! — is useless," Harris concludes. "This is adult propaganda; these are adult arguments. It is because adults don't approve of smoking — because there is something dangerous and disreputable about it — that teenagers want to do it."

If trying to thwart the efforts of Salesmen — if trying to intervene in the internal world of adolescents — doesn't seem like a particularly effective strategy against smoking, then what of stickiness? Here the search for Tipping Points is very different. We suspect, as I wrote previously, that one of the reasons some experimenters never smoke again and some turn into lifelong addicts is that human beings may have very different innate tolerances for nicotine. In a perfect world we would give heavy smokers a pill that lowered their tolerance to the level of, say, a chipper. That would be a wonderful way of stripping smoking of its stickiness. Unfortunately we don't know how to do that. What we do have is the nicotine patch, which delivers a slow and steady dose of nicotine so that smokers don't have to turn to the dangers of cigarettes to get their fix. That's an anti-sticky strategy that has helped millions of smokers. But it is fairly clear that the patch is far from perfect. The most exhilarating way for an addict to get his fix is in the form of a "hit" — a high dose delivered quickly, that overwhelms the senses. Heroin users don't put themselves on a heroin intravenous drip: they shoot up two or three or four times a day, injecting a huge dose all at once. Smokers, on a lesser scale, do the same. They get a jolt from a cigarette, then pause, then get another jolt. The patch, though, gives you a steady dose of the drug over the course of the day, which is a pretty boring way to ingest nicotine. The patch seems no more a Tipping Point in the fight against the smoking epidemic than SlimFast milkshakes are a Tipping Point in the fight against obesity. Is there a better candidate?

I think there are two possibilities. The first can be found in the correlation between smoking and depression, a link discovered only recently. In 1986, a study of psychiatric outpatients in Minnesota found that half of them smoked a figure well above the national average. Two years later, Columbia University psychologist Alexander Glassman discovered that 60 percent of the heavy smokers he was studying as part of an entirely different research project had a history of major depression. He followed that up with a major study published in the Journal of the American Medical Association in 1990 of 3,200 randomly selected adults. Of those who had at some time in their lives been diagnosed with a major psychiatric disorder, 74 percent had smoked at some point, and 14 percent had quit smoking of those who had never been diagnosed with a psychiatric problem, 53 percent had smoked at some point in their life and 31 percent had managed to quit smoking. As psychiatric problems increase, the correlation with smoking grows stronger. About 80 percent of alcoholics smoke. Close to 90 percent of schizophrenics smoke. In one particularly chilling study, a group of British psychiatrists compared the smoking behavior of a group of twelve- to fifteen-year-olds with emotional and behavioral problems with a group of children of the same age in mainstream schools. Half of the troubled kids were already smoking more than 21 cigarettes a week, even at that young age, versus 10 percent of the kids in the mainstream schools. As overall smoking rates decline, in other words, the habit is becoming concentrated among the most troubled and marginal members of society.

There are a number of theories as to why smoking matches up so strongly with emotional problems. The first is that the same kinds of things that would make someone susceptible to the contagious effects of smoking — low self-esteem, say, or an unhealthy and unhappy home life — are also the kinds of things that contribute to depression. More tantalizing, though, is some preliminary evidence that the two problems might have the same genetic root. For example, depression is believed to be the result, at least in part, of a problem in the production of certain key brain chemicals, in particular the neurotransmitters known as serotonin, dopamine, and norepinephrine. These are the chemicals that regulate mood, that contribute to feelings of confidence and mastery and pleasure. Drugs like Zoloft and Prozac work because they prompt the brain to produce more serotonin: they compensate, in other words, for the deficit of serotonin that some depressed people suffer from. Nicotine appears to do exactly the same thing with the other two key neurotransmitters — dopamine and norepinephrine. Those smokers who are depressed, in short, are essentially using tobacco as a cheap way of treating their own depression, of boosting the level of brain chemicals they need to function normally. This effect is strong enough that when smokers with a history of psychiatric problems give up cigarettes, they run a sizable risk of relapsing into depression. Here is stickiness with a vengeance: not only do some smokers find it hard to quit because they are addicted to nicotine, but also because without nicotine they run the risk of a debilitating psychiatric illness.