Ever wonder what Gonorrhea or Syphilis look like under a microscope? Feel like you want to bond with your Herpes? Now you have the chance to have your own cute sexually transmitted infection for snuggling at Plushie Sexually Transmitted Diseases.
Coolstuffexpress has made some famous microcobes into cute and snuggly stuffed "animals".
I think it is fabulous.
Thursday, January 29, 2009
How Condoms are Made
Gotta love those "how they're made" videos. Listen to a soothing British voice while you see condoms spinning around. How Condoms are Made.
Condoms are made of a mix of liquid and solid latex. Colloids were never so great!
Condoms are made of a mix of liquid and solid latex. Colloids were never so great!
Your Love is a Drug and I Just Can't Get Enough
If you're like me, you enjoy seeing the random. I seem to get a lot of random and yet interesting points of view at TED. At TED, you can watch lectures on basically any subject. I recommend taking a look.
The one that stikes me most at the moment is Helen's Fisher's "The Brain in Love". She combines the definition of love through a poet's perspective and through an MRI. People newly in love, in love for 20 years, or going through the pain of a breakup with a loved one all have the same part of their brain light up. Love resides in the reptilian part of the brain, in the part where we want.
Here is something what we've known emotionally, but now we have the scientifically vetted proof. Love lights up the same part of the brain that is lights up when taking cocaine.
Love is truly addictive.
The one that stikes me most at the moment is Helen's Fisher's "The Brain in Love". She combines the definition of love through a poet's perspective and through an MRI. People newly in love, in love for 20 years, or going through the pain of a breakup with a loved one all have the same part of their brain light up. Love resides in the reptilian part of the brain, in the part where we want.
Here is something what we've known emotionally, but now we have the scientifically vetted proof. Love lights up the same part of the brain that is lights up when taking cocaine.
Love is truly addictive.
Wednesday, January 28, 2009
Does Congress have its Economics Twisted?
The House recently cut a provision in its economic stimulus package that would include family planning services for low income populations via Medicaid. This decision House Speaker Nancy Pelosi(D-CA) had argued for including the contraception provision because it will "reduce costs to the states and to the federal government" resulting from unplanned pregnancies. (CBS)
Contraception and Economics
In addition to conservative ire, Pelosi's argument seems to stir up a heady mix of Malthusian theory, issues regarding birth spacing, and the aging population. Thomas Malthus argued that there is the potential for rapid population growth that would create demand that exceeds the existing resources (in his example, food supply). Malthus believed that in addition to natural causes, misery, and vice; moral restraint (such as marrying at a later age) could check population growth. Malthus would have loved modern contraception. In the case addressed in Congress, the limited resource is governmental funds for social programs to assist low income populations. The population in need is growing (more people find themselves in the Medicaid-eligible group due to lost jobs) while the available resource has decreased. The cost of regular birth control for one couple is much lower than the cost of a child born to a couple.
If a couple makes a set income, it follows that they could afford to better meet the needs of their family if they have one child than if they had two. Having the choice to limit unwanted pregnancies through contraception becomes particularly important for low income populations who may not be able to afford the resources needed for that additional child. Can you afford the average $11,000 it takes for the first year of a child's life?
Birth spacing is a concept that takes family planning further, using contraception to ensure a minimum number of years between each child. Studies have shown that having 3-5 years between births increases survival rates and health outcomes for the born child, the older child, and the mother. In addition to the devasting impact a lost child or mother has to a family, it is possible that a family, especially one without health insurance, could never recover financially from the burden of medical and funeral costs.
Freakonomics readers will recall an argument by Donohue and Levitt that attributes the decline in crime to the legalization of abortion. While this argument has been criticized for many angles, it does bring up possible social consequences resulting from changes in access to family planning services and products.
And then there is the elephant in the room- the baby boomer population who is rapidly becoming the retirement age. A young, working population is needed to help the government and employers meet financial obligations to baby boomer retirees on pensions and Medicare. Economists have also pushed that population growth is a source of economic growth (the larger the population, the more purchasers demanding products).
So we must ask ourselves, does the government want us to have babies or to not have babies?
What does the government incentivize: more babies or fewer?
Since it is tax season, a look at the 1040 form list of exemptions gives us a better idea of what the US government has wanted us to do. We get exemptions for the number of dependents (such as children) we have. The exemption does not cover all of the expenses related to raising a child, but it does ease the burden in the balance between demand and resources for families.
We can also look at what health insurance companies cover and not cover. For many, contraception is NOT covered by their insurance carrier, yet the same carrier will cover prescriptions for Viagra. While birth spacing is a PROVEN way families can maintain good health of mothers and children, most families do not have access to the contraception that helps couples better time births. Meanwhile, older men can continue to have an active sex life and perhaps, if their female partners are using fertility treatments or are younger, they can also have children. Governmental bodies have the option of regulating change in what insurance companies cover, yet it does not seem to be a priority. As birth spacing is linked with better health, it is likely in the financial interst of insurance companies to include contraception as part of their preventitive health package. A little governmental kick in the rear here could go a long way.
Ethics
Nancy Pelosi has since taken on criticism based on the group the contraception provision was intended to benefit: low income women. Some have said who is to say that the pregnancies that this provision would prevent would not develop into highly productive children. While they make a good point, offering contraception as an option does not mean that it is mandatory. The answer should be to offer all women access to more affordable birth control. Women who are not Medicaid eligible are still in need of the choice of birth spacing.
Ways the government could better stimulate the economy in both the short term and long term
It made sense that contraception was kicked out of the economic stimulus package. Yet there is a need for some change sooner or later.
1. Just as we provide tax exemptions for dependent children, educator expenses, and student loans provide an exemption for out-of-pocket birth control costs.
2. Act legislatively to get health insurance companies to include birth control in their standard coverage package.
3. Work with pharmaceutical companies to negotiate the price down for birth control options.
4. If having a younger, working population is needed to balance the baby boom retiree population, modify immigration laws to allow more of the young, professional population to immigrate to the US.
Contraception and Economics
In addition to conservative ire, Pelosi's argument seems to stir up a heady mix of Malthusian theory, issues regarding birth spacing, and the aging population. Thomas Malthus argued that there is the potential for rapid population growth that would create demand that exceeds the existing resources (in his example, food supply). Malthus believed that in addition to natural causes, misery, and vice; moral restraint (such as marrying at a later age) could check population growth. Malthus would have loved modern contraception. In the case addressed in Congress, the limited resource is governmental funds for social programs to assist low income populations. The population in need is growing (more people find themselves in the Medicaid-eligible group due to lost jobs) while the available resource has decreased. The cost of regular birth control for one couple is much lower than the cost of a child born to a couple.
If a couple makes a set income, it follows that they could afford to better meet the needs of their family if they have one child than if they had two. Having the choice to limit unwanted pregnancies through contraception becomes particularly important for low income populations who may not be able to afford the resources needed for that additional child. Can you afford the average $11,000 it takes for the first year of a child's life?
Birth spacing is a concept that takes family planning further, using contraception to ensure a minimum number of years between each child. Studies have shown that having 3-5 years between births increases survival rates and health outcomes for the born child, the older child, and the mother. In addition to the devasting impact a lost child or mother has to a family, it is possible that a family, especially one without health insurance, could never recover financially from the burden of medical and funeral costs.
Freakonomics readers will recall an argument by Donohue and Levitt that attributes the decline in crime to the legalization of abortion. While this argument has been criticized for many angles, it does bring up possible social consequences resulting from changes in access to family planning services and products.
And then there is the elephant in the room- the baby boomer population who is rapidly becoming the retirement age. A young, working population is needed to help the government and employers meet financial obligations to baby boomer retirees on pensions and Medicare. Economists have also pushed that population growth is a source of economic growth (the larger the population, the more purchasers demanding products).
So we must ask ourselves, does the government want us to have babies or to not have babies?
What does the government incentivize: more babies or fewer?
Since it is tax season, a look at the 1040 form list of exemptions gives us a better idea of what the US government has wanted us to do. We get exemptions for the number of dependents (such as children) we have. The exemption does not cover all of the expenses related to raising a child, but it does ease the burden in the balance between demand and resources for families.
We can also look at what health insurance companies cover and not cover. For many, contraception is NOT covered by their insurance carrier, yet the same carrier will cover prescriptions for Viagra. While birth spacing is a PROVEN way families can maintain good health of mothers and children, most families do not have access to the contraception that helps couples better time births. Meanwhile, older men can continue to have an active sex life and perhaps, if their female partners are using fertility treatments or are younger, they can also have children. Governmental bodies have the option of regulating change in what insurance companies cover, yet it does not seem to be a priority. As birth spacing is linked with better health, it is likely in the financial interst of insurance companies to include contraception as part of their preventitive health package. A little governmental kick in the rear here could go a long way.
Ethics
Nancy Pelosi has since taken on criticism based on the group the contraception provision was intended to benefit: low income women. Some have said who is to say that the pregnancies that this provision would prevent would not develop into highly productive children. While they make a good point, offering contraception as an option does not mean that it is mandatory. The answer should be to offer all women access to more affordable birth control. Women who are not Medicaid eligible are still in need of the choice of birth spacing.
Ways the government could better stimulate the economy in both the short term and long term
It made sense that contraception was kicked out of the economic stimulus package. Yet there is a need for some change sooner or later.
1. Just as we provide tax exemptions for dependent children, educator expenses, and student loans provide an exemption for out-of-pocket birth control costs.
2. Act legislatively to get health insurance companies to include birth control in their standard coverage package.
3. Work with pharmaceutical companies to negotiate the price down for birth control options.
4. If having a younger, working population is needed to balance the baby boom retiree population, modify immigration laws to allow more of the young, professional population to immigrate to the US.
Monday, January 26, 2009
Flight of the Conchords take on Sex Work
I am a huge fan of Flight of the Conchords and recommend watching the show.
In a recent epidsode, faced with debt, Jermaine considers sex work as an option to earn money. While not all sex work initiation scenes include a dedicated theme song, the industry is much more complicated that those who would depict it wholly as sexual slavery. Here's the short video of Jermaine's Sugar Lump video thanks to Jezebel and of course, Flight of the Conchords. (Eat your heart out, Black Eyed Peas!)
In a recent epidsode, faced with debt, Jermaine considers sex work as an option to earn money. While not all sex work initiation scenes include a dedicated theme song, the industry is much more complicated that those who would depict it wholly as sexual slavery. Here's the short video of Jermaine's Sugar Lump video thanks to Jezebel and of course, Flight of the Conchords. (Eat your heart out, Black Eyed Peas!)
How Marketing Does Birth Control
I'd like to say that for-profit companies that market products seem to know a lot more than governments and not-for-profit organizations about what gets people to do something new (like purchase a product).
But what is all of that marketing research being used for? If you put it all together in one loop and add in the hysterical commentary of Sarah Haskins, all of this careful targeting and messaging all seems...silly. Target Women takes on Birth Control.
But what is all of that marketing research being used for? If you put it all together in one loop and add in the hysterical commentary of Sarah Haskins, all of this careful targeting and messaging all seems...silly. Target Women takes on Birth Control.
If you were a smoker, would this get you to quit?
The Centers for Disease Control (CDC) has a series of e-Cards where well-meaning friends and family can send not so subtle notes to push healthy behavior such as quitting smoking. What if you were a smoker? Does a woman jumping in a field make you want to stop smoking? Perhaps not, but perhaps knowing (as the inside of the card says) that half of ALL adult smokers in the US have already quit may give you pause. If so many people have been able to quit, it is possible to successfully quit if you try.
Scores:
Picture: C. The Photo looks like an ad for a feminine product. Message: B- If people perceive that the norm is to quit, they are more likely to take serious steps to quitting.
Global Gag Rule Lifted for US-funded operations
In quick, yet historical move, President Obama has lifted the "global gag rule".
Family planning groups can now discuss the full range of a woman's options with her for her reproductive health, even if US government funds pay for a portion of the (non-abortion) services provided at that clinic.
Perhaps the Year of the Ox is also the Year of Common Sense Healthy Policy.
Family planning groups can now discuss the full range of a woman's options with her for her reproductive health, even if US government funds pay for a portion of the (non-abortion) services provided at that clinic.
Perhaps the Year of the Ox is also the Year of Common Sense Healthy Policy.
Sunday, January 25, 2009
Simply Safer: Basic Sex Ed
I would be remiss if I did not include at least a bare minimum of basic education on how folks can better protect themselves during all of this sexual behavior I'm talking about.
How to Correctly Put on a Male Condom
1. Make sure the condom has not expired and check the condom package & condom for tears
2. Carefully tear open the pack, making sure not to tear the condom (teeth, scissors, and knives are forbidden here!)
3. The shiny, lubricated side of the condom should be on the outside, so the condom can easily be rolled down the penis. If the penis touches the wrong side, throw condom away and use a new condom.
4. Pinching the top of the condom, roll the condom all the way down the erect penis to the base. The entire penis should be covered by condom. Do not skip the PINCH step, this is very important to prevent breakage.
5. If the condom breaks or slips off, stop sex. You should use a new condom.
6. After ejaculation and while the penis is still erect, withdraw the penis, holding the condom by the base so no semen spills on your partner.
7. Holding the base of the condom, pull down. The condom should come off. If you wish, tie it in a knot.
8. Dispose of condoms in a trash can. Do not try to flush condoms!
For advanced male condom tips, I'd also suggest looking up a post by Eric Amaranth on the Dodson and Ross site site. Dr. Betty Dodson is a fabulous resource for any of your questions on sex and your body (not me).
How to Correctly Use Lubricant
1. Use water or silicone-based lubricant, if the lubricant is flavored, make sure it is sugar-free or you'll risk infectiony revenge (hello yeast!). Do NOT use oil-based lubricants like whipped cream, butter, oil, conditioner, or vaseline. They will break the condom. Do not use spermicides, they also increase the change of infection transmission.
2. Use a male or female condom (lubricant does not replace a condom). For male condom instructions, see above.
3. Liberally apply outside the condom-covered penis and in and around the the rectum/vaginal canal.
4. If drying or friction occurs during sex, apply more lubricant.
How to use a female condom
The "female condom" is a misnomer. More properly named the "insertive condom" it can also be used by the receptive partner during anal sex. Here is some guidance for both uses.
For Vaginal Sex
1. Carefully tear open the packet along the edge and remove the female condom. Inspect to ensure there is no damage to the condom.
2. Hold the condom with the open end hanging down, pinching it the ring with your thumb, index finger and middle finger.
3. Find a comfortable position so you may easily insert the condom (squat, sit with your knees apart or stand with one foot on a chair.)
4. The condom has a smaller inner ring (closed end) and a larger outer ring (open end). Squeezing the inner ring with your three fingers, insert it into your vagina.
5. Put your index finger inside the condom until you can feel the inner ring. Use your finger to push the ring up inside the vagina. You can tell that the condom is in place when the inner ring moves into position behind the pubic bone.
6. The outer ring should lie flat around the outside of your vagina.
7. Use your hand to guide your partner’s penis into the condom. Use your fingers to make sure the outer ring continues to lie flat against the vagina opening during sex. Make sure the penis is not inserted between condom and vagina wall.
8. After sex, remove the female condom by twisting the outer ring and pulling it out gently.
9. Wrap the condom with a paper or plastic bag and throw it into the garbage. Do not flush it.
For anal sex
1. Remove the inner ring from the condom.
2. Apply lubricant in the inside of the rectum and on the penis.
3. Place the erect penis inside the condom. The penis will help you guide the condom inside the rectum just as the inner ring would for vaginal insertion.
4. The outer ring should lie flat around the outside of your anus.
5. Use your fingers to make sure the outer ring lies flat against the anal opening during sex. Make sure the penis is not inserted between the condom and rectum.
8. After sex, remove the condom by twisting the outer ring and pulling it out gently.
9. Wrap the condom with a paper or plastic bag and throw it into the garbage bin or dustbin. Do not flush it.
How to Have Safer Anal Sex that Isn't Painful
1. Use the toilet and empty your bowels
2. Gently clean the anal area with soap and water
3. Put on a latex or polyurethane condom - condoms protect from sexually transmitted infection (STI) & HIV transmission and also protects the insertive partner from bacteria in the rectum (see above)
4. Liberally apply water-based or silicone-based lubricant in the rectum and around the anus and also put it on the outside of the (condom covered) penis
5. Gently insert 1-2 lubricated fingers to loosen your anus (or your partner can do it if his fingers are in a condom)
6. Relax the anus as the (condom covered) penis is inserted
7. If it hurts when the penis is first in, remove the penis and wait about 20 seconds before reinserting
8. If drying or friction occurs during sex, apply more lubricant
9. After intercourse, before the penis become soft, withdraw the penis and the condom together from the anus.
There is no reason anal sex should hurt!
How to Have Safer Oral Sex
Some sexually transmitted infections (STIs) CAN be transmitted through oral sex. Think about the skin on your palms versus the inside of your mouth- which one is more vulnerable to cuts and scratches?
On a penis
1. A male condom can be used starting when the penis is erect. Before then, make use of your hands. It would be even safer to use a pair of unused, sterile latex gloves with lubricant, but your hands are still a better choice than your mouth on an uncovered penis.
2. Put the condom on the penis as above.
3. Now it is mouth ready. Use SUGARLESS, flavored water-based or silicone based lubricant on the outside to address any latex taste.
4. After ejaculation, dispose of the condom in the trash (again, do not flush).
On a female and/or for Rimming
1. Use a dental dam as the barrier between mouth and genital area.
2. Use SUGARLESS, flavored water-based or silicone based lubricant on the outside to address any latex taste.
If you do not have a dental dam, take your scissors to an (empty, new) male condom.
1. Unroll a new condom
2. Cut the tip off of the condom.
3. Cut lengthwise down the condom.
And now you have your own dental dam!
Why I Hate the Durex Balloon Animal Ad
The Durex Balloon Animal ad has been blazing through social circles faster than Herpes through Derek Jeter's little black book. (at least, that is what some gossip blogs have been saying).
The ad is cute and a fun little thing to pass on to friends for a joke, but does it make people more likely to USE condoms when they have sex?
Yes and no. Like with most marketing campaigns, you have to imagine the target group they are trying to reach and imagine how they would process seeing the same video.
Yes- What we have seen in condom use research is that consistent condom-users are more likely to report they bought condoms than non-condom users. This may overwhelm you with obviousness, but simple sense dictates is that if you have condoms with you, you are more likely to use them than if you didn't have them. If someone already uses condoms quite often, but not always, this ad may remind him or her to stop by to pick some up before a date.
No- think about people you know who do not use condoms (ever or only rarely). I've give you a picture that comes into my head: a semi-religious young woman who feels uncomfortable carrying or buying condoms because she associates having condoms with "sluts". This playful video may actually reinforce her association between condoms and being slutty and she'll be even more reticent to purchase (and therefore use) condoms.
I must admit that I am also annoyed by the rubbery-squeaking sound. If only they used water-based or silicone-based lubricant, they could have gone to town and protect themselves further from the latex breaking and reduce that annoying sound.
I'd advise people who click on this to see the Durex video (and outtakes) be 18 and older.
The ad is cute and a fun little thing to pass on to friends for a joke, but does it make people more likely to USE condoms when they have sex?
Yes and no. Like with most marketing campaigns, you have to imagine the target group they are trying to reach and imagine how they would process seeing the same video.
Yes- What we have seen in condom use research is that consistent condom-users are more likely to report they bought condoms than non-condom users. This may overwhelm you with obviousness, but simple sense dictates is that if you have condoms with you, you are more likely to use them than if you didn't have them. If someone already uses condoms quite often, but not always, this ad may remind him or her to stop by to pick some up before a date.
No- think about people you know who do not use condoms (ever or only rarely). I've give you a picture that comes into my head: a semi-religious young woman who feels uncomfortable carrying or buying condoms because she associates having condoms with "sluts". This playful video may actually reinforce her association between condoms and being slutty and she'll be even more reticent to purchase (and therefore use) condoms.
I must admit that I am also annoyed by the rubbery-squeaking sound. If only they used water-based or silicone-based lubricant, they could have gone to town and protect themselves further from the latex breaking and reduce that annoying sound.
I'd advise people who click on this to see the Durex video (and outtakes) be 18 and older.
Introduction to Sex, Drugs, and Behavior Change
Note: This blog seeks to find ways to better understand complicated issues of behavior change related to sexual and drug-risk related behavior. Some of the issues brought up in this blog are of a sexual nature or relate to drug use and may include notes that are (intended to be) humorous. If you think any of this may offend you, please do not read.
---
Sex. We talk about it, we joke about it, we dish about it, we brag about it. Sex has many faces, it can be (re)productive, playful, or risky in more ways than one. We like it because it feels good or, in some cases (as John Mellencamp says) it "hurts so good." Yet why do some not use condoms when they know they should?
Hurts so Good by John Mellencamp
Sex is the perfect example of learning about behavior, why we do what we do, and why it changes. There are hundreds of professionals who have spent their careers working on how to change sexual behavior and yet we all still have a lot to learn.
What have we learned from more than 30 years of behavior change activites? Actually, a good amount. We just need to pay attention to what we already "know" and try to figure out what's left.
As an example, reducing sexual risk requires a focus first on condom use and talking to partners. Avoiding or downplaying condoms only hurts us in the end.
Let's think about the abstinence-focused curriculum promoted by well-intentioned but almost willfully ignorant policy makers and misled parents. The resulting change from this strategy in youth sexual behavior has been largely contrary to goals. While some young people are delaying their sexual debut (i.e. when they first have sex), they are NOT waiting until marriage, and many are not using condoms.
We have also learned that education and awareness-building alone do not change everyone's behavior.
Drug (licit and illicit) use also gives us a great example.
In 1950, Richard Doll and A. Bradford Hill conducted a case control study that first gave the world the idea that smoking and lung cancer were linked*. From 1951-2001, Doll, Hill, et al ran a prospective cohort study that followed up doctors over fifty years to see if those who were smokers had higher rates of cancer than those who were non-smokers**. Starting in 1954, articles were published on their findings to date which showed a strong causal relationship between smoking and cancer.**
In the US, an American study with similar results was described in the Reader's Digest article "Cancer by the Carton" in 1952. While there was a decline in smoking after the buzz from this article, many continued smoke and non-users continued to initiate.
While awareness of the dangers of smoking did spur some to quit, other factors were at play. There is, of course, addiction, but that is not the whole story. But what of the numbers who initiated? Cigarette advertising a la "Mad Men" could explain some of this. We live in the era where increasing cigarette taxes and city-wide smoking bans are increasingly used and have seen a measureable decrease in smoking as a result, so that must be part of the answer. As before, the answer is composed of multiple factors, some which we know, some we guess, and others we have yet to find out.
Welcome to Sex, Drugs, and Behavior Change
* Doll R Hill AB "Smoking and Carcinoma of the Lung" British Medical Journal 1950 (2) 739-748
** Doll R, Hill AB "The Mortality of Doctors in Relation to their Smoking Habits" British Medical Journal 1954 (1) 1451-1455
** Doll R, Peto R Boreham J Sutherland I "Mortality in Relation to Smoking: 50 Years' Observation on Male British Doctors" British Medical Journal 2004 328 (7455) 1519
---
Sex. We talk about it, we joke about it, we dish about it, we brag about it. Sex has many faces, it can be (re)productive, playful, or risky in more ways than one. We like it because it feels good or, in some cases (as John Mellencamp says) it "hurts so good." Yet why do some not use condoms when they know they should?
Hurts so Good by John Mellencamp
Sex is the perfect example of learning about behavior, why we do what we do, and why it changes. There are hundreds of professionals who have spent their careers working on how to change sexual behavior and yet we all still have a lot to learn.
What have we learned from more than 30 years of behavior change activites? Actually, a good amount. We just need to pay attention to what we already "know" and try to figure out what's left.
As an example, reducing sexual risk requires a focus first on condom use and talking to partners. Avoiding or downplaying condoms only hurts us in the end.
Let's think about the abstinence-focused curriculum promoted by well-intentioned but almost willfully ignorant policy makers and misled parents. The resulting change from this strategy in youth sexual behavior has been largely contrary to goals. While some young people are delaying their sexual debut (i.e. when they first have sex), they are NOT waiting until marriage, and many are not using condoms.
We have also learned that education and awareness-building alone do not change everyone's behavior.
Drug (licit and illicit) use also gives us a great example.
In 1950, Richard Doll and A. Bradford Hill conducted a case control study that first gave the world the idea that smoking and lung cancer were linked*. From 1951-2001, Doll, Hill, et al ran a prospective cohort study that followed up doctors over fifty years to see if those who were smokers had higher rates of cancer than those who were non-smokers**. Starting in 1954, articles were published on their findings to date which showed a strong causal relationship between smoking and cancer.**
In the US, an American study with similar results was described in the Reader's Digest article "Cancer by the Carton" in 1952. While there was a decline in smoking after the buzz from this article, many continued smoke and non-users continued to initiate.
While awareness of the dangers of smoking did spur some to quit, other factors were at play. There is, of course, addiction, but that is not the whole story. But what of the numbers who initiated? Cigarette advertising a la "Mad Men" could explain some of this. We live in the era where increasing cigarette taxes and city-wide smoking bans are increasingly used and have seen a measureable decrease in smoking as a result, so that must be part of the answer. As before, the answer is composed of multiple factors, some which we know, some we guess, and others we have yet to find out.
Welcome to Sex, Drugs, and Behavior Change
* Doll R Hill AB "Smoking and Carcinoma of the Lung" British Medical Journal 1950 (2) 739-748
** Doll R, Hill AB "The Mortality of Doctors in Relation to their Smoking Habits" British Medical Journal 1954 (1) 1451-1455
** Doll R, Peto R Boreham J Sutherland I "Mortality in Relation to Smoking: 50 Years' Observation on Male British Doctors" British Medical Journal 2004 328 (7455) 1519
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