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Secret smokers: Keeping the habit on the down-low

Joe Chromo was a secret smoker since age 14, when he picked up the habit from his best friend. The 32-year-old Catonsville resident has finally stopped smoking, and his parents are none the wiser.

"I couldn't smoke a cigarette in front of my mom. I just couldn't do it," says Chromo, who also tried to keep his habit from his employers. Chromo would chew gum after smoking, change his jackets and even hide his cigarettes below his car's window so people couldn't see him smoking while driving. "I thought it was not good presentation. Some people just don't like smokers."

Despite the stigma associated with smoking, rates are still higher than health officials had sought or expected. Maryland's smoking population has decreased each of the past five years, according to The Baltimore Sun — at about 15 percent, the state has the fourth-lowest percentage of adult smokers in the United States, according to a study released late last year by the U.S. Centers for Disease Control and Prevention. But the CDC reported that, nationally, 20.6 percent of adults — about 46 million — were smokers in 2008, up slightly from 19.8 percent in 2007.

Although the smoking rate nationally has dropped sharply since the mid-1960s, when it hovered around 40 percent, the CDC had hoped to lower the rate to 12 percent or less by this year.

The lack of progress dismays health officials because smoking is the leading preventable cause of death in the United States, killing 443,000 people a year.

Dr. Richard Lamson, physician at Greater Baltimore Medical Center in Towson, knows first-hand the effects of smoking. His mother, a smoker, died of lung cancer and ever since, Lamson has taken an interest in smoking cessation and prevention. He teaches classes on the subject at Baltimore high schools.

"I'm kind-of passionate about smoking cessation. Most doctors want people to quit smoking. I really want them to quit smoking," Lamson says.

Quitting isn't easy, but it can be done. It's a matter of de-conditioning, Lamson said. Secret smokers continue smoking because they don't know how to stop. They hide their habit because they're embarrassed. "It's embarrassing to do something stupid," Lamson says. "They keep doing it because they think they're addicted. There's all sorts of levels of embarrassment with smoking."

In addition to the disapproval of friends and family, smokers have public policy to worry about, including the three-year-old statewide ban on smoking in public places, including bars and restaurants. Some colleges are going smoke-free, meaning no one can smoke on the campus, even outdoors. Starting Aug. 1, Towson University will be entirely smoke-free.

Unsurprisingly, "Not everybody's happy about us going smoke-free," admits Stuart Zang, media relations specialist at Towson University.

As part of the smoke-free imitative, Towson is offering smoking cessation classes. Kate Reeder, coordinator of health promotion and education services, teaches the classes and sees students and faculty members who are trying to quit.

Social factors are important to both groups but play out in different ways. Staff members who smoke don't want to be judged by others — society is a deterrent. But for students, it's the opposite of secret smokers: Smoking is all about the scene.

"To a lot of them it's a social thing. It's a way to meet people on campus," Reeder says.

Marklin Foster is a social smoker. The 34-year-old Baltimore resident smokes only when he drinks. No one really knows he smokes, other than his drinking buddies and his wife.

"I'm a completely social smoker. I think I've smoked not drinking, like, five times in my life," Foster says. He's been smoking for 10 years, but it has been easy to hide the habit from his family who live in Arizona. The biggest factor in Foster hiding his habit is that his dad was a smoker.

"I just hated my dad smoking. He smoked in the house and it stunk. I always asked him to quit," Foster says. "I think he'd be surprised and disappointed at me smoking."

But, for Foster, smoking while he's drinking is refreshing, and it's a hard habit to break. "When I'm in the moment with friends, it's fun," Foster says.

Lamson said he treats addicted smokers and patients like Foster who just enjoy smoking socially. He said there are three factors that deter quitting: physical nicotine withdrawal; the Pavlovian association of smoking with certain stimuli (buying a pack, seeing others smoke); and personal triggers, such as anxiety or depression.  

"There's nobody who can't quit smoking.  If you put any smoker on a desert island with no tobacco, they'll quit smoking." But, first, smokers must actually admit they smoke, Lamson said. REDEYE, MCCLATCHY-TRIBUNE and KRISTY MACKABEN, SPECIAL TO B

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Photo illustrations by Brian Krista and Tim Wong, B

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