The kind of contagion Phillips is talking about isn’t something rational or even necessarily conscious. It’s not like a persuasive argument. It’s something much more subtle than that. “When I’m waiting at a traffic light and the light is red, sometimes I wonder whether I should cross and jaywalk,” he says. “Then somebody else does it and so I do too. It’s a kind of imitation. I’m getting permission to act from someone else who is engaging in a deviant act. Is that a conscious decision? I can’t tell. Maybe afterwards I could brood on the difference. But at the time I don’t know whether any of us knows how much of our decision is conscious and how much is unconscious. Human decisions are subtle and complicated and not very well understood.” In the case of suicide, Phillips argues, the decision by someone famous to take his or her own life has the same effect: it gives other people, particularly those vulnerable to suggestion because of immaturity or mental illness, permission to engage in a deviant act as well. “Suicide stories are a kind of natural advertisement for a particular response to your problems,” Phillips continues. “You’ve got all these people who are unhappy and have difficulty making up their minds because they are depressed. They are living with this pain. There are lots of stories advertising different kinds of responses to that. It could be that Billy Graham has a crusade going on that weekend—that’s a religious response. Or it could be that somebody is advertising an escapist movie—that’s another response. Suicide stories offer another kind of alternative.” Phillips’s permission givers are the functional equivalent of the Salesmen I talked about in chapter 2. Just as Tom Gau could, through the persuasive force of his personality, serve as a Tipping Point in a word of mouth epidemic, the people who die in highly publicized suicides—whose deaths give others “permission” to die—serve as the Tipping Points in suicide epidemics.
The fascinating thing about this permission giving, though, is how extraordinarily specific it is. In his study of motor fatalities, Phillips found a clear pattern. Stories about suicides resulted in an increase in single car crashes where the victim was the driver. Stories about suicide murders resulted in an increase in multiple car crashes in which the victims included both drivers and passengers. Stories about young people committing suicide resulted in more traffic fatalities involving young people. Stories about older people committing suicide resulted in more traffic fatalities involving older people. These patterns have been demonstrated on many occasions. News coverage of a number of suicides by self immolation in England in the late 1970s, for example, prompted 82 suicides by self immolation over the next year. The “permission” given by an initial act of suicide, in other words, isn’t a general invitation to the vulnerable. It is really a highly detailed set of instructions, specific to certain people in certain situations who choose to die in certain ways. It’s not a gesture. It’s speech. In another study, a group of researchers in England in the 1960s analyzed 135 people who had been admitted to a central psychiatric hospital after attempting suicide. They found that the group was strongly linked socially—that many of them belonged to the same social circles. This, they concluded, was not coincidence. It testified to the very essence of what suicide is, a private language between members of a common subculture. The author’s conclusion is worth quoting in full:
Many patients who attempt suicide are drawn from a section of the community in which self aggression is generally recognized as a means of conveying a certain kind of information. Among this group the act is viewed as comprehensible and consistent with the rest of the cultural pattern.... If this is true, it follows that the individual who in particular situations, usually of distress, wishes to convey information about his difficulties to others, does not have to invent a communicational medium de novo.... The individual within the “attempted suicide subculture” can perform an act which carries a preformed meaning; all he is required to do is invoke it. The process is essentially similar to that whereby a person uses a word in a spoken language.
This is what is going on in Micronesia, only at a much more profound level. If suicide in the West is a kind of crude language, in Micronesia it has become an incredibly expressive form of communication, rich with meaning and nuance, and expressed by the most persuasive of permission givers. Rubinstein writes of the strange pattern of suicides on the Micronesian island of Ebeye, a community of about 6,000. Between 1955 and 1965, there wasn’t a single case of suicide on the entire island. In May 1966, an eighteen year old boy hanged himself in his jail cell after being arrested for stealing a bicycle, but his case seemed to have little impact. Then, in November of 1966, came the death of R., the charismatic scion of one of the island’s wealthiest families. R. had been seeing two women and had fathered a one month old child with each of them. Unable to make up his mind between them, he hanged himself in romantic despair. At his funeral, his two lovers, learning of the existence of the other for the first time, fainted on his grave.
Three days after R.’s death, there was another suicide, a twenty two year old male suffering from marital difficulties, bringing the suicide toll to two over a week in a community that had seen one suicide in the previous twelve years. The island’s medic wrote: “After R. died, many boys dreamed about him and said that he was calling them to kill themselves.” Twenty five more suicides followed over the next twelve years, mostly in clusters of three or four over the course of a few weeks. “Several suicide victims and several who have recently attempted suicide reported having a vision in which a boat containing all the past victims circles the island with the deceased inviting the potential victims to join them,” a visiting anthropologist wrote in 1975. Over and over again, the themes outlined by R. resurfaced. Here is the suicide note of M., a high school student who had one girlfriend at boarding school and one girlfriend on Ebeye, and when the first girlfriend returned home from school, two girlfriends at once—a complication defined, in the youth subculture of Ebeye, as grounds for taking one’s own life: “Best wishes to M. and C. [the two girlfriends]. It’s been nice to be with both of you.” That’s all he had to say, because the context for his act had already been created by R. In the Ebeye epidemic, R. was the Tipping Person, the Salesman, the one whose experience “overwrote” the experience of those who followed him. The power of his personality and the circumstances of his death combined to make the force of his example endure years beyond his death.
3.
Does teen smoking follow this same logic? In order to find out more about the reasons teenagers smoke, I gave several hundred people a questionnaire, asking them to describe their earliest experiences with cigarettes. This was not a scientific study. The sample wasn’t representative of the United States. It was mostly people in their late twenties and early thirties, living in big cities. Nonetheless the answers were striking, principally because of how similar they all seemed. Smoking seemed to evoke a particular kind of childhood memory—vivid, precise, emotionally charged. One person remembers how she loved to open her grandmother’s purse, where she would encounter “the soft smell of cheap Winstons and leather mixed with drug store lipstick and cinnamon gum.” Another remembers “sitting in the back seat of a Chrysler sedan, smelling the wonderful mixture of sulfur and tobacco waft out the driver’s window and into my nostrils.” Smoking, overwhelmingly, was associated with the same thing to nearly everyone: sophistication. This was true even of people who now hate smoking, who now think of it as a dirty and dangerous habit. The language of smoking, like the language of suicide, seems incredibly consistent. Here are two responses, both describing childhood memories:
My mother smoked, and even though I hated it—hated the smell—she had these long tapered fingers and full, sort of crinkly lips, always with lipstick on, and when she smoked she looked so elegant and devil may care that there was no question that I’d smoke someday. She thought people who didn’t smoke were kind of gutless. Makes you stink, makes you think, she would say, reveling in how ugly that sounded.
My best friend Susan was Irish English. Her parent
s were, in contrast to mine, youthful, indulgent, liberal. They had cocktails before dinner. Mr. O’Sullivan had a beard and wore turtlenecks. Mrs. O’Sullivan tottered around in mules, dressed slimly in black to match her jet black hair. She wore heavy eye makeup and was a little too tan and always, virtually always, had a dangerously long cigarette holder dangling from her manicured hands.
This is the shared language of smoking, and it is as rich and expressive as the shared language of suicide. In this epidemic, as well, there are also Tipping People, Salesmen, permission givers. Time and time again, the respondents to my survey described the particular individual who initiated them into smoking in precisely the same way.
When I was around nine or ten my parents got an English au pair girl, Maggie, who came and stayed with us one summer. She was maybe twenty. She was very sexy and wore a bikini at the Campbells’ pool. She was famous with the grownup men for doing handstands in her bikini. Also it was said her bikini top fell off when she dove—Mr. Carpenter would submerge whenever she jumped in. Maggie smoked, and I used to beg her to let me smoke too.
The first kid I knew who smoked was Billy G. We became friends in fifth grade, when the major distinctions in our suburban N.J. town—jocks, heads, brains—were beginning to form. Billy was incredibly cool. He was the first kid to date girls, smoke cigarettes and pot, drink hard alcohol and listen to druggy music. I even remember sitting upstairs in his sister’s bedroom—his parents were divorced (another first), and his mom was never home—separating the seeds out of some pot on the cover of a Grateful Dead album.... The draw for me was the badness of it, and the adult ness, and the way it proved the idea that you could be more than one thing at once.
The first person who I remember smoking was a girl named Pam P. I met her when we were both in the 10th grade. We rode the school bus together in Great Neck, L.I., and I remember thinking she was the coolest because she lived in an apartment. (Great Neck didn’t have many apartments.) Pam seemed so much older than her 15 years. We used to sit in the back of the bus and blow smoke out the window. She taught me how to inhale, how to tie a man tailored shirt at the waist to look cool, and how to wear lipstick. She had a leather jacket. Her father was rarely home.
There is actually considerable support for this idea that there is a common personality to hard core smokers. Hans Eysenck, the influential British psychologist, has argued that serious smokers can be separated from nonsmokers along very simple personality lines. The quin tessential hard core smoker, according to Eysenck, is an extrovert, the kind of person who
is sociable, likes parties, has many friends, needs to have people to talk to.... He craves excitement, takes chances, acts on the spur of the moment and is generally an impulsive individual.... He prefers to keep moving and doing things, tends to be aggressive and loses his temper quickly; his feelings are not kept under tight control and he is not always a reliable person.
In countless studies since Eysenck’s groundbreaking work, this picture of the smoking “type” has been filled out. Heavy smokers have been shown to have a much greater sex drive than nonsmokers. They are more sexually precocious; they have a greater “need” for sex, and greater attraction to the opposite sex. At age nineteen, for example, 15 percent of nonsmoking white women attending college have had sex. The same number for white female college students who do smoke is 55 percent. The statistics for men are about the same according to Eysenck. They rank much higher on what psychologists call “anti social” indexes: they tend to have greater levels of misconduct, and be more rebellious and defiant. They make snap judgments. They take more risks. The average smoking household spends 73 percent more on coffee and two to three times as much on beer as the average nonsmoking household. Interestingly, smokers also seem to be more honest about themselves than nonsmokers. As David Krogh describes it in his treatise Smoking: The Artificial Passion, psychologists have what they call “lie” tests in which they insert inarguable statements—“I do not always tell the truth” or “I am sometimes cold to my spouse”—and if test takers consistently deny these statements, it is taken as evidence that they are not generally truthful. Smokers are much more truthful on these tests. “One theory,” Krogh writes, “has it that their lack of deference and their surfeit of defiance combine to make them relatively indifferent to what people think of them.”
These measures don’t apply to all smokers, of course. But as general predictors of smoking behavior they are quite accurate, and the more someone smokes, the higher the likelihood that he or she fits this profile. “In the scientific spirit,” Krogh writes, “I would invite readers to demonstrate [the smoking personality connection] to themselves by performing the following experiment. Arrange to go to a relaxed gathering of actors, rock musicians, or hairdressers on the one hand, or civil engineers, electricians, or computer programmers on the other, and observe how much smoking is going on. If your experience is anything like mine, the differences should be dramatic.”
Here is another of the responses to my questionnaire. Can the extroverted personality be any clearer?
My grandfather was the only person around me when I was very little who smoked. He was a great Runyonesque figure, a trickster hero, who immigrated from Poland when he was a boy and who worked most of his life as a glazier. My mother used to like to say that when she was first brought to dinner with him she thought he might at any moment whisk the tablecloth off the table, leaving the settings there, just to amuse the crowd.
The significance of the smoking personality, I think, cannot be overstated. If you bundle all of these extroverts’ traits together—defiance, sexual precocity, honesty, impulsiveness, indifference to the opinion of others, sensation seeking—you come up with an almost perfect definition of the kind of person many adolescents are drawn to. Maggie the au pair, and Pam P. on the school bus and Billy G. with his Grateful Dead records were all deeply cool people. But they weren’t cool because they smoked. They smoked because they were cool. The very same character traits of rebelliousness and impulsivity and risk taking and indifference to the opinion of others and precocity that made them so compelling to their adolescent peers also make it almost inevitable that they would also be drawn to the ultimate expression of adolescent rebellion, risk taking, impulsivity, indifference to others, and precocity: the cigarette. This may seem like a simple point. But it is absolutely essential in understanding why the war on smoking has stumbled so badly. Over the past decade, the anti smoking movement has railed against the tobacco companies for making smoking cool and has spent untold millions of dollars of public money trying to convince teenagers that smoking isn’t cool. But that’s not the point. Smoking was never cool. Smokers are cool. Smoking epidemics begin in precisely the same way that the suicide epidemic in Micronesia began or word of mouth epidemics begin or the AIDS epidemic began, because of the extraordinary influence of Pam P. and Billy G. and Maggie and their eq
uivalents—the smoking versions of R. and Tom Gau and Gaetan Dugas. In this epidemic, as in all others, a very small group—a select few—are responsible for driving the epidemic forward.
4.
The teen smoking epidemic does not simply illustrate the Law of the Few, however. It is also a very good illustration of the Stickiness Factor. After all, the fact that overwhelming numbers of teenagers experiment with cigarettes as a result of their contacts with other teenagers is not, in and of itself, all that scary. The problem—the fact that has turned smoking into public health enemy number one—is that many of those teenagers end up continuing their cigarette experiment until they get hooked. The smoking experience is so memorable and powerful for some people that they cannot stop smoking. The habit sticks.
It is important to keep these two concepts—contagiousness and stickiness—separate, because they follow very different patterns and suggest very different strategies. Lois Weisberg is a contagious person. She knows so many people and belongs to so many worlds that she is able to spread a piece of information or an idea a thousand
different ways, all at once. Lester Wunderman and the creators of Blue’s Clues, on the other hand, are specialists in stickiness: they have a genius for creating messages that are memorable and that change people’s behavior. Contagiousness is in larger part a function of the messenger. Stickiness is primarily a property of the message.
Smoking is no different. Whether a teenager picks up the habit depends on whether he or she has contact with one of those Salesmen who give teenagers “permission” to engage in deviant acts. But whether a teenager likes cigarettes enough to keep using them depends on a very different set of criteria. In a recent University of Michigan study, for example, a large group of people were polled about how they felt when they smoked their first cigarette. “What we found is that for almost everyone their initial experience with tobacco was somewhat aversive,” said Ovide Pomerleau, one of the researchers on the project. “But what sorted out the smokers to be from the never again smokers is that the smokers to be derived some overall pleasure from the experience—like the feeling of a buzz or a heady pleasurable feeling.” The numbers are striking. Of the people who experimented with cigarettes a few times and then never smoked again, only about a quarter got any sort of pleasant “high” from their first cigarette. Of the ex smokers—people who smoked for a while but later managed to quit—about a third got a pleasurable buzz. Of people who were light smokers, about half remembered their first cigarette well. Of the heavy smokers, though, 78 percent remembered getting a good buzz from their first few puffs. The questions of how sticky smoking ends up being to any single person, in other words, depends a great deal on his or her own particular initial reaction to nicotine.
The Tipping Point: How Little Things Can Make a Big Difference Page 20