Pets and smoking: two cost items that are high on the list of priorities for many people with little money, says welfare worker Els Annegarn of Buurtteam Amsterdam Noord. “People who don’t have a cent spend their last money on their pets and cigarettes. It is one pack of cigarettes or the groceries.” She walks with a firm pace through the Van der Pekbuurt, where she talks during her home visits about debts, domestic violence, addictions and therefore also about the struggle of a smoking addiction.
A pack of cigarettes costs nine euros from today, 1.22 euros more than yesterday. Next year another big euro will be added. The cabinet wants to discourage smoking by raising the price of tobacco. If you now smoke a pack a day, it will cost approximately 270 euros a month and more than 3,000 euros annually – a fortune for many in the Van der Pekbuurt. “About half of the adults in this neighborhood smoke.”
Pulmonologist and anti-smoking lobbyist Wanda de Kanter will visit smokers this day with Annegarn to listen and learn. At the ‘stop smoking group’ they meet Brigitte, a woman in her sixties who would love to quit, but keeps falling back into old habits because she gains weight very quickly after quitting.
“A cigarette gives me company. It’s a buddy for tricky things. And the rest is addiction.” Cost, she says, is also one thing. “Brown can’t take it. I live on a minimum income, so I have to give up things: a subscription to a sports club, new clothes, dinners – the icing on the cake.”
Those who smoke heavily pay much more than just the costs of purchasing rolling tobacco or cigarettes. Rising healthcare costs, of course, but there are also indirect costs that you don’t often think about: someone who smokes in the house gets yellow walls and has to wallpaper and paint more often. A car that has been smoked in is worth much less when it is sold. And smokers are sick more often on average, which in turn can affect income. But will that one euro more motivate Brigitte to stop? “No.”
Patronizing
Crudely enough, the people with the lowest incomes smoke the most. Men between the ages of 45 and 65 in the lowest income group smoke three times as often as men with the highest incomes (37 versus 12 percent). It is therefore high time, especially in a neighborhood where people are tormented by inflation and high energy costs, to raise the very sensitive subject of ‘quitting smoking’.
However, this is not yet common practice in the aid sector. Even on the website of Nibud, the country’s leading financial advice center, there is virtually nothing to be found about smoking. “We choose not to do much with it,” says a spokesperson. “It is up to the people themselves whether or not they smoke.”
De Kanter knows the reflex all too well: “Politicians and aid workers are afraid to be patronizing on this point: ‘We don’t want to take away the one thing people still have.’ But that’s a twist of thought. Because it destroys the only thing they have left, which is their health.” Heavy smokers (more than a pack a day) live thirteen years shorter, the CBS calculated.
That is why Annegarn does put it on the table with people who are in misery. “Many things are beyond your control as an individual. Debts have been deposited with debt counselling, a house that is too small and poorly maintained is K with pears, but you cannot just find another home. But that smoking, you are in charge of that. And it’s possible, right? Fuses.”
COPD
Annegarn and De Kanter have known each other for a long time and find each other in a shared ambition: to promote a healthier lifestyle. De Kanter has been fighting the tobacco industry for years and Annegarn started four years ago with, among other things, exercise activities for Northerners, under the name Gezond Noord. Another nice detail: at the age of 55 – now more than ten years ago – Annegarn became world champion in the 100 kilometer running in her age category.
These two move into the neighborhood a few times a year, just like today. A fixed point is a visit to Chris, a woman who smoked two packs a day and found the perseverance to cut down, now that her husband has terminal stage COPD, a lung disease. Chris has two grandchildren – teenagers – who, much to her chagrin, have taken up smoking. “My heart is bleeding,” she says. Sometimes De Kanter hears so much misery in the conversations with the residents that she thinks: should I start talking about smoking now? “Even I think so.”
But she does it anyway, carefully, probing. “And then you often notice that it is an important subject for people. They just want to stop.” At the same time, Annegarn hears from people in trouble: ‘Without these problems I wouldn’t smoke. But now I need that cigarette.’
Many people have wrongly come to believe in this, says De Kanter. Of course it is more difficult to stop when the troubles are great, especially if the environment continues to smoke, but she wants to emphasize that a cigarette does not calm down. “The cigarette actually causes more stress,” says De Kanter, who will also visit rooms with psychiatrists and soon, for the first time, debt counselors with this message. “Smoking increases the risk of psychoses, schizophrenia and depression. People think that smoking dampens that, but the complaints such as anxiety and panic actually worsen.”
Older generation
It is bitter that smoke addicts who can do little without, are now again confronted with even more expensive tobacco, but according to De Kanter you don’t help people with cheap cigarettes. “But with a job, a house, a good income and effective, free smoking cessation counselling. In addition, raising the price of tobacco is the single most important way to ensure that fewer children start smoking.”
In the tobacco shop Cigo van der Pek they have a hard head that the existing smoker is now also dropping out. “Certainly the older generation is not going to stop for that extra euro,” thinks owner Sandra ten Have. “We do see customers rolling their own cigarettes or switching to cheaper tobacco brands. On the other hand, everything in the supermarket is becoming much more expensive. Seen in this way, the price increase of cigarettes is not too bad.”
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