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Since it's Saturday, Jen probably won't smoke tomorrow. Indeed, barring a midweek excursion to a local watering hole, she may not see or even think about another cigarette until Friday, when, likely as not, she'll be sitting in another smoky bar, puffing away at another donated cigarette.

Jen is not alone.

Of the nearly 70 million Americans who smoke, a good 20 percent routinely categorize themselves as "less than daily" smokers. If you happen to be a regular smoker, you know the type. You know because, while the people occupying that 20 percent bracket may be avid cigarette smokers, they are not usually cigarette buyers. Smokers call them leeches, public health officials call them "chippers" and nobody, it seems, has ever gone to the trouble of studying the impact occasional smoking has on their health.

Borrowed from street slang, the term chipper originally was used to describe the rare heroin user who could take the drug recreationally and not develop an addiction. In the realm of tobacco, although chippers, or "puffers," as they are also sometimes called, have always made up a fairly sizable portion of the smoking population -- little if anything is known about them.

"I don't think we have a full understanding of what that [group] is -- how they define themselves or think of themselves," says Donald Shopland, coordinator of the Smoking and Tobacco Control Program at the National Cancer Institute. "Most of the epidemiological studies that look at disease risk almost never look at those types of people."

"Almost never" may be something of an understatement. Shopland admits that in more than two decades as a public heath official, he hasn't seen a single study on social smoking. And he would probably know. Before taking his post at NCI, Shopland was the longtime editor of the world-renowned surgeon general's report on smoking.

While epidemiologists reason that chippers must lie somewhere between daily smokers and nonsmokers in terms of relative disease risk, they can only speculate as to where along that continuum "casual" smokers fall. Some scientists even suggest that the risks to chippers may be roughly equivalent to those faced by people exposed to "environmental" or second-hand tobacco smoke. "We know that the risk [to chippers] is not zero," Shopland says. But since chippers "don't contribute that much of a burden to the public health -- this is a group that we have a very, very poor understanding of."

Beyond not knowing what kind of health risks face chippers, public health officials don't even really know what their smoking habits look like, Shopland says. Because the studies that routinely confirm the existence of chippers rely almost exclusively on self-reported data and rarely include targeted questions about individual smoking patterns, there is no way to tell when and how often self-defined "less than daily smokers" smoke, he says.

"It could be that some of those people smoke a pack today and none tomorrow," Shopland says. And the questions aren't likely to be cleared up any time soon, Shopland adds. Why not? "Because you would have so few deaths" in a study of social smokers. Researchers would have to follow a huge sample over many years in order to generate any kind of valuable data, he says.

Despite the obvious conclusion that observation suggests, public health authorities bristle at the suggestion that there may be such a thing as "responsible" smoking.

The fact that the risk to chippers hasn't been measured adequately -- or at all -- should not be taken to mean that the risk doesn't exist, says Peter Kaufmann, leader of the behavioral medicine research group at the National Heart Lung and Blood Institute. Trying to identify what is a safe level of smoking "is simply not the right logic to pursue," he contends. "Fundamentally there is no bottom threshold at which smoking is safe."

Beverly Kingsley, an epidemiologist for the Centers for Disease Control and Prevention's Office of Smoking and Health -- the government's shock corps in the ongoing war against tobacco -- agrees. "There is no safe level of smoking," she says.

Next page | Rasheed, a physician, has smoked socially for years