What is the addiction threshold? Well, no one believes that it is exactly the same for all people. But Benowitz and Jack Henningfield — who are probably the leading nicotine experts in the world — have made some educated guesses. Chippers, they point out, are people who are capable of smoking up to five cigarettes a day without getting addicted. That suggests that the amount of nicotine found in five cigarettes — which works out to somewhere between four and six milligrams of nicotine — is probably somewhere close to the addiction threshold. What Henningfield and Benowitz suggest, then, is that tobacco companies be required to lower the level of nicotine so that even the heaviest smokers — those smoking, say, 30 cigarettes a day — could not get anything more than five milligrams of nicotine within a 24-hour period. That level, the two argued in an editorial in the prestigious New EnglandJournal of Medicine, "should be adequate to prevent or limit the development of addiction in most young people. At the same time it may provide enough nicotine for taste and sensory stimulation."' Teens, in other words, would continue to experiment with cigarettes for all the reasons that they have ever experimented with cigarettes — because the habit is contagious, because cool kids are smoking, because they want to fit in. But, because of the reduction of nicotine levels below the addiction threshold, the habit would no longer be sticky. Cigarette smoking would be less like the flu and more like the common cold: easily caught but easily defeated.

It is important to put these two stickiness factors in perspective. The anti-smoking movement has focused, so far, on raising cigarette prices, curtailing cigarette advertising, running public health messages on radio and television, limiting access of cigarettes to minors, and drilling anti-tobacco messages into schoolchildren, and in the period that this broad, seemingly comprehensive, ambitious campaign has been waged, teenage smoking has skyrocketed. We've been obsessed with changing attitudes toward tobacco on a mass scale, but we haven't managed to reach the groups whose attitude needs to change the most. We've been obsessed with foiling the influence of smoking Salesmen. But the influence of those Salesmen increasingly looks like something we cannot break. We have, in short, somehow become convinced that we need to tackle the whole problem, all at once. But the truth is that we don't. We only need to find the stickiness Tipping Points, and those are the links to depression and the nicotine threshold.

The second lesson of the stickiness strategy is that it permits a more reasonable approach to teenage experimentation. The absolutist approach to fighting drugs proceeds on the premise that experimentation equals addiction. We don't want our children ever to be exposed to heroin or pot or cocaine because we think that the lure of these substances is so strong that even the smallest exposure will be all it takes. But do you know what the experimentation statistics are for illegal drugs? In the 1996 Household Survey on Drug Abuse, 1.1 percent of those polled said that they had used heroin at least once. But only 18 percent of that 1.1 percent had used it in the past year, and only 9 percent had used it in the past month. That is not the profile of a particularly sticky drug. The figures for cocaine are even more striking. Of those who have ever tried cocaine, less than one percent — 0.9 percent — are regular users. What these figures tell us is that experimentation and actual hard-core use are two entirely separate things — that for a drug to be contagious does not automatically mean that it is also sticky. In fact, the sheer number of people who appear to have tried cocaine at least once should tell us that the urge among teens to try something dangerous is pretty nearly universal. This is what teens do. This is how they learn about the world, and most of the time — in 99.1 percent of the cases with cocaine — that experimentation doesn't result in anything bad happening. We have to stop fighting this kind of experimentation. We have to accept it and even to embrace it. Teens are always going to be fascinated by people like Maggie the au pair and Billy G. and Pam P., and they should be fascinated by people like that, if only to get past the adolescent fantasy that to be rebellious and truculent and irresponsible is a good way to spend your life. What we should be doing instead of fighting experimentation is making sure that experimentation doesn't have serious consequences.

I think it is worth repeating something from the beginning of this chapter, a quote from Donald Rubinstein describing just how deeply embedded suicide had become in the teen culture of Micronesia.

A number of young boys who attempted suicide reported that they first saw or heard about it when they were 8 or 10 years old. Their suicide attempts appear in the spirit of imitative or experimental play. One 11-year-old boy, for example, hanged himself inside his house and when found he was already unconscious and his tongue protruding. He later explained that he wanted to "try" out hanging. He said that he did not want to die.

What is tragic about this is not that these little boys were experimenting. Experimenting is what little boys do. What is tragic is that they have chosen to experiment with something that you cannot experiment with. Unfortunately, there isn't ever going to be a safer form of suicide, to help save the teenagers of Micronesia. But there can be a safer form of smoking, and by paying attention to the Tipping Points of the addiction process we can make that safer, less sticky form of smoking possible.

EIGHT

Conclusion

FOCUS, TEST, AND BELIEVE

Not long ago a nurse by the name of Georgia Sadler began a campaign to increase knowledge and awareness of diabetes and breast cancer in the black community of San Diego. She wanted to create a grassroots movement toward prevention, and so she began setting up seminars in black churches around the city. The results, however, were disappointing. "There'd be maybe two hundred people in church, but we'd get only twenty or so to stay, and the people who were staying were people who already knew a lot about those diseases and just wanted to know more. It was very discouraging." Sadler couldn't get her message to tip outside of that small group.

She realized she needed a new context. "I guess people were tired and hungry after the service," she says. "We all have a busy life. People wanted to get home." She needed a place where women were relaxed, receptive to new ideas, and had the time and opportunity to hear something new. She also needed a new messenger, someone who was a little bit Connector, a little bit Salesmen, and a little bit Maven. She needed a new, stickier way of presenting the information. And she needed to make all those changes in such a way that she didn't exceed the very small amount of money she'd cobbled together from various foundations and funding groups. Her solution? Move the campaign from black churches to beauty salons.

"It's a captive audience," Sadler says. "These women may be at a salon for anywhere from two hours to eight hours, if they're having their hair braided." The stylist also enjoys a special relationship with her client. "Once you find someone who can manage your hair, you'll drive a hundred miles to see her. The stylist is your friend. She takes you through your high school graduation, your wedding, your first baby. It's a long-term relationship. It's a trusting relationship. You literally and figuratively let your hair down in a salon." There is something about the profession of stylist, as well, that seems to attract a certain kind of person — someone who communicates easily and well with others, someone with a wide variety of acquaintances. "They're natural conversationalists," Sadler says. "They love talking to you. They tend to be very intuitive, because they have to keep an eye on you and see how you're doing."