September 24, 2010
Just the facts and some sage advice on quitting.
Sitting in a leopard blind at night is an amazing experience. You develop a paranoia that even breathing is too loud and will tip off a wary cat. Each and every movement is slow, deliberate, even when compared to raising a bow or rifle in a tree stand with the buck looking right at you. Well, as the PH lit the 27th cigarette that night we really had to wonder. Sure the wind was blowing from the bait toward us and tracks suggested the spotted feline would approach upwind, but still...27 cigarettes? Fortunately the frequent stifled coughs (smokers hack) did not deter the hungry beast, but enough was enough. When asked about the 4 pack a day habit, we were told that cigarette smoke doesn't frighten animals and besides "..it's the best wind tester I know of."
We won't argue whether cigarette smoke deters animals from coming into range because that isn't a real issue when it comes to smoking cigarettes and health. However before we proceed we have a disclaimer: neither of us smokes. This hasn't always been true. Former smokers tend to be the most rabid anti-smokers there are, but not us. We take a Libertarian approach and believe that adults can make their own decisions when provided with accurate information.
We feel that the medical problem of smoking has not benefited from the nanny State approach of controlling it. To some extent, new medical information is now perceived by many of our smoking patients as part of a government propaganda campaign. There's legislation in at least one state to charge a parent with child abuse/neglect if the parent is smoking in their car with a minor child. The natural reaction to this type of governmental intrusion is oppositional. We felt it's worth it though to go over some realities about smoking cigarettes. You're an adult and can make your own decisions if you have some facts.
Smoking is simply not a healthy thing to do. Sure, there are lots of unhealthy things in our world but few provide so little benefit and are so disabling and deadly. Yes we know that not everyone who smokes gets a health problem from smoking. But we can find an exception to nearly everything. It's just a fact that smoking cigarettes is destructive; rare exceptions noted.
Exactly why smoking is so harmful is less clear. There are hundreds and hundreds of compounds in tobacco smoke with long names and toxic qualities. Theories abound point to smoke particulates, specific compounds, and exposure to high temperature air as the offending quality of cigarette smoke. Smoking cigarettes can cause: cancer (lung, head and neck, esophageal, kidney, bladder, pancreatic), emphysema, chronic bronchitis, osteoporosis, hypertension, coronary artery disease, stroke and peripheral vascular disease (also included here is impotence).
Why do people smoke? Here's a billion dollar question. It's not because cigarette smoke makes a dandy wind direction detector! In reality, people begin to smoke because they enjoy it. We can debate "peer pressure" all day long, but the bottom line is that people enjoy smoking. And the children of smokers have substantially higher rates of smoking. "Do as I say and not as I do" will never actually modify adolescent behavior. Kids start to smoke because they mimic their parents, who in reality are their role models. Smoking as rebellion can also be a reason some start (the more rules, the bigger the taboo, the greater the rebellion).
In order for people to make big changes in their lives they have to perceive a need for change. The consequences of cigarette smoking provide many reasons to stop, but does so in a way that isn't particularly motivating; the time between smoking regularly and encountering a health problem is almost always years and years. Hence many folks deny the connection between health problems and smoking until the first big problem arises.
Denial is the unconscious altering of the way the conscious thinking process perceives certain things so as to protect itself from intolerable and unpleasant reality. People who smoke cigarettes are in denial about the health impact of their smoking. Almost all can reel off the warnings on the cigarette pack, but they're in denial about applying these warning to themselves.
A classic self-delusion that we hear often is "We all have to die of something". When we hear this our response is, "Well, what if you could be 100 percent sure that your next cigarette would cause the first lung cell to turn to cancer right now. Would you light it up"? We always get a "No" response. Basically people who enjoy smoking believe that they will somehow be a lottery winner and not get sick and commonly believe that they will somehow stop in the nick of time thusly maximizing the pleasure and avoiding all the pain. Fellow hunters -- that dog don't hunt!
IF (note capitals) you have a desire to quit smoking how do you best accomplish this goal? There's an old joke that goes as follows: "How many therapists does it take to change a light bulb? One, but the light bulb has got to want to change". The key to quitting is really all about understanding how people change ingrained behaviors. Human behavioral change breaks it into five stages: pre-contemplation, contemplation, preparation, action, and maintenance.
We will spare the dissertation in psychology, but briefly in the pre-contemplative stage you are not really engaged in any behavior or thought about altering your behavior in a meaningful way. Applying this to smoking, your denial is maxed and you strongly self identify as a smoker. The movement to a contemplative stage with cigarette smokers usually requires some sort of misfortune. Typical are personal illnesses from smoking or severe consequences in a friend or family member. As a result the smoker is now "contemplating" whether they should stop.
Preparation as it applies to cigarette smoking is what most advertisements for stop-smoking items key in on. Patches, gums, inhalers or pills are touted as the answer. The reality is that (to quote John Lennon) "... The movement you need is on your shoulders". Discuss what you need to do to quit with family members, your doctor, and friends, and intensely with yourself. Set a date and make it absolutely as public as you can. Elicit as much support as you can. Plan to remove ashtrays, lighters and other paraphernalia.
A word here about the "addictive" nature of cigarette smoking is in order. Nicotine is touted as a very addicting stimulant. Honestly, we're not sure it's the nicotine that's the problem. How come abuse of nicotine patches is virtually unheard of? If nicotine is so powerful, then how come teenagers aren't showing up with 5 or 10 patches on instead of risking serious school problems by smoking part of a cigarette in the bathroom? Nicotine as the only bad guy allows for FDA regulation, taxation and may not really be the number one problem as far as addiction to cigarette smoking goes. What's
so addicting about smoking is more complex than a nicotine delivery system. Is cigarette smoking addictingâ€¦.absolutely. Can it be overcomeâ€¦millions have and thousands do each and every day!
So whether you choose nicotine gum or Juicy Fruit, have a plan. Prepare for the life change. Do it. Put your multifaceted preparation into action. It's stop day and you have no cigarettes. None of your friends will give you one. You are not holding a lighter and have no ashtrays around. Work breaks are spent indoors and away from smoking areas. Sit in non-smoking parts of restaurants even if your smoking buddies want to do otherwise. You are a non-smoker now so live the role.
Maintenance involves continuing self-identification as a non-smoker. There's no need for rabid anti-smoking behavior...you just don't smoke. You now see smoking as something un-natural, unhealthy and disgusting like say joining PETA. Do not fool yourself into just smoking after meals or special occasions. Take advice from 12 step programsâ€¦One is too many and a thousand isn't enough.
We hope the information we have provided here helps you make decisions about your health care. As always, stay healthy and enjoy the outdoors.