Sunday, April 6, 2014

Celebrating Nothing: Twenty Years Without Smoking

I quit smoking twenty years ago, in March, 1994. It was one of the hardest things I have ever done.

For those of you who have never smoked, and those of you who were smokers who quit easily, it might be hard to understand why it can be so difficult for some of us.  It is because of this general lack of understanding that I consider those few who are still puffing despite the external and internal pressure to stop to be kindred spirits for whom I have great empathy and sympathy.  My heart goes out to them when I see them huddled together in desperate little groups outside public buildings from which they have been banned, or when I inadvertently come across one sneaking a smoke in a stairwell or a restroom.

I had been trying for years to break the habit and had managed to get down to just a few cigarettes a day, but quitting entirely was something I just couldn't do. I thoroughly understood the risks, dangers, annoyances, personal and social costs, effects of second-hand smoke, etc., etc., etc.  I knew all the reasons why quitting was a good idea and continuing was idiocy.  It didn't matter.

To punish myself for my lack of will power, I restricted my smoking at home to outside areas (during the winter this meant many cold hours in our unheated garage). I wouldn't smoke in our cars or in most public places. In my office I would sit huddled by a window blowing the smoke outside.  Long plane rides were agony, and the minute I got off I would sprint for the nearest smoking area.  Four hours seemed to be my comfort limit, as I recall. I tried to delay or avoid smoking at times it was most enjoyable, like after a meal or with a cup of coffee.  Nothing worked.  The thought of finishing my very last cigarette and having none available in case I changed my mind filled me with a very irrational sense of panic.

In those days there weren't the wide-spread smoking cessation programs there are now.  My physician was dutifully down on my habit but shrewdly realized that too much cajoling wouldn't work with me.  He knew of my efforts to cut down and he offered to help when I decided to quit entirely -- at that time a prescription was required for nicotine patches.

My turning point came one night when I woke up with pain in my chest.  Actually, not just pain, but PAIN -- like my heart was in a vice that someone was cranking tighter and tighter each time I took a breath.  And with this pain came a sense of fear close to terror -- something I thankfully haven't experienced as strongly again.  After the one and only ambulance ride of my life (well, so far) and a blur of activity in the Emergency Room, I wound up in the Intensive Care Unit overnight.  When my physician visited me the next day he gave me the wonderful news that I had not suffered a heart attack but rather a bout of something called acute pericarditis, which is an inflammation of the membrane surrounding the heart. The causes of this are not always clear, it happens most often to men between 20-50, and it often never occurs again.

Of course, I was waiting for the inevitable lecture about how smoking had led to this and was yet another reason to stop.  But my physician was honest and straight with me -- smoking was most likely not the cause, but of course it does contribute to the likelihood of heart attacks, something I really didn't want to experience if the pain was anything like the pericarditis attack.  Also, being in the ICU gave me the opportunity to achieve my 24-hour smokeless goal, because I had already gone 20 or so hours without a cigarette.  So I told my physician I wanted to try to quit smoking if he would help me.  He wrote me a prescription on the spot for a round of nicotine patches, and also for something which turned out to be critical -- an anti-panic drug.

I started with the biggest patch possible. I joke that I opted for the full wet-suit size. The patches helped numb the craving but it was the anti-panic pills that were key to continuing my effort to quit (I think it was called Xanax).  As I progressed to smaller patches the panic attacks grew less intense and less frequent.  But I learned that the patches couldn't provide the sudden "hit" of nicotine that was one of the things that made smoking so pleasurable to me, and the pills didn't deal with the craving for those.  These days there are substitutes that can provide a sudden increase in nicotine but they weren't available then.

After several months I made it to the nicotine-free level and though I had to continue the anti-panic pills occasionally, I didn't relapse into smoking and eventually I stopped them.

Before I quit smoking the public campaigns against the habit were relentless and often hyperbolic.  Smoking was the evil weed, responsible for everything from lung cancer to hangnails to global warming.  And life after smoking was touted as marvelous and just short of heaven itself.  Your sense of taste and smell would return from the dead, you would have fewer colds, better eyesight, and your hair would grow back. You would become a sexual athlete, your IQ would go up by 30 points, and you would succeed at business without really trying.  I think in retrospect that these over-the-top campaigns were probably responsible for as many relapses as they might have been for attempts to quit smoking because when the promised benefits didn't happen the residual cravings took over.

Indeed, I found that most of the promises were empty or misleading, at least at first. I believe it was my pre-existing skepticism of the claims that prevented my relapse when I found they weren't true or were exaggerated.  I did not immediately feel better.  I had just as many colds as before and they were just as severe.  My sense of taste didn't change, although I immediately gained weight because my appetite increased.  I did notice an increase in my sense of smell, but as one friend who had quit a few years before me joked, "The good news is you can smell better.  The bad news is that a lot of things smell really bad."  He was absolutely correct.  For example, I soon found a lot of men's colognes and women's perfumes to be really obnoxious -- scents that had been pleasantly muted before I quit smoking were now almost nauseatingly strong.

One thing that didn't smell bad to me was cigarette smoke. In fact I embraced it even though it occasionally re-kindled my desire.  Even to this day it doesn't smell that bad to me and I'm not one of those people who complain loudly if they get even a hint of someone's cigarette smoke.  Often these complainers are the very people whose cologne or perfume fills the air with a near-choking intensity-- they are habituated to it, otherwise it would probably completely mask the smell of tobacco smoke.  In general, I've tried to avoid becoming one of those holier-than-thou ex-smokers who show no compassion whatsoever for those who are still struggling with the habit. When I was smoking those crusaders had the opposite effect on me than they intended -- their stridency actually deepened my resolve to assert my own will, no matter how self-destructive that was.

Twenty years have passed and so far I've avoided the cancerous consequences of smoking, though the probability of lung cancer will never fall to what it would be had I never smoked.  Another sobering thought comes from the fact that I started smoking at a very young age (as an 8-10 year-old trying to emulate my two older siblings) and smoked more or less continuously for the next 40 years. Given my age when I quit, it is very unlikely I will live smoke-free for as many years as I smoked.

I'm very glad I quit, if for no other reason than recovering my self-esteem.  As an intellectual I knew full well that I was killing myself and harming others in the process, and that the logical, prudent thing was to quit.  But my habit was way beyond control by logic -- I was addicted and addiction required a different approach than simply reasoning with myself.  I'm very thankful for the pericarditis attack kick-starting that different approach.

People often ask if I still crave tobacco.  The answer is a sad one.  Yes. The craving isn't very strong and I have no intention of smoking again, but this shows just how thorough a grip something can have on you.

No matter how smart you think you are.


Dennis Nord said...

Well said. I have no similar experience to compare with yours. It's hard to imagine the addiction and difficulty separating from it. I am thankful you are free of the smoke. It's a very good thing! Now for the next 20 years smoke free!

Unknown said...

Nicely written, Dick.

Except for the negatives, I liked smoking and would resume tomorrow. As 78 year-old diabetic who had a 5-way bypass nearly 18 years ago and who no longer feels the urge to light up, I don't think I'll re-start.

I work regularly at a Seattle food bank and vacillate between the urge to chastise our many homeless clients who smoke and empathizing with their difficulties dropping the habit.

Promotion of smoking is also another black mark for free-enterprise economic system.


Randy said...

Thanks Dick for another wonderful piece!
I gave up smoking 22 years ago. At that time I was a relapsed smoker of about 2 years. Before that I was off another 10 years or so. I am paying for that last two year stint with some reduced lung function that recently kicked in - but nothing life shattering. When I gave it up 22 years ago I was visiting a rehab facility for the weekend to visit my 24 year old nephew who was battling drug addiction. When I got to the rehab center there was an indoctrination for visitors. We are asked to forego anything in our life for that weekend that we might consider personally addictive - alcohol, tobacco etc. So I “gave up” smoking for the weekend. I made a promise that I would stay off cigarettes as a pledge of solidarity to him. I would call if I was going to step out and he was to do the same. He died of a drug overdose about a year later - of course without calling me first. I have stayed off cigarettes since then. The week after I left the facility I had 7 days off then suddenly it was 20 - then I started to “own” my cigarette sobriety - I was doing it for me now and not my nephew. Shortly there after I started dating the woman who was to become my wife. She said in no uncertain terms said she would not be dating (or eventually marrying) someone who smoked. That made it real simple to stay off! I don’t miss it at all but sometimes I have a dream where I am a smoker and it is along the line of a nightmare rather than a reflection of past pleasures. When I gave it up 22 years ago I was commuting by train and like all of the other addicts would be lighting a cigarette as I headed up the stairs that exited the train station. Even at two years after 10 years off I had a smoker’s cough. I truly hated the fact that I was addicted - the smoking side of it did give some pleasure now and again but it did not outweigh all of the negatives. I did not want to be at the beck and call for something that actually delivers so little but with such a huge price to pay. When I gave up the first time I did it with nicotine gum. I realized at that time that among all the drugs one could be addicted to (with some pretty amazing payoffs) - the little buzz that you get from tobacco is really a joke. It mainly delivers addiction with a little kick thrown in. And as junkies will tell you it is harder to kick than heroin.

Anonymous said...

My story is similar, tho I only smoked about 20years. Hardest thing in my life was to quit. Managed to get it down to just a few a day but couldn't imagine total abstinence. First 24 hours were the worst. Didn't get all the fancy benefits of quitting. Still get cravings. My poor dad still can't quit even with copd and lung cancer. Powerful addictive properties. Read recently though that pure nicotine isn't as addictive as it is in cigarettes. I read it elsewhere but NIH a respectable source.
Congrats on your achievement!

Coleen Hanna said...

For what it's worth, I spent 6 years with you at MU in the 1980's and didn't know you smoked. I quit easily after 20 years--never was addicted--lucky in that respect. I hated people lecturing me. One "lecture" that hit the mark, though, was when my friend Caroline told me, "Just because you've never been addicted doesn't mean you never will be." WOW! Maybe there is no guarantee that things won't change. Now I see people with E-cigs and I think "Hmmm...maybe" but NAH--I'm too much of a cheapskate!