SmokingWhile I was in the UK for my father-in-law’s funeral last week, I had an interesting talk with someone who has tried and failed for some years to quit smoking.

This guy has been smoking for half his life. He started at about 16, and he’s 32. (Studies show that when people start smoking as teens—or using any drug, including alcohol—it’s much harder to quit later.) When he was 18 or 20, back when nicotine patches were prescription-only, his father paid for patches. And the patches worked to help him stop. But then he started smoking again. Since then he’s quit “a bunch of times,” as he said, but has never been able to stay quit.

I remember asking him after the first time, when he was maybe 21, why he found it so hard to stop smoking. This was around the time my mother died of lung cancer, and before my own addiction became entrenched—before I understood the ways addiction becomes woven throughout the fabric of life, the ways it changes the neurological system.

He had given me simple answers: He was always desperate for the first morning cigarette with his coffee. He missed having a cigarette with his friends when he went for a beer. He wanted a cigarette when he smelled other people having cigarettes. Smoking helped him deal with stress.

So, as the author of an addiction blog I was thinking to myself, here’s some reasons he found it hard to quit:

  • the morning hit of nicotine potentiating the caffeine—people have always used drugs together; addicts get used to using them together; think Speedball, think alcohol and Valium (a combination that has killed many people), think ecstasy and speed. Hell, think Four Loko, the crazy-ass combination of caffeine and booze that has landed college kids in the hospital in the past year.
  • the social aspect of using—he missed smoking with the people he drank and smoked with. When he went out drinking, it was natural also to smoke. He couldn’t do one without the other. (In fact, he might not have been able to socialize without drinking. I mean holy God, I understand this.)
  • simple sensory triggers—cigarette smoke creating what we addicts call “euphoric recall.” He sniffed the smoke, he suddenly remembered the burn at the back of his throat, his mouth watered, he just needed a cigarette. Alcoholics feel the fire down their throats when they see someone drinking; opiate addicts feel the spreading warmth in the bottom of their bellies when they come across “paraphernalia” or actual drugs.

And then, of course, the all-time biggest “trigger” of them all: stress. (When I was using, getting up in the morning was stress enough to make me use. Vikes with morning coffee, anyone?)

We were on a walk in a park with a group of family and I heard a particular, very familiar loose bronchial cough come out of his mouth.

“You’re not STILL smoking?” I said.

He unzipped a jacket pocket and showed me a packet of Marlboros. UK law dictates one entire side of the package be printed with the warning, “SMOKING KILLS.”

“Dude,” I said, “you have to stop.” He knows all about my mother, blah blah blah. And there we were, standing with some of his closest family.

“I know,” he said.

I asked him what was making it hard for him. He said he found it impossible not to smoke when he goes out drinking with his buddies, “and also smoking spliff makes it hard. I mean, smoking anything would make it hard,” he said. Bingo. Using other drugs. Alcohol and weed.

What’s necessary? Well, how about total abstinence and a program of spiritual fitness… But most smokers don’t see themselves as “real addicts” so they don’t think going that far is necessary.

“I’m gearing up to create the Master Plan for quitting for good,” he said. “But I don’t know what it’ll be yet.”

We talked about Chantix, which he hadn’t heard about. I told him Chantix had worked for friends of mine for whom all else had failed.

Chantix might get him clean, but staying clean is another matter. As every recovering addict knows.

He was speaking really laconically, as though he had all the time in the world to quit, as though the warning printed on the packet in his pocket were just an ad he didn’t have to pay attention to. Addicts have very selective attention. And most smokers don’t consider themselves addicts.

In fact: in trawling through some research today, I found this astonishing paper published in the journal Addiction. In this paper, “Believing in Nicotine Addiction: Does It Really Make Quitting More Likely?”* the researchers suggest that it’s counterproductive for smokers to think of themselves as “addicts” because, in some studies, those who did “expressed weaker intentions to stop smoking and had much lower expectations regarding their perceived ability to do so.”

I was amazed. They’re paying these guys to sit in a room and tell people who can’t quit a lethal substance to deny they have a real addiction. I mean, take the logic a step further: if smokers should not “believe” in their addictions, why shouldn’t alcoholics and heroin users also take the same strategy? Why don’t they just do away with rehabs and tell us all, “You’re not really addicted—believing you’ve got an addiction just takes away your power and responsibility to quit.” Unbelievable.

Nicotine addiction is real. I’ve seen it. It killed my mother. She was a prodigiously intelligent and beautiful woman who died at 58, after having lost her hair (three times), her balance, her hearing, the use of the muscles on one side of her face, and eventually her speech and her mind. She should be here today, 70 years old, playing with her grandchild. But she’s not. Because of nicotine addiction.

No one told her she had an addiction. Her physicians told her to quit but never told her she was an addict. She herself would have been mortified at the term and would have rejected it.

But in my experience, the truth sets free.

Of course, this is just “anecdotal.” 🙂

*Addiction, 106:3, 678-679, March 2011.