Over a hundred years ago Mark Twain quipped, “It’s easy to quit smoking. I’ve done it hundreds of times.” The concept of quitting a habit is as old as people, but smoking is one habit that seems especially difficult to overcome. I have patients who quit methamphetamines, heroin and alcohol, but cannot overcome the tobacco habit. They tell me it is the hardest thing.
One patient was able to quit when he got throat cancer, but only because he hated the tracheostomy tube so much and knew he would never smoke again if he did not beat the cancer odds. Others with this same problem actually smoke through the tube!
The methods and ways people quit are varied, almost as the number of quitters. Some medications are used, but these were mostly created for a different purpose. When drug testing was being done on these medications, the statistical analysis showed that a greater number of smokers quit in the active medicine group than in the placebo group. The pharmaceutical company then decided to market this effect of the medicine instead of the intended use, such as anti-depressant. There are patches, pills, electronic cigarettes, creams and all manner of physical assistance to help quit smoking.
Decision to Quit
Kicking the habit starts with a decision. Many who are pushed from the outside will say they want to quit, but really want to continue smoking. This decision must come from within. When I counsel people in my office, I simply ask them what they want to do. I then assess whether they are ready to start trying. Those who have made a firm resolve to quit smoking find a successful way.
My grandfather was given cigarettes as part of his Navy rations during World War II. At home, his wife did not like the smoke in the house, plus they had a son with asthma. So, he decided just to postpone his usual smoking. He would reach for a cigarette from his shirt pocket, take one out, look at it and say, “I’ll just wait a few minutes.” He kept putting it off until after a few months went by he realized he had gone a full week without smoking. He then took the cigarettes out of his shirt pocket and said, “No use just carrying these around…” threw them in the trash and never smoked again.
Dr. Manchester was a pediatrician who smoked and would counsel all of his young patients never to start smoking. He tried to quit, but kept going back to it and felt like a hypocrite. He paid for all sorts of programs, used all the medications and tried hundreds of times without success. He felt so discouraged that he quit being a pediatrician and became a psychiatrist. One day, he suffered a heart attack and ended up in the hospital. As he was lying in the hospital bed, he hated being there so much he knew he would never smoke again just to avoid it — and he quit easily.
I had one patient, when the patches required a prescription, who was wearing a patch for many years. We kept trying to wean him off, but he would come in for another round. I do not know if he ever got off the patches, but at least he was not smoking.
Patches with nicotine in them are now available over-the-counter. They are mostly helpful for those who really smoke for the nicotine, not for other reasons. If you get shaky, nervous, jittery, and very irritable in the first several days after quitting, then this may be an option for you. Those who can go a full day without these symptoms are less likely to benefit from patches.
There are many drugs available now to help with the smoking habit. If you are going to use these, then
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