February 8th, 2007

Let's get this out of the way:

I want to be clear about something that bothered me for a long time, and continues to bother me now, even though I've been "Smoke Free" for years:

Smokers, without exception, already know why they should stop smoking. Non-smokers who tell horror stories about smokers' lungs, lifestyles, damage to others, or costs involved do not help smokers in any way to quit. Smokers, if they want to hear anything at all about it, want to know how to quit smoking.

But enough of the "why", already. If you really want to help, and not just prove to the world how great you, as a non-smoker, think you are, then try something intelligently helpful like a method of quitting smoking, and not just more reasons for why smokers should.

OK, let's get started:

I run the risk of letting the cat out of the bag with some members of my family, but what the hell: I feel pretty strongly about this.

I spent 17 years of my life addicted to nicotine. That's right, addicted. Smoking itself may be habit, but nicotine is addictive. If I wasn't getting my nicotine somehow, I was spending my time wanting it and figuring out how to get it. The medical profession was very slow to get on board to that "addicted" notion ... its official position on smoking was that it was strictly behaviourally-motivated. The medical community as a whole maintained smoking was merely habitual, long beyond what just about anyone would call "reasonable skepticism".

Nuh-uh ... habit may have formed a part of it, but smoking is primarily a method of delivering nicotine to the blood-stream, and nicotine is addictive. So, smoking is an addiction insofar as it is a nicotine delivery system. If cigarettes ceased to exist, smokers would have to resort to some other method of getting nicotine into their bloodstreams (and subsequently their brains).

So, if you think about it, banning smoking isn't really banning nicotine addiction; in fact, as more and more alternative Nicotine Replacement Therapies (NRTs) become available, quitting "smoking" might become easier and easier, but quitting nicotine would not change at all. And smokers shouldn't think that slapping a patch onto their arms or tossing some of that truly repulsive gum into their mouths is much of an alternative ... it's just their addiction taking a different form.

I know whereof I speak. I wrote a lengthy description of How I Quit Smoking and in it I explain that the physical addiction to smoking lasted four days for me, and usually about that long for most other people, too.

Four days. Five tops. And your physical nicotine addiction is gone. So -erm- why was quitting so difficult? Well, that's the habitual part that doctors mention. I mean, if you can pop a ciggie into your mouth and feel relaxed, and comforted, and strangely good, but still fully in touch with the world ... well, heck, who wouldn't start to make positive associations? Who wouldn't learn to do it every hour on the hour (pretty much) whenever they had the opportunity, provided there were no serious negative repercussions? And, subsequently, who wouldn't grow addicted to the nicotine in the cigarettes?

When I quit smoking it was difficult to overcome the behavioural aspects, for sure. But the worst part happened in the first four days as my body recovered from nicotine withdrawal. The first four (or maybe five) days were positively the worst, but things improved after that, and I was able to concentrate on changing my behaviour.

Now, let's look at NRTs and what the theory behind them presumably is: They are sold as a way to stop smoking. Well, perhaps they do help people to stop "smoking", but they do nothing for peoples' addictions to nicotine. Would you give a recovering alcoholic a half-glass of beer every once in a while to keep them just a bit buzzed? The addictive part of smoking lasts four days, and the behavioural modification a few weeks. NRTs do absolutely nothing for behavioural modification, and actually make things worse for the recovering smoker, since the nicotine levels stay high, and the body has no chance to "dry out"!

It looks almost as if NRTs are not addiction-reduction devices at all, but just more socially-acceptable forms of addiction-feeding.

OK, and that brings me to my last rant for today: I read that there is a movement afoot locally here in Vancouver to start handing out NRTs to low-income and/or homeless people to encourage them to quit smoking. But that is based on the often-quoted but thoroughly-disputed (and, it now appears, completely wrong) claim that NRTs increase the chance of quitting smoking "by 50%" (others do a much better job of disputing that than I could).

City councillors who think that patches, gum, lozenges, and sub-dermal implants are going to reduce smoking among the have-nots here in Vancouver, may have their hearts in the right place, but they are actually only going to make the situation worse! Because of that physical component that I talked about (above) as being the only part of it that is addressed, councillors are only going to give the homeless an opportunity to stay addicted when other nicotine sources (cigarettes) have run out ... until the next Welfare Wednesday, that is.

NRTs for the homeless will only ensure more people are addicted to nicotine.

Anyone concerned would do well to remember that there is a big difference between the habitual, behaviour-related side of smoking, and the physical addiction side of it. It took doctors forever to acknowledge it (and they are a pretty smart, if somewhat linear, bunch) and now, it looks like, everyone else is going to be slow to follow.

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