D e s e r t E x p o s u r e
May
2009
A Smoker's Lament
One man's struggle to snuff out his habit — and what he learned about why it's so hard to quit.
By Hugh Dan Summers
Mark Twain is said to have quipped that quitting smoking was so easy he had done it a thousand times. Last Christmas I decided to give myself a gift and give the habit up as well. My reasons for quitting were myriad: First, I could no longer survive a full-court game in my weekly over-40 basketball league. I was also tired of paying over five bucks for a pack of cigarettes, and with the New Mexico legislature weighing a tobacco tax increase, my monthly cigarette costs could soon equal my car payment. Most important, I was tired of that disappointed look on my 11-year-old daughter Janay's face when she smelled the smoke that permeated my clothes and hair when I came inside from a surreptitious walk.
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Cigarette advertising co-opted psychology,
even medicine, in efforts to hook smokers.
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Thus, I found myself in my backyard, scanning the clear winter sky, and savoring one more soldier as I crushed the rest of the pack under the heel of my shoe. As I finished that last cigarette, I flicked the butt into the grass and reminded myself that I meant it this time.
Like anyone over 40 years old, I grew up in a world in which smoking was ubiquitous. I remember theater balconies full of gray smoke and the cherry-red tips of lighted cigarettes. I remember the large lecture hall at NMSU in which each seat had its own little ashtray and undergraduates used cool, menthol refreshment to survive freshman survey classes. I also remember a plane flight in the early 1970s on which the smoke hovered so thickly I expected plastic oxygen masks to be dropped in an effort to save the green-faced non-smokers from the 20 happy chain-smokers in the rear.
Such memories are jarring because that world no longer exists. And yet, even though I am a smoker, it is a world I do not miss. Smokers who feel persecuted as society increasingly moves toward more restrictions on when and where smoking is acceptable are allowing the nicotine in their bloodstreams to do their thinking. The health effects of smoking are so onerous to smoker and non-smoker alike that it is unreasonable to lament my loss of freedom and pine for the days when I could smoke in a restaurant dining room, light up in the airport, or, as an ex-girlfriend used to do, smoke in the aisles of the grocery store.
New Mexicans largely support our society's move to reduce smoking. In a recent poll huge support was shown for raising the state tax on cigarettes. The poll, by Research and Polling Inc., was publicized in the media as evidence that higher cigarette taxes might help cure New Mexico's budget shortfall. Stories noted that 64 percent of us prefer raising tobacco taxes rather than raising property taxes or cutting education funding.
The state of New Mexico's Department of Health reports, however, that the percentage of New Mexicans who smoke is higher than the national average. And yet, on that cool December evening, I felt as if I was the Land of Enchantment's last nicotine addict. Where once I could socialize in a corner office with other smokers, I was now reduced to smoking in my car or on the sly. Sure, I saw gaggles of smokers outside the big-box discount store when I went to buy groceries, and I saw employees huddled behind the fast-food joint furtively enjoying a smoke. But few people my age still smoked.
According to the National Institute of Drug Abuse (NIDA), smoking peaked in the middle of the 1960s. In 1964, the year I was born, half of all adult males smoked. Today smoking is principally the curse of the young and the uneducated: Twenty-six percent of teenagers report smoking, and tobacco use is highest among adults without a high-school diploma.
Like Mark Twain, I was successful at quitting smoking. I quit often. I've made at least 15 serious attempts to kick the habit during the 20-odd years in which I've smoked. Usually these attempts would last a day or two. Non-smoking friends and family members would encourage me when I proudly told them I had quit and, to their credit, were gracious when they saw me soon after with a cigarette between my lips. Why can't I shake this habit? I would ask myself.
I was attempting to end my addiction the old-fashioned way. Nicotine patches and gum never worked for me. A little dose of nicotine doesn't calm me — instead, it makes me yearn for more nicotine. Cold turkey is a phrase evocative of urban heroin junkies enduring harrowing bouts of distress. But it is not just a rhetorical flourish to a smoker. The phrase may refer to an earlier phrase: to talk turkey, meaning to speak directly or with a tough manner. It may also refer to the characteristic goosebumps and sweat experienced by an addict in withdrawal. Either way, the withdrawal symptoms of nicotine cessation, while not as vivid as those associated with harder drugs, are real.
Cigarettes affect the body in several ways to quickly insinuate themselves into the smoker's life. As disgusting as the habit is to non-smokers, the nicotine in tobacco smoke leads to the most intense pleasure a smoker is likely to feel. Nicotine stimulates the production of the neurotransmitters dopamine and serotonin. These neurotransmitters carry messages between nerve cells in the brain.
Dopamine is the underlying cause of the smile on your face when you engage in any activity that you perceive as satisfying. When my daughter eats a moist piece of chocolate cake, she is experiencing a milder version of what I felt when enjoying my first cigarette in the morning.
Serotonin is the brain chemical responsible for mood. If you know someone who has ever been depressed, it is likely a low level of serotonin caused the condition.
Smoking interferes with normal levels of both of these neurotransmitters. Consequently, for several days after Christmas, freshly free of nicotine, I was a mess. The absence of nicotine in my system induced what I refer to as the "fog." Despite getting more sleep than usual, I felt as if I had been awake for a week. My brain tingled and buzzed as my nerve cells yearned for nicotine. Sometimes the cravings were more dramatic. For several days I would occasionally experience the sensation of someone reaching into my chest and squeezing from both directions.
Once addicted, the smoker's brain functions quite differently. New levels of dopamine and serotonin are required for the brain to maintain homeostasis (natural equilibrium): In effect, the brain does not experience normalcy without nicotine-fueled boosts of neurotransmitter joy. Little wonder that fresh converts to the non-smoking creed are renowned for their grumpiness.
And I was no different. I had strategically chosen Christmas week for my attempt at quitting. My daughter was sent off to travel with Grandma and the holiday break allowed me to shut myself off and to limit my interactions with others. On the few occasions I ventured forth into the world, I was not pleasant. I would like to apologize now to the elderly lady in the white car on Las Cruces' Main Street. I would not normally flip you off; it was the lack of dopamine — really!
Nicotine, a stimulant, also affects basic processes like blood pressure and heart rate. In addition, smoking elevates blood-sugar levels, causing the pancreas to reduce the production of insulin. This leads the body to perceive itself to be in a state of hypoglycemia. The quick weight gain an ex-smoker experiences — 19 pounds in my case — is not due to substituting one oral fixation for another; it is due to the brain perceiving a crisis and demanding action. Those demands tend to be urgent calls for carbohydrates. Anyone have a candy bar?
One of the unfortunate truths about smoking is that the collection of brain receptors stimulated by nicotine are also the main structural foundation of learning. Three or four days after smoking that last cigarette on Christmas night, the worst of the withdrawal symptoms were over. Yet, deeply hard-wired changes had occurred in my brain that would trigger cravings when confronted with a cue. Eating breakfast was a big problem for me, as was driving and playing golf or cards.
It should surprise no one that my Christmas pledge to quit smoking ended in failure. I made it 27 days without a cigarette. Then, late on a Tuesday night, while driving home, I convinced myself that I could smoke one cigarette. I stopped at the local big-box discount store and did what smokers in need do every day: I bummed a smoke.
For many weeks, I was a part-time smoker. I smoked one cigarette every Sunday night and spent the rest of the week thinking about how I would enjoy that one cigarette the following week. On March 3 — coincidentally. the day the proposed tax increase on cigarettes was defeated in Santa Fe — I bought my first pack of smokes in many months. You know what happened next, don't you?
But don't feel sorry for me. Like Mark Twain, I know quitting smoking is easy. Wouldn't May Day be a great day to stop?
For more information about the hazards of tobacco use, see www.americanlegacy.com For help in quitting smoking, see the New Mexico Department of Health website, www.quitnownm.com, or call toll-free (800) QUIT NOW.
Hugh Dan Summers has written for New Mexico Magazine and the Clovis News-Journal. He still hopes to quit smoking — for good.