Good times, Bad times, Going half mad times – why people restart smoking.

The flip-side of quitting (cessation) is not re-starting (re-initiation). Re-starting smoking after quitting is common, especially in the first months, but even in the first few years.

The chemical ‘craving’ aspect is gone by this time, but the ‘memories’ of the enjoyment of cigarettes plus nostalgia may lead some people back to cigarettes.

There is no (or very little) information that I know of that is scientifically published on why people start smoking again after several month or years off, but in my experience – both with people I know who smoke and with patients – is that there are two main reasons –

  1. Stressful life events – death, divorce, illness, financial etc. etc., that leave people looking for any way to ‘calm their nerves’. What usually happens here is that they remember how smoking used to calm them down/ease their anxiety when they were smoking regularly, and try to apply the same thought process here.

 

Unfortunately, what they are remembering mostly is probably how smoking helped calm them down when they were having nicotine withdrawal etc. They will feel some stress relief with smoking (at a stressful time), and then if lucky they’ll quit again, if unlucky they are again hooked.

  1. Happy life events/Nostalgia

I personally remember when rock was young, and Susie and I had so much fun. Then I went downstairs and had a smoke, somebody spoke and then a man in a pickup truck nearly passed us by. We jumped right in, and the driver grinned, and he dropped us up the road. We looked at the swim, and we jumped right in (can you believe it!) not to mention fishin’ poles.

Ok, so maybe that wasn’t exactly what happened. I have a hard time sometimes separating real nostalgia from classic rock…, but nostalgia often occurs when fishing. There is quiet time, you are in nature (which hasn’t changed since you were a kid).  Things change in big ways and small- Berlin wall falls, waist gets bigger, smartphones invented, hair gets thinner, political parties change, ear hair grows etc. etc., but the river/lake/ocean is (relatively) timeless.  Going fishing is a way of connecting with the past, and is one of those “pause” moments in life.  What can happen however is that nostalgia can sometimes make people remember other things – smoking etc.  If not careful, people remember the ‘enjoyment’ of smoking, and may forget bad things – how hard it was to quit, the morning cough, the bad taste etc. etc.

 

Why is this important?  Well, if you start smoking on your fishing trip, then odds are you’ll keep smoking (hiding it from you spouse/partner for a few weeks, having a big fight, moving out, smoking more…..)   — ok, maybe that’s an embellishment.

It’s important because if you know that when you are in trouble, stressed, or in happy areas/nostalgic areas that lead to smoking, you can prepare for it.  Let your fishing friends/family know not to give you a cigarette if you ask.

Red Devils, Unexpected Bites, and Quitting smoking

  1. Red Devils and Quitting

I hated using a red-devil lure as a kid.  I thought it was the least effective lure – no Williams Warbler or Mepps Fly or Rapala.  It was a cheap knock off lure, and I didn’t catch anything with one.  It was the lure I used when I wanted to go use one that I wouldn’t care if I snagged it and lost it.

That is, until the biggest fish I ever caught as a kid – a 17 pound Northern Pike – decided it wanted to bite on my red devil lure.

Smoking cessation – the act of stopping smoking, is one of the hardest things some people do – others find it easy. The only truth about quitting smoking is that everyone is different. I have never actually smoked, so I don’t have the ability to speak directly about the quitting experience.

The most successful way to quit smoking is, for most people, a combination of medications and behavior change. Basically, medications can take away some of the short term physical effects of quitting, and treat the chemical dependence. Behaviour therapy is a way of making sure that you are aware of all of the cues that trigger you to smoke, and preparing you for them. – for some people, it’s when they speak on the phone, for others, it may be when they drive, or when they have a drink, or when they go out with friends. For people who are going out fishing, it may be when they are in a boat, or when they are waiting for the fish to bite, staring at their bobber/float.

Each time quitting brings people one time closer to quitting for good. Some people decide to quit once, and then stay quit, while the majority quit 3,4,5 or 6 times before quitting for good.

Something I often hear from patients is “I tried drug x before, quess it didn’t work because I’m still smoking!” or “I tried the patch, but it didn’t work” etc. etc. Quitting is difficult even with medications, and takes a mix of attitude, medications, and planning. If quitting didn’t work with drux x (Champix/Chantix, nicotine patches, Zyban etc.), it can still be tried again at a different time – they increase the chance of quitting, they don’t guarantee it. This would be like saying “I tried to catch a fish with a red devil before, but I didn’t catch any, therefore I’m never using it again…. It may be a perfectly good lure, but there needs to be technique, a good cast, some patience, and (most importantly) – fish. Things need to line up usually to catch a fish, just like things need to line up to quit smoking for good.

 

Cajun Man and 7 Ways to Reduce Death and Suffering from Lung Cancer

Adam Sandler had a character named Cajun man when he was with Saturday Night Live. When I think of the top ways of lowering death and suffering from Lung Cancer, I somehow develop a Cajun Man accent in my brain, and everything ends in “shun”, or, in a Cajun man accent, with “shone”, i.e. non-initiashone.  When looking at chest x-rays, one of the doctors I learned from developed a cajun man accent to teach me how to assess whether it was a ‘good’ x-ray – i.e. look for rotation, inspiration, and penetration – for some reason it was easier to remember when I pictured Adam Sandler saying it.

For lung cancer, the seven are:

1.  non-initiation (not starting smoking)

2. cessation (quitting)

3.  non-reinitiation (staying quit)

4.  detection (screening in some cases, early detection in others)

5.  operation (surgery is still the best treatment when it can be done)

6.  radiation (radiation can help cure some cancers, and help relieve suffering from others)

7.  medication (chemotherapy, immune therapy, pill therapy)

8.  palliation (helping patients live without suffering for as long as possible, and have a good death).

I’ll be spending a blog post on each of these, but will add in some camping/fishing posts too.