Flux Capacitors, Non-Initiation, and passing time in boats with invincible people.

  1. Non-Initiation

If I could get ahold of a ‘flux capacitor’, and go back in time with Michael J. Fox to the 1950’s, I would probably run around like and try to get the teenagers of the time not to start smoking. I’d enlist Doc Brown, Marty McFly, and Biff to help me get the message out (take those kids that are starting to smoke, get them in a headlock, and tap them on the head until they promise not to start).  Those kids who were teenagers in the 50’s to 70’s’s are the fifty to seventy year olds of today with lung cancer… I’d say “Don’t start!”

In the absence of a time-machine, the next best is just not to have teenagers start smoking. I’m pretty sure that between building a time machine, and having teenagers listen to sage advice from adults, that one is impossible –  I’m not sure which one.

On your fishing trip, if you have teenagers around, or even young adults who are old enough to make their own decision, but still young enough to feel invincible (be stupid), just don’t let them try cigarettes if they are available. If you are smoking around them (say in the boat), don’t let them have a drag, and maybe when you look at them you can put your cigarettes away for a bit.

Laws are put in place to stop teenagers from starting smoking, such as restricting sales of cigarettes, getting rid of flavoured “starter” cigarettes and cigarillos, and banning smoking at high schools (when I was young, there was an attempted ‘walk-out’/protest at the school as the teachers were allowed to smoke in the smoking staffroom, while students had to freeze outside – times have changed), which help, but laws are broken all the time.  Laws are also not in place for 18 yr olds or 22 yr olds, but they have all the features of an ideal target market for tobacco – they still think they are invincible, they don’t have alot of friends with lung problems, they need to fit in, and they want to look older.

Just don’t be a part of it.  Either don’t smoke in the boat (ideal), or if they ask for a smoke (because they had a couple of cigarettes when they were away at University and now want to show you that they are a real adult), tell them to Go Fish.

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.

 

Why Fishing and Lung Cancer?

Fishing is one of the most popular outdoor pursuits in Canada, amongst both women and men. Personally, I don’t get fishing as much as I would like, but have fond memories of fishing trips with my family – (often on the May long weekend, a time when the weather often seemed more suited for ice-fishing in Northern Ontario, freezing my fingers and butt off…  thank god for warm gloves and long johns). Oddly, although fishing wasn’t a constant part of life, some of my most vivid memories of my father and his family are from fishing trips in Northern Ontario.

Currently, I treat patients predominantly with lung cancer. While fishing and lung cancer may seem to be very disparate, I often find myself hearing from patients about fishing.

It comes up in one of two ways – the first is when I ask patients what they enjoy doing, and the second is when I ask them what they are looking forward to. For many patients, they enjoy their cottage or camper, and getting outside to fish. Often, because they may be short of breath, or lack energy, or are afraid of falls, they lack the ability to do this activity. For some patients, going on their annual fishing trip with friends or family is a highlight of their year, and often something they are very disappointed if they can’t go for health reasons. Several times I’ve moved chemotherapy treatments for patients to accommodate safe travel or special life events, and moving or delaying treatments for the annual fishing trip is common.

Sadly, lung cancer is one of the most lethal cancers, and in fact causes more death from cancer than breast cancer, colon cancer, prostate and pancreas cancer combined. For patients who are diagnosed with localized disease, just over half are cured, while for those with disease that has spread, only 1 in 25 will live for five years. For patients diagnosed with lung cancer, over half will die within the year. For the patient going on their yearly fishing trip, there is a high chance that this will be his or her last trip.

One of the reasons that lung cancer continues to be such a lethal disease, is the lack of significant fund-raising, the lack of research money, and the lack of money to support and optimize screening programs. The reason for this lack of $$$ is complex (in some ways) and simple in others. The main reason is that lung cancer patients are often blamed – by themselves, and by others – for their disease. Everybody knows that smoking causes lung cancer, the majority of lung cancer patients smoke or have smoked, so therefore, why spend money on them?

People are, of course, entitled to their own opinion. However, there are a few facts that are relevant. The first, is that no-one ‘deserves’ lung cancer. People who currently smoke cigarettes, don’t do so because they are suicidal, they do so because they are addicted. I’m sure there are some ‘perfect’ people out there, who don’t smoke, don’t drink alcohol, are not overweight, drive at the speed limit, eat a perfectly healthy diet, get 8-10 hrs of sleep per night, have never had a sunburn, and are putting themselves at the very lowest risk of cancer possible, but the majority of us are living in glass houses if we feel this way. People who have an addiction to tobacco have one of the hardest addictions in the world to break – that does not mean they are deserving of the consequence of that addiction.

The second fact, is that the majority of lung cancer currently occurs not in current cigarette smokers, but in people who used to smoke and have now quit. Basically, while quitting smoking reduces the risk of lung cancer, there are many more ex-smokers than there are current smokers. So, the majority of lung cancers occur in people who may have quit smoking 5,10, or 15 yrs ago.

The third fact, that is surprising to some, is that lung cancer in never smokers is far more common than most realize. Whether it’s due to second-hand smoke, age, environmental or occupational risks, or other factors that we don’t know yet, lung cancer in never smokers currently accounts for 10-15% of lung cancers in North America. If non-smoking related lung cancer were considered a separate cancer, it would be one of the top 6 to 8 causes of cancer death.

 

Almost everyone I know knows someone who has been touched by lung cancer – either a family member, coworker, or friend…..or fishing buddy – given that 1 in 12 people will get lung cancer, this is not surprising.

 

This project – catchlungcancer.com, has three main purposes.

 

  1. Create a webpage where people can post their fish pictures   facebook.com/fishselfie
  2. Promote discussion, and allow people to remember those who had/have lung cancer (if you can post a picture of them fishing on the facebook page, then great!)
  3. Raise money for lung cancer screening and early detection – support and research.

 

Here is how it works:

 

  1. Catch Fish
  1. Take picture of fish and self and post the #fishselfie on the facebook page facebook.com/fishselfies
  1. Donate money.

Go to www.lungcancercanada.ca and hit the ‘donate now’ button. Donate what you feel comfortable with. You can do ‘a buck a pound’ (I don’t mind if you embellish a bit…), you can have a fishing contest with your friends, and the one who catches the largest fish everyone puts in a buck a pound, you can put in 5, you can put in $1000 per pound – it’s up to you. You can have people pledge your fish beforehand if you wish.

 

Hope you enjoy fishing this year, that you make some great memories, and that you take time to reflect on those who’ve fished before and have a smile.