The Use And Abuse Of Tobacco. Part 3

How can you stop smoking? Perhaps the best insight into "How to Stop Smoking" is Mark Twain's comment: "It's easy to stop smoking - I've done it hundreds of times"! "Doctor," a harassed advertising executive patient of mine said desperately, "I've tried so hard for five years now to give up this awful smoking habit, which I know is so harmful to me, but I just can't seem to be able to. If I stop or even try to, I become so nervous that living with me is utterly impossible. I can't even live with myself. I can't sleep, I can't concentrate, I can't do my work properly, I tremble and go around like Shakespeare's young lover, 'sighing like a furnace,' life doesn't seem worth living. I've tried everything I know or hear of - hypnosis, auto-suggestion, pipes, prayer, preparations on my tongue to make smoking taste bitter, "gimmicks" of all kinds - but I always come back to these - cigarettes. What can I do?" Sigmund Freud, the founder of psychoanalysis, was trained originally as a pharmacologist, and was an inveterate, heavy cigar smoker. Undoubtedly, this habit contributed to his death and great suffering from cancer of the mouth and throat. He recognized his addiction to cigar smoking and its toxic effects on his heart. Yet after stopping several times, he couldn't hold out any longer and found it impossible to work or concentrate without smoking. In a letter to a friend he describes this craving as follows: "I have started smoking again since I still missed it after 14 months' absence, and because I must treat that mind of mine decently, or the fellow will not work for me." (Italics mine.) And still later he wrote, "It was impossible for me to entirely stop smoking, because of my present burden of theoretical and practical worries." Clearly these victims of my "lady nicotine" have become "addicts" of tobacco, and are addicted to it like so many other unfortunates who cannot live without opium, sedatives, or marihuana. The moment they stop tobacco they develop "withdrawal" symptoms that can be truly distressful and even agonizing. Luckily most smokers are not addicts enslaved by tobacco. They can break or modify the habit, so that it becomes harmless although still yielding enjoyment.

If you must smoke, at least cut down on the number of cigarettes. Many patients who find they cannot or will not give up smoking are like Mr. D. He told me, "Doctor, you want me to give up smoking for my health's sake. You know, I have very few pleasures in life. I have to work hard to support my family, have no hobbies, and I must diet to reduce my heavy over-poundage. Couldn't I just 'cut down' from one and one-half packs of cigarettes each day, to say, five or six cigarettes with filter tips and 'ration' myself this way?" As a rule this is a fairly good solution, although not ideal for many, and it makes it easier for them later to stop smoking entirely, if necessary. This "step-by-step" method is also less likely to produce severe withdrawal symptoms in many people.

Switch from cigarettes to pipe smoking. There are many ways to stop. One way to do it is to ease into it by the healthful and still satisfying way of switching to a pipe. This method of gratification gives distinction to some (they look elegant with pipes), occupation to others (keeping the pipe going with matches), quality to others (connoisseurs and pipe collectors), fragrance to a few (some tobaccos are refreshingly aromatic), and a feeling of male superiority to still others (few women, smoke a pipe - "it's a man's job"). One of my patients, Mr. P., who was a chain smoker of cigarettes, solved his craving for tobacco by becoming a pipe smoker. He reduced his nicotine intake substantially (one-fifth) in this way. Since he no longer inhaled, which both cigar and pipe-smokers do not do, he found life and tobacco still enjoyable, without suffering from his heart symptoms caused by cigarette addiction. Pipe smoking hag been a welcome relief to many of my cigarette or cigar smoking patients, and its injurious effects have proved to be minimal as compared to those from cigarettes.

Find a substitute - chewing gum, peppermints. Still another patient could stop smoking only if she kept something sweet in her mouth, like peppermints, candy or chewing gum. After the dentist protested, she changed over to non-sugar-containing candies and en joy ably substituted and triumphed over her tobacco habit. I tell some of my patients, like Mr. R., that he must have a substitute in his mouth such as chewing gum, peppermints or Sen-Sen, so he smacks away merrily all day, feeling fresh, healthy, and with his mouth and jaws working. Mrs. J. finds she cuts down and maintains an even temper with her children and husband by a "rationing" program of one cigarette after each meal and one on retiring. She says she has something to look forward to all the time! Another man "cured" himself of the tobacco habit by painting the tip of his tongue with a preparation containing silver nitrate. Smoking would cause such a bitter, disgusting taste that tobacco became repulsive to him and he stopped gratefully. This method is similar to that recently introduced to cure alcoholism by using a medicine called antabuse. If alcohol is drunk by the alcoholic while taking antabuse, he becomes violently sick and thus develops an aversion to alcoholic liquors.

An effective approach to the tobacco habit. An unusual middle-aged woman patient of mine, who was highly intelligent, educated, and raised in a very religious home (her father was a minister), combined both prayer and auto-suggestion to cure herself of the tobacco habit. It was imperative for her to do so, as she suffered from both a stomach ulcer and a heart condition. The Herculean struggle within herself to give up a fixed tobacco habit made her a nervous wreck and intolerable to live with. She refused to allow tobacco to "demonize" her life. She would set aside three daily "self-communion" periods of about 10 minutes each - on arising, on retiring, and at midday - when her children were still at school. During these periods she repeated to herself over and over again her affirmation of abstinence from smoking, her determination to abandon tobacco forever, and her prayers for guidance in overcoming the tobacco habit. The remarkable thing about her prompt tobacco cure in this way was her continuance for many years and up until now, (without thought of tobacco) of this program of self-enlightenment and self-communion. This has helped immeasurably in her health and in the philosophy and psychology of better and healthier living. Today she is a serene and healthy human being, loved and admired and a constant inspiration to her family and friends.

For most, the best cure is the application of will power. To many patients who wish to stop smoking, Shakespeare's words are pertinent, practical, and simple: "If it were done when 'tis done, then 'twere well it were done quickly." In other words, will power directed by intelligence is still the best way for many people to stop smoking the moment they have decided to stop. Every day in my office, for the past 25 years, at least a dozen patients ask me, "Doctor, how shall I stop smoking? I've tried so many methods before." I tell them: "Mr. Z., I want you to take up a new exercise that will make it possible." Mr. Z. asks expectantly and delightedly: "Why, Doctor, what is this new system of exercise?" "Mr. Z., I want you to Exercise your Will Power! You've never used this kind of exercise before!" Most of my patients, however, are like President Eisenhower. He told a news conference (as quoted in the New York Times for Tuesday, July 29,1957) "The only way I knew how to stop smoking (after the heart attack) was just to stop." In other words, it all boils down to will power, the cheapest commodity in the world and the easiest to use - if you only will do so! And the will to do so must come from a motive. The motive is your own health and well-being. Now nicotine is a well-known poison, as is demonstrated to every medical student in his second year of schooling by personal testing in the laboratory. So every heavy smoker takes a little poison daily. It gives him a momentary pick-up and nervous tension release, but the subsequent reaction is a slowdown in mental or physical efficiency. Many of my patients suffer far-reaching effects on the blood vessels of their hearts and other vital parts of the body. I shall never forget the horrible feeling I had when I first attended a large series of clinic patients who suffered from Buerger's disease - a disorder of the arteries in the legs associated with heavy smoking.

Most of these unfortunate victims were amputees and had lost one or two legs from gangrene. In this chamber of horrors, one man stands out clearly in my memory. He had lost both legs and could not stop smoking; he was now about to lose his arm. But Mr. X. stoutly maintained he would rather die than give up smoking. He simply couldn't do it. And die he did! Of course, Buerger's (or smoker's) disease claims comparatively few victims. However, it is still a good, although extreme, example of what heavy smoking can do to your blood vessels. Most of us, however, are not Mr. X., willing to sacrifice health or life for a fixed habit. We now know that heavy smoking, particularly inhaling, is injurious to the heart and blood vessels and the lungs. So why not change your habit to another safe and pleasant one - say, a pipe - or cut those cigarettes or cigars down to a few daily; or best of all, "be like Ike" - just stop!