Resist, Resist

A colleague today evinced the desire to quit smoking. I suggested she join a group to which she replied something along the lines of "I don't feel comfortable about sharing with strangers". I proposed the benefits of nicotine replacement therapy (NRT) but she further opined that there is no point in quitting smoking and keeping using nicotine as that was the problem. I put it to her that statistics suggested that she was twice as likely to succeed if she used NRT and that if she
joined a group she was twice as likely to sustain her quitting. She retorted that this was government propaganda and that she "didn't believe a word of it!"

Now this is an intelligent and self-actualised person I am talking about here and in spite of - or possibly because of - the ferocity of her response I am now reflecting on her reaction to my suggestions. Undoubtedly smokers see their relationship with their drug as a 'weakness' and their defensiveness to such perceived 'weakness' is both understandable and to a large extent acceptable. Although our societal tolerance to this self-abuse has altered insofar as where it is allowed, we still defend the individuals rights to continue to self-harm in their own time and space. It is unthinkable that anyone should be criminalised in pursuit of its practice, unlike the consumption of other legally proscribed substances such as cannabis which it is widely believed is less harmful than the tobacco it is commonly mixed with.

Imagine, if you will, in a future, some may say more enlightened age, tobacco being outlawed and its use scorned in the same way as a number of class 'C' drugs. Imagine the shame felt when for example a school teacher is caught in possession of tobacco. Someone who through their contact with children could corrupt them simply by their own possession and consumption of a tobacco cigarette! Far-fetched? Ridiculous? Think about it. Which one kills 5 million people a year?

A symptom of our society's ambiguity of this murderous product is the shared psychosis that this product should not only be allowed to be available but that society should continue to collect windfall taxes on its sale and distribution! Why not sell dope and tax it? It's clearly not a case of morality or indeed ethics! It's a case of money. Capitalist gain and the size of the potential market and the way in which illusion remains the way in which we perceive the world, the madness of so-called sanity. Smoking is a mental illness which becomes a physical even fatal illness.

My colleague is clearly struggling with this paradox.

Tobacco Crazy

I recently recalled an occasion when, as a businessman, I attended a meeting with a colleague at a clients. My colleague, a manager in his 20's, sat down to engage in a discussion and immediately produced from his pocket a small tin of miniature cigars. He opened it, removed a small and pungent cigar, placed it into his mouth and lit it with a quartz lighter he had produced from his waistcoat pocket. The blue-grey smoke drifted into the air, quickly filling the small boardroom whose table we sat around. No-one said a word. Why would they?

Forward 35 years. Imagine trying to do that now. It is utterly inconceivable that it would go unmentioned. Disbelieved perhaps, but ignored? This is the change in conscious awareness which now exists in relation to smoking. Consider this text from a 50's text book entitled The Modern Woman - Beauty, Physical Culture, Hygiene by Lillian Bradstock and Jane Condon in which the authors assert:

'Millions of moderate users find comfort daily in the use of tobacco. As long as the smoking is moderate no serious harm seems to be done. In fact, when one considers that the majority of medical men, whatever their special ideas and theories, smoke themselves, they can scarcely regard the practice as very harmful'.

I wonder if it would be possible to hold such a conversation now, much less publish such an opinion, without being fitted with a straight-jacket!

You really couldn't make it up!

Three Weeks Without a Transgression

This evening would mark three weeks since I stopped smoking and first attended my group (I actually stopped three weeks and-a-day ago!). I would have liked to have been with my support group (and to see how many of them still remain) this evening but I am required to be at the school's open evening.

Today was interesting in that instead of spending my lunchtime sat in my car pretending to smoke my fake fag I went for a walk in the glorius sunshine. I felt different. It felt different, as if I really didn't smoke anymore. I couldn't even be bothered to simulate it and dispensed with the entire paraphenalia by choice.

Perhaps the medecine is working so well I no longer need or want it!

Stats and FAQs

ASH, an organisation dedicated to quitters state the following:-
Q. What's the best way to stop smoking?
When you are thinking about stopping, talk to an expert about what's involved ­ e.g. helplines, NHS
specialist centres, pharmacists or your GP. Find out whether one of the proven pharmaceutical treatments
like NRT or Zyban would be right for you ­ they can double your chance of success, and are both
available on NHS prescription. Get your friends and family involved as they can give you moral support.
Then pick a day ­ like No Smoking Day ­ and stick to it.

The following is a transcript of a conversation with Natasha, a NHS online advisor at their gosmokefree site.

Talking...
System:
You are now connected
Natasha:
Hi, you are through to Natasha, I am an NHS stop smoking advisor, how can I help you?
P-O-D:
Hi Natasha. Can you please tell me which method of stopping smoking, in statistical terms at least, has or is proving to be the most effective?
P-O-D:
The user has requested a copy of the session transcript
Natasha:
joining your local stop smoking service and using nicotine replacment therapy thats best suited to your individual needs is the best way to help stop smoking and sustain it
Natasha:
I see you are a non smoker are you trying to help someone else give up?
P-O-D:
Ok, thanks. I read a lot of articles which claim that either cold-turkey or hypnotherapy are supposed to be the most effective ways of stopping permanently. Do you have an opinion on this?
P-O-D:
Actually I recently stopped and did so through a local NHS stop-smoking clinic using NRT
Natasha:
we are not allowed to really give out personal opinions but in terms of hypnotherapy research is non conclusive and more about the individual. cold turkey is very hard and only 2% of the population manage it and find it hard to sustain long term. Thats fantastic how long have you been smoke free?
P-O-D:
Almost three weeks, this time. I am actually a teacher and would like to be able to advise young people appropriately. Also I am writing a blog and would like to be able to state some specific and accurate statistics, if possible.
Natasha:
I can give you a link to some of our literature which may be usefull also websites such as ASH can be beneficial for statistics and information and links to other areas
P-O-D:
Thank you, that would be great
Natasha:
The BBC website also has a large ammount of accurate details and statistics related to smoking
Natasha:
http://gosmokefree.nhs.uk/quit-tools
Natasha:
http://www.ash.org.uk/ash_za0a700j.htm
Natasha:
http://www.bbc.co.uk/
P-O-D:
That's very helpful. I will search there. There are lots of organisations I am slightly cautious of taking seriously who appear in google searches so this is much better for reaearch purposes
Natasha:
our own website also has a lot of information and usefull links as well
Natasha:
Not a problem if you or any of your students need any help always feel free to contact us for any help we can give
P-O-D:
Can you let me have the link please. I will certainly recommend this as a helpful resource to anyone it might help. Thanks very much
Natasha:
http://www.nhs.uk/gosmokefree
Natasha:
No problem if you need anything else You can call us on 0800 169 0 169 7am – 11pm 7 days a week or alternatively if you want to chat again we are available from 7am to 11pm 7 days a week via web chat. Helpline number and opening hours
P-O-D:
Yes thanks, just spotted it again. Thanks again and bye
Natasha:
Bye

There are as many ways as you like to avoid it but only two real ways to quit. Now or never!

The Courage to Quit

I spoke with my brother this morning who, after asking me how my no smoking was going, told me he had bought a £1000 bicycle in preparation for his own attempt to stop. In fairness to him he'd paid £300 for this lightweight (13lbs) wonder of cycling technology which he'd not used as yet due to the fact he hadn't got a helmet and feared the consequences of falling off.

Sounds like a fairly complicated web of procrastinatory co-dependencies to me.

I also received another extremely articulate and insightful email from my ex-smoker friend which I'd like to discuss with him, and with anyone else who may wish to enter the debate about the very important discourse he raises.

In response to my last post on Bachanalian remedies he says:-

'I was a bit concerned to read that your guru was advising the avoidance of stressful situations. This is the very behaviour which leads to anxiety related disorders such as agoraphobia etc, where avoidance of a given situation enhances and reinforces the belief that the situation presents some danger to one's self.

I suggest, in my reply, that there is a remarkable book I once read entitled The Courage to Be by the theologian Paul Tillich which deals with this subject in some depth. Although not a religious man myself I certainly found this remarkable work very helpful and sustaining in facing a number of existential difficulties. I don't propose to review it here - there are in fact a number of excellent reviews available at: http://www.amazon.com/review/product/0300084714/ref=dp_top_cm_cr_acr_txt?%5Fencoding=UTF8&showViewpoints=1 one of which states;

'Technically, this book is difficult to read and often hard to understand. The book feels like an awkward translation by Tillich of his own stream of conscienceness. But, that should not deter you in any way. Once you feel comfortable with the language the book really opens up as you get a feel for Tillich's rhetorical skill. The arguments are well made and are very fun to wrestle with. He speaks on Courage in it's different forms, their manifestations in history and politics, and it's place in our modern lives. I found this book to be a very interesting (and helpful) perspective on how we arrived at the point we are in live today, both individually and collectively. Far from being an anachronism Tillich's famous book is as enlightening now as it was in the 1950's.'

My erstwhile colleague however puts the argument, relative to quitting, or continuing smoking thus:

'... in a large percentage of those situations which the addict has deemed to be stressful, the stress has actually been created by the nicotine, or more accurately the fact that the situation will temporarily prevent one from indulging the monster.'

This presumably posits the notion that the cigarette is simply the 'comforter' the vestigial and usuallydenied nipple from which one's separation causes the individual existential angst. He continues ...

'If we are to be entirely honest with ourselves, we would admit that in the vast number of cases where our attempts to rid ourselves of the demon have been scuppered by the actions of our nearest and dearest, it is more likely the case that the nictotine raddled brain of the user has engineered the situation to provide a convenient excuse for relapse.'

Self-sabotage then is another of the properties of nicotine?

Life, post nicotine, is a series of first experiences, and the sooner all these are confronted and successfully negotiated without the crutch, the better, because each avoidance will make the attempt more difficult in the future. Some situations are genuinely stressful, but in actual fact you find that the nicotine has been kidding you all along, because no matter how many fags you consumed before facing the stress, the stress was still there to be faced.

Existential angst seems therefore to be unavoidable and inevitable. However, is it not our mind and how we, the individual employ these external shields, be they nicotine, alcohol, narcotics, gambling, eating, adrenaline, violence, sex or the many other manifestations of addiction with which we are confronted almost constantly in the form of neurosis, and not the substance or activity itself that performs the delusion and allows the behaviour to become our master?

This is the problem with many forms of counselling and advice on 'giving up' (which in itself sounds like a sacrifice ... of what ?) they attach a very false importance to the effects of nicotine, which merely serves to heigten the idea of deprivation in the reformer ...

These are all valid arguments which lead to an ineluctable truth. If we truly want to quit we have to avoid all substitutes which means I and every other member of my support group have quit smoking by replacing our dummies with a blanky! In my case I have actually replaced it with another dummy, the inhalator, but given that I am now managing my existential angst without the drug capsule which goes in the inhalator, presumably this could be considered a progressive regression? I think this is known in the trade as a 'transitional object' and can take many forms, medical, psychological and spiritual and all of which serve to support the addicts move from dependency to semi-dependency, co-dependency and ultimately, unlike religion for example, to arrive at complete independence from any form of 'crutch' whatsoever.

Reader's may recall that I began this writing by pointing to the popularity and dangers of the cold-turkey route to independence. Time will tell whether the transitional approach proves to be more successful in my individual case, although there must be some statistical data I can adduce to support my theory. I will go and look!

Group Therapy

Last night was week 5 and we were thin on the ground. When I say week 5, the first two weeks were preparation for quitting and since then we have been gathering to measure our success, resolve and to receive pre-prepared distractions and support ideas.

The first weeks measuring revealed a small number whose medications and nicotine replacement therapy (NRT) hadn't been timed to co-incide with the same quit date as everyone else. A gentleman who I had taken to be a successful quitter when he had first been introduced to the group proved to be a celebrity backslider. His progress, or lack thereof, seemed to be the exponential opposite of that desired as an outcome. As we prepared to quit, he was beginning a tumultuous backslide culminating in ramping up his own consumption as ours reduced to zero. Apart from providing the odd and almost certainly unintentional comedy moment he seemed to be the tethered goat of nicotine consumption, utterly helpless before its approach, and yet one can only admire if not respect his tenacity, at least in terms of attendance.

Having quit, one faces the weekly routine measurement of one's CO levels which, in my case began at 25 on the week before we quit, immediately decline to 5 the day after quitting and has progressively lowered itself via 3 to 2, the measurement expected of a non-smoker and therefore the proof of one's commitment and measure of success. The tobacco addict's equivalent of weight-watcher's scales, the activity involves breathing down a cardboard tube which one retains - and in my case records the weeks data on in ballpoint pen - preceeded by a group confessional in which each of us is required to cough up any off-road moments when a cigarette, cigar or any form of tobacco has proven irresistible.

Feeling pretty smug myself from a complete avoidance of the demon weed I await my chance to boast a clean record whilst various others confess they have had one, two or several slip-ups, or in some cases failed to even get to their start-stopping day. Our celebrity backslider, when similarly quizzed as to how long it is since he last had a drag considers carefully with lips pursed and chin in hand, wheezing tunefully through his cupped palm before replying "an hour-and-a-half"!

Feeling home-and-dry I suppress a chortle. Now it is time for our first healthcare visitor who's purpose, we are informed, is to talk to us about how exactly to avoid stress and therefore the possibility of giving in to temptation at moments of extremis. The beatifically smiling guest assures us all that she too was once a leper such as us but now tobacco holds no power whatsoever over her. Casually but smartly dressed in loose flowing top, trousers and those tell-tale combat sandals with neatly manicured and painted toe-nails she tells us a cautionary tale of the pitfalls to be expected and avoided, avoidance being the most favoured option, before introducing us to the emergency cure should this be unavoidable - Bach's Rescue Remedy! As she adduces its great properties and constituent components, which if she is to be believed would relieve a Lion's toothache and reduce an Elephant's broken tusk to no more than an itch I suddenly realise we have been cornered. She's off, handing round samples of which, she confidently avers only one drop is ever required. A drop in a glass of water can seed another glass. A drop in ... well, an ocean!? I recall the tale that a prize of £1,000,000 lies unclaimed by anyone who believes, as this lady seemingly does, that they can prove the veracity of a homeopathic remedy! We've been offered up for seduction by the snake-oil saleswoman! Suddenly it feels like time to go home! And so I do!

The Air That I Breathe

I am tired, very tired. I didn't leap out of bed today and jump onto my exercise machine as I have for a week now. I had breakfast, then showered and promised I would make up for it later. I didn't want a cigarette either! Nor did I rush to have my pseudo-ciggie fix but waited until I drove to work.

I thought I was just in need of a couple of early nights and, like most of my colleagues, focused on the half-term holiday which promises blessed relief from the daily routine demands of the education machine, but then I received an email from an old friend which amazed me with its perceptive insightfulness:

'It was a few weeks later that it began to dawn on me that I wasn't leaping out of bed in the mornings filled with reoxygenated enthusiasm for my new healthier lifestyle. This began to nag even more as I was walking through town one day, and I found myself walking into an NHS drop-in centre which had been set up some months earlier (one of the last places on earth my previous incarnation would ever have considered to be a source of helpful advice).

The lady was rather taken aback when I explained that I had ceased my alliance some 6 weeks previously, but was now considering demanding a refund because the new lifestyle wasn't working as advertised. She asked a few more questions, and then advised that it is a common problem for nicotine users to be self-medicating with the drug to combat depression and anxiety, and suggested I go and see my GP. This was a revelation to me, and everything immediately made sense, and helped to explain why some people I have know over the years have stopped without a qualm, whereas others (no names) have stopped chainsmoking for a year or so before going back to the dungeon. It is simply because we have no other way, after decades of conditioning, to deal with our particular 'idiosynchracises', whereas those of a more cheery disposition find that nicotine withdrawal itself is not a problem (which it isn't, as long as you can separate it from the 'stuff' which is). My whole body was telling me that the only way to cope was to go off to the shop and buy a pack of 20 for a quick fix.'

Happily my friend didn't cave-in to the temptation, considerable though it was and is now into his sixth month as an ex-smoker, a considerable achievement which I look forward to matching in due course. I thank him sincerely for the honesty and candour of his revealed wisdom.