Building Hope

A large woman walked into my presentation in Hawaii. Both legs were bandaged due to circulatory problems from her diabetes. A two + pack a day smoker, she admitted she had never gone an hour without a smoke break. Her doctor had given up on her ever quitting and allowed her to leave in the middle of her medical appointments to go grab a smoke. She stayed and listened to the entire hour plus presentation. At the end she came up with a hug  and a kiss for me stating, "I've never gone an hour without smoking but you've given me hope that I can quit".

I never give up on any smoker, regardless of their struggle, I just don't expect them to quit immediately. I believe in the process, taking one step at a time and this was her first step--showing up to a stop smoking class when no one else thought she would, lasting an hour without her cigarettes and seeing that the road might be difficult but with one step, followed by another step, she could learn how to become a non-smoker.

Research shows that the attitude of a healthcare provider can influence the outcome with patients, which is the reason why in double-blind drug studies, neither the patient nor the person dispensing the drug, know who gets the real drug and who gets the placebo. Going cold turkey, just putting the cigarettes and walking away without any help, yields a 4 -6% success rate after 6 months. But by participating in a drug study for cessation medications, the success rate for those individuals taking the placebo is about 14% across the board. In both situations, cold turkey and receiving the placebo, the patient is not receiving any medication--so why the difference in quit rates? It could be because the patient is interacting with another person or because the patient believes they are receiving the true medication. Something, either the belief in a pill or just talking to the person dispensing the pills, leads this person to believe that quitting may be possible-hope is involved.

When this woman left my presentation, I congratulated her for avoiding smoking for just one hour and I encouraged her to try it again, and again, and again, until she felt comfortable and then on to the next step. Instead of believing that every smoker needs to quit-NOW, believe in progress, no matter how small the step. To that smoker, that baby step is huge but without encourage, disappointment can set in that it wasn't longer.

Never give up on any patient. Quitting can be done, it's not easy. It may be two steps forward and one step back, but progress is being made.

Is nicotine addiction a disease?

Addiction Box by Dirk Hanson

This is an interesting article about whether addiction is a disease or not. The case can be made that individuals that are addicted to a substance (whether it's nicotine or something else) have a powerlessness over the ability to abstain from their nicotine (or other substance). In this post, the point is made that often addiction is a change in the nervous system that can not be eliminated but can become dormant.

With smokers, the "need" to smoke can re-awake even after years of abstaining from cigarettes. It is something that the nervous system will always remember--"You're a puff away from a pack a day". Just like if you have learned to ride a bike or how to swim, you don't learn how not to swim or not to ride a bide, the only option is to stay out of the water and off of the bike. Same with smoking, you can not learn how not to smoke, only learn how to avoid smoking.