2118 Sometimes it just smells like death
"When I admit a new patient from the ER who reeks of cigarette smoke,. . . I watch his oxygen requirements closely and keep cancer in my differential diagnosis no matter what the reasons for his presentation." "Becoming a physician: the physical exam and the sense of smell," A. Bomback, NEJM, v.354:4;327"Among U.S. cigarette smokers, African Americans and Native Hawaiians are more susceptible to lung cancer than whites, Japanese Americans, and Latinos." "Ethnic and racial differences in the smoking-related risk of lung cancer," NEJM, v.354:4;333.
It appeared to me that the authors of this study really struggled to find a socioeconomic reason for the discrepancy between ethnic groups for lung cancer. But the findings were not explained by diet, occupation or socioeconomic status. And after 30 cigarettes a day, it was a level graveyard anyway.
My son is on a new plan to give up, or at least cut back on, the cigarettes. It's a killer of a habit, and he started at 14.
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... and it's crucial that he do so. I smoked when I was in college, and it was hard for me to quit. I don't know anybody who quit by "cutting back."
The biggest trick for me was in changing my *other* habits that made it hard for me to quit. Every morning, for instance, I would go to the student union, get a Wall Street Journal, sit down with a cup of coffee and a cigarette, and read the paper. Going to the student union, getting a WSJ, a cup of coffee and *no* cigarette to read the paper was impossible. So, instead, I changed my habit -- I went to a local restaurant instead of the student union, drank tea instead of coffee, etc. Changing the whole behavioral pattern was key, not just not taking smoking out of the same old habits.
And I quit cold turkey. The key is deciding, *really* to quit. Cutting back means deciding *not* to quit.
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