Dying of cigarettes...

This past week, I have learned that too many people I know or have know of – are dying of cigarettes.

Yes. That's right. Not lung cancer. Or Chronic Obstructive Pulmonary Disease – COPD. Those are symptoms.

Their cause?

Smoking cigarettes.

In the penultimate paragraph of the death notice in today's Globe and Mail, the family of Dr. Mary Cone Barrie, courageously wrote:

"Mary's life ended all too soon. The cause of death was cigarettes, which first addicted her at 14. In lieu of flowers, contributions to the crushing of the tobacco industry would be greatly appreciated-whether in dollars to the Non-Smokers' Rights Association, or by persuading someone you know, in Mary's name, to quit now."

Dr. Mary Barrie was an extraordinary person. An educator, years ahead of her time, specializing in Andragogy, the art and science of teaching adults. My husband enormously enjoyed teaching at the University of Toronto's School of Continuing Education under Mary Barrie's watch, when she was its Director from 1994 to 2005.

If you're addicted, as I am, to CBC:Radio One and Andy Barrie, who anchors the morning show. If you wake up with Andy, as I have, for so many years, I cannot remember. (Long before I started waking up with my husband.) If you have missed Andy desperately, as I have, since last November when he took an "indefinite leave" for "family matters" – you know that Dr. Mary Barrie was Andy's wife of 40 years.

She was 64 years old.

At close to 3 a.m. this morning, I was crying at this computer as I read a blog new to me called Life as a hospice patient, written by Judi Chamberlin, a pioneering activist in the psychiatric survivor movement.

"I believe that until people labeled as 'mentally ill' have the same rights as others, we will continue to be marginalized and discriminated against," she states in her Blogger profile.

Judi has COPD but she is not a candidate for a lung transplant. In her first blog post, Trying to make sense of it all, on December 4, 2008, she wrote, knowing that she doesn't "have a very long life expectancy," she hoped to see Barack Obama inaugurated and to be around for the Super Bowl. "After that, I'll set another goal," she said.

On Wednesday of this week, she called her post The Good Things, which says a lot, though not nearly enough, about Judi Chamberlin's take on life. It is also her gift. One of many.

Judi is 64 years old.

Last week, I received a note from a woman, a family friend, who found me though this blog. I had not heard from her for many years. She is a friend of my mother's. Brilliant, charismatic. A dynamo. When I was a kid, I babysat for her three children, now grown, with kids of their own.

Superbly accomplished. Anything she tries, she masters. With pizzazz! You never forget her. She's a force. Funny. Fabulous. I adore her.

"I've had two bouts of lung cancer (clean at the moment) and suffer terribly with my emphysema... Mind you, some days I can manage and others simply cannot breathe. That's a trial. However, I AM STILL HERE," she said her in note.

And finally, during a call this morning to my mother who is wintering in Florida and I knew would not yet know of Dr. Mary Barrie's death, she informed me of yet another amazing man I had known, a smoker, who had died recently after battling lung cancer.

I was a smoker. My husband quit 20 years ago. Addictions don't often appear here in "Coming Out Crazy," but they should. Often, addictions are highly complex and comorbid – linked to deeper psychological trauma and pain.

Timing is everything. Who knew nicotine was a highly addictive drug 50 years ago? Toxic. Poisonous. Deadly.

Alcohol is highly addictive, too. The founders of Alcoholic Anonymous knew that back in the 1930s.

Food can be highly addictive. I know. I'm an addict.

The pleasure pathway in the brain is the same for nicotine, alcohol, food – even sex.

We are human. I don't judge anyone. But I applaud the bravery, the integrity, the honesty, the audacity and the leadership of the late Dr. Mary Barrie and her family for stating boldly in her obituary, that the cause of her death was cigarettes.

Graciously and generously, they are giving all of us a unique opportunity to take action – to become activists. By either supporting the Non Smokers' Rights Association, or by helping someone to quit smoking, we can join in honouring and memorializing Dr. Mary Barrie's wonderful life and legacy.

We may make a difference for the Greater Good.

We may help each other choose to "Say yes, to life."

And, finally... Andy, Jess and Wrigley and those grieving with you – please accept my profound sympathy.

Comments

[Sonia]

Hello Sandy,

As is often the case, there is a strong link between a conversation I have with someone a few days before you post a blog on a related topic.

Just this week past, I was talking to someone about my encounters with cigarettes. As a child, I watched most men around me smoke: pipe, cigar, cigarette, and other stuff. Few women smoked in public, but that did not stop them from smoking in their homes.

I started smoking at the age of 19 (the Christmas before my father's suicide). In the almost 10 years of smoking, I quit three times; each time for about 9 months. The only person (my mother) who had the power to drive me to smoke again eventually died (from diabetes). Since her death, I have been able to stay away from cigarettes. No one can get under my skin the way my mother could.

I have been married almost 14 years, and have been cigarette-free for a bit longer than that. Stress management is a huge part of quitting - it was my lucky day when I met someone who introduced me to a relatively stress-free technique that put me in a position of control over the cigarette. The quitting process was slow, and it was worth it. I once calculated how much money I have had at my disposal for travel, books, hobbies, and for friends. That amount of money helped remind me why I quit, and continues to motivate me to this day.

Sonia

[Alison Hymes]

Judi Chamberlain's COPD was not caused by cigarettes. There are people who get COPD from other diseases and she is one of them just as there are people who get lung cancer such as Christopher Reeve's wife who never smoked and people who get cirrhosis having never drunk alcohol.

Judi's blog explains her medical causes of COPD in her particular case.

[Sandy Naiman]

Thank you, Alison for correcting my mistake.

I made an erroneous assumption – a serious journalistic blunder. I'm feeling very badly about it.

In a January 30, 2009 post on Judi's blog, "Life as a hospice patient," she detailed the causes of her COPD, which have no connection whatsoever to cigarettes.

This post – "The Medical History" – can be found here:

http://judi-lifeasahospicepatient.blogspot.com/2009/01/medical-story.html

Briefly – in 1988, Judi was diagnosed with a chronic lung disease - "patches throughout my lungs don't work properly, leading to diminished lung capacity," she explained.

For 20 years, her rare lung condition didn't curtail her passionate, pioneering champaign for the rights of psychiatric survivors. Two years ago, however, her condition began declining very quickly, despite receiving excellent medical care. She is not a transplant candidate because of bacteria in her lungs that would contaminate the donor organs.

"In addition, the post-transplant life they described (not only the anti-rejection drugs, but also frequent invasive testing), didn't sound all that appealing," she wrote. "It was at this point that I decided on palliative care and hospice."

If you decide to visit her blog at http://judi-lifeasahospicepatient.blogspot.com/ don't expect to be depressed.
But sad.

Judi is spirited and realistic. Calm, reasonably comfortable and rivetting to read. Vibrant. Visceral. A rare perspective on life. In the moment. Taking nothing, even a breath, for granted.

I recommend it.

[Tammy MacKenzie]

Good topic Sandy.
I think addiction, and its relationship to mental and emotional illness, deserves looking at.

I am a smoker.
Don't care for alcoholic excess, drugs never appealled to me, but I am definitely a nicotine addict.
I know what it does, I can probably add a lot more to all the things people have listed as reasons to quit; I had an aunt die from heart-failure secondary to emphysema caused by smoking, a friend's mother has been battling lung cancer due to smoking...
And yet I still smoke.

Oh, I have tried quitting, did so last year for a few weeks.
I am physically and mentally addicted.
I am constantly frustrated at the lack of resources and real support for people to get off nicotine addiction.
Addiction facilities do not accomadate smokers, nor can you get medical assistance. There are many options to help with quitting, if you have the money.
It bothers me that I can buy cigarettes cheaper than I can get the patch or a prescription - because I am financially challenged, my cheapest option is to continue smoking.
Because of other issues in my life which create high levels of stress, quitting cold turkey has been... less than ideal.

The government constantly puts out the message that smoking is undesireable and appears to be providing assistance to those who wish to quit, yet doesn't fund any real, meaningful assistance and continues to rake in a large amount of money on the sale of tobacco products.
If the sale of tobacco was not legal, and money put into getting people off tobacco, the short term cost would be a penny in the bucket compared to the long term costs of health care, loss of productivity in the workplace, educational advertising, and so on.

It's ironic that I was, many years ago, scorned for not infringing on non-smokers and speaking up when others did, refusing to throw butts on the ground and insisting others pick theirs up, and so on.
And now, I am scorned and judged as being ignorant, uncaring and selfish, soley on the basis that I smoke, usually by people who have never smoked.

It is not uncommon for those who are coping with the challenge of mental or emotional illness to also suffer from addiction of some kind, and I do not find it surprising.
Addictions are often a security blanket , stress-reliever or escape, and when one is already in the midst of being societally estranged, addiction becomes the friend rather than the cause of being unaccepted.

I smoke because I struggle, and I am too afraid of the effects of added stress and physical effects of quitting.
I am quite sure I could get an anti-anxiety medication to help me through it, but then, that would just be replacing one drug with another, wouldn't it?
Of course, it would be more societally acceptable, these days.
And at least I could get financial help with that...

[Sonia]

Hello Tammy and Sandy,

As I mentioned in my earlier comment, I was fortunate to have met someone who helped me find a relatively stress-free way of quitting. Here are the basics as I remember them:

For about one month, I wrote in a journal about my smoking habits without changing anything about it. Specifically: date, time, and related activities. For example, I would have written down the day of the week, the day of my menstrual cycle, whether I was driving, on the phone, between classes, coffee break at work, walking, talking to a friend, etc. Also, the time of day exactly when I picked up the pack, and when I lit the cigarette. This seems time consuming, yet it felt like a ritual, a reaching for peace of mind to appreciate the cigarette's effects on my stressed out self.

Once I saw exactly when I smoked, and how long it took me to smoke cigarettes (coffee breaks were faster than driving, for instance), I delayed each cigarette lighting by one minute from the previous month on the same day. So, if I had lit a cigarette at 7:15 am on the 1st of the previous month, this 1st I would wait until 7:16, and so on for the whole month. Just one minute more, for the same number of cigarettes. Also, I would decrease the related activities: if I were on the phone, I would wait to hang up, then have my cigarette, and focus on enjoying the effects of that particular cigarette. This went on for about 3-5 weeks. Until the stress of waiting one minute, and waiting until after the phone call had become manageable.

The next step involved increasing the time lapse between cigarettes by 2-3 minutes, keeping the same number of cigarettes (unless the desire to smoke also decreased at specific times, which did occur for me in irregular places and times). This lasted about 2-4 weeks.

The next step was to try and remove one cigarette each day. So, if previously smoking 8 per day, then as of this day for the next 2-4 weeks, I would smoke no more than 7 per day. Decrease slowly, appreciate each cigarette, eliminate other activities gradually (radio, tv, phone, driving, reading, etc.)

This was slow, cost-effective, and rewarding because I chose when to delay, when to remove, when to maintain (reach a plateau, feel stress, spend time at that rate of cigarettes per day, time per cigarette, etc.) When this becomes routine, stretch the time again.

I took a few months to quit, and I quit for 9 months each time. The habit of journal-writing has not left me: whenever I feel stress enough to need a cigarette, I go through the motions as in the past: what stress is more noticeable, what time of day, what day of month, where in my cycle, etc. ... and I restrain from actually smoking by enjoying a fruit, a drink, a treat (walk by myself, tea with a friend, chat with special people in my life). The stress release is effective because I am totally focused on the replacing activity. The best part: there is no replacing drug, there is no medical cost, and those around me support me in my moments of stress-release.

Why did it work for me? I was driven by self-interests (not the illnesses of others, or the costs to others, or the nagging from others). Also, I wanted to quit.

Tammy, I hope this helps in managing stress levels while you decide whether you really want to quit. Either way, you know yourself better than others, so trust your instincts. Good luck,

Sonia

[Tammy MacKenzie]

Hi Sonia,

Thanks for sharing this with me.
I have done some similar activities - journalling, delaying, focusing on cutting back 1 cigarette at a time, and it is definitely helpful!
Maintenance is the key, and that is where I have difficulty.

I do know there are 2 key elements for me:
- I need to FEEL a desire to quit (versus thinking "I need to quit")
- I need some life-style/environmental changes

Some things I have little control over (single sole-support parenthood, limited direct social interaction) at least for now, and other things I am working on but they take time. It's trying to find that balance between not adding to my current stress, and not using it as an excuse.

I WILL quit...
I pray I manage to do it in time.

Thanks again Sonia, for sharing your own experience and what helped, and your support.
It gives me hope that I too will succeed.

Tammy

[elizabeth]

please buy/borrow a copy of Alan Carr's wonderful book
'The Easyway to Quit Smoking'.
It is a powerful book in that he shows you how to get out of the nicotine trap and explains exactly why you are addicted.
As soon as he made me understand that I was sick with nicotine addiction and it was curable, I followed his instructions and by half way through the book I knew I would never smoke again and I haven't -that was 4 years ago and I am still thrilled.
This book deserves a much much more prominent place of importance in the battle with nicotine addiction.
He was a 100 a day smoker until he worked out what was really going on with cigarettes.
Thousands have quit with this book- I still cant believe I read a book and quit with such ease.