And you’re still a smoker. An Irish study published in the British Medical Journal defines smokers as people who smoke one cigarette or more a day. You qualify as a smoker with the Canadian Centre on Substance Abuse if you smoke one cigarette a month.

If you smoke just one cigarette a day, you’re still jeopardizing your health. According to a study of nearly 43,000 people from the mid-1970s to 2002, if you smoke just one to four cigarettes a day:

• You’re three times more likely to die of coronary artery disease than a non-smoker.
• Your risk of getting lung cancer is three times higher if you’re male, five times higher if you’re a woman.
• You’re about 1.5 times at greater risk of dying from any cause than a non-smoker.

OK, one cigarette a day is one too many and I’m fooling myself if I think:

1. Once cigarette a day is harmless.
2. That I can stick to just one cigarette a day over time.

Dad’s Smoking

My Dad actually maintained a light smoking habit for years. When he’d get home from work, he and Mother would lounge in the comfy floral chairs in the living room. They’d each have a drink or glass of wine. Dad would smoke two to four cigarettes (five, tops, but normally fewer) in his languorous, deliberate way, always blowing smoke up in a thoughtful manner. I mean, Dad could look both smart and sophisticated just smoking a cigarette.

Mother, on the other hand, smoked cigarette after cigarette, stubbing them out in the little red ashtray she carried around the house. (She was fastidious about the house and did not like dirty ashtrays.) She chain-smoked until the effects of a brain tumor finally made her quit.

This ritual was Dad’s way of recovering from the work day. But I think Mother was sometimes a little bored with the daily necessity of the event and absolute minutia that was part of Dad’s discourse.

I’m so proud of my friend who’s kicking the habit even though her husband continues to smoke around her. I received this email from her this morning:

Hi Sue,

So, now that I’ve quit smoking for 4 weeks this Sunday, I was diagnosed yesterday with bacterial infection of the bronchial tube or bronchitis. Which by the way, feels like I’ve swallowed a golf ball and it’s stuck at the base of my neck right behind my larynx. It feels really creepy and it’s a ball of infection at the top of my bronchial tube, caused by nasal drainage, AND it is seen regularly in people who recently quit smoking. It has something to do with the bronchial hairs and whatever else (I have to do some research this morning), but in any case it is quite uncomfortable and I’m now on Z-pack to get rid of it. The doctor says it’s really commonly diagnosed in those who have quit for just a few weeks, especially if they have allergies and/or catch a bad cold.

Nice. Although I had convinced myself it was something more serious, because I really don’t have any accompanying symptoms. So therefore I was thinking thyroid, tumor, or some horrible thing that would have to be surgically removed. I’ve had this blockage issue for about 3 weeks since I had a bad cold and I was afraid to go in for fear of really bad news.

The point of the story is that the doctor said a very high percentage of people can expect to get a sinus/bronchial/lung illness a few weeks after smoking cessation….who knew?

P.S. Mike never even gets a sniffle.

I thought this was a strange symptom of smoking cessation so I thought I’d look for more information. It was tough to track down, but the extensive Copenhagen City Heart Study and another study of 125 people with asthma both found asthmatics who experienced bronchial symptoms when they quit smoking. One researcher hypothesized that these symptoms were the result of nicotine’s impact on the immune system.

My hypothesis is that second-hand smoke is the cause of her illness.

Nonetheless, the infection my friend has will be temporary. The positive health impact of quitting will be gigantic and last the rest of her life.

Per my post yesterday, following is my plan for tackling the reasons I’m having an occasional cigarette.

Speaking of tackling…the only boy in my family as I was growing up was my brother, John, who was 12 years younger than me. As a result, Dad applied his fantasy of teaching a child football to me until John came of passing age. Being extremely clutzy, I found this to be a sport I could actually manage. I played football with the boys in the neighborhood until I was 14. (My only broken bones were toes. But then, I had a bad habit of playing–and kicking–with my bare feet.)

Mother called me in the kitchen one day when I was 14 and told me I couldn’t play tackle with the boys any longer. Blast! Tackle was the only kind of football they played! I just could not figure out Mother’s problem. Ah! Dad would back me up!

That was the end of my football “career.” I have been able to shock unsuspecting neighborhood kids and my boys’ friends with my skill at the game. I also gained notoriety for being the only parent to bowl over her own child in the end-of-soccer-season parent/child soccer game. But that’s another story.

Back to my absolutely no smoking plan. I’ve abbreviated my reasons for smoking from yesterday’s post. They appear in bold type.

Broken Covenant

I’m not sure what to do about this–beyond recognizing that letting this breaking the covenant business stop me makes no sense at all. After failing the first test for my driver’s license, I went back and did it again, didn’t I!

Being Around Smokers

I will walk away from all temptations to smoke. If unavoidable, I’ll suck on a nicotine lozenge.

Depression

I’m doing the correct things to address depression–except getting the level of physical activity I should have. But I’d rather skip all smoking, eat snails, even iron clothes if it would help me avoid formal types of exercise. Obviously, I still need to work on this issue.

Focus

Actually, identifying the reasons I still snitch a puff has already improved my focus. I also need to revisit my original Quit Plan for solutions to this.

Thoughts of Being Social Smoker

This is just too dangerous. It would take so little to have me chain-smoking. I have to clear this fleeting notion from my head.

Excuses, Excuses, Excuses

I need to get busy again when I’m tempted to smoke…walk the dogs, watch a movie, draw, clean house, read a book. Hey, maybe I should be planning another trip to Europe! That kept me engrossed and occupied the weeks I didn’t smoke after my July 11 quit date.

I’ve got to get back on the wagon…even that one leg I’ve been dangling over the side.

Thank you to all who inquired about the endoscopy and biopsy results. My old gullet is A-OK–no signs of Barrett’s Esophagus at this time and, of course, no esophageal cancer.

I do know that occasionally readers stumble upon the blog when they’re searching for information on esophageal cancer. The absolute best web site, for both information and support, is the Esophageal Cancers Discussion Group, which is sponsored by the Association of Cancer Online Resources (ACOR).

Also…do not ignore acid reflux. And if you’re having trouble swallowing, losing weight, have pain behind the breastbone and/or have recurring reflux or indigestion–see your doctor!

Why I Still Smoke

Susie, a reader of this forum, suggested that I identify why I’m still smoking an occasional cigarette. I thought the suggestion was excellent, because knowing why I’m clinging to the last remnant of the habit will enable me to make plans to combat this hazardous practice. Actually answering Susie’s question has been a lot like my experience with algebra–I’m clueless. But I will try.

• It’s like I broke a covenant I’d established between July 11 and September 3 by smoking in Europe. After that, lighting up at home from time to time didn’t seem sacrosanct as it had before the trip. I don’t think I feel I failed, but it was so, so cool when I didn’t smoke at all. I was pretty darned proud of myself.
• Unavoidably, I’m around a fair amount of smoking. It seems so in my face.
• My level of depression is increasing as the days are getting shorter, colder–and DARK. It’s much harder for me to be tough and focused when the black dog of depression is biting my ankle. Is this an excuse? Perhaps. But, for me, it’s also a fact of life.
• I don’t have my focus. So much is going on, in addition to depression, that it’s impossible to give being smoke-free the share of mind it had before the trip.
• I think part of me harbors a desire to be a very occasional smoker. This isn’t my dominant wish. I would prefer to not smoke at all.
• I’m making a excuses for myself at the very time I smoke. I believe I’m thinking–mostly subconsciously–that half a cigarette is no big deal. Sometimes I think I deserve it because of stress. And, very rarely, I’m so blue that I just don’t care.

I believe these are the reasons I’m still smoking. In my next post, I’ll make a plan to combat them.

My endoscopy last week went well–the gastro doc said everything looked good. The biopsy results will be in tomorrow. I’m not concerned at this point, but the threat of esophageal cancer has been one of the primary motivations for me to quit.

I don’t much disagree with readers who have posted that I haven’t quit smoking or that I’m not a “former smoker” until I’m not smoking at all. No smoking is my goal and I’m proud that I maintained that status from July 11 to September 3 and from September 14 to September 23.

Having 1/2 or one cigarette a day is a big improvement from my smoking days and a heck of an achievement for me on my first (non-pregnant attempt–and my youngest child is 23) attempt to quit. I want to be positive in recognizing that I’ve made strong strides toward quitting.

On the other hand, even smoking one or less than one cigarette a day is flirting with the addiction–very dangerous business, indeed. I want my this quit attempt to be my last attempt. And I want to be cigarette-free. I have to cut out all cigarettes.

Tomorrow I hope to address Susie’s suggestion that I identify the reasons I still smoke.

Every other year I go to the hospital for an endoscopy to check for Barrett’s Esophagus and esophageal cancer. Tomorrow is the big day for 2006.

I’m the world’s biggest chicken when it comes to anything medical, so I’m automatically nervous about the whole business. (Though it’s really no big deal, the combination of Demerol and Versed takes care of that. It’s the same for colonoscopies. If you need either of these procedures, by all means do it!)

You may recall that I lost a brother and an uncle to esophageal cancer. That makes me all the more fearful of the procedure. Jeff’s presence will help.

For the first time since I started these endoscopies, I’m feeling a little better about the biopsy part because of my smoking status.

To Susie

I do plan to respond to your astute question, but I’d like to give it some thought first. I think it will be important. Thank you for the encouragement–and the kick in the seat. Both were needed. (Readers, please see Susie’s comment on the 16th.)

Will waiters smile warmly and inquire about your needs? Will Frenchmen stop making subtle eye contact over their wine glasses? Will baguettes and brioches be abandoned in favor of low-carb diets? Will the dog-lovers of Paris all purchase pooper scoopers?

Anything could happen. In fact it has: France has banned smoking in public places.

Au revoir, Gauloises et Gitanes cigarettes! (In France, even cigarette brand names are romantic. “Gitane” actually means “Spanish gypsy women.”)

Being a Francophile and mostly former smoker, I think it’s ok for me to be a little wistful about the French smoking ban. On our visits to Paris, I made a point of having a glass of wine or cafe creme at the sidewalk tables of the iconic Cafe les Deux Magots and Cafe Flore. Seated there, I basked in history and imagined we were in the company of Modigliani, Miller, Picasso, Hemingway, Sarte and De Beauvoir–all puffing away. (I like to pretend I’m Audrey Hepburn. Talk about an imagination!)

Typically, I pick up books about historic Paris before our trips so I’ve got some idea of what happened where and to whom. I suppose I’m pretty obnoxious to travel with. My sister, Meg and Jeff put their feet down one evening when I wanted to walk to the house where Modigiani’s pregnant mistress flailed herself out the window, distraught about the artist’s death from TB.

Yes, despite my often cynical exterior, I’m really a hopeless sap. And I don’t really think taking the cigarettes out of Paris can put a dent in the allure of the City of Lights.

On October 6, I posted part of an email message from my friend who is determined to kick the habit. She and I’ve been keeping each other up to date on our progress; she sent the following email this morning:

Hi Sue,

We had a bit of a disaster at the house with our newly installed $6,000 furnace this weekend. I got back from visiting the grandchildren on Friday afternoon and noticed that the house was at about 59 degrees, so I went downstairs to fill the furnace with water. The furnace kicked on and the house was warming up and Mike and I were discussing the events of the day. He then decided to take a shower in his basement bathroom and saw water spewing out of the furnace and leaking all over the floor, at which point I realized that the furnace accidentally got over-filled since I didn’t lock up the ball lever.

To make a long story short, there was confusion, yelling, and running in circles, and calls to a friend to help us figure out how to shut our water off and to the emergency number of our furnace company to take care of the mess I created.

Two hours later fairly bedraggled, cold and wet, all was calm and fixed but I was a wreck and cracked under the pressure and had a whole cigarette in the midst of the crisis. Of course, it was only water and it wasn’t a big deal as it turned out, but this is when I turned to my usual comfort to calm me down. My biggest challenge is learning how to handle serious stress and situations that are out of my control, especially since Mike always has a pack at the ready and usually a lit cigarette in hand.

The good news is that I do believe I have successfully tackled the nicotine addiction part, but the act of smoking “the crutch”, is still lingering in my head. The cigarette did not taste good (in part because it was menthol), and I barely inhaled, but it is the act that I miss. So I cracked once prior to my two week anniversary this last Sunday. I have forgiven myself and I am intent in my resolve to quit for good and I will.

I admire this friend for a number of reasons–not the least of which is quitting smoking while living with a husband who’s less than helpful.

This friend and I seem to be in the same place–we’ve tackled the nicotine addiction but we’re still dealing with what’s in our heads. I do relate that she finds menthol cigarettes less-than-appealing.

When I was in high school, there would always be a group of girls in the restroom between classes–passing a cigarette around. Invariably that cigarette was menthol and had been hotboxed so that the inch-long tip was hotter than hot and the whole thing smelled and tasted raunchy. Yeecch! And I continued smoking?!!

Addressing a group of United Nations delegates on September 28, Al Gore cautioned that cigarette smoking is a “significant contributor for global warming.”

In response to this pronouncement, Jay Leno said, “Well, to be fair, you have to blame us for that, the nonsmokers. We’re the ones that made them go outside, right?”

Now, I happened to vote for the man (Gore, not Leno, though the outcome might have been better had I voted for Leno)–after all, he “invented the Internet.”

Winter weather blew into Madison this week, which makes global warming pretty appealing to me. My hatred of the cold didn’t stop me from huddling outside in Arctic temperatures just to smoke a cigarette. It’s great to think I’m finished with that!

Junkie Thinking Response

I have to share the response I received from a reader of my last post, which was on junkie thinking–all those excuses we use in our feeble attempts to justify smoking.

He wrote responses below my excuses:

Oh well, it’s only one puff
ANSWER: NOT ONE PUFF EVER (NOPE)

I’ll only smoke while we’re in Europe.
ANSWER: NOT ONE PUFF EVER (NOPE)

Maybe I could just be a social smoker.
ANSWER: NOT ONE PUFF EVER (NOPE)

So, what if I just have one cigarette a day? That’s not a big deal.
Answer: It is a big deal. NOT ONE PUFF EVER (NOPE)

The change in mindset is as challenging as kicking the nicotine itself…more so, in my opinion. But in order to move on, one day at a time, this has to be your mantra….smoking is never an option. Period.

I do agree that the toughest battle with quitting is the one that rages in my head. The nicotine withdrawal phase was far more manageable.

I’ve smoked one whole cigarette and three half cigarettes in the past week. I need to recapture the iron resolve I had before our vacation in September.

A couple days ago a reader wrote that I’m displaying junkie thinking when I have a puff now and then, or even an occasional cigarette. I thank her for that observation, because I can hear the crack of thin ice under my feet on occasions that I indulge.

Junkie thinking comprises all those excuses we make. Here are a few over-used susanjunkieisms:

Before Quitting

• Life’s too stressful for me to quit right now.
• I’d rather smoke than gain weight.
• I have to focus on (fill in the blank) right now, I don’t have time/energy to quit smoking too.
• I should exercise more, eat healthier, lose weight, quit smoking–I’m paralyzed! I don’t know where to start!

After Quitting

• Oh well, it’s only one puff.
• I’ll only smoke while we’re in Europe.
• Maybe I could just be a social smoker.
• So, what if I just have one cigarette a day? That’s not a big deal.

You know, I’m not fooling anyone with these sorry excuses–especially myself. Do you use any of them?