Total points	Level of dependence to nicotine
0 - 3	low Mild physical dependence. May benefit from counseling. May not need smoking cessation aids.
4 - 6	medium Counseling can be very helpful with moderate dependence. Cessation aids also may be of use to some people.
7 - 10	high Strong physical dependence. Counseling and use of smoking cessation aids are encouraged.

Above is the scoring from the Fagerstrom nicotine addiction test that was in yesterday’s post.

What Your Score Means:

0-3 points - low
Come on! You’re not hooked on nicotine. But you are hooked on thumbing your nose at society. (Has a psychiatrist ever used the word sociopath when describing you?) Quit your job, buy a guitar and a VW van, and head out on the highway, lookin’ for adventure. At that point, when smoking cigarettes is no longer an act of defiance, kicking the habit will be no problemo.

4-6 points - medium
At work you’re an emphatic nonsmoker. Out for an evening with friends, you’re the classic cigarette moocher, puffing away on bummed cigarettes. You’re straddling the fence, all right–a lot like a certain Democratic Party presidential hopeful. At some point, you’ll fall right off. I hope you don’t land on the side with the cow pies. 

7-10 points - high
Your ashtray is on your bedside table. The last thing you do before sleeping is have a cigarette. If you don’t wake up during the night, you light your next smoke before you get out of bed in the morning. (You’ve become skilled at inhaling around the hacking and hawking that also are part of your morning routine.)You need to find a doctor and hospital that will strap you to a bed and place you in a controlled coma for several weeks. When you’re released, begin smoking cessation counseling and use all smoking cessation aids 24/7 until you’re too sick to think of smoking.

Karl Fagerstrom, a Swedish psychologist who has been busy putting the buzz in the nicotine patch, gum, spray and inhaler came up with a test that’s widely used to determine just how hooked people are to nicotine.

Give the questionnaire a spin and I’ll publish the rating scale tomorrow or Thursday.

Karl Fagerstrom Nicotine Tolerance Questionnaire

For each statement, circle the number that describes you best. (What’s the use in fudging? Your doctor won’t see the answers.)

1. How many cigarettes do you smoke per day?

a) 10 or less (0)
b) 11 – 20 (1)
c) 21 – 30 (2)
d) 31 or more (3)

2. How soon after you wake up do you smoke your first cigarette?

a) 0 – 5 minutes (3)
b) 30 minutes (2)
c) 31 – 60 minutes (1)
d) After 60 minutes (0)

3. Do you find it difficult to refrain from smoking in places where smoking is not allowed (e.g. hospitals, government offices, cinemas, libraries etc)?

a) Yes (1)
b) No (0)

4. Do you smoke more during the first hours after waking than during the rest of the day?

a) Yes (1)
b) No (0)

5. Which cigarette would you be the most unwilling to give up?
a) First in the morning (1)
b) Any of the others (0)

6. Do you smoke even when you are very ill?

a) Yes (1)
b) No (0)

Total Point(s): _______

Check back in and see how you score.

Tomorrow will be the fourth anniversary of my mother’s death. I find myself missing her at the oddest times and places. It hits me like a wave that I’ve learned to dive under to avoid being caught in the churn.

Mother and I had a special relationship. I was an only child until I was nine. And she and I were a duo for several years–just the two of us.

I can’t think of any parent who was more supportive or accepting–of my screaming eccentricities and all. Even when I was in high school, if I didn’t have an after-school activity of some kind, I’d go home and have a chat with Mother over a cup of tea.

Politics was always one of the few topics we needed to avoid. Mother followed the pattern of becoming more conservative over time. I definitely have not.

Tragic Times

Mother was also extremely close to my brother, John. They really loved each other–a lot. When John was diagnosed with esophageal cancer in 2001–just before his 35th birthday–I couldn’t believe the strong front she put on.

John had an esophagectomy September 10, 2001. (Yes, the timing of John’s surgery and the World Trade Center horror was surreal.) When we waited through the long and involved surgery, Mother asked me to go outside and have a cigarette with her.

Frankly, I was frightened of the cancer and had seriously cut back my smoking–hoping to quit. When Mother asked me to smoke with her, I was frustrated, but didn’t let on, I hope.

Mother ended up dying eight months before John–to the day. She left us when John was in a remission-like phase. Although she would have been at his side during his final illness, I’m glad she wasn’t.

My brain’s functioning at the pace of those monster California slugs that used to creep out of the ice plant at night and ooze themselves across the concrete next to the pool.

It’s the mangy old Black Dog depression. Only a week ago, I told someone that I was doing pretty well. I should have found some wood to knock on.

When this happens, I move from blah to negative to weepy and I fall into a to-heck-with-it approach to things I find frustrating or challenging. Obviously, I’m going to have to be very careful with thoughts about smoking right now.

Chantix and Zyban

Last summer, the FDA approved a new drug, Chantix, for smoking cessation. Chantix eases withdrawal symptoms and reduces the pleasure of smoking if we fall off the wagon.

Zyban has been used to help people quit smoking for a number of years. It reduces withdrawal symptoms when you kick the habit. Zyban is also prescribed as an antidepressant, under the name Wellbutrin. Chantix, on the other hand, is not an antidepressant. Neither contain nicotine.

I was prescribed Wellbutrin several years ago to treat my depression. As I was leaving my doctor’s office, prescription in hand, she mentioned in an offhand manner that the drug might also help me quit smoking.

I didn’t think much about it until the next day when, at work, I realized I hadn’t gone outside for a couple of cigarettes that were routine.

Studies show both medications can be effective. Chantix may work better for some people–but most Chantix studies were sponsored by Pfizer–the drug’s manufacturer.

We all can use a little help at times.

I used to think that I couldn’t possibly write or make art if I didn’t have a cigarette burning in an ashtray next to me. Engrossed in a project, I could go through half a pack in no time–most of the cigarettes just burning in the ashtray. Until 1995, I could still smoke at work.

Fortunately, I found I could still work without a cigarette. But I hate to think of what I did to my computers before I quit smoking inside. They must have looked like the computer below.

The orange-brown, sticky crud exuded by cigarettes doesn’t just latch on to your hair, clothes, curtains, upholstery and car interior. It also gums up your computer innards.

The residue creeps into your computer via the dust route: through vent holes and into the fan, which soon will spin the speed of syrup on ice. It also seeps into removable drives and can build up on mouse balls and rollers.

I remember being terrified by my first computer. I had no idea that the cigarette beside it was shortening its life too.

I hit a point over the weekend where I seriously considered running to the store for a pack of cigarettes and becoming a full-fledged quitter quitter.

I know what’s behind my near-disaster, It’s my Black Dog. I’m not speaking of Dudley, our sweet Bassett Hound-Schnauzer mix, but the big fly swatter of depression smacking me down. (Black Dog is a name/metaphor Winston Churchill and others have called their depression.)

The Smoking/Depression Cycle

I knew it was likely that depression would pose the greatest threat to my quit effort–partially because I know that I have trouble being focused and determined when I’m depressed. It popped up when I was keeping my smoking diary, too. There’s also a large body of research that strongly connects smoking, quitting and depression.

• A survey covered in the Harvard Mental Health Letter found that about 70 percent of men and 80 percent of women why had experienced major depression had were, or had been, regular smokers.
• People with a history of depression have a 25 percent risk of becoming depressed when they quit smoking.

• In another study the Harvard Mental Health Letter reported on, found smoking doubled the risk of getting clinical depression.

My depression’s been under control for quite a while now, so hopefully I’m just having a few bad days.

I didn’t buy the cigarettes.

Ladies, it’s time to light up…because now, there’s a Camel made just for us! The new, Camel No. 9 “Light and Luscious” is just for ladies (lucky us!) who will ooze their own light lusciousness when they light that first No. 9.

Oh, so appealing, the dramatic black packaging features flirty hot pink and mint green accents, flowers and feminine Victorian scrolls. And that debonaire camel is a seductive, shocking pink.

It seems that only about 30 percent of Camel smokers were women. (Mon Dieu! Just think of the lost dollars! Though, shares of Camel maker, Reynolds American, rose about 25 percent during the last 12 months.)

So those lovely people made Camel No. 9 just for us!

Cressida Lozano, Camel-brand marketing vice president at Reynolds American was quoted in a New York Times article this week, “What we’re about is giving adult smokers a choice with products we believe are more appealing than existing products.”

Camel No. 9 demonstrates the company’s strategy that will “focus on products that are ‘wow,’ that add fun and excitement to the category,” Ms. Lozano revealed.

No. 9 is supposed to evoke the aura we exude when we’re “dressed to the nines.” The name’s similarity to Chanel perfumes is also deliberate.

Chanel

Coco Chanel’s famous Chanel No. 5 was introduced in 1921. It was one of my mother’s favorites. It was also the perfume of choice for Marilyn Monroe. During an interview in 1953, the star was asked what she wore to bed. “Two drops of Chanel No. 5,” was her answer.

I love scents. I choose flower plants for my garden based on scent. And I love to wear perfume. Unfortunately, scents are out of vogue these days–at least in the Midwest.

I make a point of buying perfume when we’re in Paris. I read that good French perfumes last longer because they’re made with potato alcohol instead of grain alcohol, which most perfumes outside France contain.

Then there’s the lovely, uncomfortable task of selecting perfume in an upscale Paris store. (Don’t dab samples yourself. It will be done for you, Madam.)

Mother loved Chanel No. 5, but her favorite perfume was Shalimar. Sometimes when I especially miss her, I open my bottle of Shalimar, close my eyes, and it almost seems like she’s in the room.

Jeff and I have been together for about 14 years now. He claims he bakes bread. All of these years he has claimed he bakes bread, but I’ve never seen it happen.

After a number of delays, the FDA said it was going to issue its decision on Acomplia (rimonabant) April 26. Oops! I guess they were just kidding, because today the maker of Acomplia announced that the FDA is once again delaying the decision. July 27 is the new target date. (I think they mean 2007.)

I wrote about the benefits of Acomplia on January 31. I’m starting to believe it will be available about the time Jeff bakes that homemade bread.

I’ve been using a cool screensaver for months now, courtesy of the Massachusetts Department of Public Health. It’s a pretty, graphic forest scene with fish swimming in a pond, birds flying and inspirational quit messages.

The Try-to-STOP tobacco screensaver is easy to download and install (otherwise, it wouldn’t be on my computer) and it’s free.

The same page also has fun, downloadable signs you can use to ask people to not smoke in your home. If your English is rusty, you can download a Haitian-Creole, Bosnian, Cambodian, Chinese, Vietnamese, Portuguese, Spanish or Russian version.

The main part of this Massachusetts site also has content you might fine helpful.

One cigarette a day to quit.

With furnaces roaring to stave off the gales of sub-zero Wisconsin weather wonderland, we’ve all got horribly dry skin–and I think I see a serious new wrinkle at one corner of my mouth. I hope the dryness is making it look more pronounced than it really is.

Mother in Law, Mother in Law…

It must have been about 11 years ago when Jeff’s mother, Shannon, was visiting us from the Seattle area. I was sitting on the sidewalk tending to an herb bed. Shannon watched over my shoulder for a while, then said, “Well, it’s no wonder you stay so thin if you work that way. There are much easier ways of doing that.”

A bit later that day, as I stood at the kitchen sink scrubbing dirt from my fingernails, Shannon looked at me and said, out of the blue, “You should quit smoking because you’re going to get wrinkles. My sister smoked and she has terrible wrinkles now.”

Now, Shannon is an amazing woman and I admire her greatly. She does speak her mind. She’ll also wash and mend your clothes (unasked, of course) when you’re out for the day.

Born in an Oregon logging camp, where her mother was the cook, Shannon learned to make do very well with very little. One of her sisters says Shannon would be the person to be stranded with on a desert island because she would find a way to get them fed and taken care of. I don’t doubt it.

Shannon’s especially busy this time of year preparing taxes through the senior center to help “the old people.” (She being a youngster of 85.) She’s also having radiation treatments for recurrent breast cancer and helping a neighbor prune his roses because, “He doesn’t do them right.” She is a force!

The Grape Arbor

On her Madison visit of the wrinkle conversation, Shannon tut-tutted over grapevines growing on the fence.

“That’s bad for the fence and I’d like to have a grape arbor built for you,” she announced.

We thanked her but told her we had the yard all planned out. Shannon ignored us and continued talking about the arbor. We showed her the yard sketched out in detail on graph paper–we are serious gardeners. Shannon ignored us.

Before we left for work the next morning, Jeff got firm with his mother and said we absolutely did not want a grape arbor in the yard.

The Contractor

After work that evening, as Jeff approached our house he saw people standing in the front yard. It was Shannon. And a contractor. They were forehead to forehead, discussing details of the grape arbor drawing she’d done that morning.

Smoking in the Car

For some reason, I seem to always drive beside cars with smokers on my way to work. My instant thought is, “Oooh …that cigarette looks good.” Then I remember how wonderful it is to not have the odor and presence of cigarettes in my car.