Quitting to Win

That's the name of a new blog by Jen, my cousin-in-law, once-removed (daughter of a cousin of Kirsteen's).  She's quit smoking and is going public with it.  Kudos to her I say, and a brave way to plunge into the commitment.  Along with that, I think she's an incredible writer, creating a visceral mood that I go for myself...only she does it better.  So check it out and put the pressure on her.

Reading her blog has made me think a lot.  About smoking and smokers.  About cancer.  Life...all that.  I need to talk about it.  Not so much as a response to Jen—because I can't say my thoughts will be all that encouraging—but as a reflection of my past choices versus cruel random chance.

I quit smoking when I was 25—having had my first puff at 13 though not getting serious for a few years.  Call it a ten-year pack-a-day habit.  My first attempt to quit lasted more than three months.  Oh, I was cruising!  But my friends smoked...and we all drank.  One unremembered night I said 'screw it' and bummed a smoke from a friend.  So much for that.  The second attempt lasted less than a month while my friends put up with my pilfered cravings for weeks before I succumbed to the dishonor of a personal purchase.  Before my third attempt I had switched to a ridiculously light brand, though it's really the hand-mouth habits I needed to overcome. (I would chew pens and pencils for years to come...now I've got TMD issues...sigh.)  I was sick and didn't feel like smoking for a few days, so I took advantage of the opportunity.  Cold turkey.  Sheer willpower.  Not one puff since.  That was August 27, 1989.

The bottom line in my choice is that I was fat and I smoked—a double whammy—and of the two, it was easier to quit smoking than to lose weight. (Indeed, I got fatter over the years.)  I quit smoking for my own health, even though I can't say that health and fitness have ever been a priority in my life.  There's a little reward to quitting, several weeks later, when you notice your increased stamina.  Gotta go up two flights of stairs?  No problem now!  I think it's one of the best choices anyone can make (even better to never start).  It's an expensive and disgusting habit that has no upside beyond the camaraderie among other smokers afforded by segregation to outdoor islands of second-hand tolerance.

On July 28, 2008, I was told I have lung cancer: adenocarcinoma non-small cell lung cancer; one of four prevalent flavors and the most common among nonsmokers.  It's not caused by asbestos or mercury or any other substance we've figured out...genetic translocation (a random mutation) is one theory.

So I can't blame myself for getting lung cancer.  That's a fear of many smokers, not only that they contract lung cancer, but that's it's something they could have avoided...the guilt and stigma of having made the choice to kill oneself.  It's often the next question asked when my condition comes up, "Did you smoke?"  Well, yeah…but.  It still makes me feel guilty for having cancer.

A lot of smokers never get lung cancer; a lot more than most people would guess.  The bastards.  Old people who smoke, especially, are really starting to piss me off. How dare they live long lives while I'm sentenced to the disease they should have!  But that's not how I really feel and it's not how cancer works.  It's exceedingly random.  Most often, it doesn't care if you're an ab-crunching vegan or a buns-of-beer couch potato.  Sure, there are risk factors...inhaling mercury vapors is a seriously bad thing.

I'm sure there are many undiscovered causes and risk factors for cancer; manmade and natural and including the influence of lifestyle choices.  Could my cancer still have been caused by my own behavior?  Sure.  Could it have been caused by some toxin being dumped into our environment?  I suppose, but I'm not keen on angrily seeking retribution against a phantom menace supported only by anecdotes and conspiracy theories.  It's just as likely to be my own genes turning against me.

It is what it is.  It's cancer.  It's insidious.  It sucks.

On smokers: I don't have an issue with people who smoke.  It's a legal activity (sort of) and a personal choice.  Everyone knows the risks these days.  It’s your body and your life to burn as quickly or slowly as you choose.  Smoking’s not the only way to go—many people make choices that increase their risk of death, including over-eating and adventurous outdoor activities.  This one though, you're giving yourself a good, oh, I dunno, one-in-four or five odds of dying from lung cancer.  Roll the bones, if you're hot you're hot.  What are the odds you'll die in traffic tomorrow?  Unlike alcohol, tobacco tends to kill only the user—a libertine outcome to be sure.

I sometimes find myself in the position of defending smokers.  As a health issue, I think second-hand smoke has been overblown.  If you live, work, or otherwise engage with smokers for long hours every day, you're certainly getting a worrisome dose.  Beyond that, getting a whiff of tobacco as you pass an outdoor smoker does not warrant melodramatic coughs or chest spasms...certainly not any more than eau de frat-boy doused with Axe cologne.  I support smoking bans in publicly-owned buildings, but not private establishments.  People, including owners of private businesses, should have choices.  Most restaurants in Tucson had gone non-smoking before the ban.  There was no need for it here.

There's another paradigm of smokers that I don't buy into...that they cost us more in healthcare.  Au contraire, the evidence I've read online (picked randomly to match my viewpoint, of course) indicates that smokers cost less than other people.  The reason?  They tend to die younger.  They tend toward unhealthy lifestyles and rarely go to the doctor.  They tend to drink more than other people.  Their tendancy to survive a major illness or trauma is less than healthy people.  News flash: if you die from your first heart attack, ya ain't gonna be a burden on the healthcare system.  The corollary is that the more you use healthcare, the more you survive illness and disease precisely because you are vigorous and strong, the more you use the latest in preventative medicine and diagnostics technology—the longer you continue to live—that's when you rack up the costs on healthcare.  United is into me for several hundred thousand already (at their cost).

So, really, we should thank smokers.  And how about these ironic initiatives that tie tobacco taxes to children’s healthcare?  They can’t quit now!  It’s for the kids!!!

Us fat people are more complicated.  I've been fat all my adult life...over 300 pounds at my greatest.  Boy, that was a wakeup call.  Despite that, my doctors never declared me to be unhealthy.  My weekend-warrior lifestyle was enough activity to keep me relatively fit under all the extra baggage, though I was certainly warned of the inherent dangers as I grew older and my blood pressure was ticking up.  Some modest effort and changes in eating habits brought me down a stone or two, while Lipitor kicked ass on my cholesterol levels.

These days I hover around 250 pounds, after regaining half of the 70 pounds I lost during my initial months of chemotherapy.  My doctors don't want me to lose (nor gain) weight now.  My fat reserves, along with my relative youth and underlying health, as it were, are all vital elements to my survival with cancer.

Could it be that past bad choices in behavior are now resulting in a benefit?  Does it even matter what choices I made?  Given the randomness of my own cancer, I don’t regret having smoked.  I don't regret quitting either.  I'm glad I did.  I'm also glad that I ate too many delicious cheeseburgers and pizzas that should have been donated to anorexic celebrities.  Sometimes, I just want to tell people to do whatever they feel like doing.  Seize the day for tomorrow we may die!

But seriously, Jen. You stink when you smoke. Don't look back.