I just copy and paste it from Medscape Blogs. It was originally posted by Kendra Campbell (Psychiatry/Mental Health) on March 14th. It’s about medical student/physician who smokes.
It’s time to come clean. I have a dirty little secret that I’ve kept from many people for a long time. I have intentionally not written about it publicly, as I was afraid of all the condemning comments and accusatory reactions. I’m a med student/soon to be doctor, and I smoke.
Now let me explain. I started “experimenting” with smoking at a young age. I guess I was around 15 when I smoked my first cigarette. It wasn’t a big deal at the time. It was just one of those “it’s bad to do it, so I’m gonna do it” type of rebellious acts. I didn’t smoke very often at first, just every once in a while with my friends. Years later, I began smoking a little more frequently. I was never a “heavy” smoker, but since then, I’ve definitely inhaled far too many cigarettes than I should have.
I have tried to quit many times. In fact, I went a few years without a single cigarette. Ironically, it was during med school that I started up again more heavily. Now, I consider myself to be a “social smoker.” I rarely smoke alone, or during the day. My biggest trigger is alcohol. If I have a beer, glass of wine, or margarita, the urge just hits me like a nicotine monster. I can’t seem to resist the temptation to light up after I’ve had a few drinks.
So, how can I be a medical student, training to be a doctor, and continue to light up? Before I started med school, I knew the dangers of smoking. It’s pretty hard to avoid the anti-smoking ads (which have become even more prevalent recently), and if you somehow didn’t see those ads, you could simply read the warning on the outside of the package. But I did it anyway. Then I went to med school. I learned about what smoke does on a biochemical level. I studied the pathologies it causes. Now, more than ever, I know about the relationship of smoking to lung cancer, emphysema, bronchitis, and many other diseases. I am perfectly aware of the dangers of smoking. Yet I still haven’t been able to completely kick the habit.
What’s wrong with me then? Well, to it put simply, I am an addict. You can educate an addict on the dangers of doing their drug of choice until your lips turn blue, but that doesn’t mean they will quit. Ask any heroin addict if they think shooting up is good for them, and I guarantee they will tell you no. But invariably, they find it quite difficult to quit.
Am I alone on this one? Absolutely not. Millions of people are addicted to smoking. And here’s the kicker: there are quite a few people in the healthcare industry who smoke. Med students smoke. Doctors smoke. Nurses smoke. Smoking permeates the whole spectrum of workers in the “health” industry. But how can this be? Shouldn’t we know better?
The literature is ripe with articles on this very topic. Some people believe that the healthcare industry has a higher proportion of smokers than many other industries.
Still, it is utterly embarrassing for me to admit to the world that I smoke. I hide it from my fellow students, residents, attendings, and just about everyone else I meet. I don’t want people to think that I am “weak” and know that I would do something so destructive to my body.
Speaking of which, that’s the other huge dilemma that I have with smoking. I consider myself to be a relatively healthy person in general. I eat fairly well, I exercise regularly, I do yoga, I meditate. Save for this one nasty little habit, I consider myself to be a pretty healthy person. In fact, I’ve used that excuse to continue smoking at times. I say to myself, “I am so healthy otherwise, what is one little cigarette going to do to hurt me?”
I have a billion other excuses and defense mechanisms that I’ve constructed to allow myself to continue smoking. They have served me well for many years. But now I’m one year away from being a doctor. My job will be to provide healthcare to my patients. I’m supposed to educate them on the many ways to become healthier. I should be a role model of healthy habits. Yet, I have not yet been able to quit smoking. Perhaps this makes me better able to “get” my patients. As a smoker, I understand all too well the struggles involved with smoking cessation.
I encourage everyone to share their thoughts. Tell me how terrible I am for smoking. Tell me that you smoke too. Tell me what you think about doctors who smoke.
I’m attaching few comments below. Actually, there were 100 comments to the post but attaching all 100 comments is not a wise choice, I think
# 1
I am a nurse that smokes too. I am embarrassed about it and try to hide it from my coworkers and patients. I’ve tried quitting numerous times without success. I will try to quit again but it may take several more attempts. That’s the way it goes when trying to quit smoking.
Like you said, I also consider myself quite healthy in all other aspects of my life. I am a decent weight, eat well, and try to exercise.
What irks me is when overweight people berate me for smoking. If I did the same to them about their weight, it would be considered inappropriate and mean. I’m tired of people lecturing me about smoking. I KNOW it’s bad for me!
Are we as health care workers expected to be perfect? We are human, after all. And like you said, maybe it helps me relate to my patients more. That is, to understand the struggle with addiction and trying to improve lifestyle habits.
Just my two cents
# 2
I’m a med student/ soon-to-be-PA, and I’ll say to you what I say to my patients: smoking literally re-wires the receptors in your brain. It’s no wonder quitting is difficult, and in fact most people who are able to quit for good only make it to that point after several failed or abandoned attempts. And the receptors don’t care about logic, they don’t care about guilt, they just care about nicotine. So don’t be too hard on yourself. It’s not an excuse, it’s a fact of your neurophysiologic life.
On the other hand, if you feel like you’ve had enough, and you really truly want to quit, you should talk to your primary clinician. You don’t have to keep doing something you don’t really want to, just because your brain says you have to. We understand a lot more about addiction to nicotine than we used to, and there are tools available to help you get over it that didn’t exist just a few years ago.
So it’s not about making you feed bad for smoking — if you already feel bad about it, the question is, how bad? It’s not about telling you about the health benefits of quitting now — the question is, do you feel like those benefits will be worth the effort of quitting?
# 3
I tried several times to quit, of course, with utter failure. I can relate to the alcohol trigger because as soon as I quit drinking, giving up smoking was a walk in the park. Didn’t even notice I had quit!
Giving up drinking seemed so much easier.
# 4
I’m also a 3rd yr student, and I also smoke similarly to you. I’m not entirely addicted to nicotine, I can go weeks without smoking, but with alcohol, it can be hard to resist. I feel like such a hypocrite, and I when I smell a patient that just lit up I know everyone in the hospital is judging them…. For me smoking is definitely related to my mental health. When I am depressed or stressed, which is unfortunately kind of often, I smoke more. When things are going well, I smoke less. Maybe you feel the same way? I’ve found that when you are out drinking, when that urge to smoke hits chewing nicotine gum can effectively satisfy that craving, but I also love the social aspect of smoking, the oral fixation, the getting outside the bar and just chatting it up with random people… but in the end its the addiction to nicotine. Try the gum. Try an ecigarette. Try something. We both should quit.
# 5
I’m an Osteopathic medical student and used to smoke as well.
I was a US Marine for 9 years and I smoked while active duty. When I got out I stopped but one of the things that helped me was actually two habits;
1) Substitute the “timed” smoking habit of going outside of the hospital or clinic can be substituted by using that time to have a planned activity, (i.e. take off your lab coat and do 20 push-ups or go to gym (or respiratory lab) and do 10 minutes on the stair stepper.
2) Visualize while exercising the release of hormones etc. Imagine how smoking kills the bronchial cilia and how much more vigorous your lungs feel exercising instead.
It may sound simplistic but in my personal experience, all the chemical smoking cessation products alone are not as effective habit substitution and exercise.