Smoking

This blows me away.

Today I saw a guy standing on top of a big No Smoking sign that is painted on the sidewalk outside the hospital so that people don't have to walk through smoke to get into the building. He was smoking. Better yet, the hospital he was smoking outside of was the Respiratory Rehbilitation Hospital.

I have also recently looked after a woman, in her 30s, diagnosed with lung cancer, in her 30s, who comes in in a cloud of that sour, stale, ashtray smell that comes from being in enclosed spaces with many burning cigarettes, who is practically ripping her IV out the second her chemo is in, so she can go out and smoke. Lung cancer. In her 30s. So addicted she reeks of it, and can't sit still for an hour so she can get the chemo that might actually cure the cancer, if she stops feeding it carcinogens.

I also looked after a lady today who was successfully treated for lung cancer, who wants her port-a-cath (a catheter that goes into the big vein near her heart so she can get chemo and bloodwork easily without needle pokes every time) taken out because she can't afford the cab ride in once a month to have it flushed. When she was rooting around in her purse, though, I saw a pack of cigarettes. $10 a pack for smokes, but can't afford a monthly trip to the cancer treatment facility for maintenance on the access device that delivered the chemotherapy that cured her. Of lung cancer.

This blows me away. I guess I have never been addicted to anything, so I really can't relate. I can't understand a need that defies logic, that defies health. Do these people not make the connection? Or is it that they know that smoking causes cancer, but maybe just not to them? Maybe they believe that their lung cancer is the kind caused by unfortunate genetics or smog. It seems like that invincibility factor should wear off sometime in the late teens or early twenties, especially for people who have faced their mortality head on, via cancer.

I would really like to understand this. What does a craving feel like? Is it a conscious thought that you need a smoke, or is it some disquiet, some anxiety, maybe butterflies in the stomach that you know will go away if you smoke? Is it a physical sensation? Or an emotional one? Conscious or subconscious or unconscious? Maybe it's just that the cravings are so intense that it's not worth enduring them for the sake of health. Maybe the actual state of being addicted means that the hell of changing that state is, literally, worse than death.

There are several reasons I do not smoke. One is purely vanity. It makes you ugly. You can tell at a glance someone who has smoked a lot for a long time. They have that stereotypical smoker face, the face that almost seems like it's been left in the hot sun too long and has melted, just a bit, with deeper, longer lines than there should be. I spend lots of time and energy and money trying not to look 33, I certainly don't want to do anything that will make me look my age, or older.

Another reason I do not smoke is emphysema. I feel claustrophobic at the thought of having to gasp for every last breath. I panic at the idea that I might not be able to walk to the bathroom or speak three words in a row, or eat a meal because I was too breathless. I can't even stand the thought of scuba diving, because of the possibility of running out of air (although interestingly enough, I would consider climbing mountains, where there is little air), let alone the idea of being breathless at rest, on dry land.

The other thing about smoking is that I am fundamentally cheap. I cannot fathom scrounging nearly $100 for a carton of cigarettes, however fast or slow they would be consumed, when there are (for example) so many pairs of shoes out there, looking for good homes, that can be enjoyed over and over. I wonder how many pack of cigarettes would equal the cost of my new kitchen?

Anyway, if anyone can enlighten me on the subjective experience of addiction, I am interested. I would like to be unjudgmental and understanding. I would like some insight. I am consumed by curiosity about the sensation of a physical need so overwhelming that one would be willing to die for it, however concrete or abstract the risk might be. So, to those addicted to something, anything, share your experience with me. Privately or publicly. I am fascinated. Help me understand.