Confronting the habit

Edgar L. Jones

April 06, 1993|By Edgar L. Jones

IN television commercials they're called "The Patch," touted as an easy way to break the cigarette habit. Just stick one on your hip or shoulder or chest, and all day long small amounts of nicotine seep into your bloodstream, lessening the urge to light up.

Several pharmaceutical companies produce what are formally known as nicotine transdermal systems. The idea is to use a fresh patch daily and to reduce the nicotine dose gradually. In order to use the patch, the patient must first stop smoking to avoid nicotine overdose. So people must be primed psychologically to give up tobacco even before they begin wearing the patch.

Our family physician wisely prescribed a patch program for me that put emphasis on overcoming psychological dependency on smoking. After 35 or 40 years of pipe smoking (in a switch from earlier cigarettes), I was slow to acknowledge that I had let the pipe and the whole ritual of cleaning and filling it become a security blanket in stressful situations. My constant puffing was the probable cause of poor circulation and shortness of breath. I couldn't claim I didn't inhale, not with those symptoms.

Yet in reading the patient's handbook, I found reason to be hesitant. When nicotine is withdrawn from habitual tobacco users, they may have adverse reactions that include nervousness, irritability, headaches, dizziness, chills, upset stomach, lack of concentration and constipation. On a more encouraging note, the patches not only can lessen the impact of abrupt and total withdrawal but also ease unpleasant side effects. This might be considered a win-win situation but for one disturbing thought: The patch relies on nicotine to fight the avowed enemy -- nicotine!

I quit smoking last Nov. 7. I survived the first day by keeping busy with my hands, chewing gum, eating snacks, telephoning friends. The next morning I applied the first patch, and according to my nightly notes the urge to smoke seemed a little less intrusive. In the afternoon, however, it took me two hours to write a three-paragraph letter.

As smokeless days continued, I began to grasp the difference between a physical and psychological need to smoke. I didn't get rid of ashtrays and smoking equipment, as the manual advises, but I had no urge to light up. Instead, I missed the feeling of relaxation, the inner comfort and support that I drew subconsciously from my pipe. Smoking had braced me for the tasks ahead and rewarded me for missions accomplished.

What bothered me most was a clogged-brain sensation, as though my mind had short-circuited or fogged up. It's hard to describe, but I've talked to two friends who had similar withdrawal symptoms. I became forgetful about common names, spellings, street locations, what I intended to do next. A fresh patch and several cups of coffee usually cleared my head. Meanwhile, I muddled through November and December with nary a puff.

As the year ended, so did my second batch of patches. I didn't order any more, knowing that they delivered nicotine to the bloodstream, albeit in small doses. I notified my doctor that after nearly two months without an irresistible urge to smoke, I ought to be able to do without a chemical fix. And so I should. But my notes for Jan. 5 say: "Sure do miss my pipe. My head doesn't work well without tobacco." And three days later: "I'm very discouraged by stunning effect of no tobacco. Stupefying effect is better description."

The craving got steadily worse in February and began to include a hunger for the sensation of smoking, not just the psychological uplift. I wanted and needed to do some writing, my sole creative outlet over many years, but hours at the typewriter yielded nothing of merit. I was tired all the time, fell asleep in my chair, took too many naps and had nothing much to say even to my friends.

Was this an unusually heavy dose of the winter blahs or, more to be dreaded, a premature case of senility? If this was to be a geezer's life without tobacco, I was ready to go back to nicotine.

The deal I struck with myself as spring approached was to make one last serious effort to write a printable article. If that failed, I would have to accept the verdict that I was losing more than I gained in trying to overcome the effects of nicotine dependency. Of course, once my brain cleared up I might come to a different conclusion.

Edgar L. Jones is a retired editorial writer for The Sun and columnist for this page.

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