Here goes another peculiar analogy. I notice that Uncle Eli has been thinking along related lines.
The doctor (and anyone else I speak to) tells me, unequivocally, that since my MI (heart attack), I absolutely have to quit smoking. No surprises there, then.
Why? Putting aside the derivative opinions of those who aren’t really qualified to know (most of the people who say this apart from the experts), what is the scientific basis of the nedical advice I am receiving? And what will the consequences of ignoring it be?
First, let’s look at the explanation I have been given. By continuing to smoke, I would increase the risk of further heart attacks, probably double it. How does the doctor know this? The cardiologists have a large information base, demonstrating a statistical relationship, historically, between smoking and heart attacks; the evidence is very strong that smokers are more at risk than non-smokers. This statistical probability is generated from real data, and expresses the likelihood/risk of future damage/injury on well-understood physical and theoretical principles.
I can be confident, though, that I don’t have to heed their advice; I could take up smoking again if I wish after all, it’s a free world (cough). For whilst I am told that I would be at an increased risk, it is, after all, only a statistical risk; there is no certainty that I would have another attack, nor can they specify a timescale, either for another prospective attack, or for my future mortality (which will come, its just a matter of when…).
So while I can reasonably assume that I would be at increased risk if I did smoke, I can also (apparently) rationally choose to ignore this advice, since it is speculative and not able to commit to a certainty that I will have a heart attack in the future.
What do you think? Should I take up smoking again? Am I trying to find an excuse to continue doing something which I enjoy and is a habit, even though I know that it is going to be bad for me eventually?
Likewise, I can (apparently) rationally choose to ignore the experts who have used real world data and have calculated the risks using statistical probability, to tell me that the climate is warming, that sea level will rise this century, that patterns of weather on which agriculture and food supply rely are likely to change. After all, their analysis is also ’speculative’, and there are no certainties about the future of the climate/environment.
Here is the chance for you to give me some advice, then; should I adapt (smoke, but stop if I don’t feel well?), mitigate (stop and avoid the increased risk altogether?), or ameliorate (buy some chewing gum/patches, eat boiled sweets, whatever?). Perhaps I can just ignore it, and it will all go away eventually… ater all, we all have to die some time. 
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April 18, 2008 at 3:40 pm
Anonymous (kind of)
I think you should stop smoking. The adverse effects are not binary - cigarettes will take their toll on you whether you have another heart attack or not. If you were able to compare, you’d feel better without them.
Of course people get something positive from smoking. I don’t think it’s just a pleasant habit - or if it is, then refusing to quite is pure laziness.
Nicotine is an antidepressant and a stimulant. If life feels too bad without it, try SSRI’s, Wellbutrin, Ritalin, or a combination. These meds are not without side effects, but they are certainly less hazardous than smoking.
April 21, 2008 at 1:04 pm
The Tuatara
Allan Carr’s Easy Way To Stop Smoking. Worked for me, about 18 years ago. Never (and I mean never, even when tempted) regretted the decision.
The difference between smoke/no smoke (apart from the presence of fire) and the climate change issue we confront is that we have to both adapt and mitigate. There’s a lot of sh*t coming down the road before the mitigation does any good. A lot of sputum to couhgh up before you can smell the roses.
Aargh. That’s enough tortured analogies for tonight.
And keep on taking the tablets.
April 22, 2008 at 12:32 am
John Mashey
1) Both my parents died of lung cancer, and only one ever smoked, but she died younger, also. She tried very hard to stop, but couldn’t. Hence I’d say, stop if there’s any way.
2) If you started when you were a teenager, it will be *very*hard. Cigarette company business plans depend on hooking kids while their brains are developing to wire them for addiction. I don’t know if “Twista Lime” and similar things are sold over there, but you can guess who candy-flavored cigarettes target.
3) You might want to read Allan Brandt’s fine book “The Cigarette Century”.
In particular, of the group that produced the 1964 Surgeon general’s Report in the US, half were smokers. As the results accumulated, most of the smokers stopped, but (page 229):
“In spite of the findings, as well as the urgings of his fellow committee members and the entreaties of his wife and daughter, Cochran relied on his own statistical analysis to support his decision to continue smoking. Having smoked for a long time, he could not become a statistical nonsmoker, only a former smoker. Quitting now, he reasoned, would reduce his chances of succumbing to lung cancer from 40 percent higher than a nonsmoker’s to 24 percent. ‘I think the comfort of my cigarettes is worth that 16 percent chance,’ he explained. He nevertheless conceded that he would probably cut down, and he noted that ‘I certainly intend to see that my children never start.’”
Now, having had an “event” (as the doctors are wont to say), and having been told later “my heart disease was progressing”, i.e., getting worse, I ended up with a quad bypass, and am a much better boy with regard to exercise & diet & lifestyle. Fortunately, I never smoked, and live in one of the fiercest non-smoking areas on the planet, which makes it easier.
I’d suggest you may want to look at the statistics, not just of death, but of the manner of dying and how *you* feel about them:
a) Fatal heart attack - well that’s it.
b) Near-fatal heart-attack - well, probably crippled.
c) Lung cancer - that’s a year or so and not nice.
d) Other - after all, you could get run over by a truck next year, in which case you might as well enjoy the year.
April 22, 2008 at 11:09 am
guthrie
Both my grannies gave up smoking when told to by their Doctors and this undoubtedly helped them live longer and healthier lives.
I’m sure there is also direct physical evidence of the effect that smoking has on your heart due to the various chemicals in your bloodstream.
April 22, 2008 at 7:37 pm
John Mashey
Your link to Eli has an extra http…
April 28, 2008 at 1:50 am
Hank Roberts
You’d make me very happy if you do quit. I watched my dad do it — he (and my mother) said he would still wake up years later from nightmares — reaching out and grabbing for cigarettes dancing, dancing, just out of reach. We know now there are at least two antidepressants in tobacco smoke, last I heard, and plenty else. Knowing a bit of the pharmacology might help recognize the process, and supplementing something else for a while apparently can really help the change.
April 29, 2008 at 1:47 am
Lab Lemming
I suggest that you buy “smoking credits” from one of your non-smoking friends to become nicotine neutral. Then inform your cardiovascular system that your smoking has been offset.
April 29, 2008 at 10:02 pm
Aaron Lewis
Stop! Smoking kills brain cells. We old guys must be the wise ones.
May 3, 2008 at 2:20 pm
EliRabett
My mom gave it up in her forties because of iritis and she kept on missing it for decades but she kept with it. I gave up smoking a pipe when I was ~30 and still occasionally miss it, but things taste and smell a lot better (including me according to my wife, there are benefits!!)
May 6, 2008 at 5:18 am
Steve Bloom
New results from Stan Glantz and minions, IMHO grounds to finally put an end to the trade:
Secondhand Smoke Exposure Can Cause Cell Damage In 30 Minutes
Smoking got both my parents. I never took it up, but breathed second-hand smoke continuously as a child (made worse by living in a cold climate).