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The Smoking Gun

We often hear smoking gun used to describe the “ah ha” moment of a who done it.  I was unsure of the meaning and asked Siri.  My Apple genius defined it as “as piece of incontrovertible incriminating evidence.” 

I know two things with high confidence: (i) there is a very strong correlation between smoking and lung cancer, and (ii) implying smoking as a cause adds to the self-induced stigma that smacks down research for my disease. So, how do we address the stigma without pointing the smoking gun?

I couldn’t stop because I was addicted to nicotine.  When I was young and fearless, almost everyone smoked and I joined the crowd.  In my 30’s, most quit.  I tried, many times and ways, but couldn’t.  My addiction was stronger than will power.  Addiction is irrational.  Most addicts recognize the harm, but recognition caves in the face of physical craving. 

How is addiction to nicotine different from alcohol, heroin, or cocaine? It isn’t but what do the health authorities call it?  The Center for Disease Control (CDC) says smoking caused 480,000 deaths last year in the United States. Note absence of the word addiction.  The CDC also says about 88,000 people die annually from alcohol abuse.  Note abuse is not addiction.  Almost 35,000 people died from heroin overdose in 2015, according to the National Institute of Health.  Note again, overdose is not addiction. It is unreasonable to suggest these deaths resulted from one time or occasional use.  

I contend not using addiction to characterize the root cause is part of the problem.  If I smoke, abuse or overdose, I am branded guilty of doing something wrong.  I am causing the problem.  There is no disease or medical abnormality; therefore, there is nothing to research.  This individual guilt becomes a collective stigma.  If our national health authority doesn’t treat use as addictive, it certainly won’t be prone to find new treatments. Nor, will there be interest in treating consequences.  Thus, the paltry research funding for lung cancer.

Many people experiment with addictive drugs and are fortunate to stop short of addiction.  But, when one can’t stop, one is addicted and mechanisms must be found to treat the addiction. So, let’s change the nomenclature.  I am addicted to nicotine and my addiction likely caused lung cancer.  Where is the smoking gun pointed now?

Stay the course.

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Tom, I really appreciate your continued dedication to discussing nicotine addiction, the people who suffer from it, and the need for our country and culture to refocus how we address and manage this health crisis. This affects all of us!

If I may share a brief snippet of my life, some may recall that I was diagnosed with Stage IIIA NSCLC (adenocarcinoma) in early 2016, at age 40. I had a brief smoking history from my early 20s and was able to easily quit. I don't know whether addiction is *allowed* to be easy, so I can't say whether it was ever an addiction. I do know that my doctors did not consider me high-risk for lung cancer prior to my diagnosis.

My father (not biological, but the one who raised me), was a life-long smoker. He tried so hard to quit, on several occasions. He was successful for periods of time, as well. He was diagnosed the year I moved out of state, just after Thanksgiving. He came up to visit with my mom, just prior to his diagnosis, and he'd been sober for many, many years, but we gave him codeine syrup and whiskey because he was in so much pain from the hacking and the tumor that was resting on his spine. He couldn't sleep lying down, because the pressure was too great to breathe. I visited him at Christmas, just a month later, and he told me that even if he'd known in hindsight he would get lung cancer, he wasn't sure he would have been able to quit. And was he frightened of his disease? Of course he was. He was terrified. It broke my heart. He died the morning after I returned home. That was sixteen years ago. I hate that some diseases are used as punishment for "bad behavior" . That needs to change. 

There are at least two life affirming facts I want to become prevalent in our culture. 

1. Nobody deserves to get lung cancer.

2. Nobody deserves to die from lung cancer.  

 

 

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