On Smoking and Death
“I don’t want to quit smoking,” my patient says with her face firmly set. I’m taken aback.
“I don’t think that’s true,” I say,” you just told me you quit, then you started again because your brother and grandson died in the past few months and you’re struggling with the loss. I don’t think it’s that you don’t want to quit, it’s just that quitting while you’re coping with emotional trauma probably seems too tall an order.” She becomes tearful and wipes her eyes with a tissue.
I can’t fix any of this for her. I can’t bring her family members back, I can’t take the rest of her stressors away, I can’t cure her of the multiple diseases that rack up such high medical bills, and I can’t even offer her a very effective tobacco cessation treatment. She is already on antidepressants with a long history of depression, she has tried, and didn’t find too helpful, the various tobacco cessation aids, the ones that didn’t give her nightmares or cause her to consider killing herself, that is. Perhaps the least I can offer is compassion and attempt not to be another person she sees the need to defend herself against.
mybetterdoctor 
I’m wiping away a tear too. I know just what this woman is feeling about the whole thing. The one drug that “takes the edge off” is the one we MUST give up. Recently I was given HELL about my electronic cigarette by a medical “professional”. So no matter what I do, I’m still the same old stupid woman who “refuses” to give up something that actually helps. I’m back to smoking the real thing, even though I know it’s bad for my body. (but good for my mental health) Chantix made me want to kill myself. I guess that would be a way to quit smoking, no? I shouldn’t have listened to the nasty little perfect and pure resident and I wouldn’t be smoking real cigarettes again. Some “mature” behavior on my part…
Give yourself a break! It is really hard. Most people who quit for good have quit and started many times. It means rah time you quit, you’re MORE likely to quit for good.