Smoking: Sources of Addiction
In the November, 1994 column we briefly discussed the scourge of the smoking habit and graphically illustrated the devastating effects it has on the body. We noted that it is very difficult to stop this baneful habit because of its addictive nature. This month we continue by exploring the sources of addiction. Smoking is addictive primarily because of chemical dependency due to the nicotine content of the tobacco. Indeed, the industry has recently been accused of manipulating this content in order to make a particular brand even more addictive and thus increase sales. Another area that causes dependency is the oral satisfaction gained from the habit of smoking. This throwback to a primitive oral need is a very strong and fairly well hidden satisfaction that adds to the addiction. There are many substances added to the tobacco to make it more palatable and to exaggerate this basic oral pleasure. The subconscious layer of mind enjoys and gets security from ritual. Smoking satisfies this need easily with the ritual attached to reaching for the cigarette, tapping it to pack the tobacco, reaching for the matches or lighter, and finally lighting the tip of the cigarette so that it bursts into a smoldering flame that transforms the noxious weed into smoke. The smoker watches the smoke curl upward and is able to fantasize unknown dreams. He may even form smoke-rings and watch them fade into the now. After a very short time the muscles get used to this ritual and the lower consciousness is pleased with its fantasy, which may be romantic and adventurous. At least it satisfies a certain mechanical need. It seems that the subconscious mind rapidly turns this habit into a reward situation, whenever there is a feeling of anxiety, uneasiness or unsettled behavior, the play-out of this ritual gives a reward to the lower consciousness, that is, keeps it busy so that it can forget the disrupting influences. We can better understand how this works if we consider that the subconscious is the animal-like part of ourselves that behaves as if it had a mental age of three to four years. It wants what it wants, when it wants it, and it will act up unless desires are satisfied now. Consider a three-year-old child and his behavior and liken your own lower-self to this. The lower-self can make no judgments. It acts only as programmed even though it does have the ability to make monumental changes in the physical and psychic forms of our being. It will always do the bidding of our middle-self (conscious self) if it knows what that is. In other words, it will act according to the program we give it, providing that it is clear what that program actually is. Anything unclear about the program will probably be ignored and result in no action and a reversion to previously set patterns. These are some of the facts that make giving up the habit of smoking so very difficult. So we see that the first thing we need in order to give up this disgusting and life-threatening habit is to firmly make a middle-self resolution and conclusion to give up the habit. We must consciously make the logical decision to change our behavior. This must be an unequivocal decision. Then begins the second procedure to transform this desired change to the lower consciousness in order to reprogram him/her. This we will explore next month.§
Smoking: Quit “Cold Turkey"
Last month we assessed the affliction of addiction. We saw that the first thing one needs in order to quit smoking is a firm resolve. We’ll now look at how to stick to your decision to quit and make it work. We know that if we can reprogram the subconscious it will be able to bring about the change in habits that we desire as well as to avoid the physical and psychic changes known as “withdrawal symptoms.” We must convince our lower self that this is what we really want. There must be no hesitation, confusion, obliquity or equivocation in the transmission of the act of will. If there is, the subconscious will sense this and act only according to previous patterns, or the old program of satisfaction through smoking. The use of the Nicotine Patch is not advised, as this an equivocation. There is no need for physical withdrawal symptoms as long as the subconscious knows exactly what the middle (conscious) self desires. A firm act of the will is the most decisive and effective tool. A technique of “shouting it out” may help to convince the lower self that a change is really wanted. This technique means that whenever you are alone (even driving in the car) you may shout, “I have stopped smoking” so loudly that the subconscious cannot help but hear and be convinced. If this is done several times a day, the message gets through to the lower mind and one notices an ease developing in overcoming the habitual behavior. This technique also works to overcome other unwanted habits. Thus I advocate one to stop supplying the subconscious with the pleasure of the ritual, oral satisfaction and chemical dependency all at once-"cold turkey.” Daily chanting of the new mantram “I have stopped smoking” several times a day, especially when shouted, helps accomplish the goal. Have frequent discussions with your subconscious, as in prayer, giving it moral support, praise and pleasure and always reassuring it that “This is what I want. It will be good for the body and our whole being.” It may help to set a goal in time so that after the change has been successfully accomplished the lower self will be rewarded by some special activity that it enjoys, perhaps a special trip or food. Make the time interval sufficiently long that the behavior will not revert to the previous habit. This will vary with your own experiences. Frequent prayers to Lord Ganesha imploring His help is also advised. Live as if the goal of stopping this ugly habit has already been accomplished in its fullness. The message to the subconscious must always be “I have stopped smoking,” not “I am in the process of giving it up,” or “I will give it up.” A new habit ritual may be formulated to replace the old one, such as daily exercise, a meditation ritual, reading or whatever will satisfy the insatiable “3-year-old” subconscious. This assures continued success. In my own case, I had stopped the habit for three years and was again hooked because someone handed me a lit cigarette while my mind was occupied with a floor show. Unconsciously, I took a drag, was hooked again and had to repeat the entire process. Of course, it did not take long the second time to overcome the habit. So we must always be aware of what we are thinking and doing in order to do that which is healthful and happiness producing.§
Smoking: The Fancy of the “Civil” Cigar
In the last article we described the process of convincing the subconscious mind that we really are stopping the smoking habit. We expressed our conviction that using replacement therapy merely prolongs the physical addiction and adds to the pains of quitting But cigarettes are just one corner of the tobacco trend. This month we debunk cigars. When we think of a man smoking a cigar, what images pop into our mind? Cigar smokers are usually affluent men of influence and power, and the lower self hangs on to this image as a desirable end. The genteel man retiring to the drawing room after dinner for a brandy and cigar seems to be an image that the subconscious can identify with as an attractive goal and makes it feel as though he/she has attained an enviable social spot. The reality is, however, that the cigar smoker is also an addict. Even though he may not inhale the smoke, the nicotine is absorbed from the oral mucosa. There may be slightly less irritation and trauma to the lungs than in cigarette smoking, yet cancer of the lung is still common in these people. There is the added irritation and trauma to the mouth and lips that tends to cause malignant changes of the labial and oral mucosa. Since many people also chew on their cigars, resulting in some swallowing of the noxious tobacco, carcinoma of the esophagus is quite common. So the reality is that the coveted image of the cultured gentlemen is not valid. The result is an uncomely, disease producing addiction. The irritation of the oral and labial mucosa can cause “white spots” (Leukoplakia, which is precancerous) and “red spots” that are true cancers. Cancerous lesions of the lip are not uncommon amongst the cigar smoker. A constant “upset stomach” is also often the result of swallowing the “juice” from the chewed end of the cigar. There is a new trend in the young “in” society-clubs of today to switch to cigars from cigarettes, thinking that it is less hazardous. There are many smoking clubs, often called “The Georges Sand Society,” forming in the larger cities to memorialize the women who smoked cigars. Georges Sand was not only the lover of Frederick Chopin, she was also one of the few women in history that was addicted to cigar smoking. The fact that many women have taken to cigars also is not only alarming but suggests that there will be more cancer amongst these women in the future. This includes breast cancer, for there is some evidence that smoking tobacco increases the incidence of breast cancer. There is also evidence that irritation of the urinary bladder from the absorbed toxins is connected to cancer of the bladder. Many restaurants are now catering to the cigar smoker by offering separate rooms for the smoking of the cigar, thereby carrying on the great myth of affluence and being cosmopolitan. We must eliminate these these false images from the minds of our young adults and instill in them a reality of the dangers of smoking so that they may make an informed decision to give up this dangerous and expensive habit. The smoke from cigars is not only a very carcinogenic substance, it is also offensive to almost everyone. I see no glamour associated with cigar smoking, nor does it indicate affluence, intelligence or power. Stamp out its use.§
Tobacco
We have been discussing the various modalities of the use of tobacco in our present day situation. We now take up an ancient method that was used by the American Indians as a bonding, declaration of truth, binding agreement of peace amongst the elders of the community. The image that fascinates our subconscious is of the elder, the scholar, the wise man, the secluded one, the contemplative, the thinker. All images that are desirable and very powerful. This use of tobacco is in the smoking of a pipe. The pipe smoker is probably involved in more ritual than any of the other methods of smoking, which is very satisfying to the subconscious.. This is manifest by the ritual of choosing one or more fragrant blends of tobacco, the ritual of packing the tobacco into the pipe, indeed, the ritual also of emptying the pipe of the used tobacco, also the complicated ritual of cleaning the pipe making it ready for another ritualistic ceremony of mixing the blends, packing the bowl of the pipe, and lighting the tobacco, getting it to burn at a desirable rate. All of this adds to the power of the addiction to the tobacco. His smoke is the least offense of all the others as it is mixed with various delightful and satisfying fragrances. Who does not remember passing a pipe smoker and having the fragrance of his particular tobacco remain for a considerable time after him? This is another aspect of the addictive nature of the pipe smoker. Could such a delightful memory be caused by a killer? Yes, indeed it is! For pipe smoking has all of the health hazards of any other type of tobacco. It also has it own particular health hazards exclusive to the pipe smoker. First, it is often the cause of pain in the jaw due to asymmetric pressure from clinching the pipe stem between the teeth. This sends tension and pressure to one temperomandibluar joint more than the other. Nature responds to this unnatural tension by producing pain and swelling in the temperomandibular joints. Many people go through years of unnecessary pain not knowing the reason for it. The stem of the pipe is usually elevated in temperature due to its proximity to the flame. This hot pipe stem is constantly irritating, mechanical and elevated temperature combined, the mucocutaneuos junction of the lip which often ends up in a cancer of the lip. The constant irritation of the oral mucosa produces changes either precancerous or cancerous in the mouth. Slugs of tobacco juice may come through the pipe which produces irritation to the esophagus and stomach which may lead to cancers in theses ares, at the least inflammation and/or indigestion.. Usually pipe tobacco smoke is not inhaled into the lungs so there may be less likelihood for lung cancer; but the nicotine is absorbed by the mucosa of the mouth and pharynx. Because of this there is the attendant chemical changes that are produced by all tobacco use. Through a rather complicated chemical reaction there is a tendency to lower the bodies stores of Vitamin B12; Vitamin C; and other chemical changes that are detrimental to ones health. The physical changes that occur with these deficiencies are very serious. An old teacher of mine told me that if one smokes he should supplement his diet with vitamins, “C for tobacco and B for Booze.” Perhaps the advice should have been, “Just say, No, to the killer.” Tobacco in any form is truly a killer and also produces great morbidity to those who use it. The next article will discuss smokeless tobacco and its particular hazards.§
Smokeless Tobacco’s Bane
We have been discussing the serious and sometimes death-dealing effects of smoking tobacco in its various forms. Each modality has its own peculiar health hazard as well as the general ones that come from nicotine addiction and tobacco use. This is true of the smokeless use of this noxious plant. In the West there has been an alarming increase in the use of snuff and chewing tobacco over the past two decades, especially among teenagers and young adult males. The most popular form of this use is moist snuff. Snuff is a very fine pulverized tobacco leaf that is inserted into the nostrils and sniffed into the upper nasal and air passages. Moist snuff may be sniffed or chewed. It is proven that cancers of the nasal linings and upper airways are very common in snuff sniffers, and it is difficult even to ponder the pain and trauma associated with this disease and its treatment. Snuffing also causes chronic sinusitis, tracheitis, laryngitis, and often erosion of the septum of the nose. Snuff still is causative in cardiovascular disease and may even cause stress and possible anomalies in unborn children of pregnant female users. Frequent users of smokeless tobacco, especially chewing tobacco, are subject to gingival recession and gingival infection. Often the teeth fall out of the jaw with no unusual trauma. Leukoplakia and oral cancers are also common, as are cancers in the upper gastrointestinal tract. Because of the loosening of the teeth, it is often impossible for these people to get a nutritionally adequate diet, thus adding to their susceptibility to malignancy and other diseases. The immediate result of chewing tobacco and/or snuff is increased salivation and the necessity to spit out this mouth load of saliva. This adds another hazard, the sociological one, as the obnoxious spittle may transmit many disease carrying germs outside the body and thus spread infections that are common to these users. The chewing of tobacco is common in the East and especially in India. Many times chewers will add betel quid to a mouthful of tobacco. It has already been shown that the use of the betel nut (Areca) is carcinogenic. It seems to be causative in the high incidence of cancer of the upper digestive tract, especially among men in India who mix tobacco and betel. The unsightly spitting of red-tinged saliva is all too often seen in India, especially in and around her temples. It is esthetically disgusting to see the oduvars, religious musicians, singing praises to the Deity while interrupting each verse with a spit and a cough. In the West, head and neck squamous cell (tobacco related) cancers are 2-4% of the total cancer burden. In India this figure becomes 40% of total cancers, bringing a great health burden upon the nation. Most of the head and neck cancers we see are preventable by consuming a diet high in vegetables and fruits and eliminating smoking, chewing and snuffing of tobacco. Since habits are difficult to break, public health officials are, through education and the enlistment of dental personnel, trying to prevent people from starting. Before leaving the subject of tobacco and its hazards we must also note that secondhand smoke, air that is polluted with the smoke of tobacco, is also carcinogenic and may also cause all of the diseases we’ve discussed. This is especially true for children who must constantly breathe the polluted air, as in the home environment.§
Second-Hand Smoke: How Safe?
Last month we stated that passive smoking, also called “second-hand smoking,” poses serious health risks. We will now look at how smoking not only hurts the smoker but those around him or her as well. It may not suffice to simply quit smoking, we should also try our best to avoid smoke-filled environments. Passive smoking is the inhalation of the side stream of smoke emitted from tobacco between puffs on the cigarette, and/or inhalation of the exhaled smoke from the smoker. This smoke presents a special problem. It contains more particles of smaller size than the directly inhaled smoke and is often deposited deeper within the tissue of the lung. The pathological changes depend upon the total amount of smoke particles inhaled and the duration and frequency of exposure. We do not need to be in near proximity to a smoker to be assaulted by this poison. Smoke particles are carried great distances by diffusion, convection, and other modalities. The public relations aspect of the separate “smoking dining areas” in our finer restaurants really is not much safer than the adjacent “Smokers” section, for the air is mixed by central air circulation, often without being filtered. This is also true in air travel. If you watch the wafts of smoke rise and disperse in front of you while you are in or next to the smoking section, it doesn’t take much imagination to determine where the smoke will end up. Although the separate sections are an improvement, we should not rely on a possibly inadequate air filter to be the final act of safety. Unfortunately, there is no “threshold” toxin level that is considered safe. What is clear is that prolonged contact, primary and secondary, determines toxicity. It is thought that there are about 53,000 annual deaths in the US caused by passive smoking, 37,000 of these come from combined cardiovascular disease. Spousal smoking accounts for much cardiovascular disease and pulmonary changes, as well as increased mammary carcinoma. Is it any wonder that our youth are developing pulmonary weakness and disease? There is a two-fold attack that secondary smoke has upon the tissues of the nonsmokers’ body. All the usual carcinogens, fiber and other chemicals have their direct toll on the physiology of the cells, much like they do in the primary smoker. But there is the added effect of the carbon monoxide diminishing the oxygen-carrying capacity of the blood. With reduced oxygen in the blood, there is an obvious decrease in the viability of the cells of the heart and respiratory organs. This low-level deprivation of the brain oxygen levels leads to subtle but permanent brain and vascular changes. In women, these subtle changes are more profound if she is also on the “pill.” The tender tissues of infants and children are the most susceptible to second-hand smoke. Being exposed many hours a day, they develop many pulmonary conditions such as allergies, asthma, chronic bronchitis and cardiovascular problems. Later in life, many develop cancers. Studies have repeatedly shown that children of smokers do not develop physically or mentally to their full potential. Yet, in spite of the scientific proof, people do not want to believe this is true. So it seems logical that a smoke-free school, workplace and home would take this public health burden off of us and give us all a chance to lead healthier lives.§