Holly Hagle 7 6 2011

Holly Hagle, Ph.D.

When I entered the world of blogging a couple of years ago, for some reason I envisioned a three-part series on the ways substances have affected my personal life.

First I wrote about childhood trauma because I personally and professional believe that trauma plays such an important role with mental health and substance use disorders. Then I shared my personal experience as a loved one of someone who died from a prescription drug overdose. Now, I am writing about how I personally believe that my father could have lived 10 years more if he had been able to quit smoking.

As a trainer for IRETA, when I talk about the consequences of substance use, I always include tobacco. One fact I share with most audiences is that according to the Centers for Disease Control and Prevention (CDC), on average, smokers die 10 years earlier than nonsmokers. Every time I share that statistic, it sticks in my throat.

My dad was a youth in the 1950s who started smoking at age 12 with his friends (a common first experience for a lot young people at the time and not unusual today). Dad lived to be 70 years old but research suggests that he could probably have lived at least 10 more years if he had been able to quit as a middle-aged man.  In a 2013 study, Dr. Prabhat Jha and other researchers found that “Smokers lose at least one decade of life expectancy, as compared with those who have never smoked. Cessation before the age of 40 years reduces the risk of death associated with continued smoking by about 90%.”

Like most smokers, my dad had multiple quit attempts, some very successful. He was able to quit for over a year at one point.

How could Dad have gotten more help?

But nicotine is one of the hardest addictions to recover from. And a cigarette is an incredibly effective drug delivery system: a person who smokes about 30 cigarettes a day (a pack and a half) receives 300 hits of nicotine to the brain every day, each one causing the adrenal glands to discharge epinephrine (adrenaline) and stimulating the brain’s reward pathways. However, although the body responds to the effects of cigarettes almost immediately, those effects also dissipate quickly. Experiencing the drug’s rewards (or avoiding withdrawal), requires another cigarette. The American Cancer Society found that only about 4-7% of people are able to quit smoking on any given attempt without medications or other help.

There are several ways to quit smoking, including getting help through your doctor, individual or group counseling, and medications (both over-the-counter and prescription). How could Dad have gotten more help? He could have tried all of these options, some in combination with others. A major life stressor (losing his job) led him back to smoking and he made few attempts to quit thereafter.

Even though we are in an epidemic of opioid addiction and especially opioid overdose, tobacco is still the #1 substance responsible for deaths worldwide. As the Surgeon General reported in 2014, “The century-long epidemic of cigarette smoking has caused an enormous avoidable public health tragedy. Since the first Surgeon General’s report in 1964 more than 20 million premature deaths can be attributed to cigarette smoking.”

My personal experience and my knowledge of tobacco’s profound effects on morbidity and mortality have convinced me that we cannot accept that people will just continue to smoke. Instead, we should continue to aggressively address smoking across the world, our country and within our families. We have made some inroads with prevention messaging, as the rates of cigarette smoking among youth has declined in recent years (2011 – 2014). However, during the same time period, the use of other forms of consuming tobacco like e-cigarettes, hookahs, and smokeless tobacco products increased.

As I wrap-up my three-part series, I would like leave things on a positive note:

Trauma can be addressed. We are resilient.

Overdose is preventable. Where there’s life, there’s hope.

Smokefree is possible. Never settle.

Maybe it’s wishful thinking on my part that Dad could have lived longer had he been able to quit, but I don’t think so.