Smoking and the Happiness Quotient

My mother loved her morning ritual of coffee, The New York Times crossword puzzle and a cigarette. As an avid bridge player, she was unhappy when smoking at the table was banned and she had to dash outside for a quick smoke between games.

The role of the cigarette in my mother’s morning routine and bridge game was so key to her happiness, according to the FDA, that it offset the benefits of quitting smoking by 70%. According to the New York Times, the FDA has added “happiness” either lost or gained to the cost-benefit ratio of reducing smoking. The benefits of living longer, healthier lives and the costs of health care for those with smoking-related diseases are, according to the FDA, to be discounted by 70% against the 5-minute pleasure of smoking a cigarette.

If the momentary pleasure of stopping the craving for a cigarette is the “happiness quotient”  that the FDA is calculating with smoking, then I have something to say about this.

As much as she enjoyed her cigarettes, my mother begged us, her 4 daughters, never to take up smoking. She regretted the habit: the smell, the physical demand to smoke, the expense, the increasing push out to the sidewalk. She feared the slow death that both her mother and her mother-in-law suffered from smoking: the panting to catch a breath, the rattling in the lungs, the fear that she wouldn’t get any oxygen in her next inhale. My mother tried to quit many times using acupuncture, hypnotism, the patch and willpower. Her doctor told her that quitting cigarettes was more difficult for women than quitting heroin.

Mom stopped smoking in her 70s, when she finally admitted to herself that she was having trouble walking from the parking lot to her favorite department store, Bealls. It took a combination of fear and anti-anxiety pills to quit. All her adult life, doctors had promised her improved lungs if she stopped smoking. Six months after her last cigarette, she complained to a nurse that her breathing wasn’t getting any better. Snappily, the nurse told her she was decades late in quitting if she had wanted any improvement. Her best hope, the nurse added, was to slow the slide further into COPD (chronic obstructive pulmonary disease).

It’s not like my mother wasn’t warned. Both her mother and mother-in-law drowned slowly in their lungs, my family helplessly watching. “A terrible death,” my mother said many times, shuddering with foreshadowed fear for herself.

By most standards my mother lived a long life — she died at the age of 84. The 2 decades preceding her death were a slow moving avalanche to death. Recurring bouts of pneumonia attacking her weakened lungs, her challenge to breathe increased from a frequent shortness of breath to a daily struggle to walk the 25 feet from her bedroom to the kitchen. My tall and proud mother drooped with exhaustion from the strain of trying to extract oxygen with a fraction of her tar-clogged lungs still functioning.

My 20-year-old visited my mom in the hospital when she was fighting what we didn’t know would be her last battle with pneumonia. At that point she was sitting up and seemed to be past danger. She perceived the horror he was trying to hide at the ravages of COPD that he saw in her. Honestly, she looked like hell warmed over, bony shoulders heaving for breath, skin grey and sagging, monitors beeping in a circle gathered around her.

She said, “You see that smoking is going to kill me.”

“Yes, Grammie,” he answered.

“Don’t you ever smoke or this will happen to you,” she glared. He nodded.

The final words she ever spoke to him were a few minutes later, as he hugged her goodbye, “This is all worth it if it keeps you from smoking.”

Her lungs closed up again later that night. They put a forced air mask on her that pumped oxygen into her lungs. It was the hospital’s way of getting around her explicit instructions not to intubate. She came to panicky alertness a few times over the next 2 weeks, her eyes wildly sweeping left and right, speechlessly asking what was happening and why. She finally died, her heart slowed and ended.

So let’s calculate the happiness quotient:

Happiness gained from smoking and lost if smoking is reduced or stopped:

  1. temporary calm lasting a few minutes
  2. effect of clarifying the mind, gaining focus temporarily
  3. momentary ease from the uncomfortable physical craving for a cigarette, caused by smoking
  4. looking totally cool when you’re in your teens

Benefits my mother would have gained from quitting years earlier or never smoking:

  1. relief from smoker’s hack
  2. clothing and house smell better
  3. more time spent at the bridge table with her friends
  4. the ability to walk through the department store or play golf with her friends and husband
  5. fewer lung-related illnesses like pneumonia
  6. the ability to taste and smell food again
  7. fewer midnight dashes to the hospital, gasping for breath
  8. longer life span, which means more time with her husband, children, grandchildren and great- grandchildren
  9. reduced fear of lung/throat cancer and emphysema/COPD
  10. not have had 20 years of straining to breathe, exhaustion from the effort, limited ability to walk or to enjoy any physical activity
  11. avoid drowning in her own lungs

Here’s what I have to say to the FDA: If smoking creates so much happiness than why do 62.9% want to quit?

This happiness measurement does not include the effect on the family who, in my case, has stood by helplessly by while cigarette smoking claimed another life, the 3rd in 2 generations for our small group. It won’t claim me, my husband or my son – the lesson was clear enough for us. We are non-smokers now and hopefully throughout our lifetimes.

Suzanne B. Robotti

Suzanne Robotti founded MedShadow Foundation in 2012. Learn more about Su and her mission.

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