- 注册
- 2002-10-07
- 消息
- 402,225
- 荣誉分数
- 76
- 声望点数
- 0
Every time I wrote about the ever-more-tragic opioid crisis in 2017, I felt a shameful pang of recognition.
Last month, a 20-year-old woman told me how using drugs made her lead what she called a double life of lying, sneaking around and wilful blindness to the harm she was doing to herself — and to her family.
It was a truth she could no longer deny when she awoke in a hospital bed after an overdose to see their stricken faces.
But, even then, it took her several tries to stop.
There were nearly 3,000 apparent opioid deaths in Canada in 2016; smoking kills more than 10 times as many Canadians a year after taking an average of at least a decade off their lives.
I know that I have kept smoking through such should-have-been wake-up calls as watching my father struggle for air as he died of cancer. He’d never taken a single puff.
The latest was a summer night at bedtime, that quiet moment when busy kids relax against you in the dark and confide. My nine-year-old told me that he knew I smoked, although he thought, oddly, that my vice was cigars. Didn’t I know it was bad for me?
How could I not? I’ve known it since his age. I’ve quit for entire years at a time yet always reached for the Pall Malls again and soon would be back to a dozen a day. Even in 2017, in an age of gruesome labels, smoke-free sidewalks and ubiquitous vaping, I’m one of the final half-a-dozen smokers clustered at this newspaper’s back door on the coldest days.
“I don’t want you to die, Mummy,” my son said in a moment that felt both agonizing and ripped from the pages of the same Grade 3 health curriculum that had once made me tell my own mother the same thing.
The little voice whispering that I had to quit got more and more insistent, but it wasn’t until a week before Christmas that I found myself in Marta Klepaczek’s office at the University of Ottawa Heart Institute.
It was 12 hours after my last cigarette and I was feeling downright edgy.
An advanced care nurse, she manages the institute’s smoking-cessation program that anyone can call on for help using what’s known as the Ottawa Model. It’s been adopted by more than 300 Canadian hospitals and around the world.
I felt like apologizing for my stupidity when I ask why we keep smoking, but Klepaczek is utterly non-judgmental.
The short, obvious answer: It’s an addiction cemented through reinforcement and some people, for myriad reasons ranging from genetics to environment, find it harder to beat. She’s heard smokers refer to cigarettes as their best friend, their steady, a lover.
“People still refer to it as a lifestyle choice when, in fact, it is a true addiction,” Klepaczek said. “And not only a true addiction but it is comparable to a chronic disease. I think if smokers understood that better they would also maybe take lapses or relapses not as a personal failure and a reflection of weakness but the fact they need access to more support and support for longer.”
I started in an era when a best friend’s mom could still send us to the corner store to buy the menthol super slims we would steal from her purse to practise blowing smoke rings. I was the sucker who coughed, sputtered, then loved it.
I smoked my way, a few a day, through high school and university. Then cigarettes were my work companion, filling time waiting at crime scenes or hanging outside the courthouse, where I bummed smokes to the just-released from jail and the occasional judge.
Wanting kids got me to butt out but I soon lit up again, starting with what I now know is impossible for an addict: ‘just one’ cigarette.
‘I’ll never again have a smoke at sunrise in my garden with a cup of coffee, make an unlikely new friend in a knot of smokers, or be Joni Mitchell on an album cover, smoke curling elegantly from my fingers.’ Ashley Fraser/Postmedia
Meanwhile, everyone I know had quit — except smokes cadged from me.
I’m one of the about one in six Canadians who still smoke, either every day or occasionally, a rate the federal government hopes to push down to fewer than one in 20 by 2035. Trouble is, those who haven’t quit are likely still smoking because we’re really addicted. I’d have to be — I’m paying about $2,400 a year for the privilege of getting out of breath running up the stairs.
I learn from Klepaczek that I have one big disadvantage — that I smoke within 30 minutes of rising — but two major advantages: I don’t live with anyone who smokes (my husband has never even tried one) and my home and car are long since smoke-free.
She goes through the options: prescription drugs such as Champix and Zyban and over-the-counter nicotine replacement therapy, both long-acting — patches — and short-acting — inhalers, gum, lozenges or mouth spray.
When I say that I’m going to try cold turkey, Klepaczek tells me to go for it but encourages me to have a plan ready for what I’ll do when a craving strikes.
She has some helpful insider tips, like that quitters should cut back on coffee to avoid becoming a jittery mess because smokers actually metabolize caffeine twice as quickly as non-smokers. And she emphasized the four Ds of damping the desire — distraction, deep breaths, drinking water and delay.
“An average craving is two to five minutes,” she said. “What you’re feeling is a want, not a need. That’s the paradigm shift.”
And Klepaczek sends me off with some good news.
Twelve hours after my last smoke, a quick breath test shows that the carbon monoxide level in my blood has fallen to near that of a non-smoker, down to six parts per million from what was likely 20 ppm.
Within 48 hours, my risk of a heart attack will go down and my sense of taste and smell get better. Within 72 hours, my lungs will relax, making it easier to breathe.
In a year, my risk of heart attack will be half that of a current smoker. Within 10 years, my risk of dying from lung cancer will have fallen by half.
I leave the heart institute, wending my way through a phalanx of smokers and their plumes of smoke. As of Jan. 1, a new provincial law means they now have to step off hospital property.
I think bitterly that I wouldn’t have to pass people with needles in their arm if I was kicking heroin.
I pick up some nicotine mouth spray at the drugstore, planning never to need it. I have a week off work with nothing to do but quit, right?
Day One, I feel great and inspired by Klepaczek’s and my family’s encouragement, I smugly go to a yoga class and cook a celebratory dinner.
By Day Two, I’m antsy.
On Day Three, yoga again. But I fall down trying to do the tree pose and wind up in the fetal position, tears pooling on my mat. I yell at my kids. I drink too much red wine.
It’s hard. I literally dream about smoking. I take a lot of baths and read about the nefarious history of the tobacco industry.
Day Eight — Christmas Eve — and I pick a fight with my ever-patient husband and flee a party because all I want to do is smoke. Or scream. Or both.
Back at work — Day 10 — colleagues roar with laughter when I tell them without irony that “I have rage.”
Day 12, heading into the last weekend of 2017, I feel like the worst is over, thanks to nicotine mouth spray when an endless supply of carrot sticks and chewing gum aren’t enough.
I hate that I’ll never again have a smoke at sunrise in my garden with a cup of coffee, make an unlikely new friend in a knot of smokers, or be Joni Mitchell on an album cover, smoke curling elegantly from my fingers.
But I’ll also never huddle in a doorway in a blizzard to get my fix, hide guiltily from my neighbours in my pyjamas or have that lurch in my stomach when I realize I’ve smoked my last cigarette and the store is closed.
Most of all, I hope I’ll never struggle to breathe, a tube in my nose attached to a clanging oxygen tank.
On Day 11, I had asked my nine-year-old — the kid who’d begged me in the moonlight to quick smoking — if he’d noticed any changes.
He shrugged, his nose in a book.
“Your breath smells better,” he said, then looked up and smiled.
“It’s hard, but I know you can do it.”
Need help quitting? Call the Quit Smoking Program at the University of Ottawa Heart Institute at 1-866-407-7848. For information on all quit-smoking programs, visit MyQuit.ca or call 1-877-376-1701.
查看原文...
Last month, a 20-year-old woman told me how using drugs made her lead what she called a double life of lying, sneaking around and wilful blindness to the harm she was doing to herself — and to her family.
It was a truth she could no longer deny when she awoke in a hospital bed after an overdose to see their stricken faces.
But, even then, it took her several tries to stop.
There were nearly 3,000 apparent opioid deaths in Canada in 2016; smoking kills more than 10 times as many Canadians a year after taking an average of at least a decade off their lives.
I know that I have kept smoking through such should-have-been wake-up calls as watching my father struggle for air as he died of cancer. He’d never taken a single puff.
The latest was a summer night at bedtime, that quiet moment when busy kids relax against you in the dark and confide. My nine-year-old told me that he knew I smoked, although he thought, oddly, that my vice was cigars. Didn’t I know it was bad for me?
How could I not? I’ve known it since his age. I’ve quit for entire years at a time yet always reached for the Pall Malls again and soon would be back to a dozen a day. Even in 2017, in an age of gruesome labels, smoke-free sidewalks and ubiquitous vaping, I’m one of the final half-a-dozen smokers clustered at this newspaper’s back door on the coldest days.
“I don’t want you to die, Mummy,” my son said in a moment that felt both agonizing and ripped from the pages of the same Grade 3 health curriculum that had once made me tell my own mother the same thing.
The little voice whispering that I had to quit got more and more insistent, but it wasn’t until a week before Christmas that I found myself in Marta Klepaczek’s office at the University of Ottawa Heart Institute.
It was 12 hours after my last cigarette and I was feeling downright edgy.
An advanced care nurse, she manages the institute’s smoking-cessation program that anyone can call on for help using what’s known as the Ottawa Model. It’s been adopted by more than 300 Canadian hospitals and around the world.
I felt like apologizing for my stupidity when I ask why we keep smoking, but Klepaczek is utterly non-judgmental.
The short, obvious answer: It’s an addiction cemented through reinforcement and some people, for myriad reasons ranging from genetics to environment, find it harder to beat. She’s heard smokers refer to cigarettes as their best friend, their steady, a lover.
“People still refer to it as a lifestyle choice when, in fact, it is a true addiction,” Klepaczek said. “And not only a true addiction but it is comparable to a chronic disease. I think if smokers understood that better they would also maybe take lapses or relapses not as a personal failure and a reflection of weakness but the fact they need access to more support and support for longer.”
I started in an era when a best friend’s mom could still send us to the corner store to buy the menthol super slims we would steal from her purse to practise blowing smoke rings. I was the sucker who coughed, sputtered, then loved it.
I smoked my way, a few a day, through high school and university. Then cigarettes were my work companion, filling time waiting at crime scenes or hanging outside the courthouse, where I bummed smokes to the just-released from jail and the occasional judge.
Wanting kids got me to butt out but I soon lit up again, starting with what I now know is impossible for an addict: ‘just one’ cigarette.
‘I’ll never again have a smoke at sunrise in my garden with a cup of coffee, make an unlikely new friend in a knot of smokers, or be Joni Mitchell on an album cover, smoke curling elegantly from my fingers.’ Ashley Fraser/Postmedia
Meanwhile, everyone I know had quit — except smokes cadged from me.
I’m one of the about one in six Canadians who still smoke, either every day or occasionally, a rate the federal government hopes to push down to fewer than one in 20 by 2035. Trouble is, those who haven’t quit are likely still smoking because we’re really addicted. I’d have to be — I’m paying about $2,400 a year for the privilege of getting out of breath running up the stairs.
I learn from Klepaczek that I have one big disadvantage — that I smoke within 30 minutes of rising — but two major advantages: I don’t live with anyone who smokes (my husband has never even tried one) and my home and car are long since smoke-free.
She goes through the options: prescription drugs such as Champix and Zyban and over-the-counter nicotine replacement therapy, both long-acting — patches — and short-acting — inhalers, gum, lozenges or mouth spray.
When I say that I’m going to try cold turkey, Klepaczek tells me to go for it but encourages me to have a plan ready for what I’ll do when a craving strikes.
She has some helpful insider tips, like that quitters should cut back on coffee to avoid becoming a jittery mess because smokers actually metabolize caffeine twice as quickly as non-smokers. And she emphasized the four Ds of damping the desire — distraction, deep breaths, drinking water and delay.
“An average craving is two to five minutes,” she said. “What you’re feeling is a want, not a need. That’s the paradigm shift.”
And Klepaczek sends me off with some good news.
Twelve hours after my last smoke, a quick breath test shows that the carbon monoxide level in my blood has fallen to near that of a non-smoker, down to six parts per million from what was likely 20 ppm.
Within 48 hours, my risk of a heart attack will go down and my sense of taste and smell get better. Within 72 hours, my lungs will relax, making it easier to breathe.
In a year, my risk of heart attack will be half that of a current smoker. Within 10 years, my risk of dying from lung cancer will have fallen by half.
I leave the heart institute, wending my way through a phalanx of smokers and their plumes of smoke. As of Jan. 1, a new provincial law means they now have to step off hospital property.
I think bitterly that I wouldn’t have to pass people with needles in their arm if I was kicking heroin.
I pick up some nicotine mouth spray at the drugstore, planning never to need it. I have a week off work with nothing to do but quit, right?
Day One, I feel great and inspired by Klepaczek’s and my family’s encouragement, I smugly go to a yoga class and cook a celebratory dinner.
By Day Two, I’m antsy.
On Day Three, yoga again. But I fall down trying to do the tree pose and wind up in the fetal position, tears pooling on my mat. I yell at my kids. I drink too much red wine.
It’s hard. I literally dream about smoking. I take a lot of baths and read about the nefarious history of the tobacco industry.
Day Eight — Christmas Eve — and I pick a fight with my ever-patient husband and flee a party because all I want to do is smoke. Or scream. Or both.
Back at work — Day 10 — colleagues roar with laughter when I tell them without irony that “I have rage.”
Day 12, heading into the last weekend of 2017, I feel like the worst is over, thanks to nicotine mouth spray when an endless supply of carrot sticks and chewing gum aren’t enough.
I hate that I’ll never again have a smoke at sunrise in my garden with a cup of coffee, make an unlikely new friend in a knot of smokers, or be Joni Mitchell on an album cover, smoke curling elegantly from my fingers.
But I’ll also never huddle in a doorway in a blizzard to get my fix, hide guiltily from my neighbours in my pyjamas or have that lurch in my stomach when I realize I’ve smoked my last cigarette and the store is closed.
Most of all, I hope I’ll never struggle to breathe, a tube in my nose attached to a clanging oxygen tank.
On Day 11, I had asked my nine-year-old — the kid who’d begged me in the moonlight to quick smoking — if he’d noticed any changes.
He shrugged, his nose in a book.
“Your breath smells better,” he said, then looked up and smiled.
“It’s hard, but I know you can do it.”
Need help quitting? Call the Quit Smoking Program at the University of Ottawa Heart Institute at 1-866-407-7848. For information on all quit-smoking programs, visit MyQuit.ca or call 1-877-376-1701.
查看原文...
