Do You Smoke?

[gll99]

bazooka is that you or an impostor?
I don't recognize the avatar
I remember when........

Anyway ontopic.....

As I said before, after a tough struggle I finally quit smoking over 30 years ago after many years of heavy smoking but got a lot of second hand smoke from coworkers and during business meetings for a least 10 more years until the no smoking in offices and meeting rooms became a rule.
I have no expert facts except that every time I used to get a chest xray the technician would ask me to confirm that I was a smoker before letting me get my shirt back on and leave. They never ask me now. What did they see before? My blood pressure was 10 to 15 points higher as a smoker and my at rest heart rate was about 10bpm faster. Was that a good thing or bad? The nicotine had to have some effect and the tar must have darkened my lungs enough to raise some questions at the time.

My 2 grandfathers who both smoked the pipe lived into their 90's. Did they inhale? I don't recall. My parents who both died in separate accidents many years apart came from large families so I have many relatives well into their 80's. My risk factors in the city are no doubt very different than these country gals/boys so it's hard to compare probabilities and what would have happened if I had continued smoking all these many years. Who really knows? But I won't go back to it after getting my freedom from that trap. (directed at myself)
I don't lecture anyone who wants to smoke. I won't complain about the smoke because I can easily avoid it if I want. It's your life do with it as you wish but the inside of my home is smoke free. You may smoke out on the porch when you come to visit. I will provide you with a chair and ashtray and may even sit with you outside (upwind) while you enjoy your needed fix so we can have a nice chat.

[macleod]

Wow.

So, what made you decide to quit smoking? For the US, the no smoking in the office became widely accepted in the late 80's early nineties. So that means that you quit in the late 70's /early eighties. I dont recall their being any "dont smoke" ads and all the stuff that we have nowadays, so I am just curious.

Also, I am guessing that you are int he age group where the doctors (when you started) never mentioned the ill effects of smoking and they probably even said that it was OK / healthy. Do you remember doctors saying that?

[AlecWest]

I dont take what a person says as either 100% or 0%, but rather parts of what they have said.

Wise position. I certainly wouldn't want to suggest that cigarette smoking, overall, is good for anyone's health. It probably isn't. The only time I even hinted that it "might" be was in my post mentioning those two articles ... one on Med-Net, the other published by Scientific American ... both, arguably, reputable publishers of information. And, the only reason I made that post was because vitualis' use of the "bullshit" word had me saying to myself "Oh my God, another absolutist." Prior to that post, the only things I said healthwise regarding the issue of smoking were non-absolutist.

I also admit I was a bit annoyed that, in his "bullshit" post, vitualis deleted the "quotename" reference to saladonyourlincoln's post (also absolutist) saying that cigarette smoking was the ONLY known deterrent to Alzheimer's disease, making it appear that it was "me" who said it. It was NOT me. And even in my response to that post, I merely said it was a "possible" deterrent as suggested in two articles by (IMHO) two reputable publishers of information.

I do not pretend to be a medical expert. But, in the eight years I spent as a claims analyst for Blue Cross Blue Shield, working closely with physicians on matters related to utilization review, my "wisdom" on medical related issues (such as it is) is perhaps a bit more experienced than the common person on the street. And in those years, I learned that in medicine, there are no absolutes ... no rigid interpretations ... that fit any one anomaly or disease mechanism. And sometimes, a thing that popular culture thinks is deadly poisonous may be found to have beneficial properties if only medical science is openminded enough to explore them ... and not just dismiss the possibilities out of hand.

True story. Back in 1775, a British doctor named William Withering had a patient with severe heart problems. Dr. Withering could not help him. So, the patient sought out the services of an "old Gypsy woman" who treated him with herbs. The patient reported to Dr. Withering that the herbal treatment had helped solve his heart problem.

Now, had Dr. Withering listened to his patient's tale of a Gypsy herbal cure, laughed out loud, and replied, "This is bullshit -- utter, sloppy nonsense," that would have been the end of things insofar as Withering was concerned. Instead, Withering kept an open mind and investigated.

He hunted down the old Gypsy woman. She was unwilling to share her secret remedy freely ... so Withering paid her for it. And, the rest is history. Dr. Withering became credited as the man who turned the "purple foxglove," a plant considered by popular culture (and doctors) to be poisonous and deadly, into a powerful heart medication called "digitalis," prescribed even today under the drug names Digitoxin and Digoxin.

Point is, this treatment came from a "tale" that to most people would seem ludicrous on its face. But scientific inquiry proved it wasn't so ludicrous after all.

[p_l]

[gmatov]

Michael,

You are going rabid.

You are saying that all the articles that are slightly FOR smoking say "may", whereas all the articles AGAINST smoking only say "may" cause this or that.

You NEVER see a smoker in the hospital who is not suffering from a smoking related disease. Only with another disease which the MDs will surely attribute to smoking.

You NEVER see a broken leg patient in the hospital without a broken leg.

If a smoker does not get the "traditional" smoking related disease, you pass it off as not germane.

A forty year old self proclaimed exercise nut dies of a heart attack while running, well, big deal, one of a million.

A twenty year old college hoops player dies on the court, well, big deal, one of a million.

A thousand 90 year olds smoke every day, you are gonna die. Maybe you'll be on your 3rd or 4th primary care physician, but you are gonna die. You might not be there to watch, and say I told you so, but they will die.

I don't know where the penguin came up with the 53,000 figure. Everything I had read said 300,000 "secondhand smoke" deaths. I like that in particular, as the ACS and all the rest can't say how many die of "first hand smoke", just that "second hand smoke" is horrible, some of the posters here have said they go to bars for 6 or 8 hours and cough up their lungs when they leave.

Not while they are there in the miasma, mind you, but when they leave.

You are like all the other medicos, brainwashed by the med schools. The last time I had an injury at work, a bad abrasion, the MD asked if I smoked, said yes, he said, Quit. Sure, like it will keep 300 pounds of iron from shearing the little meat there is from a shin.

As well, the last time I took a physical at wotk, I had to blow into the lung capacity tester. "Well, plain to se you're a non-smoker." Well, no, pulled my pack out and said at least one pack a day.

You MD types have a one size fits all mentality. And, a we know more than you do, mentality. And you are SO MUCH smarter than the rest of us. Why, you probably prescribed Vioxx till the day it was pulled from the market. And you probably STILL prescribe Celebrex, because the maker says it ain't so.

You ain't gods. You're just mechanics, with a piece of flesh and bone as your workspace rather than an auto or a machine tool.

I KNOW that I can make a machine tool as good as new when I minister to it. You can only guess if the books covering the same illness will pertain to the poor soul on your examination table at any given moment.

Get off your high horse, pal. The web has ALL the things you want to know. We just can't get a prescription as easily as from an MD.

(Really a good thing for the hypochondriac, huh? Diseases they didn't even know existed. Like the one with absolutely no symptoms, a friend, actually a co-worker, said "Oh-Oh, I got that." He got Lyme disease in an area that has no Lyme disease carrying ticks.

hell, he's still living and been on disability 5 years now.

Cheers,

George

[gmatov]

"Read the above poll. About half of people here don't smoke and hate being around people who smoke! That's why there is the change. There are simply more non-smokers than smokers. wink.gif"

Michael,

I beg your pardon, but "about half" sounds like GW's "mandate".

Is that, or is that not, a majority? And if it is, does that mean you should hammer those poor souls who still smoke? Are you also a death foe to the pro-choicers, as you seem to be to the pro smokers, ie, you are no f'in good,you rotten bastards, you cause medical costs to rise for me.

According to you in your prior posts, smokers die young. How can we cost as much as a 90 year old Altzheimer's patient who has been in a home for 20 year?

How can we cost as much as a big fat broad who has to have pieces of limb cut off at intervals because of diabetes and lack of blood circulation?

How can we cost as much as the thousands who have had heart attacks from the drugs YOU, as an MD, have prescribed over the years that Vioxx for one, and Celebrex, for another, and Fen-Fen, for another, and God knows how many other drugs you, as MDs, God's anointed, trained by the Detail Men from Merck, Pfizer, Astra Zenica, etc.,

You know, they keep saying that every large building here in the US should have a portable defibrillator available. And every story about it says that half of all heart attack victims die before they get to the hospital. I guess that logically means that the other half of heart attack victims die after they get to the hospital.

So, what's the biggie?

I agree, there is a jerk up above who should be able to see a yellow card, as I can, for his obnoxious insistence that the thread be locked. I thought there were only 2 people who could insist on that, at least one of whom has had a thread locked on me. A Brit, wouldn't you know?

Cheers,

George

[Shadowmistress]

Oh damn!
Batten down the hatches! Run for cover! Hit the deck! Every man for himself!

[vitualis]

I also admit I was a bit annoyed that, in his "bullshit" post, vitualis deleted the "quotename" reference to saladonyourlincoln's post (also absolutist) saying that cigarette smoking was the ONLY known deterrent to Alzheimer's disease, making it appear that it was "me" who said it. It was NOT me. And even in my response to that post, I merely said it was a "possible" deterrent as suggested in two articles by (IMHO) two reputable publishers of information.

Whoops. But, when I quote multiple people in a single post, I tend not to put in their handles except for the first one.

True story. Back in 1775, a British doctor named William Withering had a patient with severe heart problems. Dr. Withering could not help him. So, the patient sought out the services of an "old Gypsy woman" who treated him with herbs. The patient reported to Dr. Withering that the herbal treatment had helped solve his heart problem.

Ah... the power of anecdotes. Anecdotes give the illusion of truth where there is actually only limited evidence and interpretation.

Firstly, it is extremely unlikely that digoxin "solved" the heart problem as such. Digoxin is useful in the symptomatic treatment of heart failure but it does not an effect on mortality. Secondly, I suggest that you have a look at the Merck drug formulary from 100 years ago (which was recently re-released with the 17th Edition of the Merck manual).

A lot of those the "medications" in there are as a result of "herbal" treatments as well. Most of those are not only useless, but frankly dangerous.

The simple fact of the matter is, everything has possible beneficial usages. That, however, is not a justification to persist with (or recommend) something that is known to be harmful.

@ George:

You are saying that all the articles that are slightly FOR smoking say "may", whereas all the articles AGAINST smoking only say "may" cause this or that.

George, please actually follow the thread. There are observational studies that suggest smokers have a lower rate of neurodegenerative disorders which may be due to the nicotine.

It is, however, FACT that smoking causes lung cancer and COPD, increases the risk of heart attacks and strokes, increases the risk of peripheral vascular disease.

The weight of evidence is not equal.

It is not too different to someone arguing FOR the consumption of arsenic because it MAY be an aphrodisiac.

It should be noted that although the hypothesis of the effect of nicotine as a neurodegenerative protectant is biologically plausible, it is extemely difficult to prove. Why? It would not be ethical to give someone nicotine (even sans cigarettes) due to its already KNOWN cardiovascular adverse effects (hence why the articles mention looking for nicotine like substances).

You NEVER see a smoker in the hospital who is not suffering from a smoking related disease. Only with another disease which the MDs will surely attribute to smoking.

Whoa... George, I think you are the rabid one here. I see patients all the time in hospital who smoke and are in for something else. I can also tell you that smokers generally stay in hospital longer even for non-smoking related illness. A great example would be elective surgical patients. They are harder to anaethetise. There are more likely to have anaesthetic complications. They are more likely to have wound infections.

You NEVER see a broken leg patient in the hospital without a broken leg.

Actually, I've sent quite a few people with broken bones home from the ED. I'm not sure what you're getting at.

You MD types have a one size fits all mentality. And, a we know more than you do, mentality. And you are SO MUCH smarter than the rest of us. Why, you probably prescribed Vioxx till the day it was pulled from the market. And you probably STILL prescribe Celebrex, because the maker says it ain't so.

You ain't gods. You're just mechanics, with a piece of flesh and bone as your workspace rather than an auto or a machine tool.

Hmm... George, I think you really need to chill out. You MD types have a one size fits all mentality? I'm sorry, but you just definied hypocrisy in that one sentence.

Firstly, I can guarantee that I do know more than you in terms of medicine. Your previous posts on health issues prove that. And guess, what? Society demands that I known more than you in these issues.

Just like I'm pretty sure that your regular lawyer knows law more than me (and probably most laypersons) and an automechanic knows his field of expertise.

As for rofecoxib. Yes, I did prescribe it on occasion where it was indicated. And no, I generally don't prescribe celecoxib (I think the relevant entries in my blog make that clear)... And guess, what? I stopped prescribing rofecoxib when it's adverse effects because clear. What more do you expect?

You deem us not gods (which I thoroughly concur with) and yet you have a god-like expectation of the profession (i.e., we know a priori everything there is to know about every possible illness and medication). You don't like us? Don't see us! Health care is voluntary.

Get off your high horse, pal. The web has ALL the things you want to know. We just can't get a prescription as easily as from an MD.

Sorry, but that is like saying that the web has all there is to know about being an engineer or a lawyer or accountant or machine toolist, or any other specialised skill. If you actually have a trade, you would know that to be false. Your previously posts on PUD and GORD proved that. Time to get off YOUR high horse George?

Best regards.

[vitualis]

Is that, or is that not, a majority? And if it is, does that mean you should hammer those poor souls who still smoke? Are you also a death foe to the pro-choicers, as you seem to be to the pro smokers, ie, you are no f'in good,you rotten bastards, you cause medical costs to rise for me.

What?

Yes, I would say that is a majority.

As for "death foe"? That's rather strong words. I am a "foe" to pseudo-scientific twaddle.

The "pro-smokers" who like to masquerade as "pro-choicers" seem to love to spout pseudoscience or at least fill the debate with FUD. However, it doesn't really matter. If you don't like your government's decisions, you guys live in a democracy. No one is trying to ban cigarettes. Just smoking in enclosed public spaces (which undeniably makes sense from a public health perspective).

According to you in your prior posts, smokers die young. How can we cost as much as a 90 year old Altzheimer's patient who has been in a home for 20 year?

Your point being? We can't treat Alzheimer's. There is no quick fix that putting money into will fix that problem. People cost the health budget the most generally in the last year of their life. Dying young isn't really all that relevant because you are dying from chronic illnesses.

How can we cost as much as a big fat broad who has to have pieces of limb cut off at intervals because of diabetes and lack of blood circulation?

Because that "big fat broad" is probably a smoker as well.

How can we cost as much as the thousands who have had heart attacks from the drugs YOU, as an MD, have prescribed over the years that Vioxx for one, and Celebrex, for another, and Fen-Fen, for another, and God knows how many other drugs you, as MDs, God's anointed, trained by the Detail Men from Merck, Pfizer, Astra Zenica, etc.,

George, get a grip.

You know, they keep saying that every large building here in the US should have a portable defibrillator available. And every story about it says that half of all heart attack victims die before they get to the hospital. I guess that logically means that the other half of heart attack victims die after they get to the hospital.

So, what's the biggie?

The biggie is pretty obvious but obviously escapes you George. When you have a VT/VF cardiac arrest (which is different from a generic "heart attack"), minutes count. If you are defibrillated on the scene, your chances of surviving are pretty good -- very good (?50-70%). By the time it takes to get you to a hospital, your chances of revival are bad, VERY bad. Even if we get your heart pumping again (? 20%) the chances of you leaving hospital without permanent brain damage is very low (? 1-4%).

There are very few things shown to provide a clear benefit in survival for someone with a cardiac arrest. Early cardiac defibrillation is one of the few.

Regards.

[gmatov]

Michael, Michael, Michael,

I should hope to hell that you know more than I as regards Medicine.

My cousin took Celebrex for over 6 years, for pain and, I guess, as an anti-inflamatory. She had a heart attack, at about 58. We come from a long lived line, her mother is still living at 90, my youngest aunt just celebrated her 84th Christmas Eve, my own mother died at 87, and our G'mother died at 94. her father lasted till his 80's, my own was 79 at death. So, we do not come from short lived stock. By the way, he was born in 1884, so he lived through some of the diseases that were incurable at the time, even down to a simple cut, which could become septicemic. That wasn't treatable till WWII, with penicillin. You MDs could only burn incense and prey. Or give some laudanum to ease the passing.

PUD and GORD? Whoa. You're back in your money making guise. Give 'em Zantac, come back next month for another bottle, 1500, US, per year.

Or, go to Pepcid AC, which "I know my ulcer medicine is healing my ulcer, but when I really need it, I take a Pepcid AC." Whoa, your 1500 buck pills are curing your ulcer, but you take an OTC for when the "Acid really gets bad"? No TUMS, no Maalox?

I DON"T go to MDs, as a rule. I break something, I go. I have a back problem, right now, that even a neurosurgeon can't fix. So, what the hell would I come see you for?

One size fits all? "Quit smoking." Cut down on fats.", "Exercise more."

What more does an MD tell you? He doesn't say you need more calcium, more copper, more selenium, more chromium. He might say you need B-12, and I just happen to run a fat clinic that gives them, so bend over and drop your drawers.

When MDs start doing medicine, rather than "practicing" it, I may go on a timely basis. You don't know what you are doing, why should I accept your ministrations?

Cheers,

George

[Faustus]

Only the brown filtered ones do that.

[AlecWest]

True story. Back in 1775, a British doctor named William Withering had a patient with severe heart problems. Dr. Withering could not help him. So, the patient sought out the services of an "old Gypsy woman" who treated him with herbs. The patient reported to Dr. Withering that the herbal treatment had helped solve his heart problem.

Ah... the power of anecdotes. Anecdotes give the illusion of truth where there is actually only limited evidence and interpretation.

True. But, not all discoveries come about by raw research. Some discoveries can trace their origins to a researcher who had the curiosity to follow up on an anecdote to see if there is some truth to it.

Firstly, it is extremely unlikely that digoxin "solved" the heart problem as such.

True, it didn't. But in 1775, and in the patient's eyes, it did.

Digoxin is useful in the symptomatic treatment of heart failure but it does not an effect on mortality.

It might have a dramatic effect on mortality if you need Digoxin but don't have it at the time you need it. 8)

Secondly, I suggest that you have a look at the Merck drug formulary from 100 years ago (which was recently re-released with the 17th Edition of the Merck manual).

A lot of those the "medications" in there are as a result of "herbal" treatments as well. Most of those are not only useless, but frankly dangerous.

Amen to that. I'm constantly amazed at the number of people who buy herbal remedies without even bothering to run them past the PDR to look for contraindications. Scary.

The simple fact of the matter is, everything has possible beneficial usages. That, however, is not a justification to persist with (or recommend) something that is known to be harmful.

Believe it or not, we're in complete agreement on that ... and it was all I was really trying to say. Any substance is a Sword of Damocles, swinging both ways. For every indication, there's a contraindication. And, each person is entitled to know of the potential benefits (indications) and risks (contraindications) of the substances they use ... and decide whether the benefits are worth the risk.

In smoking, I've probably made a very unwise decision. But, I'm also convinced that smoking cannot be ALL bad. The researchers who are studying the effects of nicotine, nicotinic acid and nornicotine on the hippocampus and other regions of the brain where memory issues reside probably have different opinions on that ... but would probably NOT use the term "smoking" in a beneficial way. They'd be concerned with the substance itself ... in this case, nicotine or byproducts of nicotine. But, the relationship between "smoking" (anecdotal) and the presence of nicotine/byproducts in the brain, performing the "beneficial" action, is inescapable since non-smokers would not show that presence.

But as you said, smoking as a "delivery system" is probably less efficient and potentially dangerous. I do hope their research bears fruit and that a means is found to safely deliver the correct substance to the correct region. My grandmother (a non-smoker) died with Alzheimer's ... and watching her waste away, day by day, is a horror I would not wish on my worst enemy.

[Faustus]

Congrats all this has been the longest offical poll thread ever. Its now 2005 and everyone is likely trying to quit smoking. :/ In honor of that I'm closing this long running burned out thread.

Flaystus (who has not yet started trying to quit smoking)


for further discussion I'd suggest perhaps the off site politics forum?
www.politick.org.uk