I smoke at least a cigarette a day, on weekends maybe 3 a day. I
quit totally for 7 months. I can go a few days without any. I
psychologically need cigarettes. What is the harm of 1 smoke at
the end of the day? My diet has improved over the past few months
and I am not a sedetary person. I also do not have high blood
pressure.
_______Dear Stillsmoking, I think this type of "controlled smoking" is generally a bad idea. Shutting the door all the way is always safer than keeping it open a crack. Doors that are open a crack have a way of blowing wide open and hitting you in the face. Let me show you my answer to a question similar to yours which I posted just yesterday on my Ask DrSteve web site:
Reproduced by permission of the author from http://www.DrSteve.org
Dear DrSteve, You've touched on the chances of a former smoker returning to the habit by occasionally indulging. However, I cannot convince
my husband that his will power isn't greater than that. What are the statistics and health effects for someone who indulges once or
twice a month (3-4 cigarettes each time)? How long would it be before he succumbed? He says he has no cravings the next day,
but he was addicted to cigarettes for 11 years (to the tune of a pack a day). It's been a year since he quit and he didn't start
indulging until 6 months of total abstinence. Is he on to something, or is he just kidding himself? Mrs. Will Power Dear Mrs. Power, If I was a betting man, I would bet that within a year or two your husband will be back to smoking a pack a day. Unfortunately,
my statement is based more on "clinical intuition" than on rigorous research. I don't know of any published research which studies
the feasibility of "controlled smoking" in previously addicted smokers. I doubt that such studies are being performed, because reputable researchers all know how addictive nicotine is and how likely it
is, in general, that someone who was previously addicted to a substance will become re-addicted if they stop using the substance
altogether and then attempt to use their "drug of choice" in a controlled fashion. For instance, many studies have been performed which attempt to look at whether or not alcoholics can become "controlled
drinkers." The evidence suggests that 95% of them end up becoming dependent on alcohol all over again when they try to drink in
a controlled fashion. Nicotine is a more addictive substance than alcohol. A greater percentage of users become dependent on it,
and it is definitely harder for most smokers to quit and stay quit than it is for most alcoholics to stop drinking and remain sober. If
this logic applies, then your husband's chances of controlling his smoking indefinitely are no better than 1 in 20! If your husband was my patient and I couldn't talk him into giving up his "occasional" cigarettes, I would attempt to strike a bargain
with him. I would ask him to tell me how he would know he was beginning to lose control of his smoking. He would probably
acknowledge that increasing his consumption beyond a certain point (either in terms of cigarettes per month, or times smoking per
month) would be an indication that he was heading back to daily smoking. I would then attempt to cut a deal with him. If we
agreed that he was going to limit himself to 10 cigarettes per month (an amount which has fairly minor health consequences if it can
be maintained at that level), I would encourage him to keep a log of his smoking, and try to convince him to agree to quit
altogether as soon as he exceeded his monthly quota. Negotiated "quit plans" such as this are more acceptable to most people
than plans which are dictated by an authority figure or family member. I believe that your husband has resumed smoking because his brain's reward center missed the kick that it was getting from
nicotine. The reward centers of former addicts have demonstrated what they are capable of doing when left to their own devices.
Will power and good intentions are just great, but the allure of repeatedly releasing the "feel good" neurotransmitter dopamine in
the brain's pleasure center can humble just about anyone, especially those who have already been there. Your husband should quit
while he is ahead (NOW), but, unfortunately, he may have to learn this the hard way. Good luck to the both of you! DrSteve _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ I hope you see what I am driving at. People should quit while they are ahead, and close those doors as securely as they can.
The information posted herein is for general educational purposes only. Please consult your physician for specific medical advice regarding your condition.
Steve Adelman, M.D.
Keywords: smoking, controlled smoking, chipping
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