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What do you do in this situation?

Misty Avich

Hellooooooooooo!!!
V.I.P Member
My husband is a compulsive smoker and has been rushed to hospital 4 times this year due to COPD flare-ups. The last time he did he had a mild heart attack and I witnessed it, which really frightened me. But as soon as he was out of hospital a few days later all he was worrying about was having a cigarette. I thought that experience would be enough to put him off smoking for life but it obviously didn't.

He won't use e-cigarettes, and despite partially wanting to quit smoking he won't do it. I've tried to support him by buying nicotine patches but he still went back on to smoking. I don't know how else to help.

He is on prescribed medication and inhalers, but every now and then he still gets a day or two where he is out of breath just sitting, even though he's taking his medication and inhalers regularly. This weekend is one of those times. But it's also hard for me, because when he's out of breath like this he snaps at me and spoils my weekend, which I look forward to after 5 days of work. I find it hard to give much sympathy, because of the way he carries on smoking and won't help himself. I know all this could be avoided if he quit smoking.

This is one thing I hate about democracy. The law says you "can't stop" a person from smoking if they don't want to quit, but that means you have to put up with the consequences of their smoking-related illnesses, and you constantly worry about them because you love them, but they are no joy to live with when they can't breathe.

You only get one pair of lungs. Look after them. There's no excuse to smoke, not even "I am stressed". Be like me, I've never smoked. I tried it when I was 12 but I thought it wasn't worth the hassle so I didn't do it any more.
 
That's just the problem with addictions, and smoking is extremely addictive. To them, nothing else matters, they have to smoke, and they can become very selfish because it doesn't just affect them, but those around them. They won't stop for someone else, or for their own health even. The only way for them to stop is if they themselves want to stop. Unless they want to stop, there isn't much you can do.
 
The one amazing thing I've seen with any kind of pattern was how a group of former employees I knew were all hardcore smokers. They tried hypno-therapy and they quit. Though one ended up lighting up a cigar a few years later and he backslid into the habit. He finally quit about six months after that.

Will power is simply not enough when it comes to nicotine addiction. People often don't realize how nicotine can be every bit as addictive as can heroin.

"Partially wanting to quit". Your own words. Keep trying, and save his life.
 
What I am about to say here is going to come off cold and unsympathetic, but in these situations, couples in this situation need to make rational decisions even if emotionally it's difficult to face.

I work as a respiratory therapist at a large metropolitan medical center. I am also a respiratory therapy instructor. Nicotine addiction, for some, is simply too powerful. Some people have the genes for addiction and are highly responsive to those chemicals, much more than others. Reason and logic are irrelevant. All the education is irrelevant. All the desperate, tear-filled, pleading with him is irrelevant. Your husband knows full well what it is doing to him. Giving him an emotional lecture won't change what damage has been done, nor will stop what he is going to do in the future. Frankly, there's little evidence, within the context of advanced, adult COPD, that stopping smoking will reverse the damage that has been done. Any medications he is taking to manage symptoms are negated by repeatedly smoking. Any long-term improvements from medications will only be from NOT smoking.

For many people, it's a tremendous amount of mental and physical energy, will power, and goal-oriented behaviors. For sure, many people can break addiction. For others, especially when it comes to the state of health your husband is in, he may be of the mindset, "What's the purpose? I've only a short time to live, might as well enjoy my cigarettes." It's a frustrating and sad thing to watch it all unfold in front of you.

Ultimately, it has to be his decision and his will. He has to do it for himself, not you.

All I can suggest is, if you haven't done so already, make sure his affairs are in order. Contact a lawyer, get the Will, the Advanced Medical Directives, all that sorted out. Most people with advanced COPD, once they get the point of multiple admissions per year, don't live much longer.

I know this is not what you wanted to hear. I probably overstepped my bounds here, but do understand, I've been doing this for nearly 40 years and seen many a loving, well-meaning family member make regretful decisions. I know there are physicians that love to talk to their patients with flowery, positive language. The hopeful optimism. The "sugar-coating". However, all this clouds rational decision-making. Nobody wants to be on a mechanical ventilator with a tracheostomy tube lingering in a hospital ICU. Be very careful what you wish for when it comes to medical interventions.

All I can say, I would not want to be in your situation. It's painful enough to watch from a caregiver perspective. Please understand all of this does come from a good place.

Take care.
 
I don't get at him too much because I do know how addictions work. While I've never been addicted to smoking, alcohol or drugs, I have been addicted to internet forums in intense ways that was probably how a smoker feels. My therapist had told me to avoid the internet forums for one week but telling that to me was as useless as telling a smoker to just not smoke for one week. And giving me all these tips and advices, such as ''distract yourself on to other things'' and ''turn your phone off and leave it in another room'' are also a waste of time, because it's like telling a smoker the same and to hide their cigarettes or not buy any. It's all utterly hopeless advice when you have an addiction. The internet forums were damaging my mental health but I still carried on, because I got twitchy otherwise and just had to post. I had to.

So I do keep this in mind when it comes to addiction. But at the same time I still worry about my husband's health and what he's doing to himself. I told him to not give up for me, but to give up for his own sake. He spent the whole of the pandemic frightened of catching the virus and dying, but the knowledge of cancer and other smoking-related diseases doesn't seem to have the same effect.

This is why I don't feel smoking is a choice. Surely when addiction gets the better of you, it controls you, and it no longer is a choice but is an obligation, a habit some people might not even want to have but find it difficult to seek help. If smoking wasn't a risky, unhealthy habit then it wouldn't be so bad.
 
This is how my wife's dad passed away heavy smoker. could not breath went to hospital. Things got worse refused certain treatments said goodby to wife and children passed away few days later.
 
Speaking as an addict in recovery, sometimes it seems to be those who love us that suffer the most. The relationship between an addict and their drug can be impenetrable from the outside.

I’m sorry you’re dealing with this, Misty. It’s good to get support from other people who are in a partnership with an addict. Something like Al-Anon in the United States comes to mind. A place where those who are attached to addicts can learn and support each other.

Not exactly applicable but, at least a place to start:
https://al-anon.org/
 
I sympathize with your predicament. My father smoked unfiltered Camel cigarettes for many decades, consuming two packs a day from his youth until his late fifties when he quit. He was also a heavy drinker (functional alcoholic for most of his life). These habits ultimately brought several bouts with various cancers that put him in hospital more than once and he died from pancreatic cancer in his mid 80s. It was not fun to watch his decline. His sister was also a heavy smoker and wound up with a severe case of COPD that required here to drag around an oxygen bottle for a decades. She lived to be 86 but her last couple of decade were not fun and I only assume she stopped at some point, but I do not know when.

I tried a puff off a butt when I was around 5 years old and that set it in my mind how awful it was. I did not try again until I was nearly 40, and did a couple of puffs and quickly identified it as a nerve poison that was just as bad as my 5 year old brain had figured out in the early part of the 1950s.

If your husband has not quit already or shown a deep interest in quitting since his diagnosis and hospitalizations, it is unlikely you will ever convince him to stop. It must come from his own resolve and abilities to resist. My father's addiction to alcohol persisted until he was diagnosed with pancreatic cancer, so I have seen the mood swings and health issues that radiated from that and his earlier smoking addiction. He spent nearly a month in hospital when he started having intestinal bleeding issues in his late 70s or early eighties. His last 5 or 6 years of life were rather grim in my view (in and out of the hospital multiple times finally passing in his own bed at home while I stood by his side).

I wish you and your husband all the best in finding a way to avoid the health nightmare it eventually becomes. Please pardon me if any of what I have written causes you more distress than you already suffer from with his current inability to quit. I have lived through it with my father and it was not pleasant. Your husband can quit, but it is not easy and his resolve is not yet strong enough to overcome his need. Your story has brought back memories that I had pushed aside after my father's passing. Stay strong and offer whatever help you can, but it is ultimately out of your control. I hope he comes to his senses on this out of consideration for the emotional pain he is causing you.

Forgive my personal history on this as I am aware it offers little help. I just wanted you to know that others have had to deal with similar experiences.
 
What can possibly set someone like your husband at cross-purposes to himself is the fact this terrifying crisis is likely causing him to rush back into the arms of one source of comfort which also happens to be the greatest source of his suffering.
Nothing we could do to the tobacco companies would be sufficient punishment for the purposeful manipulation of nicotine levels to addict more people and the squelching of scientific proof of the harms of their products.
 
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This subject is hard for me to give much insight from a smoker's perspective as I and my family never smoked. So, I have questions for smokers or for those who have knowledge about this topic and addictions, and so what I say is just my opinions on this matter from being an outside observer and from having a father who was an alcoholic.

If addictions are mostly physical caused, as many suggest or state, then why can many sleep through addictions? I mean if they can go 8-10 hours without nicotine, alcohol and food, does this not imply that these addictions can be dragged out more during the day, or even be more mentally caused? Also, if nicotine passes through the system in several days or so, and they were not using nicotine for awhile after that, it seems like this too suggests these relapses and addictions can be stopped long term or more permanently than believed, as they stopped for a period of time, often for long periods before and as any physical addictive nature was too far away to be seen as the source of the relapse.

So, this brings me to the questions then.. What are some mental reasons people smoke? Some daily routine? Reduce stress? Need to use your hands for something? They think it is cool? Peer pressure? Desire (conscious or subconscious) to push the other away? Have no belief they can succeed long term? No reasonable step by step goal? Lack of trust that smoking is the main cause of their ailments, denial, or because they like the smell, feel or taste of it, lack of will power or energy, etc? Would not it seem thus we cannot lump all persons together and assume physical addition, genetics involved, etc.,as the reasons why each person smokes, or keeps returning back to it differs, and as some overcome such additions. Thus, it seems like unique solutions for each case could be needed.

And how do we know if such addictions are through birth or learned, unless there was certain science data and testing to confirm such. Often it is easier to have black and white thinking coming from members of society, like for them to say either it must be just physically addictive and that is why they cannot stop long term, or others may say those users just do not care about others around them and just lack some motivation. I think each case is different, and if one does not get to the root of the situation, such addictions or habits will be more difficult to stop for long term, if wrong assumptions are being made and society enables their ways by not digging deeper and by not finding out the likely mental causes too that if bettered could make not returning to that addiction easier.

I am not saying smoking, excessive alcohol consumption and overeating for instance may not have physical or genetic addictive components that either initiates or prolongs that addiction. Of course typical solutions offered there can be tried and addressed. What I am saying is if nicotine patches do not work for necessarily most to stop that smoking need, and many sleep many hours without that extra nicotine need those hours anyway, something else likely is often contributing to that need to smoke more excessive times during the day. So, as one or more of many unique causes could be involved, we cannot assume that if the causes were found, then dire outcomes in not being able to quit long term would occur. Too often people want simple solutions for why things occur or not, what will happen or not or be the end result, or they may have quick excuses for why they do or cannot do things without really examining things further or without admitting something else could be contributing. Wanting easy answers will cause more failures. If the addiction was long term, it is reasonable to expect it may take some reasonable time to figure things out, but that may mainly require competent psychological breakdown and assistance, to see what psychological factors could be involved and to try different approaches.

I will give another example. Let's say there is a very overweight person. A few quick general assumptions may come to the mind for those who notice such persons. 'Oh, they are addicted to food and are just overeating. They do not care about their health. They must sit all day and get no exercise, etc'. What if the reasons were not that at all, or even just partly that. Would it not help to look into possible other specific causes? Are they depressed or bored? Are they not aware of what they are eating or how fast they eat as attention is elsewhere? Maybe they mistakenly think they are eating the same amounts as thinner others. Are there some other physical condition(s), imbalances, slower metabolism, or some medication causing this? Are they stressed or hungry all the time, and why? Do they not look at or care about nutritional labels? Do they subconsciously eat to get more attention sympathy, or to keep others away? Are there sensory issues such that they need certain tastes, feel and smell, in their mouth etc? Do they lack a plan or reasonable goal? Not enough energy, motivation or belief to achieve that? Regardless of the reason or reasons, being general for the causes and outcomes, or assuming things, rarely works. Figuring out possible other causes and trial by error is often needed. There is hope for all if they want to prioritize that by getting to the bottom of things.

But, what I do agree with is things will not be necessarily easy with many with an addiction, as often more than one cause seems involved, physical and mental. and long term usage and relapses often meant many things were likely tried without success or that the user finds that item hard to resist because of seeing more benefits with that substance than not, which may show some distorted reality. However, I just think more users can be doing more for themselves, if they really wanted to be off that, or to be in the best of health. Many may convince themselves it is just some physical addiction thing, but that I feel often is at most a small part. I think many are deluding themselves into thinking there are not other things they could do to better stop relapses. Once one finds possible causes, then it is easier to come up with solutions that target those. Too often ones want a quick solution that works indefinitely or they may give up. That is not reasonable. It often requires a whole new way of thinking about smoking, and diversion to other things, only after finding the causes and helping better those. Further information, support, intervention, and resources are often needed to breaking addictive rigid habits.

The purpose of my post here is not to offend any here who are addicted, or their family members, but to give a different point of view which often is needed to make the best informed decisions.
 
Thus, it seems like unique solutions for each case could be needed.
I think everything you said in your post boils down to this. Addiction science is meaningful and sometimes useful, but also limited. It becomes a convoluted mess of behavioral and chemical dependencies.

It’s a similar idea to every autistic person being different. Although we are united by something that we call autism, each person’s experience here is so different. It would be the same for the addict. There’s this one term that encompasses a group of people, but within that group, there’s infinite variability in the experience with substances and therefore, what to do about it.
 
My husband is a compulsive smoker and has been rushed to hospital 4 times this year due to COPD flare-ups. The last time he did he had a mild heart attack and I witnessed it, which really frightened me. But as soon as he was out of hospital a few days later all he was worrying about was having a cigarette. I thought that experience would be enough to put him off smoking for life but it obviously didn't.

He won't use e-cigarettes, and despite partially wanting to quit smoking he won't do it. I've tried to support him by buying nicotine patches but he still went back on to smoking. I don't know how else to help.

He is on prescribed medication and inhalers, but every now and then he still gets a day or two where he is out of breath just sitting, even though he's taking his medication and inhalers regularly. This weekend is one of those times. But it's also hard for me, because when he's out of breath like this he snaps at me and spoils my weekend, which I look forward to after 5 days of work. I find it hard to give much sympathy, because of the way he carries on smoking and won't help himself. I know all this could be avoided if he quit smoking.

This is one thing I hate about democracy. The law says you "can't stop" a person from smoking if they don't want to quit, but that means you have to put up with the consequences of their smoking-related illnesses, and you constantly worry about them because you love them, but they are no joy to live with when they can't breathe.

You only get one pair of lungs. Look after them. There's no excuse to smoke, not even "I am stressed". Be like me, I've never smoked. I tried it when I was 12 but I thought it wasn't worth the hassle so I didn't do it any more.
I do not smoke, as I am allergic to tobacco products, tobacco smoke, and nicotine in general (even eating eggplant has enough nicotine to trigger it). I suffered with childhood asthma because my father smoked. My father was a smoker most of his adult life, probably started in the military, WWII. I don't remember how much he smoked, probably about a pack a day, maybe more. He was a well known flight instructor in the area, and flying was his life. One day during his physical, the doctor told him if he smoked one more cigarette, he would not pass his next physical. He struggled with it for a year or so, then got hypnosis. He was smoke free for the next fifteen years, then he was diagnosed with lung cancer. He died at age 82, barely getting to meet his only grandson.

I have seen first hand how addictive smoking can be, and have experienced it's effects. His greatest regret as he was dying, was that he would not be able to teach my son to fly. You are going to have to find something he loves more than smoking (if that is possible), and show him he will lose it if he continues. I wish you the best of luck with this.
 
Unfortunately, no one can make anyone do something that they do not want to do.

My husband was a heavy smoker too, and tried to stop, knowing how much I hated it.

One horrible memory, was on visiting his auntie, as she hugged me, she withdrew back fast and said in a shocked voice: no! When did you start smoking? She smelt second hand smoke on me and I seriously wanted to hit my husband for that! He, of course laughed.

Was offered a new car if he quit smoking. He tried everything reasonable to stop smoking. Sometimes he did quit, but only for a short time.

Then, we started studying with Jehovah's Witnesses and on Nisan 14 ( the memorial of Jesus' death), he prayed to our Creator, Jehovah and threw the pack away and for nearly 24 years, he has not smoked.

However, he is foolish in other areas and I can see how it is effecting his health and he knows what to do, but doesn't and that is highly frustrating and now, I tend to shrug my shoulders and think: if you want to destroy your health, go ahead!
 
I have experienced this so many times in my life. My father, many uncles, aunts, cousins, and almost all my family members have died from emphysema caused by smoking. The very few remaining that are still alive is suffering from it. Emphysema is the destruction of the alveoli in the lungs caused by smoking. It never heals back. COPD is a symptom of emphysema.

Most of my family smoked, assuming it was healthy and was a natural thing to do. My father berated and punished me for not smoking, but even as a very young kid I could not believe it could possibly be a good thing. It seemed profoundly unnatural.

One of my uncles ended up in the hospital under a respirator. His addiction was so strong, he was caught trying to put a cigarette up to the respirator's air inlet. My father had to be sedated because he was so hostile and belligerent and kept trying to get his cigarettes. He was taken home, where he smoked end to end even through the night. He went back to the hospital before the next morning because he couldn't breath. He died that evening.

I don't really have any advice. It just seemed that the addiction was so much stronger and so beyond anything that could be done.

Just, for what it's worth; you're not alone.
 

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