16^th January 2013

It is -8⁰c outside the hospital as I arrive.  I am rushing to get inside from the warmth of my car to the warmth of the hospital as fast as I can without slipping on the icy footpath.  As I travel the 100 yards or thereabouts I pass the hospital’s “smoking station”. A place set up because since 1^st of July 2007 it has been illegal to smoke in public places.  Since then we have seen the growth in “smoking stations”.  As I pass this one there in the dark at -8⁰c is a nurse; no coat, no jumper or cardigan; smoking.  If ever there was an image of how addictive nicotine is that has to be it.  She is on what is probably her only 20 minutes break during her shift and she has gone out into the freezing cold night to get her fix of her chosen drug.

Now I know the smokers amongst you and even some non-smokers will be saying “sanctimonious old git” because I am a non-smoker – well actually an ex-60 a day smoker, though in fairness I probably gave away ten or so a day to patients.  I could get through six plus on the drive to work in London and another six on the way home.  But it is not the fact people smoke that concerns me, hey it is a free world and if you want to fill your body with chemicals that can and do kill go ahead.  No the thing that bothers me is that nicotine is so addictive that people will go to any length to get their fix and once hooked struggle desperately to stop.  I know from when I smoked that at 3.00 a.m. when I was out of cigarettes and woke up wanting one I would drive to a vending machine and buy a packet.

I remember being told once that pure nicotine crystals if ingested would kill you.  With this and all the other risks why do so many, especially the young more start each day and become addicted.  Furthermore how can we stop them from starting?  Perhaps you may say should we stop them?  It can be argued that once hooked nicotine will drive the user to their next fix more readily than any other drug.  It has been argued that as the most addictive substance in the world; nicotine has a 96.5% addiction likelihood; it should be banned.  Studies show while alcohol, caffeine, and cannabis are the most commonly used drugs, it is nicotine that has the highest rate of reinforcement (continued use) and dependence (difficulty with cessation).   The top five “addictive” drugs are nicotine, crack, Methamphetamine (smoked), Crystal Methamphetamine (injected) and Heroin.  But nicotine is the only “drug” in this group that can be legally purchased and this is what makes it dangerous.  Equally of the five four are or can be smoked.  Smoking gives the user of any drug the fastest hit of their substance of choice – about 8 seconds.

The government tries to get us to stop.  It pushes up the price – well that never stopped me.  They run adverts on the television – we ignore them like many adverts because we are in the kitchen making a cuppa. They force manufacturers to hide the brand – when I smoked a cigarette was a cigarette Sovereign and Players No 10 it did not matter so long as it was a cigarette.  They raise the age you can buy them – I started aged 11 behind the Health Authority buildings with Dave Agar (sadly he is no longer with us).  None of that worked.  My father even showed me cancerous lungs – in one eye and out the other.  What got me to stop – being offered a choice, the cigarette or the mortgage.  The mortgage won.  So what choices can we offer people?  And what can we replace nicotine with?

They say sex is a great if not the greatest driver of humans, particularly men.  Though having watched both modern and not so modern women it appears to drive them just as much.  Just say George Clooney, Nicholas Cage or try Luke Benward and Justin Bieber for the younger ones and look into their eyes, the signs are the same as if you say Ursula Andress, Samantha Bond, Drew Barrymore, Avril Lavigne or Lindsey Lohan to a man.  But what if you add a cigarette to the picture which has now developed in your mind’s eye.  The picture to the right shows a young lady who most men would see as attractive, everything is as it should be.  But then look again and think if she were standing before you right now looking into your eyes what would you see?  Her long blonde hair flowing over her shoulders or the curves of her body accentuated by her limited clothing or would all that be lost by the smell of her ashtray breath as she exhales and says “Hello darling”.

Over the years, since I gave up smoking, I have come to see the cigarette as a barrier.  When I smoked it was a bridge, “have you got a fag mate” it opened up a conversation – unless you were in New York where asking for 20 fags got you some very strange looks in the 1980s, perhaps not today anyway – and allowed you to develop friendships or get over a problem, share information, even gain the attention of a patient, the list was almost endless.  But now things have changed and the cigarette and all its associated smells and sights puts a cloud between you and beautiful things.  Yet people continue to smoke and new smokers join the band daily.

Should we be making it even harder for the smoker to get their fix or should we be treating them as some-one who is an addict and providing them with treatment?  It is a question that will run on for many years to come.  However, to the beautiful people out there putting that cigarette to your lips; in my eyes; it moves you from a beautiful person to person; your beauty is lost to me in a cloud of smoke.

It is still -8⁰c outside and I am willing to bet some-one is stood at the smoking station outside the hospital without a coat or jumper or cardigan but with a cigarette to their lips.