A wall of smoke

Joyce is 58, and as I walk in for her annual physical I am confronted by a wall of stale smoke as I enter the room. She doesn't have to tell me, she's started smoking again. It was just 2 months ago that she had completely stopped smoking. I had tried all the medications plus counseling, and now the new medication, Chantix. Chantix works by blocking the receptors in the brain that give people the pleasure from smoking. It's worked better than other devices or drugs I've used in the past. I thought we had finally won a 40 year battle with an addiction. But my heart sinks now, knowing that we have lost. Joyce tries to put a positive spin on the situation, "I haven't quit quitting", she says. But honestly, looking at her across the chasm that divides us, I see a 100# overweight woman with grey coarse skin, bags under her eyes, and stained with nicotine. I am struggling to maintain hope for Joyce. "You were right," she says, "it did make the cigarettes taste like cardboard. But it reminded me of those cigarettes from the late 60's, 'Lark' I think, that also tasted like that, and I really wanted one." I proceeded with Joyce's physical, ordered her mammogram and blood tests, and asked her to attend a free smoking cessation class. I don't believe she is ever going to stop, but I have to try. Sometimes I am surprised by who finds hope to break free from an addiction.