How a heart attack patient could quit smoking and the art of teaching

A Real Life Story on How a Heart Attack Patient Could Quit Smoking: For experiencing, not for following blindly without evaluation

This is a story of how a heart attack patient could quit smoking. Since the major heart attack in 2001, for eight years I didn't smoke, but started smoking again though it was pure taboo for a heart patient like me.

How I became a major heart attack patient and forced to quit smoking first time

I had a major heart attack in 2001 when I was 49. That time I held a senior position in Mobile launch, leading a hectic life and smoking nearly a pack of cigarettes a day. By the grace of God and instant appropriate actions taken by a number of people, my wife first, I escaped death narrowly. Post my angioplasty, I quit smoking, NOT BECAUSE OF DOCTOR'S STERN WARNING, but primarily because,

I remembered the unbearable terrible pain in my heart throughout the attack (note the role of mind).

But human mind is forgetful,

Even the memories of strongest pains fade out with passing time (note the role of mind).

Deeply ingained barriers to evil addictive habits fade out with time

After eight long years of abstinence, in a casual environment where others were smoking, I smoked my first cigarette again. There is a truth,

If you start smoking even one cigarette a day, you have become an inevitable smoker.

And that's how things proceeded. Initially for a few years, I smoked 3 or 4 cigarettes a day when I was outside home. One day when my wife asked me, 'Do you smoke?' I had to say, 'Yes' as I cannot lie.

Then onward I got a self-assumed license to smoke also at home (note the role of mind).

Number of cigarettes a day increased. Dutifully, I did my annual check up with my cardiac doctor who was one of my saviors by timely and impeccable Angioplasty as far back as 2001 when the technology was at its infancy and failure rate of my stent was 30%, (told to me by my doctor).

Otherwise, I didn't feel any discomfort and all my parameters were normal. I was living a vigorous life.

My cardiac doctor's casual approach to lifestyle issues of a major heart patient

About six years ago, during my annual check-up, my doctor asked me all on a sudden, 'Do you smoke?'. Again I had to say 'Yes.' He just mumbled, 'Smoking may kill you' and in bold letters across the prescription wrote SMOKER. I was rattled but didn't stop smoking.

After all, my doctor can't monitor what I do in my private life (then again who can?).

How could he know whether I smoked during the year! Also, how could he remember previous year's incident when he never went through my previous records! (over-busy doctors in conventional medicine treatment usually gives 3 to 5 minutes to a patient).

Just as I thought, next year onward my doctor never checked whether I had indeed quit smoking (possibly he absolved himself from taking responsibility thinking all patients as responsible adults).

How I had to quit smoking cigarettes for life: I caught COVID 19

Then COVID 19 happened in early 2020. It was a world war waged by the virus on humans. I got an early warning from my niece in Dubai. When full-fledged war was raging over a locked down world, I was certain that with my weak lungs and damaged heart condition I would surely die if COVID catches me.

Still I made special arrangements to get a dozen packs of cigarettes delivered at home (note the extreme adamant attitude of a hard core smoker). I didn't quit smoking. My devious logic was,

Whatever damage of my organs have, already happened. A few months of quitting smoking won't improve my condition. (Note the deviousness of a smoker's mind.)

I had a valid point though. The locked down COVID condition was absolutely stifling and we were desperate and depressed at the same time. Aware of the looming threat and my precarious health condition, I wasn't sure to come out of the dark long tunnel of COVID alive.

Excuses of a hard core smoker to continue smoking against all advises

Talking about excuses of a smoker against quitting smoking, a list of excuses follows (this list I have compiled myself without referring to any other source).

• When I feel lonely, a cigarette gives me company.
• When I feel elated, I need to smoke to rejoice.
• When I am depressed, I must have a smoke to stop myself from sliding into medical depression.
• When my brain is working intensely at high speed, I need a smoke to stimulate my brain further.
• After every meal, I must have a smoke as it is highly enjoyable.
• When I am hungry, in empty stomach I get maximum satisfaction from a smoke.
• When I am in company of smokers, I should join the group as a way to increase the companionship thus avoiding exclusion.
• When I have had a strong cup of coffee, I must have an accompanying smoke.
• When chill comes and winter sets in I must smoke to enjoy the cold further.
• When the first rains come, I must smoke amidst the sounds of rains falling.
• When I am on a nature trip amidst pure nature without pollution, I must smoke to enjoy the pure air further.
• When I sit with a grand view of natural beauty, I must smoke to heighten the enjoyment.
• As in the polluted city we breath the impure air equivalent to smoking a pack of cigarettes a day, what difference can it make if I smoke six to seven cigarettes a day (such figures appearing in media must be banned).
• I had an additional excuse. From some dubious source I came to know that if a patient with a bad heart condition stops smoking he or she may slide into a medical depression which is deadlier than smoking.
• I knew of cases where a man, a heavy smoker, lived happily with a good health and peacefully died at the age of 95. So, why can't I?

Ugly pictures of cancerous lungs started appearing on every pack of cigarettes. In every film show, it is mandatory to show the severe ill effects of smoking. Many places you can see, 'Smoking is injurious to health with increased risk of cancer'. A hard core smoker's mind just filters out those unpleasant things.

World is a nice place, and to really enjoy living how can I not smoke?

Also, cancer of lungs may happen to others but not to me.

Recommendations for intensifying fight against addictive smoking

Let me list out my recommendations for intensifying fight against the evils of such an innocuous thing as smoking by a heart patient.

1. Patient records must be digitized even for an outdoor visit to a cardiac doctor. The doctor must scan through the patient's historical records before starting session with the patient.
2. Cardiac patient records must be available countrywide so that any doctor in any part of the country can refer to the patient's records before starting session with a new patient. A nationally unique ID must be generated the first time a cardiac patient visits a cardiac doctor.
3. A list of lifestyle related questionnaire each cardiac patient must answer in a digital form before entering the chamber of the doctor. And the doctor must scan through these answers starting session with the patient. A representative list follows:

• When do you take your meals?
• What meals do you take?
• When do you go to bed?
• How long do you sleep?
• How do you generally feel after your night's sleep, tired or fresh?
• Do you smoke?
• Do you do your daily exercise? If yes, what kind of exercise you do and for how long? Guided or self-taught?
• What is your actual working hours?
• What is your work related stress?
• How is your private life? Stress free or stressful?
• Do you eat junk food often?
• Do you eat red meat frequently?
• Do you love to eat sweetmeats?
• Did you suffer from any severe disease or highly stressful situation for an extended period during the last one year?
• Did you change your job, relocated your residence, or had a divorce during the last year?
• Did you suffer from a deep anxiety, financial or otherwise during the last year?
• Are you taking your prescribed medicine regularly?

There must be severity criterion value attached to each question. For example, if I were a cardiac doctor, smoking would have severity value 'Critical' and when my patient admits to me to be a smoker, I would have responded to the patient with, 'If you don't stop smoking at least for 9 months before your next visit, I won't be your doctor any more. You have to find a new doctor.

That is the 'Hammering in' technique. One highly effective way to impress upon me with my unruly mind that smoking is deadly to me is to use Hammering in technique, not just scribbling 'Smoker' on the prescription.

4. Patients, especially cardiac patients must take a Nicotine test before entering the doctor's chamber. Following are the AI based results I got.

---

Nicotine test

A nicotine test, also known as a cotinine test, can help determine whether a person is a smoker or uses other forms of tobacco. Here are the key points about nicotine tests:

What It Measures: A nicotine test detects the level of nicotine or the chemicals produced by cigarettes in the body. Nicotine is the addictive substance found in tobacco products.

Testing Methods: Blood Test: A blood sample is collected from a vein in the arm. This method is considered the most reliable way to detect nicotine use.

Urine Test: A random urine sample is used. Nicotine and its metabolite, cotinine can be detected in urine for several weeks after tobacco use.

Saliva Test: Occasionally, a saliva sample may be used.

Hair Test: Rarely, a hair sample is employed.

Interpreting Results: High Levels: Elevated levels of nicotine or cotinine indicate active tobacco or nicotine product use.

Moderate Levels: Moderate concentrations suggest that the person has refrained from tobacco or nicotine for two to three weeks.

Low Levels: Non-detectable concentrations may be found in nonsmokers or individuals exposed to environmental smoke.

Duration of Detection: Nicotine appears in the bloodstream about an hour after inhalation. Cotinine can be detected in the blood for up to 10 days after quitting smoking.

Legal Reasons: Nicotine tests are often conducted for legal purposes, such as employment screenings or court requirements. Remember, while a blood test is invasive, it remains the most reliable method for detecting nicotine use and assessing exposure among nonsmokers (passive smoking).

If you’re considering quitting smoking, a healthy diet rich in protein and nutrients can support your journey.

And further related link:

Medicinenet.com: How to quit smoking: This website gives detailed advise on how to quit smoking. The stats of smoking related deaths only in US every year was a staggering 430,000 plus every year.

Strategies for quitting smoking

Nicotine replacement therapy (NRT): Consider options like  nicotine patches, gum, lozenges, nasal sprays, or inhalers.

Avoid triggers: Identify situations or places associated with smoking and plan to avoid them. (comment: this is avoidance. Rather face the challenges.)

Distaction: Distract yourself during cravings by delaying or engaging in other activities. (comment: this is avoidance. Rather face the challenges.)

Chew on something: Chew sugarless gum, hard candy, or crunchy snacks to keep your mouth busy. (Comment: this is too conventional. the solution lies in your mind).

Don't have 'Just One': Resist the temptation to havde just a single cigarette, as it often leads to more. (Comment: A stark truth).

Get physical: Engage in physical activity to distract from cravings, even short bursts help. (Comment: intense mental activity is very effective as well).

Additional resources for helping quitting smoking

Verywell Mind: Natural Remedies to Help You Quit Smoking.

Verywell Health: How to realistically quit smoking: 24+ steps to take right now.

Verywell Health: What to know about nicotinde withdrawal.

Verywell Mind: 10 Tips for the Time When You Quit Smoking.

WebMD: 13 Best Quit-Smoking Tips Ever.

HelpGuide.org: How to quit smoking.

Remember quitting smoking is a journey, a long journey if you think it as long, but a very short trip, if you can change your mind that way.

---

Recommendations for fight against smoking contd..

5. There should be countrywide database of medical records of especially of cardiac patients accessible to every cardiac doctor, simply because heart diseases are the biggest killers of humans worldwide.
6. Once a cardiac patient is identified as a smoker, the patient must undergo a smoking free rehabilitation program at own cost before consulting any cardiac doctor in the country barring emergent health situation.
7. Ills of smoking should be taught in schools at various levels, because knowledge absorbed during early years create more permanent impression on the mind.
8. Ban smoking in every public area and impose heavy fine if the ban is violated. Unfortunately, all airports have a separate smoking room with stifling air where taking a single breath is difficult. Hotels still have smoking areas usually in a corner on the roof or on the ground level.
9. Nonsmokers counseling groups should proliferate.
10. Campaigns to make smoking socially looked down upon should be run regularly.
11. Cigarette companies and tobacco industries should be heavily taxed to hike the cost of a smoke. This may not be implementable because the hard truth about this kinky self-destructive human society is, all controlling and business driving agencies largely depends on the revenues from peddlers of poison in the form of tobacco or industrial chemicals based fertilizers and pesticides (refer Smoke and Ashes by Amitav Ghosh).
12. Tobacco farming like poppy seed farming must be strictly controlled at source.

---

Let me return to my narrative. Where was I? Oh okay, we have reached the COVID 19 stage.

During COVID times I continued smoking but in spite of all precautions caught the dreaded disease. It was more complicated for me as typhoid piggy-backed COVID. Miraculously I survived. My weak lungs though were heavily affected and when I took my first puff of smoke after COVID, it tasted so horrible that finally I could leave smoking cigarettes for good. For more than two years I didn't smoke.

Then when visiting a rural farm surrounded by bidi smokers I picked up a bidi and took a puff. It tasted good and I got hooked again. I became a bidi smoker. Not a heavy smoker, still a bidi smoker.

On 28th December, 2023 when I visited my cardiac doctor, he pondered on the fact that it has been a long 22 years since he put on my stent. Instead of more reasonable approaches such as Holter monitor or Angiogram, he prescribed the fancy and costly test of MyoView which checked my heart muscles which turned out to be alright.

Happily I went on an outstation sojourn for 10 days. I returned to Kolkata on 16th of January, 2024 and on 18th January had a scary breakdown on my way home by public transport.

I was on the sidewalk and after purchasing a coveted snack, my backpack weight increased to about 5 kgs. Suddenly I lost my ability to take a single step. I sat down on a roadside shop stool and measured my pulse rate. It was way too fast with frequent beat drops. I felt deadly tired. Calling a cab, I reached the safety of home.

Five days later when I visited my doctor, he prescribed Holter monitor for 4 days.

Based on the results and results of Angiogram and EP test, an ICD implant was made over my heart in a new hospital by a new doctor. During my four day's of hospital stay, naturally I could not smoke. Returning home, first thing I did was to have my first smoke after 4 days of abstinence! I had a small stock of bidis at home. Though I smoked sparingly, my stock finally got exhausted.

I was not unduly worried. I just have to go out and in fifteen minutes I will get my replenishment. Things though turned otherwise.

I discovered that both my son and my wife strongly objected to my going out in the street as I had an operation after all. They had logic in their favor, I had to agree. So I requested my wife to get me a pack of bidi. She simply refused. Again that was natural. I cannot fault her stand. She had tolerated enough of my dangerous whimsical self-destructive living for time immemorial (just like our civilization). On principle, I couldn't ask my son to get my bidi (oh, I have principles after all!).

Then I called up my young friend next door who provide a lot of help to our family. His first reaction was, 'Bidi? Is it good for your health? Now now, what could I say! I said, 'No, it's not.' He ended the discussion with his advise that I should stop smoking altogether. I consider him as my younger friend with lots of experience. So I value his words.

I remembered the words of my elder son living in US. A few days back his first words were, 'Did you quit smoking?'

Well it makes four of my closest ones against me. And all for valid reasons.

Under the current circumstances of my narrow escape from a potentially catastrophic end, their resistance was not only valid, it was sanity. I had only the night's smoke left.

I called up my closest friend. Told him about my predicament. Suddenly he became agitated. I have never seen him losing his cool. He asked me, 'Would you daily pour liquid rat poison at the base of a tree you love, instead of organic nutrients?'

That clinched the issue finally. He knew that I love trees with all my heart. And most surprising of all,

I discovered I don't really love my damaged body and myself. What a dilemma! What a revelation!

My friend is the best teacher I know. He has the rare knack of going to the heart of a problem in a flash.

But after all, I am not just any hard core smoker. I am a very obstinate person as well. That night I smoked my last puff.

For life I hope. Because, there was a saying,

Once a smoker, always a smoker.

The barriers I put up in my mind

Still I can't forget my severest weakness and helplessness on 18th January 2023, sitting on a stool on the sidewalk.

I will always remember the deep unspoken worry in the minds of my dearest ones.

I can't forget my social isolation as a smoker from all those who matter most in my life.

Their final emphatic rejection of my smoking and the immensely costly ICD implant sitting above my heart.

So much I have to discover, so much I have to let the world know. My real life's work has just begun at the age of 72. Finally, I cannot play with my life any more. It doesn't belong only to me.

It is I who realized only two weeks back, most human deaths are unnatural as diseases are unnatural. I even preached for everyone to strive for natural death, living a healthy life well beyond the nineties.

I have now been able to erect a great many walls against the very DIRTY HABIT OF SMOKING.

It is now time to look ahead with sanity.

Disclaimer: The characters in the story the reader should take as fictitious. The 'I' in the story is not necessarily the author. But the incidents had happened, realizations expressed by real people in all their earnestness. All advises the reader should verify before application. The article is not a health guide. It rather is a hard core collection of experiences and conclusions. It is entirely up to you to follow and go through the consequences :).

---