God, I miss smoking.
I used to be so coy and cute and worldly standing by the bar with a cocktail and a cigarette. Seriously. People said so.
It all started innocently enough. I was in a play in college and my character was required to hold a cigarette during several scenes. After a show, this girl I admired said offhandedly, "You look good with a cigarette. Sort of sexy." To a gangly, awkward, 19 year-old closeted queer in a Catholic school searching for some positive reinforcement to cling to, that was all I needed to hear - I started smoking immediately.
I also knew it was bad for me. We all do. We know how it destroys lung function, increases risk of heart disease, cancer, osteoporosis, high blood pressure, etc, etc. But dammit, it was FUN. It was so fun that I was able to ward off the friendly advice of people who loved me and medical professionals and substance abuse counselors and yoga teachers and the scowls of strangers on the street with an addict's perverse enjoyment of the thing that's gonna kill him.
"If it was so much fun," you ask, "why did you quit?"
I quit when some facts and my own protesting lungs made it too ridiculous to continue.
People with HIV smoke at the rate of between 50 and 75 percent (depending on the study) compared to around 20 percent of the general population. I attribute it to amateur stress management and self-medication - that's what it was for me. It was also a visible form of defiance and denial. "Screw you, disease and social convention and medical wisdom. I'm in charge of my life. I've given up so much to deal with this shit, you are not taking the one fun thing I have left."
The problem is that an act of defiance and denial quickly ceases to be fun and becomes more like a bad marriage - built on an idealistic promise that, despite overwhelming evidence to the contrary, is maintained out of principle, stubbornness and fear.
That's how it was with me. Then I read this recent report by Nancy R. Reynolds in the Journal AIDS Education and Prevention. Three points kept bugging me:
- The lungs of a person with HIV are more susceptible to cancer, emphysema, pneumonia,acute bronchitis and tuberculosis. This risk increases dramatically among HIV+ smokers.
- The incidence of cancers, especially lung and cervical cancer are higher among HIV+ smokers and develop at a significantly younger age than the general population.
And the biggie:
- Smokers with HIV negate some of the effects of antiretroviaral medications by smoking. Thus, HIV+ smokers had a 36% greater chance of developing an AIDS-defining condition and a 53% higher risk of dying than HIV+ persons who did not smoke.
In working with addicts and working through my own addiction issues, I've come to realize that a person will usually stop using for two general reasons:
1. It hurts too much to continue.
2. It makes complete sense to quit.
Sometimes they happen together. In my case, the facts in that report wouldn't leave my head. They were there during my run the next morning, when my protesting lungs forced my pace to go (was it my imagination?) slower than usual. They wouldn't leave me alone. I quit two days later and I haven't picked up a cigarette since. That was seven weeks ago.
Besides simply feeling better physically, I've noticed a lot of side benefits. My clothes smell better, my car is cleaner, I'm not always worried about my breath- Ken kisses me more. I don't feel like a leper standing out in the cold with the other smokers and I don't have to always worry about carrying a lighter and cigarettes everywhere I go. Plus, I'm saving a shitload of money.
A pack of cigarettes costs around six bucks in Montana - cheaper than some places.
That's $42.00 a week, $168.00 a month, $2184.00 a year. What could I do with an extra $2100.00 a year?
Just so we're clear: I don't want to be one of those newly-converted who scowls every time somebody lights up a cigarette. I really don't. I understand how much fun smoking is, and how complicated. I just want you to have the facts. The very disturbing facts.
And maybe, if you're a PWH, they'll hit you like they did me and you'll improve the quality and length of your life. Just maybe. And if you know someone who's HIV+ who has been trying to quit, show them this article, it might be the thing that does it for them.
And if not, smoke 'em if you got 'em.
I just won't be joining you coyly by th e bar anymore- I'm saving up for a trip to Mexico.