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President’s Page: Confessions of a (Reformed) Tobacco Smoker

ACC PresidentDan G. McNamara in frotit of Heart House.

I once fantasized over a list of imaginary “incredible revelations” guaranteed to startle most of the population: What would be more astonishing

than

to find: That Mary Baker Eddy had regularly

visited

month?

her

doctor

once

That Aimee Semple

a

McPher-

son enjoyed a cocktail before dinner? That Kools?

the

Surgeon

American chose

General smoked

Or that the President College

Chesterfield

of

of the

Cardiology

regular

(behind-

While puzzling over all this, I happened onto T. Joseph Reeves (MD, FACC) of Beaumont, Texas. I spoke to him of my dilemma. Many people respect Reeves’ opinion simply because of his academic record but, in addition, his size alone has always carried enough weight that few would argue with his strong recommendation, especially if personally delivered. Reeves strongly recommended that I follow his instructions, which I have slightly modified and paraphrase as follows:

the-barn4 ?

During the summer of 1980 I awakened to the reality of the last preposterous example and began having the uneasy sensation of impending predicament. Within 8 months ACC President Brandenburg would hand over the chain of office. My choices were: suffer the ignominy of accepting the office that is the very archenemy of the cigarette industry while carrying a measure of nicotine within my circulation or embark at once on the reputedly painful and toilsome task of abandoning tobacco forever!

The T. Joseph Reeves Painless and Pleasant Method of Stopping Smoking Dr. Reeves points out that there are two aspects to cigarette addiction. One is the chemical addiction (both to the tar and to the nicotine) and the other is a psychological one. It is necessary first to overcome the chemical addiction. In order to do so you should begin with the type of cigarette you are smoking at the time, buy a carton of that and at the same time buy a carton of each brand that provides a progressively lower level of tar and

October 1991

nicotine for a total of six cartons. It is somewhat easier to keep up with the tar content of the cigarettes rather than the nicotine, so the values expressed in Table I are given in milligrams of tar. Also, for each brand of cigarette listed you can find other brands that have an equal amount of tar so that if you cannot find a carton of the brands listed several other brands at the same level are available, although not all cigarette manufacturers print on the package the amount of tar contained in each cigarette. Go to the grocery store and purchase six cartons, one each from six successive phases listed in Table I, beginning at the level at which you are currently smoking. If you start with phase I, you should proceed through phase VI; but if you start with phase IV you should proceed through phase IX, et cetera. If you are already smoking cigarettes at the level of phase V, VI,VII or VIII, you can accomplish your goal by simply going through five, four, three or two phases, respectively, rather than the full six phases. You must never backtrack, that is, never regress to 8 mg if you have reached the 5 mg stage, nor should you jump any stages. For example, if you are at 8 mg and think that you are doing quite well do not skip 5 and go straight to 4 mg, but continue smoking each cigarette of each pack until the whole carton is completed. During this time it is not necessary to make any attempt to cut down on the number of cigarettes you are smoking. In fact, as you begin smoking cigarettes with less tar content you will probably be smoking more than you did previously. Plan for the approximate day that you will complete the program and announce to some of your family and friends that you will complete the program and stop smoking at the end of the last cigarette of the last pack of the last carton. Plan for the day ahead of time. Purchase yourself some very good hard candy. Brush your teeth often during the day, not only to remove the desire to smoke but also to prevent the development of cavities in your teeth from eating so much hard candy. If you like good wine, purchase youself some very good wine. Plan to treat yourself to quite good meals the first week or two after you have quit smoking. It is especially helpful to have an exceptionally

The American Journal of CARDIOLOGY Volume 48

811

AMERICAN

COLLEGE OF CARDIOLOGY

TABLE

I

Phases

I Through X

The

4 VIII IX X

structured

Brand

arettes.

By the time I reached

the absurdity of puff-puffing tract

23 16 8

Camel, Chesterfield (regular, unfiltered), Macho (regular, box) Marlboro, Winston Vantage, More, Golden Lights, Northwest King True, Vantage Ultra-lights, Dora1 II Cambridge 100’s (soft pack) Kent Ill, Triumph, Barclay 100’s (soft pack), Lady Go-Diva-Go (box) Now 100’s (soft pack), Super-Pacifier 100’s Cambridge 85’s (soft pack), Barclay 80’s (box), Barclay 85’s (soft pack), Carlton 100’s (box), Carlton 85’s (soft pack), Now 85’s (soft pack), All-Day-Sucker 120’s (box) Cambridge 80’s (box) Now 80’s (box), Carlton 80’s (box)

those

1981

me

2

The American

Journal

that level

away to ex-

of tar became

if not ludicrous. But I believe

that going through that last phase for the long-standing, hard core smoker accounts

: 3 2 1

for part of the success

of the Reeves

system for me and for several converts of my own. When the day came to stop entirelyNovember

0.1
welcome

15, 1980-the

If you are not entirely satisfied with this method at the end of 6 months I will be very surprised. I would appreciate your letting me know at the end of 6 months how happy you are with this method. What are the determinants

The clean air in my office, car and behind my barn is bonus enough. The good taste of food

the release

of this method with its low recidivism?

It

from bondage of

. the ridding from the body of

the yellow,

pasty nicotine and the black,

loathsome

tar.

Each

day

beyond

No-

vember 15, 1980, puts me one day further away from the game of crossing the fingers that this cigarette a carcinogenic obstructing

of success

relief was so

that a relapse is inconceivable.

the habit

fine meal the evening of the day that you are no longer smoking. Ask for any amount of praise from your family and friends that is required. If people do not remember to give you praise voluntarily, request it of them. Keep reminding yourself that smokers are relegated to the back of the plane and back of the bus and have a special place set aside for them in certain restaurants. Also, in histograms relating to socioeconomic category and IQ, smokers usually occupy a position in the column to the far left. Remember also that each day that you have gone without smoking results in your lungs becoming cleaner and cleaner and your coronary arteries clearer and clearer. You will find that both the chemical and the psychological addiction quickly disappear. An unexpected bonus is that you begin to deal with problems and frustrating situations, as well as the celebration of important, satisfying events, by means other than lighting a cigarette.

nanograms

embarrassing

l

October

took

all 200 of that last carton of 3 mg tar cigTar’/ Cigarette

The tar content of 187 brands of cigarettes can be found in the Federal Trade Commission “Report of Tar, Nicotine, Carbon Monoxide of the Smoke of 187 Varieties of Cigarettes,” March 1981.

812

process

months. The hardest part was staying with

Phase II III IV V

NEWS

will not lay down

cell in the airway

placque

or an

in a nutrient artery.

When I consider that I had smoked one

may lie partly in the faint embarrassment

package a day of cigarettes containing 23

of standing in line at the grocery store to

mg of tar in each cigarette,

pay

that each package

some

$40

rettes-something

for a sackful

of ciga-

you don’t want to do

tained

460

I calculated

of 20 cigarettes

mg of tar and each

concarton

more than once. It may be that the cure

4,600

comes

5.7 kilograms, or 12 l/2 pounds, of tar, or

in the ritual of lining up the six

purchased

cartons, labeled and arranged

on a shelf in decreasing concentrations tar, ceremoniously

of

finishing off one car-

mg. In 34 years I had inhaled some

about enough to make three good-sized tar babies! I trust that overtaxed bronchial cilia, having removed

all or most of that

ton, graduating to the next on the list and

pile of tar, will now be called on to deal

planning for the happy day of the last. It

only with that tar exhaled

could be the relatively long time you have

who

to carry out the program

Reeves.

to “get the tar

out,” so to speak, and to become the fact that smoking

not

Volume

48

yet

by neighbors

confronted

Dan G. McNamara,

Dr.

MD, FACC

President American

over.

of CARDIOLOGY

used to

days will soon be

have

College

of Cardiology