Island Med Student

It’s time to come clean. I have a dirty little secret that I’ve kept from many people for a long time. I have intentionally not written about it publicly, as I was afraid of all the condemning comments and accusatory reactions. I’m a med student/soon to be doctor, and I smoke.

Now let me explain. I started “experimenting” with smoking at a young age. I guess I was around 15 when I smoked my first cigarette. It wasn’t a big deal at the time. It was just one of those “it’s bad to do it, so I’m gonna do it” type of rebellious acts. I didn’t smoke very often at first, just every once in a while with my friends. Years later, I began smoking a little more frequently. I was never a “heavy” smoker, but since then, I’ve definitely inhaled far too many cigarettes than I should have.

I have tried to quit many times. In fact, I went a few years without a single cigarette. Ironically, it was during med school that I started up again more heavily. Now, I consider myself to be a “social smoker.” I rarely smoke alone, or during the day. My biggest trigger is alcohol. If I have a beer, glass of wine, or margarita, the urge just hits me like a nicotine monster. I can’t seem to resist the temptation to light up after I’ve had a few drinks.

So, how can I be a medical student, training to be a doctor, and continue to light up? Before I started med school, I knew the dangers of smoking. It’s pretty hard to avoid the anti-smoking ads (which have become even more prevalent recently), and if you somehow didn’t see those ads, you could simply read the warning on the outside of the package. But I did it anyway. Then I went to med school. I learned about what smoke does on a biochemical level. I studied the pathologies it causes. Now, more than ever, I know about the relationship of smoking to lung cancer, emphysema, bronchitis, and many other diseases. I am perfectly aware of the dangers of smoking. Yet I still haven’t been able to completely kick the habit.

What’s wrong with me then? Well, to it put simply, I am an addict. You can educate an addict on the dangers of doing their drug of choice until your lips turn blue, but that doesn’t mean they will quit. Ask any heroin addict if they think shooting up is good for them, and I guarantee they will tell you no. But invariably, they find it quite difficult to quit.

Am I alone on this one? Absolutely not. Millions of people are addicted to smoking. And here’s the kicker: there are quite a few people in the healthcare industry who smoke. Med students smoke. Doctors smoke. Nurses smoke. Smoking permeates the whole spectrum of workers in the “health” industry. But how can this be? Shouldn’t we know better?

The literature is ripe with articles on this very topic. Some people believe that the healthcare industry has a higher proportion of smokers than many other industries.

Still, it is utterly embarrassing for me to admit to the world that I smoke. I hide it from my fellow students, residents, attendings, and just about everyone else I meet. I don’t want people to think that I am “weak” and know that I would do something so destructive to my body.

Speaking of which, that’s the other huge dilemma that I have with smoking. I consider myself to be a relatively healthy person in general. I eat fairly well, I exercise regularly, I do yoga, I meditate. Save for this one nasty little habit, I consider myself to be a pretty healthy person. In fact, I’ve used that excuse to continue smoking at times. I say to myself, “I am so healthy otherwise, what is one little cigarette going to do to hurt me?”

I have a billion other excuses and defense mechanisms that I’ve constructed to allow myself to continue smoking. They have served me well for many years. But now I’m one year away from being a doctor. My job will be to provide healthcare to my patients. I’m supposed to educate them on the many ways to become healthier. I should be a role model of healthy habits. Yet, I have not yet been able to quit smoking. Perhaps this makes me better able to “get” my patients. As a smoker, I understand all too well the struggles involved with smoking cessation.

I encourage everyone to share their thoughts. Tell me how terrible I am for smoking. Tell me that you smoke too. Tell me what you think about doctors who smoke.

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