With their fanatical zeal, you have to wonder how far busybodies will go

"Tell me, when you see a smoker, do you see a person enjoying themselves? Or a cancer waiting to happen?"

This is an excellent question. The first thing I do when I se a smoker is look into that persons eyes to see if I can discover why they smoke (not very scientific, I admit).

Then I listen to see if I can hear if they have health problems (again, not very scientific). One of the reasons that lung cancer is so serious is that there are rarely any symptoms before it has reached an advanced stage. A persistent cough or breathing problems are the most common symptoms. Others may include shortness of breath, coughing up blood, chest pain, and pneumonia. In about half the cases, the cancer has spread beyond the lungs by the time it is discovered.

When you say, "enjoy" I read, "feeding the addiction". Nicotine is an insidious addictive substance, more powerful than heroin, so I’m not sure if the word “enjoy” is appropriate.

Reasearch has shown in fine detail how nicotine acts on the brain to produce a number of behavioral effects. Of primary importance to its addictive nature are findings that nicotine activates the brain circuitry that regulates feelings of pleasure, the so-called reward pathways. A key brain chemical involved in mediating the desire to consume drugs is the neurotransmitter dopamine, and research has shown that nicotine increases the levels of dopamine in the reward circuits. Nicotine's pharmacokinetic properties have been found also to enhance its abuse potential. Cigarette smoking produces a rapid distribution of nicotine to the brain, with drug levels peaking within 10 seconds of inhalation. The acute effects of nicotine dissipate in a few minutes, causing the smoker to continue dosing frequently throughout the day to maintain the drug's pleasurable effects and prevent withdrawal.

What people frequently do not realize is that the cigarette is a very efficient and highly engineered drug-delivery system. By inhaling, the smoker can get nicotine to the brain very rapidly with every puff. A typical smoker will take 10 puffs on a cigarette over a period of 5 minutes that the cigarette is lit. Thus, a person who smokes about 1-1/2 packs (30 cigarettes) daily, gets 300 "hits" of nicotine to the brain each day. These factors contribute considerably to nicotine's highly addictive nature.

So the question must be postulated, is this really “enjoyment”, or is it something quite different?

"We're not downplaying the risks. We know the risks."

That is all anyone can ask of an adult.

I can't disagree with anything you have said.

I admit I have done the same - I just wish it had't gotten to the level where those on our side have had no recourse but to resort to the same tactics as those of the antis.

While it has happened, it is far too rarely, that a die-hard anti will discuss the issues rationally. Regardles of what we say they counter with something off topice.

For example, as you say we are primarily speaking of private property rights, antis ignore that and say they have a right to breathe smoke-free air and no one has the right to permit it.

It borders on farce many times.

In a recent TV debate I did with an anti from NJ, talking about SHS. I gave her specific numbers from our own government regarding relative risk of lung cancer. She's going on and on about SHS exposure "CAUSES" lung cancer and that is why it has been declared a class A human carcinogen. I used the same sources of statistics that she used and showed how, according to her sources drinking whole milk has a higher relative risk for lung cancer than exposure to SHS, yet was not considered a class A human carcinogen for lung cancer. Why one and not the other was my question. Her response - "I feel like I'm talking to a memberof the Flat Earth society."

The blinders at times are a bit much.

Nicotine is an insidious addictive substance, more powerful than heroin...

Uh...have you ever asked a recovering heroin addict if nicotine was more addictive?

It is exactly this type of statement that turns a well-written response, appreciatively devoid of condescension, into a vehicle that I perceive as propaganda. Regurgitating this oft-quoted line does not make it fact and detracts from an otherwise informative post about the effects of nicotine on brain chemistry.

A link with some refutation of the aforementioned statement:

THE ADDICTIVENESS OF NICOTINE

Granted, this site is pro-smoking, but where else am I to turn when confronted by the superior resources that are the anti-smoking lobby? Thank goodness for the internet, a wealth of information, regardless of your political leanings, on any given subject.

I believe that smokers understand that nicotine is habit forming. They also understand that the anti-smoking forces will go to great lengths to reach their goal. Lies, propaganda, and the distortion of scientific evidence may further their cause, but in turn, with the discovery of the truth, smokers only become more entrenched in their positions.

"Uh...have you ever asked a recovering heroin addict if nicotine was more addictive?"

On numerous occasions. They have all said the same thing - heroin, while more difficult to kick in the first week is far more manageable than tobacco which has a three day, three week, three month cycle of addiction.

If you choose to believe the "nicotine itself is not addictive and smoking is just a habit" mantra – a message often perpetrated by the tobacco industry - then that is your right. I don't have an agenda, I only want to see fewer people die in pain.

When you say, "enjoy" I read, "feeding the addiction". Nicotine is an insidious addictive substance, more powerful than heroin, so I’m not sure if the word “enjoy” is appropriate.

Sir, I beg to disagree. It is the act of smoking that poses the increased risks of various health problems, not the intake of nicotine. This attempted comparison between nicotine and heroin is, IMHO based on reading I have done regarding chemical dependency, by far more dangerous to health than that of smoking itself.

The changing of the definition of addiction is more at fault than anything. Researchers in the early 70's called addiction " a bad habit that is especially difficult to break" and 20 years later other researchers confirmed that " As addictions have been converted into diseases, bad habits have been upgraded and transformed into addictions - yesterday's hard to break smoking habit is today's nicotine addiction."

As to the late diagnosis of lung cancer, as was earlier suggested, couldn't that have something to do with the fact so little research funds are going into seeking out better early detection as opposed to how much money is going into smoking cessation programs and anti-smoking lobbying by the people who should be doing the research to find cures and early detection methods?

As an oncologist who treats lung cancer patients I would think you would be appalled at the millions of dollars the American Cancer society is pumping into advertising campaigns in Florida to pass the no-smoking amendment on the Novemeber ballot.

Wouldn't your patients be better served with those funds being spent on seeking cures rather than being spend on telling private property owners how to conduct their business?

I have tried to be reasonable, rational, and unemotional in my posts to you, sir, however you have not even given me the courtesy of a response. I find that disconserting from one so critical of the posts of some others.

When I first came to FR over two years ago, I received advice from a fellow physician that, until today, I have studiously followed. "Never engage a smoker on a smoking thread. There's not one thing that you can say, not one painful experience you can relate that will make them change their minds."

I think at least part of the reason you're getting beaten up is that the thread, at least for some of us, is about liberty, not smoking. It is about a bunch of anti-smoking, anti-capitalism, anti-freedom creatures trying to crush free choice under the boot of the state. They are perfectly free to establish smoke free enterprises, but they don't. Rather, they proclaim they'll run yours the way they see fit.

Imagine the opposite. Imagine you decide to operate your practice in a smoke free setting, but the smokers arrive and tell you you must allow them to smoke in your office. When you refuse, they call in the police who tell you they can light up, and if you try to stop them you'll be closed down and prosecuted. Believe it or not, you'd find many of us defending your rights in that situation.

They have all said the same thing - heroin, while more difficult to kick in the first week is far more manageable than tobacco which has a three day, three week, three month cycle of addiction.

Anecdotal evidence at best. To which, I could produce the same. Any number of ex-smokers who quit "cold turkey" with little or no adverse effects, or so they claim. Do you think that the fact that the heroin addicts were likely incarcerated, in a substance abuse program, or that heroin is illegal had any play in their pronunciations?

If you choose to believe the "nicotine itself is not addictive and smoking is just a habit" mantra – a message often perpetrated by the tobacco industry - then that is your right.

I do believe that tobacco is habit forming. Addiction is just another word that is used to stigmatize. Just curious, do you receive these messages subliminally? I haven't seen a tobacco ad in, let me think...well...many, many years. Perhaps the reception of this particular mantra requires a medical degree.

I don't have an agenda, I only want to see fewer people die in pain.

Calling smokers names, insinuating that they are getting what they deserve, and refusing to address legitimate evidence contrary to your opinion can be perceived as an agenda. I applaud you for your devotion to your patients. If you are half as committed to them as your are to this thread, then they are lucky indeed.

I appreciate your openness - it's refreshing.

I don't think it really matters who is the first to go ad hominem. To be honest, it used to be always the anti smokers, and as I explained a bunch of us are tired of it and occassionally work from a pre-emptive strike mentality.

Does that help the debate? Possibly, only because of the reasons it is done - it shows those unaware of the total situation just how rudely smokers are treated. Is it the best way to do that? Probably not, but sometimes a little pro-active self defense is good for morale.

I appreciate your opposition to smoking bans and rudeness to smokers. In this debate there are 3 types of people the smokers, the non-smokers and the anti-smokers.

I fit in the first category, you are in the second. I have been unable to determine where DrLuv fits because with in the cross fire of ad homs he has declined to reply to any of my posts. From what I could gather he seems to be a cross somewhere between non-smoker and anti-smoker.

To me it is primarily a private property issue and I can not understand why people who do not like being around tobacco smoke don't do one of 2 things - either speak with the owner to change the smoking policy or use their wallet and open their own establishment that prohibits smoking. Instead so many insist that the government must do it for them.

One of the arguments in favor of smoking bans is that they will improve business because the non-smokers staying home will start coming out. It's just not true, it doesn't happen.

A total smoking ban in "public" places is going to take effect in Delaware starting in November. Originally there were certain exemptions to it. At the last minute an amendment was added to remove those exemptions, in order to "level the playing field." Pardon me - but if smoking bans are so good for business, why does the playing field have to be leveled???

My apologies for what may appear to be a rant - I'm just tired of automatically being tarred with a broad brush because of my views on this issue. More often than not my particular view is classified of that of a "nicotine addict that demands to have her fix anywhere and anytime she wants it." When the truth of the matter is that I believe the ownerof a private establishment open to the public should have the right to make the decisions regarding the clientele they wish to entertain.

the ones that downplay the risks

Doc, could you give me a little something more concrete than vague risks? As close as you can, how does smoking change the probabilities of cancer? I'm not looking for something without a reference point, like twice as likely, but something really meaningful, where I could actually understand how risky the behavior is. Something along the lines of, for every 1000 smokers (who begin smoking at age 20) 10 will die of lung cancer by 40, 15 by 50, 25 by 60, etc. For every non-smoker, 1 will die of lung cancer by 40, 2 by 50, 3 by 60.

"insinuating that they are getting what they deserve"

I never said that, nor did I ever imply it, you disingenuous creep. Look, you win. I am not wasting one second more of my precious holiday debating folks who believe the moon is made of green cheese. I had no idea that for some of you, smoking is some type of perverse religious experience.

If you want to believe what you believe - this is America - go right ahead. If you have the misfortune to land at my doorstep or one of my colleagues, be assured we will do everything in our ability to provide you with quality of life.

My last words on this thread are these: Stop smoking, you'll live longer...

What a shame you only chose to mostly interact with those you could easily castigate, instead of those truly seeking a solid discussion of the issues.

I for one am truly sorry you chose to not engage in discourse with those who wished to talk with you.

I am sorry to say, but your avaoidance of serious and not mean spirited questions asked of you has given me the impression that you are not interested in a healthy discourse on this issue. Several of your responses have been without personal degradation or ad hom attack, but the vast majority have not been such.

I understand your wish to enjoy you "holiday," but for the sake of science, intellectual discussion and the protection of the rights you contend to support, your avoidance of numerous posts (not just mine) with legitmate points of contention and desire for discussion belies your contention that you are personally opposed to some of these proposed laws.

Please enjoy your "holiday" there are many of us here who are interested in a discourse with you on this subject.

My last words on this thread are these: Stop smoking, you'll live longer...

Should read: Stop smoking, you may live longer. Non-smokers can die too (and die young). Surely you're not suggesting that all of your patients are smokers, nor that all of the cancers you see in smokers are attributable to their smoking - that would be sophistry.

Religious experience? No. Enjoyable experience? Yes. Would cancer be enjoyable? No. Would it make any difference if I knew what caused my cancer and had something to blame it on? No.

Tell me Doc, when you see a non-smoker and they ask you "What caused my cancer?", do you answer, "Well, we just don't know." And, when you see a smoker/ex-smoker and they ask you, "What caused my cancer?", do you invariably answer, "Your smoking."?

Thanks for your further comments. I think we are in agreement about smoking laws. I wish they would leave the airlines alone, too. In due course there would be lots of advertised smoking and non-smoking flights and airlines, as was already happening before the regulations. And, rude behavior is just rude behavior. In the days when smoking was the norm, I was sometimes on the receiving end, and I am very sorry to see many non-smokers behave badly now.

I do sympathize with Dr. Luv, though. I often overeat, arguably a worse habit than smoking. If a cardiologist came on a food thread and reminded me that the free radicals from all those chips are not worth it, I hope I would say "thank you very much".

One poster made the interesting point that he smokes tobacco, but never tobacco industry products. I have wondered if someone smoked natural tobacco in pipe, in moderate amounts, what his risks would be. That seems a lot different to me than smoking poison-sprayed plants mixed with who knows what chemicals, surrounded in chemically treated paper.

"violent reactions"? Oh, I don't think so. Most of the reactions to "Dr. Luv's" presumptuous, pompous blathering has been rather subdued.

If there are smokers here who feel "victimized" and otherwise not in control of their own lives and "Dr. Luv" wants to speak to them, that's fine. Most of us here don't fit that category and don't like being patronized by someone we don't particularly trust.

We all know what road is paved with good intentions. Normal adults don't try to force their beliefs on other adults when they're not welcome. Those who believe in their own superiority do so regularly.

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