COPD patient wanting to leave to smoke

wooh, BSN, RN · Oct 19, 2011

Pulling out tubes, falling, etc etc....sure. But to jump from smoking to "using their IV to do drugs" is ridiculous. Sorry.

I've had multiple patients do just that. It's not that big of a leap.

Altra, BSN, RN · Oct 19, 2011

Holy cow. How do you make the connection between someone wanting to go out to smoke to THIS??

Pulling out tubes, falling, etc etc....sure. But to jump from smoking to "using their IV to do drugs" is ridiculous. Sorry.

Ridiculous?

My hospital has had not one but two sentinel events r/t patients injecting illicits into peripheral IVs, central lines, and dialysis catheters.

blondy2061h, MSN, RN · Oct 19, 2011

Whatsgoingon, are you a nurse? I find it interesting that all of your posts are in this thread. I have a hard time believing a nurse would feel that smoking has benefits, as you have stated.

talaxandra · Oct 19, 2011

Smoking does have some health benefits - a reduced incidence in ulcerative colitis, lowered incidence of Parkinson's Disease, some protection against endometrial and thyroid cancers, decreased incidence of pre-eclampsia, and a significant reduction is the severity of psych drug side-effects. According to this source this disease reductions of smoking save around 150 Australian lives a year. That number's just a little overshadowed by the estimated by the 15,000 annual Australian smoking-related deaths, though.

I also agree that denormalisation is a technique that's been used to stimgatise smoking and make it less attractive. It's also a technique used to stigmatise obesity and the obese, with great effect, though unlike smoking it's not affected the incidence, just increased the level of stigma and social isolation of fat people.

I disagree with whatsgoingon, who does so far in their membership seem to be a one-theme pony, that smokers are viewed as "essentially worthless because of their 'addiction'". I also think the fact that so many people can't quit even though they want to, who are in every other respect successful at whatever they undertake, strongly indicates a level of very real dependence. There's also strong evidence connecting preventable disease with second-hand smoke exposure.

whatsgoingon · Oct 19, 2011

Blondie, I'm not a nurse. But I am aware that nurses are on the front line with a difficult balancing act to perform. Medical care of the last 40 years has become heavily technologized where medical staff can almost be considered as part of the technology. The great risk is that the human element, the person-to-person acknowledgement between carers and patients is compromised. My interest in the smoking issue is where information is so dominated by one superficial mentality, i.e., producing propaganda, that it detrimentally affects the psychology of carers/providers. When a group (smokers) is constantly referred to as "just addicts", a group that MUST be "converted", it opens the door to bigotry and the consequence of substandard care, i.e., potential iatrogenic effect.

This is why it's a very serious matter: "As many as one in four doctors who responded to a 2005 Canadian Lung Association survey admitted to providing lesser care to smokers."

http://www.nationalpost.com/news/canada/story.html?id=2417574

That's 25% of doctor respondents admitted to providing lesser care to smokers. If it was a fraction of a percent, it should be sounding alarm bells. 25% is extraordinary, catastrophic. How did it get to this point? And as far as I'm aware there was no follow-up of that research. If anything the situation is worsening. Unfortunately, this is to be expected when the medical/Public Health administration departs from its primary mission of medical care and recklessly ventures, again, into social engineering crusades.

I'll provide some additional information in the posts below if you are interested in understanding how we got to this point. It is information that you will not typically encounter in the mainstream because it does not fit the antismoking agenda. To be clear, I'm not pro-smoking as such. Rather, I'm pro-sanity.

whatsgoingon · Oct 19, 2011

The official line is that there are no benefits in smoking which is only an addiction. This is an erroneous view that was peddled by the Temperance Movement in the 1800s and that was also picked up by the Eugenics Movement of early last century. Given the unfounded belief that there are no benefits in smoking, the question then becomes why people continue to smoke. The eugenicists (physicalists) "resolve" this question by claiming that the entire behavior is held together by "nicotine addiction".

Post WWII, nicotine was, rightly, not considered an addiction. Nicotine was re-defined, contrary to available evidence, as "addictive" by US Surgeon-General C. Everett Koop in 1988 and very much in line with the physicalist view. The Office of the Surgeon-General had long been aligned to antismoking and a "smokefree" society, i.e., ideologically compromised.

It was also defined so in 1994 by an "expert panel" very much aligned to antismoking.

http://www.newscientist.com/article/mg14319381.300-us-ruling-turns-smokers-into-junkies.html

Some of the benefits of smoking:

http://www.ncbi.nlm.nih.gov/pubmed/20414766

http://diseases-viruses.suite101.com/article.cfm/nicotine_antiinflammatory_h1n1_cure

http://news.discovery.com/human/smoking-is-good-for-you.html

http://ajplung.physiology.org/cgi/content/abstract/289/2/L268

http://www.sciencedaily.com/releases/2006/09/060918165352.htm

http://www.intelihealth.com/IH/ihtIH/EMIHC000/333/20792/317857.html

http://www.dailymail.co.uk/health/article-405425/The-gas-cigarette-smoke-save-pregnancy.html

http://www.thecrimson.com/article/1993/2/11/study-finds-benefits-of-pollutant-pa/

http://dengulenegl.dk/English/Nicotine.html

Just nicotine is a cognitive enhancer. It aids focus. It is not surprising that some of the more profound intellectuals, writers, musicians, artists, scientists of the last century were smokers.

The latest that smoking is a habit, not an addiction:

http://www.sciencedaily.com/releases/2010/07/100713144920.htm

Nicotine is not peculiar to tobacco. There are small quantities in potatoes, tomatoes, green peppers, egg plant, and black tea.:

http://content.nejm.org/cgi/content/extract/329/6/437

Nicotine is also a precursor of nicotinic acid, also known as niacin or vitamin B3 (NIcotinic ACid vitamIN).

whatsgoingon · Oct 19, 2011

from the royal college of physicians (a group very aligned to antismoking since the early-1970s):

"it is now widely accepted that nicotine is the primary addictive component of tobacco smoke. in recent years, however, it has become clear that the psychobiological mechanisms which mediate the addiction are more complex than they first appeared..........however, the experimental animal data also indicate that, when compared with many other drugs of dependence, the reinforcing properties of nicotine appear relatively weak. thus, it may be that nicotine alone does not have the powerful addictive properties necessary to account for the highly addictive nature of tobacco smoking, and that addiction to tobacco reflects complex interactions between nicotine, other stimuli associated with the inhalation of tobacco smoke, and possibly other environmental, social or behavioural stimuli associated with smoking." (p.45, 2007)

http://www.rcplondon.ac.uk/pubs/contents/4fc74817-64c5-4105-951e-38239b09c5db.pdf

a prominent american tobacco control advocate (michael siegel) recently noted that the idea of "addiction" is highly "flexible" in antismoking circles: "the anti-smoking advocates seem to change the science on whether smoking is a choice or an addiction based on the issue of the day. if the issue is a lawsuit, then smoking is an addiction. if the issue is refusing to hire smokers, then smoking is a choice. if the issue is the fda regulating nicotine, then smoking is an addiction. if the issue is denying medical care to smokers, then smoking suddenly becomes a choice again."

smoking has numerous aspects - psychological, pharmacological, perceptual, behavioral, social. people smoke for different reasons at different times. nicotine - just one aspect of smoking - is mild in effect, on a par with caffeine.

whatsgoingon · Oct 19, 2011

There are two main, interconnected reasons for the "nicotine addiction" myth. Firstly, it serves the deranged antismoking goal of a smokefree world legitimized by a eugenics framework. Smoking is depicted as useless, maintained only by nicotine addiction and where "addiction" is intended in the most derogatory sense of the term. This fosters the idea that smokers are reckless, "intoxicated", irrational, irresponsible persons. And it is intended to create outrage in particularly nonsmokers. Nonsmokers who allow themselves to be brainwashed by the propaganda then demand protection from irresponsible "addicts". Even more perverse is the claim that nicotine is "more addictive" than heroin or cocaine. Such irresponsible, agenda-driven statements trivialize what are profound differences between these substances.

Secondly, the nicotine addiction myth also serves the pharmaceutical cartel. By depicting smoking as due only to nicotine addiction, the pharmaceutical cartel has been able to peddle its nicotine replacement therapy (NRT) as the major/only means of quitting smoking. It was fully expected, according to the nicotine addiction model, that people would simply put on a nicotine patch and they would quit smoking. But it doesn't quite work that way.

Yet, the success rate of NRT at one year is 3+% above a 3+% placebo baseline. At one year, NRT has a failure rate of ~97%. At two years, it is even closer to a 100% failure rate. This further and greatly undermines the "nicotine addiction" model.

http://www.bmj.com/cgi/content/extract/338/apr29_1/b1730?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=smoking&searchid=1&FIRSTINDEX=0&sortspec=date&resourcetype=HWCIT

The pharmaceutical cartel pushes for smoking bans and increased taxes on tobacco by funding antismoking groups. The medical establishment also peddles these essentially useless products. When bans and increased taxes are instituted there is an increase in NRT sales.

http://news.scotsman.com/tobacco/Nicotine-patch-sales-rocket-in.2766561.jp

http://www.independent.co.uk/life-style/health-and-families/health-news/bonanza-for-nicotine-gum-and-patches-as-millions-try-to-quit-456426.html

http://www.sbpost.ie/breakingnews/?c=ireland&jp=mhkfgbqlidcw

http://www.brudirect.com/index.php/2010120134492/Local-News/nrt-products-in-demand-since-cigarette-price-hike-says-jpmc.html

Knowing that these products are essentially useless, BP has even managed to weasel these products onto taxpayer-funded Pharmaceutical Benefits Schemes, e.g., Australia, Canada, where they are handed out like candy, making even more profits for BP. Worse still, BP has also been allowed to peddle the dangerous drug Champix/Chantix.

http://blog.al.com/spotnews/2011/01/birmingham_court_to_oversee_pf.html

http://www.lawyersandsettlements.com/articles/chantix/chantix-suicide-side-effects-57-15821.html

http://www.bnet.com/blog/drug-business/reports-of-psychotic-violence-on-anti-smoking-drug-chantix-pile-up-but-pfizer-isn-8217t-seeing-them/5163

While it is aware of these serious problems, BP is peddling this drug in Japan.

http://www.nytimes.com/2011/01/04/business/global/04smoke.html?_r=1&src=busln