My Mom's Story

In a 1960 poll organized by the American Cancer Society, only one-third of all doctors in the United States believed that cigarette smoking should be considered a 'major cause of lung cancer'. According to that poll, 43% of American doctors smoked cigarettes regularly, with another 5% reporting occasional smoking (Proctor, 2011). Of course, the detrimental effects of cigarettes and the link between cigarettes and lung cancer was well documented at that time, but the tobacco industry went to great lengths to hide this information from the masses by implementing their own pro-smoking propaganda. My parents grew up during this time period, and they carried those pro-smoking beliefs with them for decades, even after the 1998 Master Settlement Agreement was finalized. The Master Settlement Agreement was signed between the 4 largest tobacco companies and nearly every U. S. state to recover billions of dollars in health care costs associated with treating illness related to cigarette smoking.

My mother finally quit smoking at the age of 66 - after 5 decades of smoking. It took nearly losing her life for her to realize the damage that smoking had done to her lungs. 

In January of 2022, my mom contracted a serious case of pneumonia. It was not COVID-19 pneumonia (thank goodness), but it was the worst case of pneumonia I had ever seen. She was kept in the intensive care unit at Parkview Hospital for nearly a week until she was stable enough to be moved to the progressive care unit. When I visited my mom in the hospital, my heart sank upon laying eyes on her. I could hardly recognize her. She was hooked up to an oxygen tank, receiving 5 liters of oxygen, and she was barely coherent. The hospital staff brought her lunch - a grilled cheese sandwich, soup, and pudding - and sat it down on a try in front of her. She was so weak she could not grasp her silverware. How did they expect her to feed herself? I got up to spoon feed her some pudding. I spoke to her in a childlike manner: "The pudding is good, isn't it, Mom? Do you want some more pudding?" And she excitedly said, "More! More!" 

This childlike exchange was the extent of our interaction.

What had happened to my mom? She looked like she had aged over a decade since being hospitalized. She was unable to communicate her needs and wants. She could only speak in one- to two- word sentences. She reminded me of someone in late-stage dementia. I did not understand what was happening to her. Just weeks prior, my family and I had visited her for Christmas, and we all opened presents together. She laughed with us, talked with us, and ate lunch with us. The nurses and doctor on duty at the hospital could not fathom that my mother had lived alone prior to this hospitalization. "She was not like this a few weeks ago!" I kept telling them. "She could use a phone! She could pay her bills! She could cook a meal!" The woman lying before us on a hospital bed could do none of those things. In fact, this woman could not walk, toilet herself, or even remember how her husband had died. 

I was scared. I had never seen my mom so sick and weak before. The doctor had told me that infections can cause cognitive impairments in older adults. I had a hard time understanding what was happening. When I got home from visiting her, I decided to do some research. I read all kinds of medical articles - news articles, blogs, and empirical studies. I began to wonder if the pneumonia had unmasked an underlying dementia diagnosis in my mother. According to Mills (2020), the risk for complications related to infection increases with age due to changes in how the immune system responds to infection. "One of these complications is the acceleration of cognitive decline. Infections can cause short term cognitive impairments which are reversible once the infection is cleared, but they can also lead to long-term cognitive impairments in people who are already on the trajectory toward dementia" (Mills, 2020). 

Would my mother survive? If so, would she recover? 

I continued to visit my mother regularly. One day I was speaking with one of the nurses who was taking care of my mother. I told the nurse that my mom was a lifelong smoker, and I asked if all those years of smoking had weakened her lungs and opened the door for the pneumonia to get this bad. In so many words, the nurse confirmed my theory. Thinking aloud, I told the nurse that if my mom survives this infection, she'd better not go back to smoking. The nurse agreed with me and urged me to do all I can to help my mother stop smoking.

I had an idea. I decided that I was going to drive to my mother's apartment after I left the hospital, and I was going to dispose of all her cigarettes, lighters, and ashtrays in the apartment. Then I was going to clean the apartment to get rid of the smoke smell. I thought to myself: "If she comes home and buys herself more cigarettes and starts smoking again, then it's on her. At least I know in my heart that I tried to stop her."  I could not, in good conscience, let her return to that apartment with cigarette paraphernalia lying around. I knew there was a chance that this would not work, that she would be extremely angry with me, but it was a gamble I was willing to take.

A couple of weeks later, my mom was well enough to return home. She completed physical therapy in the hospital's rehab unit, and although she was still weak, she could walk. She could hold a conversation. She was coherent enough for me to tell her what I did. I looked at her and, firmly but lovingly, I told her, "Mom, when you get back to your apartment, there won't be any cigarettes there. I got rid of everything. I am not ready to lose my mom yet. I hope that you will not go back to smoking. You nearly died, and if you go back to smoking and catch pneumonia again, you probably won't make it." She look at me tearfully and said that she did not want to smoke anymore.

As of December 2022, she has not had a cigarette for 12 months. 

Quitting smoking is hard, and I am thankful that my mom was able to stop. Nearly dying opened her eyes to the extent of damage that cigarettes did to her lungs. It is possible to quit smoking, even after 50 years of doing it. If you or a loved one are interested in stopping smoking, talk to your primary care doctor to get some help.

If you do not have a primary care doctor or want to learn more on your own before visiting your doctor, here is a great resource on smoking cessation from the Centers for Disease Control and Prevention: https://www.cdc.gov/tobacco/campaign/tips/quit-smoking/index.html

Quitting is possible, and you are not alone.

References

Mills, B. (2020, July 9). Do infections accelerate cognitive decline? Cognitive Vitality. https://www.alzdiscovery.org/cognitive-vitality/blog/do-infections-accelerate-cognitive-decline

Proctor, R. N. (2011, July 5). The history of the discovery of the cigarette-lung cancer link: evidentiary traditions, corporate denial, global toll. Tobacco Control (21), 87-91. doi: 10.1136/tobaccocontroll-2011-050338.