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This statement was angrily snapped at me by an irate clinic participant on her third successive day of cheating during her stop smoking clinic. She was mad because I kept telling her that she was blowing her chance at quitting smoking. I told her that as long as she smoked three or two cigarettes or even a single puff, she should just smoke the other two packs she would normally consume in a typical 24 hour period. She was suffering horribly and was convinced that all this misery had to serve a useful purpose. I was belittling her valiant attempt, and she was mad as hell at my arrogance.

She had been in other professional programs before. The other programs considered an 80% reduction in smoking a great accomplishment. Sure, they thought 100% would be better, but not all people could do 100%. Her physician would probably agree as well, that, if she couldn't quit, at least she drastically reduced her smoking. Her family and friends were most likely equally impressed by her major victory. Then she would come in to our meeting and I would say she was back to square one and should either smoke everything or stop all together. What made her so mad was her conviction that I really thought she was doing a great job but wouldn't admit it to her.

Contrary to her beliefs, I did not consider her attempt at reducing smoking a praiseworthy effort. Cigarette smoking is an addiction. Because of this, smoking is an all or nothing proposition. While her other programs, family, friends and other professionals may have viewed her drastic reduction as impressive, they all failed to understand that reduction was a temporary state. Reducing smoking by 50, 80, 90, or even 99.99% is worthless. It will result in a complete failure in the attempt. This failure will most often result in an eventual return to the old level of consumption and may even lead to a substantial increase over the level smoked prior to the attempt at quitting. It does not pay to cut down for a day or week or even a month just to become a heavier smoker for years afterward because of it. The end result of such a pattern is often the loss of one's health and eventually one's life. No one has ever lost his or her life from following our clinic's cold turkey and total abstinence approach, but many have already died and many more will die from disregarding it.

Eventual loss of health and life is not the only problem with cutting down in our program. There is the more immediate problem of intensified withdrawal lasting over a longer duration of time. It's not that the quitter is treating herself to one or two a day. In fact, she is prolonging the period during which she feels that she is depriving herself of 30 or 40 per day. This period will last until she either totally quits and survives through the initial quitting phase or until she reaches her old level. Unfortunately, the latter is the outcome in the vast majority of similar situations.

For a person truly dependent on nicotine, cutting down on tobacco consumption is guaranteed suffering and failure. It doesn't pay to suffer just for the sake of suffering. Quitting cold may cause some discomfort, but it is short term, and the end result can be freedom from cigarettes. Sure, quitting cold turkey can be difficult. But--for an addict--quitting by any other means is virtually impossible. Given the choice between difficult and impossible, go for the difficult. At least there is a chance of success. With that success comes improved health, self-esteem, societal acceptance, more money and an overall improvement in the quality of life. Once quitting is accomplished, all that needs to be done to maintain a life free from nicotine addiction is to - NEVER TAKE ANOTHER PUFF!