Smoking Ban Nearly Drove Me to Suicide

A little over a month ago, I learned how to tie a “hangman’s noose”.  I also called the local humane society to see about relinquishing the care of my cat, and was making other necessary preparations before putting the noose around my neck.  This was after the property management at my apartment complex announced they would soon be implementing a smoking ban in all tenants’ units.

For many tenants, such bans mean a major change in lifestyle, or at least a major inconvenience in having to go outside to smoke (especially during our Maine winters).  Some smokers will be able to quit, and others will be able to make other necessary adjustments.  In my case, this ban was ‘the last straw’ in a series of losses to my autonomy, and to my quality of life.

I’ve suffered with severe Social Anxiety Disorder (SAD) and depression which has worsened over the years.  There has been, and there still is no effective treatment available to me either geographically or financially.  These conditions have slowly taken things away from my life – things that most people can take for granted, like being able to drive, having a social circle of friends and family, and being able to socialize in general.

The depression alone has taken away my interest in any hobbies or activities that I used to enjoy.  I am left with sitting in my rocking chair watching TV, and smoking cigarettes for about sixteen hours a day.  I’m not ‘lucky’ enough to be able to sleep away the emotional pain and depression like some other depressed people can.  On my better days, I can use the computer (although too often, it feels like salt in the wound when those of us who suffer with SAD so desperately need real human contact).

Also, because of the effects of sexual abuse I endured both as a child and an adult, I’m now unable to have a ‘significant other’ in my life unless I would still be willing to drink every day or night in case sex was expected of me.  So, I am almost totally isolated.

I knew that I wasn’t mentally or emotionally equipped, nor did I have the necessary social support to try to quit smoking.  I cannot even go to the community building until after dark to check my mail because of the horrible anxiety and (yes irrational) discomfort I experience from just feeling looked at. To be forced to go outside to smoke with that kind of social anxiety would have been far beyond being a major inconvenience.

I’d had thoughts of suicide in the past, but after finding out about the impending smoking ban, I was fully ready to follow through.  It took one helluva lot of strength I didn’t know I had, but ultimately, I got through that very scary episode of suicidal intention – only because I’d discovered electronic cigarettes.  But “e-cigs” may not be a feasible answer for all smokers.

Now I am aware that there are people who have little or no sympathy for those who can no longer smoke freely. (And that is understandable – I did feel guilty about my own second-hand smoke.)  And I’ve been painfully aware that some people have little empathy for those with mental health issues.  (Over the years, I’ve learned to dismiss such people as having their own issues – ones I hope never to have.)

But, it needs to be brought to light that people with severe mental problems suffer in a way that is beyond the understanding of most people, and their priorities for the future are often very misguided.  The very act of trying to quit smoking by these people can be dangerous, and can actually lead to severe depression and/or suicide.

Consider these citations:

Many prior studies have found an association of current smoking and suicide (Leistikow & Shipley 1999). In addition, a recent review cited some evidence that smoking cessation could precipitate a clinical depression (Hughes 2006) and, thus, might lead to increased suicide.”

“In terms of actual data, many lines of evidence indicate smoking causes a physical dependence on nicotine and this results in a withdrawal syndrome (Hughes 2007a) that includes worsened mood and other behaviors that would increase the risk of suicide.”

“… increased suicidal behavior early on after cessation due to nicotine withdrawal is clearly plausible.

– John R. Hughes, University of Vermont, Burlington, VT

Nicotine has some positive effects on symptoms of psychiatric disorders… several studies have shown that some symptoms of psychiatric disorders may be exacerbated by nicotine withdrawal. Therefore, attempts to quit smoking pose additional problems to patients with mental health problems.

– Fagerstrom K and Aubin HJ. Management of smoking cessation in patients with psychiatric disorders. Current Medical Research and Opinion. 2009;25:511–8. Ref; Australian National Preventative Health Strategy.

Smokers with a history of anxiety disorders have an impaired ability to quit smoking and fail to respond to cessation pharmacotherapy that is usually effective in smokers without such a history, new research suggests.
These findings have considerable clinical relevance,” write Megan Piper, PhD, from the University of Wisconsin School of Medicine and Public Health and the Center for Tobacco Research and Intervention in Madison, and her colleagues.”

“This work suggests that clinicians and researchers should assess anxiety disorder status if they wish to predict patients’ withdrawal and likelihood of achieving abstinence,” the study authors add.”

In summary, it is clear that to ask people with mental illness to quit smoking when they’re at their most vulnerable is unfair, cruel and even inhumane. Across-the-board impositions of smoking bans by landlords or property management in one’s home without regard for the mental health of a tenant crosses a line, and further kicks those who are already down.

Many of us with emotional/mental problems would like to quit, but we would likely have an incredibly difficult time doing so. Those who are losing the strength to struggle, or who are in the midst of a mental health crisis may well be at risk of deadly consequences when being forced to quit.


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