Smoking

I'm a smoker. Its something that I've readily admitted the entire time I've blogged. I grew up in a smoking household, my mother and her father smoked until they died from complications due to Huntington's Disease. My grandmother smoked a single cigarette from 40 until she turned 50. Then she quit completely.

I quit for a few years, and promptly started up again after a nasty relationship break-up. Soon thereafter I began to show physical signs of my Huntington's. I've made several good attempts to quit. Quitting is for my sake as well as the sake of Jane but not only do I find that one of the few things I really enjoy has been taken away, my depression and shakes seem to become worse. I've asked my neuro about this, and he thinks (off the record) smoking does make a difference. My psychiatrist says in his opinion it doesn't. 

Thompson Twins-"Doctor, Doctor"

That being said my own smoking has gone down from a pack and half to three to four cigarettes a day. Any higher and its just not worth it to me & any farther down and my depression alone swings past the tipping point to "don't get out of bed without serious prompting."  This last time, Jane actually handed me a pack of cigarettes after I was in bed for two weeks. I also don't smoke in the home but outside, so the house doesn't smell up. 

Still, while I still can I'm considering trying the gum one last time at a piece and a half three times a day. That would give the benefit and 'rush' from smoking while still getting myself off the actual cigarette while I still can. 

So what do the experts have to say? Their opinions are also mixed. 

From Beth-Israel Deaconess Medical Center's Home Safety for Huntington's Disease webpage:

If the person with Huntington's disease 

smokes, remember that it may be one of his few pleasures. Taking cigarettes away could cause agitation and extreme emotional upset. Instead, consider the following tips to keep smoking from becoming such a fire hazard in the home:

• Do not allow smoking in bed, which should be a rule for all members of the household.
• Look at the places where the person tends to smoke. Remove anything that could catch fire easily, such as newspapers, magazines, boxes, dried flowers, or leaves.
• Make sure that the floor and furniture are flame-resistant.
• If your loved one smokes outside, make sure it is in a low-risk area, away from dried wood, leaves, flowers, or flammable chemicals.
• Use ashtrays that are large, stable, and fireproof. Make sure the ashtrays are placed in an area where they cannot be easily knocked onto the floor. An ashtray attached to a floor stand might be a better alternative.
• Cigarette holders can help the person hold the cigarette without it burning down to their fingertips.

Talking Heads-"Burning Down the House"

Excerpted from A Caregiver's Handbook for Advanced-Stage Huntington's Disease by Jim Pollard (pg 42). 

**I've bolded the portions pertainting to helping to quit smoking.**

Half jokingly and half seriously, physicians who are experts in caring for people with HD have referred to HD as "one of the smoking diseases." Certainly a very large portion of people with HD smoke cigarettes. People with HD often view it as "one of the last pleasures I have left." Smoking becomes symbolic of independence.

Smokers and their caregivers are faced with a number of problems. Some folks with HD have an altered sense of hot and cold. Their fingers are often burned lighting cigarettes or smoking them down to the butt. Impaired judgement can make them unaware of the danger of burns to clothing, ashtray fires, or lighting the cigarettes of friends who are themselves unsafe smokers. The movement disorder makes it unsafe to use and dispose of matches and lighters. Impulse control problems may drive them to take another person's lit cigarette right out of his mouth.

The unsafe smoker doesn't want to hear your suggestion to quit or your offer of more supervision. Caregivers are often caught in a power struggle. If the unsafe smoker has a lengthy spell of illness or hospitalization that precludes his smoking, use it as an opportunity to encourage him to cut down or quit smoking. Although this may put the caregiver in a patronizing position to the unsafe smoker, it may reduce or eliminate unnecessary risk of burns and fire.

Caregiver Tips Regarding Smoking

• Take seriously the smoker's emotional need to smoke.
• Discuss the use of nicotine patches.
• Build a reward system to encourage him to quit.
• Use large ashtrays that are solid, sturdy, and untippable.
• Limit smoking to a well-protected area.
• Purchase nonflammable clothing, furniture, and floor covering.
• If necessary, have the smoker wear asbestos vest. Install extra smoke detectors.
• Use a "smoker's robot." It holds a cigarette to prevent ashes and embers from being dropped.

Soon I'll be updating with even more sources, but here is a very interesting discussion by carers(caregivers)  on dealing with the smoking issue with their loved ones.at the Huntington's Disease Lighthouse. 

Take care and "Top of the mornin' to you"

Catch Paul Ware on Facebook or Twitter. I can also be reached via email (delete no spam) but much prefer the Facebook message option.