How does tobacco use really affect the lives of individuals and families? That simple question led us on a long journey of understanding. With the help of 225 smokers and nonsmokers in every corner of America who spent many hours telling their stories in great detail, we believe we now have a much better picture of the challenges faced.
What they told us is well worth sharing: the precise dynamic of how smoking affects couple relationships and parentâchild relationships; how anger, silence, and secrecy are wrapped up in the smoking dynamic; the battle in the home behind closed doors as both smokers and nonsmokers invoke personal rights and the American way in efforts to win arguments and defend positions; the intimate, behind-the-scenes private and personal discussions over health and the effects of smoking on smokers and nonsmokers; how smoking controls oneâs life in many ways, controlling when and where a smoker can find a place to smoke without retaliation and where nonsmokers can find a smoke-free environment.
And, by far the most important of all, we learned how absolutely essential positive communication isâhow smokers and their loved ones will never be at peace until they find a way to speak courageously and honestly from the heart, and, even more important, until they find a way to listen to each other from the heart and genuinely understand what each is saying. Positive communication aims at building bonds between individuals and making it possible to work together toward common goals. Rather than lining up against each other and struggling toward some kind of false victory, one side over the other, smokers and nonsmokers can unite in their families and find ways so that they can live more happily together.
Reading the many stories in this book from lifelong smokers, unrepentant smokers, smokers who canât quit, smokers who donât want to quit, former smokers, and lifelong nonsmokers gives us a broad and deep understanding of the controversy that has raged in the media and that is really fought behind closed doors.
The reader quickly sees how many people really are not listening to each other and can, thus, doom themselves to playing out their lives like an endless and hopeless TV political discussion. All this may seem entertaining on TV, but in reality, it is terribly demoralizing.
Reading this positive, objective, nonjudgmental book is a step in the right direction, a way out of the dilemma. Communication leads to a better understanding of each other, which leads to respect and appreciation for each otherâs needs, which leads to more fulfilling lives together.
Each of the stories you will read in this book is, as nearly as possible, the original words of the people who chose to talk candidly about the social, physical, and psychological impact of tobacco use on themselves and their families. The authors have changed names, dates, locations, and other details that might identify individual respondents, in order to protect their privacy. For information on the methods used in this project, please turn to the Appendices.
Tobacco use significantly affects and can determine the shape of all familial relationships. Given the complexity of family relationships and range of family types, we will limit our examination here to how tobacco use affects two types of familial relationships in particular: marital and couple relationships and parentâchild relationships. Tobacco use influences each of these types of relationships in significantly different ways. However, many of the key issues in both types of relationships are the same: the need for trust, intimacy, respect, and communication.
Since the family often includes couple and parentâchild relationships, the effects of tobacco use on each of the relationships are complicated by the complex interconnections of the family unit as a whole. Furthermore, in regard to experiences as a child in oneâs family or origin can influence the relationships of adult partners with tobacco and consequently shape their own familial relationships with their children. After all, the path of least resistance is to practice as adults what we learn as children.
Smoking invariably influences couple relationships in many ways. For the nonsmoking partner (or the partner who has quit), issues of trust and intimacy are paramount. Many nonsmoking correspondents describe feeling betrayed when partners smoke in secret, or pretend to have quit smoking. Nonsmoking partners are also apt to suffer stress over the physical, emotional, and financial effects of smoking on their family as a whole. Finally, nonsmoking partners who experience the illness or death of a partner due to smoking must undergo the emotional, physical, and psychological stress of caregiving in addition to the loss of a partner. The knowledge that illness, disfigurement, or death could have been prevented can lengthen and aggravate the grief process for survivors of loved ones.
On the other hand, the smoking spouse/partner must deal with feelings of guilt and shame if they believe that their habit or addiction is harmful to their partners and other family members. Unfortunately, as revealed by much of their testimony, the pressure from loved ones to quit only increases the intensity of feelings smokers already have, inflating their sense of failure and humiliation. This can lead initially to increased use of tobacco. Smokers who admit the dangers of tobacco use also report stress about prematurely leaving their partners and families without adequate means of support due to smoking-related illness, in addition to fear for the health of their loved ones and themselves.
Further, because smoking often becomes an issue of rights and choice, to smoke or not smoke may be a threat to individual autonomy and equality within the relationship. For example, female partners who smoke may feel that their right to smoke should not be a right their male spouse can revoke, and male partners may feel publicly humiliated when their spouse and children âscoldâ them about their habit and pressure them to quit. These emotions only exacerbate the problems of smoking in families and do not lend themselves to what is so essential for both smoking and nonsmoking family membersâcommunication, empathy, and support.
Tobacco use also affects marital/partner intimacy. Many nonsmokers, including those who have quit, speak to the difficulties of intimacy with a smoking spouse because of the physical effects of tobacco useâthe smell of tobacco on the breath, hair, skin, and clothing of their partners. Additionally, some partners point to smoking and smoking-related illness as the cause of diminished libido and impotence for their smoking spouse/partner. Nonsmoking partners may be so repulsed by the physical effects of tobacco use on their spouse/partner that they lose the desire for intimacy and become physically and emotionally estranged; some contemplate divorce. For the nonsmoker, a partnerâs secret smoking or broken promises to quit may foster feelings of betrayal that lead to a loss of trust. Some nonsmoking spouses do not understand how their partners cannot quit a habit that endangers their own health and threatens their relationships. As with other marital/relationship problems, lack of desire for intimacy, loss of trust and communication, and anger about the dangers of secondhand smoke, all of which a nonsmoker may experience with a smoking spouse/partner, can lead to further estrangement, the internalization of guilt for dissolution of the relationship: âit was my fault,â and divorce.
It is difficult for both smokers and nonsmokers to understand each otherâs needs and fears. The nonsmoker believes that if their partner really cared, they would make the effort to quit. The smoker feels constantly misunderstood and under pressure to quit; besides, it is not easy to kick an addiction. But while the issues surrounding smoking in a marriage are heavily emotional, communication often deteriorates into unproductive arguments; a nonsmokerâs fear for his spouseâs well-being turns into disgust and ânaggingâ and a smokerâs inability to quit become insidious secret smoking.
Testimony
My present husband has allergies and smoking bothers him. Smoking bothers my mother-in-law. I just say you have to take me the way I am, even though deep inside I would like to quit smoking. It doesnât make me feel good. I am tired all the time. (a smoker who canât quit)
*****
My sisterâs house was in a constant state of tension for two years as she struggled to quit. Her husband and seven-year-old daughter put tremendous pressure on her. She smoked when they were not around. She resented the pressure and hated herself for sneaking. (a former smoker)
*****
I met my second husband about five years ago and did not realize, even after we married, that he had been a smoker for years and only quit cold turkey eight years earlier! He had smoked since he was about eighteen. We were married six months when I saw him on the porch hiding a cigarette from me. I never even considered that he might smoke. He stopped hiding it shortly after I saw him that first time, and expressed sorrow and guilt that he had started again. I noticed that his teeth yellowed faster and that he had a lingering odor that even a shower and mouthwash couldnât get rid of. I mentioned kindly that the smell offended me and turned me off at night. I was careful not to insult him for his habit; I wanted to prevent upset in the family for this minor irritation. I wouldnât divorce him for it; but it sure could be a source of friction that could gnaw at you until you let it out over something that might not even be related. (a former smoker)
*****
My husband and I feel fortunate that we were able to celebrate our recent anniversary. Had I not insisted that Frank see a doctor, a few months would have made all the difference. There is no doubt in our minds that had he waited he would not be here now, or if he had lived, the quality of his life would have been changed dramatically. There is no doubt whatsoever that years of cigarette smoking were the cause of his cancer. Our children have suffered with us. (a former smoker)
*****
Just prior to the cancer diagnosis, my marriage had been very strained. I had established a small business for my wife as a hedge against the very possibility that I might be incapacitated; I wanted her to have âa way to goâ if I was unable to continue to support her, or if we separated. The hospital was 185 miles away, I was thought to be dying, and she had her business to maintain, which was her sole livelihood. She could only visit an average of twice a week. The feeling of abandonment was devastating! (a former smoker)
*****
I encouraged my spouse to try whatever was available to quit smoking. However, I did not like being with him when he was trying to quit. Itâs not an easy time. He cheatsâhiding behind trees even. Now I say, âKeep smoking, but donât take it out on me. End your life sooner, thatâs your choice.â Weâve gone through the process many times and he always goes back to smoking. (a nonsmoker)
*****
My husband of almost 51 years is still on his feet at 94. He has breathed secondhand smoke half a century with me without so much as an allergy. He did develop bladder stones and gallbladder stones after he was 90, but no prostate cancer. Will I kill him someday with my smoke? (a smoker who canât quit)
*****
âŠI married for the third time, to a woman who smokes. Well, now I canât breathe in my own home. I refuse to hug her for the stench of cigarettes in her hair, her breath stinks, and we now sleep in separate rooms after only five years of marriage. (a former smoker)
*****
Husband number two nagged me quite a bit about smoking, but I needed my friendly cigarettes to get by. I never really had what you would call a stable home life. In smoking I found something that I could count on and control, and no one was going to take that away. (a smoker who canât quit)
*****
My wife and three children have been strongly opposed to my smoking for several years, and I have not smoked in the presence of my children for at least the past five years. I continue to smoke in the presence of my wife, over her objections and constant reminders that it is extremely detrimental to my health. Obviously I recognize that I have a serious addiction. (an unrepentant smoker)
*****
Stories
A Smoker Is Not Being Fair to Their FamilyâA Former Smoker
My wife passed away in May of this year, and I would give my right arm if I could have her back with no suffering on her part. My wife was eighty, and I was eighty-five at the time of her death. We were both a-pack-a-day smokers having started the habit in our early twenties. My gripe is that a smoker is not being fair to their family and those who inherit the position of caregiver. Of course, I do not regret one minute spent in giving her my undivided attention. I wish I had her back. In 1983, I was in the hospital with a respiratory problem, and upon discharge, my physician advised that if I stopped smoking I would probably add five years to my life span. I stopped immediately. To date, it has been ten years. I have emphysema. It is not severe; I can do almost anything a person my age is capable of doing. After my return from the hospital, and for several years following, I pleaded, begged, and implored my wife to stop smoking.
This is my gripe: Not being an M.D., my prediction may not hold water; however, I believe that had my spouse quit smoking, she would be alive today.
Currently, my life is lackadaisical and without direction. I have few friends, and they seem to live as couplesânot singles. Having my spouse (a common smoker) leave is like having the bottom drop out of my life. It is difficult to understand why people continue to smoke when so much information is available to demonstrate that continuing the practice leads to eventual suicide. Tobacco ruined our lives and took hersâit could have been avoided.
He Wouldnât Accept the Fact That Smoking Was Turning Me OffâA Former Smoker
My husbandâs smoking has affected our...
