By Doug Brunk, San Diego Bureau
The day Dr. Robert L. Kistner turned his back on cigarette smoking was Jan. 1, 1982, a behavior he began as a 14-year-old growing up in St. Louis.
"I smoked through high school, college, and through medical school and the Air Force," said Dr. Kistner, now a vascular surgeon in Honolulu. "As I got into practice in the 1960s, I was still smoking."
For him, taking drags from a cigarette "was a very enjoyable thing to do. It was relaxing. I smoked long and heavily. I really hungered for cigarettes."
When the first Surgeon General's Report on Smoking and Health came out in 1964, "it became obvious that there was something bad about the stuff," Dr. Kistner said. "But the horrible extent of it and its far-reaching effects that we now know really well were just becoming fact. Ultimately, I was faced with [the notion that], 'this is something I really enjoy but it's not pleasing to other people and it's not good for me.' It's something I had to get rid of because I began to preach to people that they shouldn't be smoking and then I'd be reaching for a cigarette. It was incompatible."
His two young daughters also gave him flak about his habit. "Fortunately, they did not take up smoking," he said. "They were turned off by the smell of it and the dirty ashtrays."
Dr. Kistner gradually weaned himself from cigarette use in the late 1970s. First, he chose to not smoke during his workday when he was around patients. Next, he decided he wouldn't smoke at work or at home. Then, he lit up only when he left Hawaii on business travel.
In the end, he appointed Jan. 1, 1982, as his cold turkey quit date. He has not smoked since.
"For some reason, my mind was made up enough that I didn't smoke and it did not make any difference," he said. "It was a conviction. From that point on, for 6 months or 6 years, I'd walk around where somebody was smoking and just smell it. But I had no desire to pick one up."
He went on to note that physicians who currently smoke are "not only hurting themselves, but they're hurting their environmentnot just by smoking but by giving the example of smoking. It's very much against the [medical] profession."
From Basketball to Cigarettes
Smoking was commonplace in Dr. Richard D. Hurt's hometown of Murray, Ky., in the early 1960s. He picked up smoking after dropping his basketball scholarship at Murray State University.
"After my first year of college, it was obvious that I was going to have to do something else to make a living besides play basketball," recalled Dr. Hurt, an internist who directs the nicotine dependence center at the Mayo Clinic, Rochester, Minn. "So I dropped my scholarship, joined a fraternity, and started drinking and smoking like what I thought everyone else did at the time."
He described himself as a heavy smoker from the get-go, puffing three packs a day through the rest of college, medical school, an internship, 2 years in the Army, and his residency.
Like many other smokers, Dr. Hurt spent years trying to quit; sometimes for as little as 30 minutes, other times for as long as a week.
One day his wife, who also smoked, phoned him at work to tell him she had signed them up to attend a smokers' clinic at Rochester Methodist Hospital. "Had it not been for her calling me that day, I don't think I would have ever stopped smoking," he said. "More than that, I would probably not be here today. She was the motivation."
The group support there "made it so I was able to focus attention on me and what I was doing," Dr. Hurt said. "There was no pharmacotherapy at that time. I was focusing my energy and attention in a way I had never done before."
For him, the hardest part was the constant urges to smoke. "I took it in time increments that were manageable," he said. "I knew I could stop smoking for an hour, but I wasn't sure about 2 hours."
After a group session on Nov. 22, 1975, he drove home and quit smoking for good.
"There's an old adage in the alcoholism treatment world: Take it 1 day at a time," he said. "Some people take it in smaller increments than that. I certainly did [in] the beginning. The urges to smoke can be very powerful and intense, but they don't last very long."