President Obama's press conference covered a lot of topics yesterday—including, unexpectedly, his continuing struggle to quit smoking. To help us understand just how hard it is for some people to break their nicotine addiction, we turn to Dr. Richard Hurt, Director of the Mayo Clinic's Nicotine Dependence Center.
JOHN HOCKENBERRY: Good morning, everyone. John Hockenberry, here. You know, I don’t care what you think. We’ve been talking about the issues that Barack Obama talked about yesterday, but it seems to me that almost nothing he said yesterday about healthcare, about Iran, is bigger than this:
PRESIDENT OBAMA SOUND BITE: Look, I’ve said before, that as a former smoker, I constantly struggle with it. Have I fallen off the wagon sometimes? Yes. Am I a daily smoker, a constant smoker? No. I don’t do it in front of my kids. I don’t do it in front of my family. And, you know, I would say that I am 95 percent cured. But there are times where, there are times where I mess up!
JH: Ninety-five percent cured…is that like five percent pregnant? Hmmm. I have so many questions about this. For instance, who in the White House gets him the cigarettes, right? Is it the Secret Service guy? Is it somebody in the kitchen? I mean, Michelle Obama said during the campaign that she told him to quit smoking. If Michelle Obama told me to quit smoking--I’m not even married to her--I would quit smoking. OK? So, he’s in a very dangerous game here. Who’s reacting to this?
LISTENER SOUND BITE: I think the press is making a big deal out of the President’s smoking problem. It is a problem. He is addressing it. He’s trying to take care of it. I think we should leave him alone. He has many other problems around the world, dealing with the economy, dealing with foreign policy, the list is endless.
JH: Well, our listeners are right about that. 877-8MY-TAKE, or firstname.lastname@example.org. But, maybe the stress of dealing with all those issues may actually be partly why he’s having so much trouble quitting smoking. Joining us to talk more about the President’s smoking and the potential for the bully pulpit being a real teachable moment for health care professionals around the United States is Richard Hurt, who’s Director of the Mayo Clinic Nicotine Dependence Center. Good morning, Richard Hurt.
Dr. Richard Hurt: Good morning.
JH: Are you a doctor, by the way?
RH: I am.
JH: Alright. Dr. Hurt, thanks for being with us. First of all, you know, people are going to rag on me for making more of this. But, it seems to me, it is a moment where suddenly the significance and severity of nicotine addiction takes center stage, and I’m wondering what kind of opportunity you think this is for you?
RH: Well, I think it just underscores how difficult this is for some people. Now, not everyone struggles with this because the brain chemistry of each of us is different. But the cigarette is the most efficient delivery form of nicotine that exists. It gets nicotine to the brain basically in five heart beats, with a very sharp spike of nicotine, the likes of which you can’t get any other way. Even giving it to yourself intravenously doesn’t get it to your brain as fast as inhaling it. So, every cigarette does that. And for some people, the brain chemistry is altered and the brain receptors say, ‘I want a cigarette under this circumstance,’ and that makes the cravings and urges very difficult. Other people don’t have any trouble at all. Everyone knows an Uncle Charlie. Uncle Charlie smoked two packs a day for 30 years, couldn’t hold a job, was married four times, and one day woke up, and said ‘I’m going to stop smoking,’ and he did.
JH: That’s great. I love how that rolls off your tongue there, Doctor.
RH: So, everybody knows one of those people. And for every smoker who struggles with this, they know an Uncle Charlie, and they say, you know, if he could do that and I can’t, then I must have some characterological flaw. But that’s not the case at all. It’s really a matter of brain chemistry and the neurobiology of this. And all smokers are not alike, so. We treat this as a very serious medical problem, and we have a residential treatment program for people who struggle with this, and I just finished it last week, actually, and that’s like if you went into treatment for other, other drugs with dependence, and we treat it that way, because it is that severe for some people.
JH: Sure, and the President was treating it seriously when he signed, at his news conference, the bill that is going to actually bring tobacco under the same regulatory regime as other substances. Here he is, signing the bill:
PRESIDENT OBAMA SOUND BITE: Each day, 1,000 young people under the age of eighteen become new regular daily smokers. And almost 90 percent of all smokers began at or before their eighteenth birthday. I know: I was one of these teenagers. So, I know how difficult it can be to break this habit when it’s been with you for a long time.
JH: Do you think there’s the chance, Dr. Hurt, that Barack Obama will have more influence as a smoker struggling with this in public, than as someone who maybe doesn’t have the experience in attempting to influence those young people?
RH: Well, he certainly understands this, and I think that’s really important. And I think that the federal government could do a lot more than we’ve ever done before. Because every year, 450,000 Americans die of tobacco-caused diseases. That’s the equivalent of three fully-loaded 747’s crashing daily, 365 days a year, with no survivors. Now, were that to happen today, three airliners go down, does anyone doubt that the federal government through the F.A.A. would ground all 747’s throughout the world until the problem was fixed?
RH: And that’s what happens on a regular basis, and so, we need to come to grips with this, because this is an epidemic that is of gargantuan proportions.
JH: And the President is struggling with it, quite publicly. Richard Hurt, thanks so much for that. He’s the director of The Mayo Clinic Nicotine Dependence Center. He spoke with us from Rochester, Minnesota.
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