People who act against their (costly) medical treatment

[2SkodaFamily]

Each time I arrive at the Oncology Centre at St James Hospital, Leeds, it never ceases to amaze me how EVERY time I go in or out, there are people sat outside smoking in the smoking shelter, even whilst still connected to the stand carrying their chemotherapy.

 

It amazes me because I can't imagine having cancer and still smoking. Why would anyone do that while they are being treated for this life-threatening disease? I can rationalise that someone who smokes convinces themselves that cancer will never happen to them; but surely once you are diagnosed any sane person would quit instantly? Or at least switch to nicotine patches? How THICK do you have to be to carry on smoking once you've been told you have cancer? I mean, if you had a broken leg, you wouldn't go outside and break it again would you?

 

However - and this is the question I want to ask - what (if anything) should the NHS do about it? Should the NHS continue to treat cancer patients who carry on smoking? Even as a self-confessed leftie, I find it hard to justify spending precious NHS money on people who wilfully act against their own best interests deliberately. But then I remind myself that even these people have a right to life and treatment. It's a genuine dilemma for me.

 

I'm a lifelong non-smoker but I will concede that if I was a smoker that's been given x months to live, then I would be thinking "Sod this, I'm going to enjoy the time I have left and carry on smoking. What difference can it make?"

 

Similarly - people being treated for cirrhosis of the liver who still drink. 

 

I'd be interested to hear the thoughts of others. I'm genuinely neutral on this.

[Aspman]

Both your examples are addictions and things people turn to in times of stress.

I would guess having cancer is very stressful for them making it harder then ever to quit.

 

I know some people that have thrown away their fags as soon as they get the diagnosis never to touch another. But it's probably not like that for everyone.

 

I think most hospitals offer help to get off the fags while they're in for treatment.

 

TBH I would consider withdrawing treatment where patients make no effort to kick the habits that got them into trouble but you'd need to offer people quite a few chances.

[KenONeill]

My immediate thought - lung cancers are a subset of cancers treated with chemo..

[2SkodaFamily]

It's not just lung cancer Ken. Smokers are prone to throat, mouth and stomach cancers to name a few. 

[GentleGiant]

I know someone with throat cancer who continued smoking even while in hospital having his treatments, then continually lied that he had given up.

 

Now he is moaning that they are not prioritising his follow-up treatment. (Whilst having a fag).

 

I personally think (even though he is a friend), that if you arent even willing to TRY and give up whatever is making you ill, you shouldnt get the treatment.

[2SkodaFamily]

Both your examples are addictions and things people turn to in times of stress.

I would guess having cancer is very stressful for them making it harder then ever to quit.

 

I know some people that have thrown away their fags as soon as they get the diagnosis never to touch another. But it's probably not like that for everyone.

 

 

This is what my mum did. She stopped smoking immediately she was admitted to hospital purely because it wasn't allowed on site (even in 1991) but never once had any cravings. It was weird, like a switch had been flipped. Especially since she had tried various methods of stopping, and failed with all of them.

[Liomer]

My wife has just been diagnosed with lung cancer at the age of 66, after 40 + years of smoking. As a life-long smoker myself, I'm not about to go in to the pros and cons of smoking - that belongs in other fora. HOWEVER, smoking is a very powerful addiction, and getting away from this addiction is very stressful. As far as my wife is concerned the expectation of death in the not too distant future is more than enough stress to bear. She also feels that horses bolting and stable doors come into the equation. As well as being an addiction for her, she enjoys smoking, as do I, and if her days are short she needs as much enjoyment as possible, if only to take her mind off the intense pain that she suffers from time to time.

When, not if, she has left me a widower, I might try to give up, but until such time I am going to continue smoking so that we can still enjoy something together.

[2SkodaFamily]

I know someone with throat cancer who continued smoking even while in hospital having his treatments, then continually lied that he had given up.

 

Now he is moaning that they are not prioritising his follow-up treatment. (Whilst having a fag).

 

I personally think (even though he is a friend), that if you arent even willing to TRY and give up whatever is making you ill, you shouldnt get the treatment.

 

It shouldn't be beyond science these days to test for carbon monoxide levels and other things that would be present in the blood with someone still smoking.

[2SkodaFamily]

My wife has just been diagnosed with lung cancer at the age of 66, after 40 + years of smoking. As a life-long smoker myself, I'm not about to go in to the pros and cons of smoking - that belongs in other fora. HOWEVER, smoking is a very powerful addiction, and getting away from this addiction is very stressful. As far as my wife is concerned the expectation of death in the not too distant future is more than enough stress to bear. She also feels that horses bolting and stable doors come into the equation. As well as being an addiction for her, she enjoys smoking, as do I, and if her days are short she needs as much enjoyment as possible, if only to take her mind off the intense pain that she suffers from time to time.

When, not if, she has left me a widower, I might try to give up, but until such time I am going to continue smoking so that we can still enjoy something together.

 

I'm sorry for your news. I can understand your decisions.

[Liomer]

I'm sorry for your news. I can understand your decisions.

Thanks

[bilun777]

Each time I arrive at the Oncology Centre at St James Hospital, Leeds, it never ceases to amaze me how EVERY time I go in or out, there are people sat outside smoking in the smoking shelter, even whilst still connected to the stand carrying their chemotherapy.

 

It amazes me because I can't imagine having cancer and still smoking. Why would anyone do that while they are being treated for this life-threatening disease? I can rationalise that someone who smokes convinces themselves that cancer will never happen to them; but surely once you are diagnosed any sane person would quit instantly? Or at least switch to nicotine patches? How THICK do you have to be to carry on smoking once you've been told you have cancer? I mean, if you had a broken leg, you wouldn't go outside and break it again would you?

 

However - and this is the question I want to ask - what (if anything) should the NHS do about it? Should the NHS continue to treat cancer patients who carry on smoking? Even as a self-confessed leftie, I find it hard to justify spending precious NHS money on people who wilfully act against their own best interests deliberately. But then I remind myself that even these people have a right to life and treatment. It's a genuine dilemma for me.

 

I'm a lifelong non-smoker but I will concede that if I was a smoker that's been given x months to live, then I would be thinking "Sod this, I'm going to enjoy the time I have left and carry on smoking. What difference can it make?"

 

Similarly - people being treated for cirrhosis of the liver who still drink. 

 

I'd be interested to hear the thoughts of others. I'm genuinely neutral on this.

It's called  " Being in Denial ".

[LeeHarrison]

When I was in hospital last year, for 4 weeks I watched so many people filtering in and out for a quick fag. I even asked the fella who was in the bed opposite me why he was still doing it - he was in for a triple (IIRC) by pass, he said veru bluntly "if its my time to go then so be it, I could walk out of here after the op and get hit by a bus"! In a way I sort of thought that I made him right, but then just thought 'what a d1ck', he had 4 kids, was only early 40's, why not even give yourself a bit more of a chance?!

From the day I had the stroke I haven't touched a fag (15 months now) and the biggest part of that was because ofy kids. I've got a weak ticker, am on 5 different types of med a day, all to take the strain off of the heart, plus warfarin, so even drinking has gone out of the window. I'll have a cider, maybe 2, once a week but no more, because I want to watch my boys grow up.

Everyones different, will power helps, but some people obviously don't give a flying one about whether they live another day or 10 years and don't care about those that they will hurt when they do kick the bucket.

[GentleGiant]

It's called  " Being in Denial ".

 

That sound like my siblings, our paternal grandfather died of lung cancer, our father survived lung cancer but the chemo eventually killed him, our mother got cancer even though she gave up nearly 30 years ago; yet they both still smoke and dont see it as a problem.

[vRSgone]

I'm a non-smoker (never had a puff in my life - well, I nearly did, once at a party, but I managed to give him the slips). The point I'm trying to make is though that non-smokers can never understand the powerful addiction that nicotine is - apparently more powerful than heroin!!

My wife is a long time smoker & now she suffers from COPD & she has tried literally everything to give up - hypnosis, acupuncture,patches etc & the longest she has managed is about a month, & living with her during that time was murder!! She has tried really hard to give up, more for my sake than hers, but she just eventually succumbs.

Even the thought of living the rest of her life in a wheel chair with an oxygen cylinder is not enough to deter her from the dreaded weed.

 

People are different & some with a strong will power may find it relatively easy to give up; others never will or can, even the threat of premature death is not enough to make them give up.

 

It would also appear that peoples susceptibility to cancer is greater than others, regardless of whether they smoke or not. I had an aunty who smoked at least 60 fags a day, & for most of her life they were the full strength non- tipped variety; when they became unavailable, she used to snap the tip off the filter tip fags! She died aged 96 from a no-smoking related illness. On the other hand my dad died aged 55 from lung cancer & he was only a light smoker.

 

I suppose (but can never really imagine), that if you have been diagnosed with a particularly virile form of cancer, then the mindset must be - "what else is there to lose?". Why punish yourself if your time on earth is limited? 

I don't know really, just the ramblings of a lifetime non-smoker trying to see it from their point of view.

[Auric Goldfinger]

I'm amazed that nursing staff actually push the smokers outside in wheel chairs and carry there drips so they can have a fag, right under the sign next to the Hospital Entrance, so it fills up the Reception area with blue stinky smoke, which people have to walk through to enter the Hospital and the sign says in big red writing

 

 

 

                  NO SMOKING

 

 

 

I rest my case m'lord

[Chriswright03]

So are we saying here that smoking is the only cause of cancer?  There they are struggling to find a cure and it is staring them in the face.

 

People make choices and that is life.  Should we stop treating people because they have made bad choices?  NHS is still if I recall correctly funded by taxes and the biggest majority of tax comes from fags so the Government will take the money off them for years yet refuse to treat them when they need it.  Seems a bit wrong to me.

 

I don't smoke, have never smoked and am very anti smoking BUT it is wrong on so many levels to judge people on the fact that they are addicted to something that the Governments of all parties have made millions from for decades.

 

I would suspect obesity costs the NHS as much if not more than cancer and that is caused by addiction as well.

 

Edited for spelling.

[Auric Goldfinger]

So are we saying here that smoking is the only cause of cancer?  There they are struggling to find a cure and it is staring them in the face.

 

People make choices and that is life.  Should we stop treating people because they have made bad choices?  NHS is still if I recall correctly funded by taxes and the biggest majority of tax comes from fags so the Government will take the money off them for years yet refuse to treat them when they need it.  Seems a bit wrong to me.

 

I don't smoke, have never smoked and am very anti smoking BUT it is wrong on so many levels to judge people on the fact that they are addicted to something that the Governments off all parties have made millions from for decades.

 

I would suspect obesity costs the NHS as much if not more than cancer and that is caused by addiction as well.

 

Fair point but they shouldn't smoke in Hospital/pub/shop/work place entrances etc etc. It'a an offence I believe to smoke within 30mtr of a public entrance

 

Why should everyone else suffer the stinky blue smoke

[2SkodaFamily]

When I was in hospital last year, for 4 weeks I watched so many people filtering in and out for a quick fag. I even asked the fella who was in the bed opposite me why he was still doing it - he was in for a triple (IIRC) by pass, he said veru bluntly "if its my time to go then so be it, I could walk out of here after the op and get hit by a bus"! In a way I sort of thought that I made him right, but then just thought 'what a d1ck', he had 4 kids, was only early 40's, why not even give yourself a bit more of a chance?!

From the day I had the stroke I haven't touched a fag (15 months now) and the biggest part of that was because ofy kids. I've got a weak ticker, am on 5 different types of med a day, all to take the strain off of the heart, plus warfarin, so even drinking has gone out of the window. I'll have a cider, maybe 2, once a week but no more, because I want to watch my boys grow up.

Everyones different, will power helps, but some people obviously don't give a flying one about whether they live another day or 10 years and don't care about those that they will hurt when they do kick the bucket.

 

The logic of this amuses me.

 

"If it's my time to go then so be it" - so why bother having the treatment? Also he's saying "I want the NHS to keep me alive but I refuse to take any responsibility for my part in it."

 

The logic of the analogy "I could be hit by a bus tomorrow" is all well and good. However it fails in two regards. 1; Yes you could be hit by a bus tomorrow but if you keep running into the road and playing chicken with buses it becomes a lot more likely. 2; Having already been hit by the bus, you wouldn't run out in the road and try it again unless you were a bit thick.

 

You, on the other hand, have made sensible life choices.

 

Someone else commented that if you've never been a smoker you can't appreciate the addiction, but on the other hand it remains my view that smokers can quit if the "why" is large enough. My mother quit instantly when she was admitted to hospital.

 

My in laws had a similar experience. They were both smokers, heavy ones too. FIL had a triple heart bypass in 1998 but carried on smoking. He tried quitting but since MIL didn't stop, he understandably found it hard to stop while she was still smoking. He literally dropped dead in 2005 of a heart problem. (possibly not smoking related actually, but there you go) and MIL carried on smoking. She, too, had a major health scare involving her respiratory system and stopped instantly.

[2SkodaFamily]

I'm amazed that nursing staff actually push the smokers outside in wheel chairs and carry there drips so they can have a fag, right under the sign next to the Hospital Entrance, so it fills up the Reception area with blue stinky smoke, which people have to walk through to enter the Hospital and the sign says in big red writing

 

 

 

                  NO SMOKING

 

 

 

I rest my case m'lord

 

I am VERY loud about objecting to the utter ***** who smoke along the walkway from the car park to the hospital. You carry on poisoning yourself if you want, but I have the right to arrive for MY cancer treatment without walking through your toxic, cancer-causing cloud.

[2SkodaFamily]

So are we saying here that smoking is the only cause of cancer?  There they are struggling to find a cure and it is staring them in the face.

 

People make choices and that is life.  Should we stop treating people because they have made bad choices?  NHS is still if I recall correctly funded by taxes and the biggest majority of tax comes from fags so the Government will take the money off them for years yet refuse to treat them when they need it.  Seems a bit wrong to me.

 

I don't smoke, have never smoked and am very anti smoking BUT it is wrong on so many levels to judge people on the fact that they are addicted to something that the Governments off all parties have made millions from for decades.

 

I would suspect obesity costs the NHS as much if not more than cancer and that is caused by addiction as well.

 

No, of course smoking isn't the only cause of cancer. However if you wanted to create cancer in your body, smoking is the odds-on best way to do it. Also smoking is a good way to create heart disease and a host of other nasty illnesses including strokes.

 

If someone was treated for a broken leg, and then every time as soon as the plaster came off, they went and broke it again with a hammer, we would rightly think that person was crackers and commit them. I don't see the difference between this and smoking, to be honest.

 

You make a good point about obesity.

[Chriswright03]

Fair point but they shouldn't smoke in Hospital/pub/shop/work place entrances etc etc. It'a an offence I believe to smoke within 30mtr of a public entrance

 

Why should everyone else suffer the stinky blue smoke

Yes I agree entirely.  I had the misfortune to spend a number of hours at Grimsby Hospital on Sunday night because my wife's mother had a fall.  Every time the automatic doors open they are accompanied by an announcement that this is a NO SMOKING site and smoking is banned.  That is ALL of the site and yet people just stand outside the door puffing away.  No point in banning something unless you are going to enforce it.  They can't though and what would they do with the staff who nip out for a quick fag?  Make them walk the 1/4 of a mile to the end of the site and stand on the corner and dump all their fag ends in the street? 

 

Never be done.  Token (empty) gestures that show how little is actually cared about the problem.  Fact remains that anti smoking laws were brought in by a Government that makes millions from the taxation because it needs to be seen to be doing something.  That they are not working has not been addressed probably because many of them are unworkable.

[GentleGiant]

 

My wife is a long time smoker & now she suffers from COPD & she has tried literally everything to give up - hypnosis, acupuncture,patches etc

 

How many hypnotherapy sessions did she attend?? It took my mother three sessions over a 6 month period to relieve the craving; but she hasnt so much as looked at a ciggie since.

 

The biggest issue with long term smokers is withdrawal symptoms, going cold turkey can have some nasty side effects 3-6 months down the line, and patches are only any good if you use them properly and taper them off until the nicotine cravings stop.

[Auric Goldfinger]

My wife is a long time smoker & now she suffers from COPD & she has tried literally everything to give up -

 

 

I WAS a long time smoker, 60 a day + cigars. I too suffer from COPD and still take medication for it. Before I stopped 10  years ago I got a really bad chest infection and was off work for almost 6 months and after extensive visits to a Lung specialist  He told me : " If you don't alter your ways you'll be in a wheel chair in 5 years and in eight you'll most  likely will be dead "    That was the last day I smoked   :yes:

 

That was the deciding factor that made me stop smoking

[Aspman]

One thing to note is that it's never too late to quit.

 

The risks associated with smoking related diseases drop quite quickly if you quit.

 

Ok you'll never have the low risks that a life-long non-smoker has but you could be significantly lower than someone that continues to smoke.

 

So the argument that the "damage is done" is a poor one.

[Dr Zoidberg]

This is one of those things that covers a wide range of situations, and exactly where you draw the line will depend on your own experience and feelings.

At one end of the scale you might have heavy drinkers in need of a liver transplant that refuse to give up on alcohol - most of us would agree that in that situation it's not the best use of the money and donor organs. At the other end of the scale, pretty much all of us do *something* that adversely affects our health, even if it's just eating a bit too much and not doing enough exercise, and very few people would say we shoudn't get NHS treatment.

Somewhere in the middle is the dividing line.