As a family physician for over forty years, I’ve dedicated enormous time and effort to ending tobacco use through a non-finger-wagging approach to patients in the clinic and the hospital, as well as through the use of humor and parody to students in middle schools and high schools.

Few conditions demand more of patients and their physicans than the journey, the odyssey, to becoming a former smoker.

Hello. My name is Sharon and I am an addict. My drug was tobacco. Exposed early, by smoking parents, I tried tobacco in high school and was quickly dependent. It calmed me. It gave me something to do with my hands. I smoked out my window at home and, when I could, other places. I was not alone. This was 1964.

In the mid-1970s, as a preschooler, I used to stare at a poster in the waiting room of my pediatrician’s office. This poster depicted a disorderly person, dark hair unshorn, snarling and puffing on a cigarette. The poster’s caption: Smoking Is Very Glamorous.

Several months ago, I was in an appointment with “Richard.” Richard was a 45-year-old Italian-American construction worker, a father of three (four if you counted Gerald, his family’s new labradoodle puppy—which I did), and a devoted husband to his wife, Sherri, his high-school sweetheart. Unfortunately, none of these descriptors explained why he and I were in the same exam room. That was because I am a medical oncology scribe. I write notes for an oncologist. Richard was our patient: a former smoker receiving treatment for Stage IV lung cancer.

When I was a third-year medical student in 1972, the young attending physician on my cardiology rotation said smoking was okay. Actually, he said that he had wanted to do something to manage the stress of his work and had looked carefully into the options that were available at that time. He told us that smoking a pipe seemed like the safest option, so that is what he did.

I was looking forward to seeing her in my clinic that morning. Marsela was a 60-something-year-old Albanian grandmother whom I had been following for her chronic anemia. At first, the visit went as I expected. Her bloodcounts were stable, and she had no new symptoms.