I pass a hospital on my walk in to work.  Inevitably, someone dressed in blue scrubs will be smoking outside in the designated area.  Maybe a surgeon relaxing after a difficult procedure?  A nurse escaping from the hectic demands of a busy ER shift?

A homeless man bends down in front of me to pick a cigarette butt up off of the sidewalk.  I suspect it helps him stave off the hunger for a little while longer.

The light turns red and a beautiful, new Mercedes SEC 500 comes to a halt on the other side of the street.  The tinted driver window rolls down and a cufflinked sleeve comes out into the light, cigarette ashes blow off, window goes up.  He’s going to ruin that new car smell.

Despite societal efforts to create new terms to categorize different groups of people, “smoker” remains the great equalizer that defies all imposed boundaries.

I notice these details and acknowledge that others may not.  We’ve been socialized to accept smoking as part of our daily landscape.  It’s as mundane as peanut butter and jelly.  Milk, eggs, bread, cigarettes.  Lunch break, coffee break, bathroom break, cigarette break.  Discarded coffee cup, crumpled paper bag, old shoe, cigarette butt.

We would gasp if we saw that nurse using crystal meth to get a bump of energy before returning to his ER shift, cringe if that homeless man bent down to pick up a discarded syringe and call the police if that driver flicked an empty beer can out the window.  We would protest if an employer granted an extra break to accommodate any other chemical dependence.  But smoking is different.

We have come to accept an arbitrary determination about “good drugs” and “bad drugs.”  The good drugs have been approved by the Food & Drug Administration and are legal.  The bad ones have not been and are illegal.  Cigarettes rest comfortably in their own niche:  unregulated by the FDA, but legal.  More addictive than heroin, but sold at the corner market. 

If you grew up watching television in the ‘50s and ‘60s, you saw Lucy and Desi, or maybe Fred and Barney, urging you to smoke their cigarette of choice.  You saw doctors touting the health benefits of one brand over another.  Smoking prevalence in the United States peaked.  How ironic that those who started smoking to be rebellious turned to something so pedestrian.

I grew up during the age of the Marlboro Man and Joe Camel, but like most adolescent boys, Superman was a bigger draw.  We passively absorbed Marlboro’s unprecedented product placements—one ad every 5 ½ minutes on average—while watching Superman II.  I was a college graduate by the time this practice became illegal.

When I arrive to work around 8:00am the phone lines have already been open for three hours and by midnight another 1000 callers will have picked up the phone to talk with one of our Quit Coaches about the triumphs and struggles of their addiction.  The Centers for Disease Control reports that 70% of smokers say they want to quit and they call us when that desire turns into action.  Everyone has a tipping point.  Is one of those people on the phone that doctor, that homeless man, that cufflinked Mercedes driver?

We recently reached a tipping point in this country:  Today, more than half of Americans live in a city, county, municipality or state that bans indoor smoking.  Today you don’t see your favorite celebrity push his favorite brand of cigarette during a commercial break.  Everyone has access to a state quitline to get help quitting.  The pendulum is definitely swinging the other way.  How fast it swings is up to us.

Once on my walk home I overheard a woman on a cell phone answering questions about her smoking history that sounded familiar.  I resisted the temptation to ask her about her experience, opting to let her tell her story to her Coach in confidence as it should be.  Will she become one of those ex-smokers who gasps when her sense of smell returns?  “Did I smell like that?”  Will we become a country that gasps at nicotine addiction the way we do at other addictions?  There’s nothing wrong with gasping—it means we’re still breathing.