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Smoke Gets in Their Eyes

"People rationalize all kinds of bad habits," Sherman said.

Seidenman agrees: "Knowing that you shouldn't smoke and not smoking are two different things."

Sue Goodman Smokes in Her Office
Sue Goodman Smokes in Her Office
Sue Goodman, 70, smokes in her Lanham, Md., home. She confines her smoking to one room in the house. (Andrea Bruce Woodall - The Washington Post)

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'Quitting Is Worse'

Published statistics on who smokes and why wouldn't likely lead you to sniff out a 59-year-old woman with a college degree and a job that puts her well out of poverty's reach.

Like Elaine Keller. A 59-year-old technical writer who lives in Springfield, Keller smokes about half a pack a day -- down from 2 1/2 packs -- of generic-brand cigarettes, "augmented by two or three lozenges or pieces of nicotine gum." In the course of her work, Keller spends a lot of time tooling around on MedLine, the federal government's online library of health-related research publications, so she's no stranger to smoking's dangers.

"Why do I smoke, even though I know it is bad for me?" Keller ruminates in an e-mail. "Because I know, through bitter experience, that smoking cessation is even worse for me."

Stop Smoking Clinic's Seidenman said Keller's feelings are common. "One of the main reasons people don't join the program is because they think their lives are going to be miserable" when they quit smoking, he said. "These people aren't willing to confront [that discomfort]."

Keller's last attempt to quit smoking -- with the help of nicotine patches, gum and lozenges -- led, she said, to a 35-pound weight gain. Worse, she said, was her loss of ability to focus at work and on the road. When she smoked, she said, "I was producing 10 pages a day" at work; when she quit (with the help of the patch) last December for about five weeks, she said, "I was down to two pages a day."

"It was like, forget it! I can't even read, let alone write," Keller said. "I was also extremely depressed. I can't function, I can't think, I can't even drive a car. I was sleeping 12 hours a day."

So, though she said she's "concerned about my lungs," Keller's still smoking. "I don't think I'm in love with the cigarettes," she said. "The ritual is not important at all. I need the normalcy that nicotine brings. If I could find a way to get nicotine without drawing it in through my lungs, I would very happily give up smoking."•

Jennifer Huget is a regular contributor to the Health section.

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