The arena of the unwell

April 4, 2009 3:43 AM

Novelist Chris Paling diary of his time spent on 'Beirut', a high-intensity hospital ward for the treatment of digestive diseases - where a third of patients are there due to the effects of long term alcoholism.
posted by fearfulsymmetry (58 comments total)

That was ghastly. Imagine recovering from intestinal surgery with alcoholics shtitting, dying and puking all around you and when you are finally well enough to be able to eat you are given Marmite.
posted by srboisvert at 4:38 AM on April 4 [1 favorite]

In the US, would it be normal to have six such patients in the same room, all together?
posted by anastasiav at 5:13 AM on April 4

After reading that I think I need a drink...of water.
posted by RussHy at 5:20 AM on April 4

Wow. I just read that (beer in hand) and can safely say I was horrified- talk about visceral horror.

In all fairness, he didn't mind the Marmite.
posted by dunkadunc at 5:52 AM on April 4

A very sobering read.
posted by gomichild at 6:10 AM on April 4 [2 favorites]

we should have some sort of acronym for warning people of something that you shouldn't read while trying to eat.

or maybe i could have just figured it out from the comments.
posted by janepanic at 6:15 AM on April 4

I've learned a lot about pain since I came in here, and I now know I've been lucky to have avoided it for much of my life.

This is what I hear over and over from surgery patients -- even those who have gotten the best care in the world at a facility that is more like a resort or hotel than a hospital. They say, "I never knew what pain was until now..." The takeaway should be that surgery really, really sucks, you shouldn't think of modern healthcare as a backstop for your bad habits, and you'd better start taking care of yourself now. Stop drinking. Oh yeah, and don't let 'em nationalize your health care.
posted by Faze at 6:18 AM on April 4 [1 favorite]

What health care? Nationalized health care would be a step up for a lot of folks.
posted by RussHy at 6:35 AM on April 4 [11 favorites]

Imagine recovering from intestinal surgery with alcoholics shtitting, dying and puking

Imagine that you an alcoholic in the hospital, shitting and puking and dying, alone.

The author mentions that many of his fellow patients weren't visited by anyone. I'm not sure that they didn't appreciated being around other people.

Oh yeah, and don't let 'em nationalize your health care.

yup. because the indigent and hopeless deserve to die in the street or in a flophouse so that white middle class people don't have to share a hospital ward with their inferiors.... what was your argument?
posted by geos at 6:49 AM on April 4 [30 favorites]

In 1993 I spent nearly a month in an alcohol rehabilitation center. Waking after my first night in the treatment center was worse than a hangover. Through the night, the nursing staff fed me 15 tabs of Serax, an anti-withdrawal medication. When morning arrived, I was toast. My wildest drunk couldn't touch the level of inebriation from mass dose Oxazepam. After two days, I finally had to tell the psych doc, "Listen, I came here to get straight, not turned into Jello." With that, my recovery began.

My last day there, after a month, was an eye opener. That last day began just like all the rest, but it quickly changed as we were sitting around the breakfast table. The 74 year old lawyer who had been with us the past four days in a detox bed had left against medical advice while the rest of us were at the nightly 12-step meeting. The morning paper said this former president of the state bar association had put a shotgun to his face and pulled the trigger. Lest there be any doubt about it, alcoholism is a terminal disease. If you don't kill yourself slowly through liver or other organ failure, the utter helplessness of the condition will cause desperate acts.

As we tried to pull ourselves together, the 69 year old former publisher of the city newspaper, the geezer with the wet brain, was wandering the halls looking for his shoes. "You mean the ones on your feet?", the nurse asked, as he looked sheepishly confused at the rest of us. He was on his way to the dinner party at the former governor's mansion, at 8 o'clock in the morning — at least in his mind. Make no mistake, alcoholism is a progressive disease. Over time, it rips every fiber of sanity from the most lucid of individuals.

At 9:00AM group, this new guy, a fellow the same age as me, suddenly lurched forward and fell to the floor. His body began shaking violently as his eyes rolled back in his head. A withdrawal seizure, right there in the middle of the floor in the center of our group circle. Twenty minutes later the medical staff finally had him semi-alert and sitting up in a chair. This adventure would be repeated twice more by the same fellow on the same day. It isn't a pretty sight. Alcoholism is a painful physical addiction every bit as powerful as the strongest narcotic.

Later that evening, during outside visitation hour, the beautiful wife of one of our three week patients stopped in to say hi. This girl was drop-dead gorgeous... except when she smiled. You see, she had no front teeth — a gift from her abusive alcoholic husband who slammed his fist into her face during a drunken rage one night, because he said, "you're too sexy." That she was. Curves like fine geometry, eyes that mesmerized, and a toothless grin. Alcoholism is a family disease. It hurts the ones we love the most. It isn't a game.

To those who advocate pricing alcohol beyond affordability as a way of curbing alcoholism, realize that the alcoholics number one priority is finding his next drink. It isn't going to their job, or looking for work, or showering, or even looking for rehab. All focus and effort is on satisfying the addiction. Beg, borrow, or steal... he will get his next drink... or die trying.
posted by netbros at 7:22 AM on April 4 [59 favorites]

netbros, I hear you, but given that Britain has an enormous problem with alcohol consumption, and given the historical success of government interventions like the Gin Act, I see the sense in examining the use of pricing policy to regulate drinking. Perhaps not for hardened drinkers, but perhaps by making high-strength alcohol more expensive for young people with limited incomes, moving them to lower-strength alternatives or safer cannibis.
posted by alasdair at 7:36 AM on April 4

Alcohol-related hospital admissions cost the NHS £1.5bn a year, the alcohol duty raises £8.3bn a year*. If you've been spending £500-800 a month on alcoholism you've made a considerable contribution to HMRC. The drinks industry, quoted in the above link, says that 70% of that would flow back to the Treasury.

Alcoholism is a terrible, terrible thing, but there's a frightening tendency in some commentary on it to focus on the sinner rather than the sin. On a hospital ward devoted to acute and chronic stomach conditions, you are going to be surrounded by puking, shitting, dying, reeking people in terrible pain no matter what put them there.

* As I understand this factsheet from National Statistics. When did the National Statistics website get so hard to use? it use to be one of the best-kept secrets on the internet, with every bit of data you could image at your fingertips, now it's a bewildering mess.
posted by WPW at 7:39 AM on April 4 [1 favorite]

Netbros, flagged as Fantastic.
posted by WPW at 7:49 AM on April 4

WPW: Not to detract from the story, but also found here and here.
posted by dunkadunc at 7:59 AM on April 4 [1 favorite]

Well, it was new to me. I've been there, and on the NHS.
posted by WPW at 8:07 AM on April 4

I hear you, but given that Britain has an enormous problem with alcohol consumption, and given the historical success of government interventions like the Gin Act, I see the sense in examining the use of pricing policy to regulate drinking. Perhaps not for hardened drinkers, but perhaps by making high-strength alcohol more expensive for young people with limited incomes, moving them to lower-strength alternatives or safer cannibis.

Given the horrific failure of Prohibition in the US in more modern times, as well as the wide availability of ethanol and (worse yet) ethanol/methanol blends in various consumer and industrial products, any such Act is likely to cause far more harm than good. Think about the effects of moving the price point of booze upwards: all hardened alcoholics, not just the most desparate among the homeless, will end up drinking Listerine or the equivalent.
posted by Inspector.Gadget at 8:09 AM on April 4 [1 favorite]

Jesus christ, I have to stop drinking.
posted by bookish at 8:15 AM on April 4 [1 favorite]

As someone who consumes three beers a day, I have one thing to say to these people: please die faster, and in more pain.

Increasing the cost of alcohol will do nothing stop them from killing themselves, but the millions of people who aren't addicts will certainly be made to feel it. If you want people to stop drinking too much, show them the suffering it brings relative to the suffering it alleviates. Let those too stupid to be swayed complete their suicide, and therefore serve to warn the next generation.

Better yet, encourage them to do something noble with their wasted lives. Tell them to wrap their yellow fingers around the throat of a moralizer who believes drug use is a sin, and rid the world of a real evil as their final act.
posted by 0xdeadc0de at 8:17 AM on April 4 [2 favorites]

He talks of people spending £500-800 a week, about £72-114 a *day*, on booze. That's $107-168 US, or €79-125. That's a fuckload of booze even if you're drinking Johnny Walker Blue. If you're drinking anything reasonable, you're talking gallons of the stuff. Per day.

Do you really think that pushing the minimum up by 50p, or even £2, is going to change anything, to people who are dropping on the order of forty grand plus a year in booze?

At least, if it's a tax, they can shove that into the NHS to deal with the fallout.
posted by eriko at 8:21 AM on April 4

Eriko, it's actually £500-800 a month, but it's still a lot.
posted by WPW at 8:26 AM on April 4

I am a daily drinker and I look forward to my evening dram, but serious alcoholism was never an option for me after a stint as a cab driver after high school. Most of my customers were alcoholics and busy dying in pieces. I saw and smelled things that made me fear ever going there myself. It would be a shame to raise the price of alcohol out of everybosy's range in a vain attempt to fix an addiction problem. Far better to spend money on alcoholism treatment for those who need it.
posted by RussHy at 8:28 AM on April 4

0xdeadc0de, when I used the word sin I was making a literary allusion, not a moral judgement.
posted by WPW at 8:29 AM on April 4

Yes, but, isn't there a case for bringing taxation on booze in line with alcohol content? So people drink less vodka/gin/alcopops/cider and more low-strength beer? Could be aligned with a reduction in the drinking age (to reflect reality) and the legalisation of cannabis. All as part of a mechanism to ameliorate the effects of alchohol by trying to move people, especially young people, into socially-mediated "grown-up" or "European" models of drinking.
posted by alasdair at 8:30 AM on April 4

All as part of a mechanism to ameliorate the effects of alchohol by trying to move people, especially young people, into socially-mediated "grown-up" or "European" models of drinking.

Deliberate government-enforced price discrimination hardly fits with a more permissive, responsible model of drinking. The problem isn't booze. The problem as far as alcoholism is addiction, and the problem as far as other socially negative aspects of alcohol is irresponsibility. Alcoholism is a chemical addiction, and presenting cannabis as an alternative - by itself - is unlikely to fix that.
posted by Inspector.Gadget at 8:34 AM on April 4

any such Act is likely to cause far more harm than good

Gorbachev's 1985 alcohol reform program raised Soviet male life expectancy by three years, from 62 to 65. By '88 the program had ended and life expectancy fell accordingly. It's 59 now. I'm aware it's not entirely alcohol's fault; the breakup of the USSR and the sodium-rich Russian diet are also to blame. But god damn, adding three years to the national male life expectancy is something public health officials haven't been able to do since the 1950s vaccine era. This sort of heavy-handed legislation works, so long as it's followed through. I just can't wait until we have solid 10-year data on public smoking bans.
posted by The White Hat at 8:53 AM on April 4

So people drink less vodka/gin/alcopops/cider and more low-strength beer?

In my own drinking history, I never did go for the spirits, it was always beer. It started out as a couple or three a day, evolved to a six-pack every day when I was in my early twenties, on to a 12-pack a day in my thirties, and by the time I finally sought rehab assistance when I was 40, I was drinking 15 or more beers every single day, and twice on weekends just for good measure. Low-strength beer? Just means you have to get up and pee more often.
posted by netbros at 8:56 AM on April 4 [1 favorite]

I think legalizing booze at 18 would help, mostly because it'll take the fun out of binging away from one's parents. It works fine in other countries. Binging in college doesn't do much to trigger alcoholism, but some of my fellow students who are my age and are even in some of my classes are alcoholics precisely because of drinking too much, though they probably also have a predilection to become addicted to alcohol. Most aren't addicted, but some are addicts.

Not only that, but change beer culture. Stop making it cool to get drunk off your ass. Relish a glass of alcohol for its taste - I hate beer because it tastes like cereal, but I don't mind a dash of whiskey mixed in coke or a little peach schnapps in orange juice, since it adds to the flavor. Don't just laugh at drunkenness, show contempt for drunk people - less so the addicts, more so the people who are on their way to becoming addicts. Yes, it's fine to drink booze, but when you drink too much you're fucking stupid.
posted by kldickson at 9:04 AM on April 4 [4 favorites]

Gorbachev's 1985 alcohol reform program raised Soviet male life expectancy by three years, from 62 to 65.

Is there clinical data to back this up? There are so many confounding factors occurring during the same period in history that it's difficult to figure out the accuracy of that statement.
posted by Inspector.Gadget at 9:06 AM on April 4

Gorbachev's 1985 alcohol reform program raised Soviet male life expectancy by three years, from 62 to 65. By '88 the program had ended and life expectancy fell accordingly. It's 59 now. I'm aware it's not entirely alcohol's fault; the breakup of the USSR and the sodium-rich Russian diet are also to blame. But god damn, adding three years to the national male life expectancy is something public health officials haven't been able to do since the 1950s vaccine era. This sort of heavy-handed legislation works, so long as it's followed through. I just can't wait until we have solid 10-year data on public smoking bans.

Ludicrous. The alcohol reform program was so unpopular that if it wasn't abandoned, the government would likely have fallen. Besides, did you read the article? The reform program contributed to the creation of a nationwide distribution system for illegal counterfeit vodka (often containing methanol), which is what's killing so many Russians today. These programs don't work.
posted by nasreddin at 9:09 AM on April 4

Netbros, flagged as a repeat comment.

Not that it isn't a really good comment, but at least mention the fact that you're copying and pasting.
posted by bardic at 9:13 AM on April 4 [2 favorites]

Or maybe I'm suffering from a severe case of Vuja-de, and I apologize. But didn't you write this comment in another thread?
posted by bardic at 9:16 AM on April 4

...didn't you write this comment in another thread?

So what? Is there some rule he broke? His comment was perfectly appropriate here, whereas your comment is pure fucking noise.
posted by RussHy at 9:26 AM on April 4 [3 favorites]

As one who loves the taste of alcohol in all its myriad wondrous forms and ranks the sensation of being drunk somewhere as being distinctly worse than a cold and not quite as bad as the time I had salmonella, I can't favorite kldickson's comment hard enough.
posted by infinitywaltz at 9:27 AM on April 4

But didn't you write this comment in another thread?

Yes, I have, as linked above by duncadunc, in both my old blog and on AskMe. No malice intended. As I pondered the article in the FPP, all the thoughts that came to my head were of that final day I spent in alcohol rehab. Alcoholism is an insidious killer. It ruins lives. It ruins families. All of that was contained in that anecdote I wrote in 2001. So rather than reinvent the wheel, I copied portions of it here. Hopefully, it might be useful to someone who is suffering right now. My apologies to those who have already seen it.
posted by netbros at 9:38 AM on April 4

Paling's article is not so much a discussion of alcohol policy than a sensationally rendered account of a hospital stay. His personal disgust for the reality of medicine is what comes through the clearest, inflected not a small amount by class conciousness. As someone who recently spent a week in hospital with an intestinal issue, I know the pain and indignity are profoundly affecting, but to portray his account as informative to a discussion of policy seems weak. It's all "gosh poop stinks" and "I'm in here with these hopeless losers."

Oh yeah, and don't let 'em nationalize your health care.

The Paling article states there were three nurses for six patients. 2:1 is pretty damn good staffing levels in the US.
posted by werkzeuger at 9:53 AM on April 4 [2 favorites]

You know what works? Cold turkey.
posted by Faze at 9:54 AM on April 4

Oh yeah, and don't let 'em nationalize your health care.

You...do know that you can't actually catch The Poor, right?

I've spent the last...mmm...twenty-odd years of my life watching my father slowly destroy his brain due to his alcoholism. He's still functioning, but allow me to say, with absolute knowledge, that washing down a couple benadryl with a glass of vodka does no one's mind any good whatsoever. (I'm sure his allergies are suppressed with that little combo, but the loss of long-term memory can't be brilliant.)

I possibly drink a little too much, but about once a year, I purposely go dry for a spell, just to make sure I still can. Believe me, you really really really do not want to wind up an alcoholic, even a functioning one. You will fuck up yourself, your kids, your spouse and your friends, roughly in that order.
posted by kalimac at 10:10 AM on April 4 [2 favorites]

You know what works? Cold turkey.

Cold turkey does not work with alcohol. That will kill a serious alcoholic.
posted by stavrogin at 10:16 AM on April 4 [3 favorites]

Cold turkey does not work with alcohol.

It depends on how the turkey is served and what you're drinking with it; a cold turkey sandwich with maybe a little cranberry sauce goes nicely with a light lager or a glass of Riesling.
posted by infinitywaltz at 10:51 AM on April 4

Faze:You know what works? Cold turkey.

For those alcoholics who avoid isinglass-cleared beers and nasty whites and reds - go here for your cure!
posted by davemee at 10:55 AM on April 4

Is there clinical data to back this up?
Ludicrous.... These programs don't work.

As it happens, yes, there is clinical data.* Where are your peer-reviewed journal articles?

*Citations, in case the links don't work: 1. McKee M. ALCOHOL IN RUSSIA. Alcohol Alcohol. 1999;34(6):824-829. 2. Cockerham WC, Snead MC, DeWaal DF. Health Lifestyles in Russia and the Socialist Heritage. Journal of Health and Social Behavior. 2002;43(1):42-55.
posted by The White Hat at 11:09 AM on April 4

Cold turkey does not work with alcohol. That will kill a serious alcoholic.

Oh come on, it's the lack of willpower that causes anxiety, life threatening seizures, delirium tremens and hallucinations, shakes and possible heart failure.
posted by werkzeuger at 11:09 AM on April 4 [1 favorite]

Low-strength beer? Just means you have to get up and pee more often.

But what about the health effects of giving your body more water and time to metabolize the alcohol?

A friend of my fathers was a beer drunk who went through a case a day, starting soon after breakfast. I knew him when I was in my teens so didn't really realize what was going on until my friend told me about it (in an offhand/dismissive way, not inviting questions) in our twenties, so I don't know for sure that he was (relatively) healthy considering his diet & lack of exercise.
posted by morganw at 11:32 AM on April 4

If netbros hadn't repeated his comment here, I wouldn't have had the opportunity to read it, so I'm grateful that he did.

And dying is hard, no matter what the cause.

(Also, faze, what the hell? "Don't let them nationalize your health care?" What's that about?)
posted by jokeefe at 11:37 AM on April 4

This article (or diary, or whatever you call it) was well-written, but incredibly moralistic -- so much so that it produced the same helpless, doomed-beyond-repentance feeling I often get when exposed to evangelical Christian depiction of the hell which awaits sinners. It is true that those who suffer from alcoholism do so largely out of the public eye, and most of us live in blissful ignorance of their agony.

Yet the agony here, the hellishness, is about sickness, pain and mortality. Forget alcohol. That's only one route. So I'm a little confused that the author anchored his work there, when the horror here is obviously about the indignity and loss of control that goes along with being caged in a mortal, drippy body.
posted by theefixedstars at 12:09 PM on April 4

...
the horror here is obviously about the indignity and loss of control that goes along with being caged in a mortal, drippy body.

Exactly, you're making my point better than I managed to. The alcoholic angle seems curiously tacked on, with the authors pain, wounds, lack of dignity being the real topic. It leads me to wonder if it was reworked to be topical and therefore publishable.
posted by werkzeuger at 12:50 PM on April 4

My father, before he started his latest vacation to Florence Prison here in AZ, developed a raging case of Acute Pancreatitis. His pancreas was so swollen and inflamed, you could actually clearly see the organ from outside of his body. No x-ray magic needed. A solid, constant drinker for nearly 30 years, my father really struggled in the hospital because he had to deal with not just the Pancreatitis, but it was also the first time in many, many years that he had to go without drinking. Just the week long stretch he was in the hospital was miserable and unbearable, and when the doctors told my father that he had developed his problem from drinking too much and that he'd be back in the hospital before too long if he didn't stop drinking completely, my father laughed in their faces. The first stop after he left the hospital was the liquor store to pickup a handle of Lord Calvert, which he had half-finished before we completely the 18 mile drive out to his trailer on the edge of town. I didn't stop him.
Now that he's been in prison for 3 years, I (assume) he's finally really dry. My own personal experience with the inside of prison comes from television shows like Prison Break and Oz, so I really don't know if it's possible that he could somehow be getting alcohol in there. I know that if someone told him by mixing together some common cafeteria items and letting them ferment, then mixing bleach or rat shit or something with it and wallah! Wiskey! He'd be all over that. I haven't seen him or spoken with him since he went to jail though, so I just assume he's finally found the sobriety his doctors warned him he'd need if he wanted to live to see 60.
The nice thing is, having grown up subjected to the whimsical love/beatings of a man who was constantly intoxicated every moment of every day, I have no desire to drink. Every great, great once in a while, I'll share a few glasses of wine with my wife or have a beer with the boys, but there's nothing I hate more than being drunk. No thanks.

I'll smoke a bowl with you though.
posted by Bageena at 1:00 PM on April 4 [3 favorites]

Considering that netbros seems to be genuinely trying to save lives, he could post his comment in every thread, although that might dilute the message somewhat.
posted by StickyCarpet at 1:07 PM on April 4 [2 favorites]

yup. because the indigent and hopeless deserve to die in the street or in a flophouse so that white middle class people don't have to share a hospital ward with their inferiors.... what was your argument?



The states provide healthcare for the indigent. Next time save your faux outrage for something you know anything about.
posted by bunnycup at 4:11 PM on April 4

The states provide healthcare for the indigent.

And what fantastic care they get!
posted by rtha at 6:24 PM on April 4 [1 favorite]

What a gripping, harrowing read. Thanks for posting this.
posted by goodnewsfortheinsane at 7:12 PM on April 4

I think legalizing booze at 18 would help, mostly because it'll take the fun out of binging away from one's parents. It works fine in other countries. Binging in college doesn't do much to trigger alcoholism, but some of my fellow students who are my age and are even in some of my classes are alcoholics precisely because of drinking too much, though they probably also have a predilection to become addicted to alcohol. Most aren't addicted, but some are addicts.

Not only that, but change beer culture. Stop making it cool to get drunk off your ass. Relish a glass of alcohol for its taste - I hate beer because it tastes like cereal, but I don't mind a dash of whiskey mixed in coke or a little peach schnapps in orange juice, since it adds to the flavor. Don't just laugh at drunkenness, show contempt for drunk people - less so the addicts, more so the people who are on their way to becoming addicts. Yes, it's fine to drink booze, but when you drink too much you're fucking stupid.

18 is already the legal drinking age in the UK, which is where this article was written. Unfortunately the lower drinking age does not seem to come with the calmer drinking culture of their Continental neighbors.
posted by atrazine at 1:23 AM on April 5

Deliberate government-enforced price discrimination hardly fits with a more permissive, responsible model of drinking.

But there is already a government-enforced price discrimination, and one that reflects history rather than any rational basis. I'm proposing taxing booze according to strength, so vodka becomes more expensive and bitter beer less so. This might form part of an attempt to move people away from "let's get smashed fast, drink in the car park" high-strength booze to more socially-mediated and slower consumption, like in pubs. One of many required measures, I'm sure.

Some people will still become alchoholics: that does not detract from the historical success of these policies as public health measures. Alcohol inflicts huge social damage in the UK: it seems reasonable that good government might try to shape its consumption to mitigate this damage. Pricing is one of the tools that might be used.
posted by alasdair at 4:53 AM on April 5

The problem with taxing alcohol is that everyone, even non-abusers, pays the same tax. Make the tax cumulative over the course of the year. The more you drink, the more you pay.
posted by RussHy at 11:43 AM on April 5

In Dubai, you can't buy alcohol without a special card, that tallies your allotment as a percentage of your proven income.
posted by StickyCarpet at 3:22 PM on April 5

That was hard to read.
posted by Devils Slide at 5:39 PM on April 5

On the article, I thought it was an interesting read but you could experience roughly the same spending time in a place where people's bodies were paying them back for any number of continued abuses. In my days as an EMT, one of our "frequent flyers" was a forty something year old diabetic who, despite losing both feet and almost dying due to blood sugar issues, could not stop drinking 10-15 liters of Coke a day. He's dead now.

As far as the sin tax issue, I just don't buy it. I'm a daily drinker but I feel no particular compulsion to drink. If tomorrow all booze was marked up 1000%, I'd be pissed but I'd just wind up drinking a 10th as often.

I've been a hardcore smoker (1-2 packs a day) for just under 10 years, and I can say with absolute certainty that the cost has never been more than a minor annoyance, even though it has increased almost five fold since I became a regular smoker. Right now I can afford my habit without having to forgo any necessities, but in more desperate times I've skipped any number of things including food in order to buy cigs. Yes, I have actually gone more than an entire day without eating anything except a few ketchup packets (I could teach you how to make a passable tomato soup with them, but that's another story) but I made sure that I had my beloved Camel Lights. Any hardcore smoker would understand and relate to this.

I'm actually making my first real quit attempt in over 5 years starting in less than two hours. I certainly use the monetary savings as an incentive when thinking about what I'm preparing to undertake, but it could never be my only reason for quitting, and if I didn't feel ready to quit I wouldn't stop if you told me that cigs were $25 a pack starting tomorrow.

Not everyone who drinks is an alcoholic, and not everyone who smokes is hopelessly addicted to nicotine, but I'd definitely guess that there's a much greater ratio of those who can drink without becoming addicted than those who keep control of their smoking. Either way, taxation of these "sin items" is nothing more than a disproportionate tax on the poor, and the revenue often isn't even spent on the applicable healthcare costs which is often used to justify these taxes.

Picture yourself at the bottom of a pool. You've been there for over a minute and your lungs are BURNING. You feel as if you may pass out and die at any moment, unless you can get to the surface...Are you going to hesitate if I tell you that there's a $5 tax to come up for air? How about $10/$25/$50? You may stop people from drinking with taxes, and you may stop people from smoking with taxes, but if you're looking to curb addiction it just ain't going to happen via a monetary penalty.
posted by rollbiz at 7:35 PM on April 5 [1 favorite]

Best of luck to you with your smoking cessation rollbiz. I quit seven years ago after 30 years of a pack to a pack-and-a-half a day. Feel free to MeMail if you have any questions, but I know you'll do just fine.
posted by netbros at 7:41 PM on April 5 [1 favorite]