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    Now Tobacco Has Killed My Big Brother
    Jonathan Foulds, PhD posted:
    The following article is a personal account by Michael O'Donnell and published in the American Journal of Health Promotion :
    I have to leave in a few hours to go to Kevin's funeral. We greet people at 10, mass starts at 11, and then we go to the cemetery to bury Kevin next to my dad. Kevin has already been cremated. Brothers and sisters, cousins, aunts and uncles, and friends started coming to town a few days ago. We are trying to focus on celebrating Kevin's life and supporting each other, but mainly we just feel sad…empty. At least that's the way I feel. I have been anticipating, fearing, this day for decades.
    Kevin started smoking in high school, maybe in junior high. He had the usual stimulants…parents, uncles, neighbors all smoked and cigarettes were easy to find.
    I started worrying about Kevin's smoking when I was in college, after my parents had quit smoking, when I really understood the health impact. My reasons for wanting him to quit were selfish; I just did not want to bury Kevin at such a young age…i.e., so early in MY life. I talked to Kevin about quitting smoking for decades…until he wouldn't listen any more. He was a tough case for me…so smart…valedictorian of his high school class, the first person I ever met who got an 800 on his SATs. He had an answer for everything I said. A couple of years ago, he told me that smoking a cigarette helped him control his "explosive emotional disorder." Kevin was always very kind—in fact, I cannot remember ever seeing him angry—but apparently he lost his temper sometimes, for reasons he could not understand. He said he could feel these emotions building in advance, have a cigarette, and then feel them dissipate. Then again, maybe this was just one of those intellectual mazes he had constructed in his mind to explain to himself why he smoked.
    Kevin actually did quit smoking last fall, just over a year ago. He had been diagnosed with lung cancer, his doctor told him to quit, and he quit. He used a combination of nicotine replacement therapy and Wellbutrin. He was complaining about the Wellbutrin; it clouded his thinking and made it difficult for him to write…his passion in life. I told him that the doctors probably wanted him to keep taking Wellbutrin to make sure he did not pick up a cigarette; maybe it had something to do with controlling his explosive emotional disorder. He said,"Don't worry, I am NOT going to smoke again." I asked how he was so sure, and he said, "Because I will die if I smoke." I was floored. How could he have smoked for nearly 50 years if he was concerned about dying? Somehow, after all our discussions, he did not believe that tobacco would kill him until he got lung cancer and his cancer doctor told him so. Did I forget to tell him that obvious fact? Did he construct another intellectual puzzle in his mind to convince himself that he would be THE ONE who escaped the very predictable path from tobacco to early death? I ask these questions because I don't want to go through this again. I don't want to lose another person I love to tobacco. Maybe I should have been more selfish in my discussions with Kevin, not focusing so much on my concerns for him, and instead telling him I did not want to bury him at such a young age…in MY life.
    When tobacco killed my younger brother 2 years ago, I was inspired to write a scholarly essay summarizing the complex causes of smoking and strategies to help people quit.1 Today, I am just tired of losing people I love to tobacco. I feel empty losing Kevin. This is how everyone feels when they lose someone to tobacco. If you know someone who smokes, please tell them that you have a friend who lost two brothers to smoking. Ask them to quit for you, so that you don't lose them so early in YOUR life.
    Reproduced with permission. Michael O'Donnell, (2013) Now Tobacco Has Killed My Big Brother. American Journal of Health Promotion: January/February 2013, Vol. 27, No. 3, pp. iv-v. doi:
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