Smokers / Vapers

[pathologyDO]

Curious to see how people work around nicotine addiction during 3rd year? I quit smoking 4 years ago and have fallen into a continuous depression throughout 1st and 2nd years. Unfortunately I've been feeling so down and out that I picked up an e-cig and it has boosted my mood, focus, and motivation tremendously... but I know it will be hard to deal with during 3rd year.

Anyone still use nicotine in some form during 3rd year, and if so, how do you get by?

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[Tired]

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[pathologyDO]

Dip. Learn to gut it.

Haha, no thanks, I would rather have a headache than barf on my patients

 

[Tired]

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[pathologyDO]

I don't have headaches or an upset stomach.

I would count on an exit getting treated exactly like a lit cigarette. I wouldn't pull it out if I were you.

lol. that's hardcore... I think. What does this mean exactly?

 

[TraumaLlamaMD]

Exit = e-cig + autocorrect, most likely.

 

[pathologyDO]

I'm genuinely surprised at the fact that only 1 other person uses some form of nicotine. Surely there are some others?

 

[the argus]

You should just quit again. I quit cold turkey during MS2 after an 11 year pack/day habit and it was the best decision I have ever made, quite literally. Figure out what was causing you to feel depressed in the first place and correct that, don't use nicotine as a crutch.

And in terms of using an e-cig during M3, as long as you don't need it every hour you will be fine. You will have opportunities to pop outside for 5-10 minutes throughout the day to take a few puffs, and if you are discreet no one will know. Lots of residents/attendings smoke, and as long as it doesn't interfere with your work no one will care. Or if you are really worried about being "caught", just by some nicorette.

As an aside, I rotated through a hospital during M4 that had a nicotine-free hiring policy. They would actually do nicotine urine tests prior to hiring you, and then terminate your employment if they found out you were smoking afterwards. Seems a little overbearing to me.

 

[TraumaLlamaMD]

As an aside, I rotated through a hospital during M4 that had a nicotine-free hiring policy. They would actually do nicotine urine tests prior to hiring you, and then terminate your employment if they found out you were smoking afterwards. Seems a little overbearing to me.

AFAIK this isn't uncommon - I have at least a few friends who matched this season to systems with this type of policy. If you're able to quit again, you do leave more doors open for the future.

 

[pathologyDO]

You should just quit again. I quit cold turkey during MS2 after an 11 year pack/day habit and it was the best decision I have ever made, quite literally. Figure out what was causing you to feel depressed in the first place and correct that, don't use nicotine as a crutch.

And in terms of using an e-cig during M3, as long as you don't need it every hour you will be fine. You will have opportunities to pop outside for 5-10 minutes throughout the day to take a few puffs, and if you are discreet no one will know. Lots of residents/attendings smoke, and as long as it doesn't interfere with your work no one will care. Or if you are really worried about being "caught", just by some nicorette.

As an aside, I rotated through a hospital during M4 that had a nicotine-free hiring policy. They would actually do nicotine urine tests prior to hiring you, and then terminate your employment if they found out you were smoking afterwards. Seems a little overbearing to me.

Right on. Yes I totally get what you're saying about quitting again... the problem with is that I already identified what is depressing me, and that is 100% medical school. Since it's board study time, I literally at all costs need to score well and if that means going through nicotine withdrawal again .. so be it! On another note, thanks for this info about being able to take breaks.

AFAIK this isn't uncommon - I have at least a few friends who matched this season to systems with this type of policy. If you're able to quit again, you do leave more doors open for the future.

This sucks. The e-cigarettes seem like a much safer modality to intake nicotine, posing probably minimal amounts of health risk compared to real cigarettes so I think the no smoking policy shouldn't apply to e-cigs (I'm sure they could care less and still ban e-cig smokers too).

Its pretty lame that I cannot use nicotine as a stimulant instead of, say, caffeine. Seems like I have a conundrum here.

 

[Tired]

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[pathologyDO]

The trend in the health industry seems to be to treat e-cigs like real cigarettes. There's all these articles coming out now about the "hidden dangers" of vaping, and how it's just a marketing tool to make cigarettes socially acceptable again. I listed to a congressional hearing when they hauled the heads of Blu and couple other companies in, and just completely slaughtered them. WHO is arguing that "second hand vapor" is a health threat (http://www.who.int/nmh/events/2014/backgrounder-e-cigarettes/en/). More places are banning their use indoors. I don't think that e-cigs are going to be acceptable in any hospital you go to, though admittedly, I have yet to see anyone try.

You have multiple options beyond smokes and e-smokes if you want to continue using nicotine. There are lozenges and the gum if you want on-demand products, or you could wear a patch while you're in the hospital. I personally continue to dip. Cigarettes have become so demonized that anything that resembles smoking is pretty much out in a hospital. I suppose you could try rolling your own, then claim that it's marijuana, since for whatever reason none of the health Nazis have a problem with smoking that. But even then, I think the smell will give you away.

Oh, I didn't plan on actually using them inside the hospital! I meant go outside and smoke the e-cig, because I know it wouldn't take long for someone to report it and me be getting unprofessionalism marks or some other ridiculousness if I tried indoors.

As for alternatives... maybe the nicorette gum? When I last tried to quit I used the patch but it turned out to make me really itchy so that was a bust. The e-cig happened to work well for me quitting. Honestly I like the e-cig b/cuz part of the smoking is physical for me and I like the feeling of inhalation of the nicotine - typing this out sounds weird but it is what it is. It's nice to know that someone else is using a tobacco product and hasn't been kicked out or anything - are you in a large residency or? Wondering if you had any problems with finding a residency program that didn't test for nicotine.

 

[colbgw02]

I had to get nicotine tested for fellowship. And this was in a relatively smoking friendly part of the country.

 

[Mad Jack]

When my hospital campus banned smoking, I just gave up the habit entirely. They owned everything for blocks, so smoking was effectively banned within a three minute walking distance of the hospital, and you can't just sneak away for a minute when you're working on the tenth floor, walk over a few blocks, have a cigarette, and come back without anyone noticing. Worse yet, our hospital phones were wifi-based, so if you left campus, you couldn't take calls, so you'd not only have to leave, but you'd have to find someone willing to hold you phone for at least 15 minutes, which basically made you look like an ass. I just gave it up when I realized the only time I could actually get in a cigarette was my lunch break, which left me choosing between food or nicotine.

 

[Light Yagami]

I quit smoking before med school. Luckily, I don't have an addictive personality so have no craving to smoke; however, I do regularly pop the 2mg nicotine lozenges during 3rd year rotations because the nicotine helps greatly with my motivation and it helps me stay awake. They are discrete and it looks like you're popping a mint.

 

[colbgw02]

If you had failed, would they have cancelled your match?

I didn't (and still don't, really) know the answer to your question, mostly because I've never really used tobacco in any appreciable amount, but I looked back at my fellowship contract. There is no specific language about nicotine/tobacco use in the contract, but there is a paragraph about adhering to the faculty handbook. Of course, I didn't read the handbook, but I assume this is a pretty standard way of contractually enforcing a university's policies without getting into the weeds too much.

I then searched for their tobacco policy online, and it looks like they announced a tobacco-free hiring policy just a few weeks before I was offered my position and a few months before I signed the contract. Putting on my not-a-lawyer hat for a moment, I'm not convinced they could have rescinded the contract for this reason, because I could have quit before working there in theory, but it seems like they could have fired me after my employment started if I was found in violation of the policy.

I have no idea with what frequency, if at all, this policy is enforced. There definitely were/are employees smoking there, but I wonder how many of them were grandfathered in. In any case, this sort of thing seems to be trendy now in medicine.

 

[OscarWao]

I listed to a congressional hearing when they hauled the heads of Blu and couple other companies in, and just completely slaughtered them.

I would loved see this if you could send the link!

 

[Kaustikos]

OMG. Just smoke the e-cig! Get a vapor flavor that's delicious and smells good. Don't smoke around the hospital. Problem solved. E-cigs are way better than cigarettes. They're like portable hookahs.

 

[jdh71]

Curious to see how people work around nicotine addiction during 3rd year? I quit smoking 4 years ago and have fallen into a continuous depression throughout 1st and 2nd years. Unfortunately I've been feeling so down and out that I picked up an e-cig and it has boosted my mood, focus, and motivation tremendously... but I know it will be hard to deal with during 3rd year.

Anyone still use nicotine in some form during 3rd year, and if so, how do you get by?

The gum. Fits in your pocket. Chew it anywhere.

E-cigs probably aren't good for your lungs either *cue the muted trombones*

You can chew the gum indefinitely.

 

[pathologyDO]

I quit smoking before med school. Luckily, I don't have an addictive personality so have no craving to smoke; however, I do regularly pop the 2mg nicotine lozenges during 3rd year rotations because the nicotine helps greatly with my motivation and it helps me stay awake. They are discrete and it looks like you're popping a mint.

I LOL'd

The gum. Fits in your pocket. Chew it anywhere.

E-cigs probably aren't good for your lungs either *cue the muted trombones*

You can chew the gum indefinitely.

Sounds like I need to pick up some of the gum

 

[Kaustikos]

I routinely spend 30+ hours in the hospital at a time. This doesn't really work.

Well, I was offering a safer alternative vs smoking cigarettes. More like a "if you have to smoke, don't use cigarettes." we can smell it. Or the cologne/perfume you suddenly decided to put on.

 

[KnuxNole]

There are a lot of residents and med students who smoke. They usually find time for a smoke break for 5-10 minutes, especially the students. where I did my rotations, they could do it on hospital grounds, but where I'm at now, you can't smoke near the hospital...

 

[Kaustikos]

There are a lot of residents and med students who smoke. They usually find time for a smoke break for 5-10 minutes, especially the students. where I did my rotations, they could do it on hospital grounds, but where I'm at now, you can't smoke near the hospital...

True. I know what you mean. I kind of feel like the character from "thank you for smoking" because I'm essentially advocating smoking. But with an edit that vapor is safer because the stench isn't there.

 

[Derberry]

I also vaping but don't smoke anymore. For me, I was a regular smoker over 12 years and about 30 1.5 (30 cigarettes) I smoked per day. However, it was the headache for my family and myself. I was looking for a method to quit it anyways. However, vaping has helped me to quit it. Now I am totally free and don't smoke anymore. If you would like to get ideas this can help you https://www.blacknote.com/store/

Thank you so much!