Bobbie has tried to quit smoking before. It was the early ’80s, when she was living as a man, a drug addict, and an alcoholic. She— then, he— worked as a singer in piano bars, soaking up the free drinks and taking amphetamines. A favorite source was over-the-counter Benzedrex inhalers. They’re meant to clear congestion, but she broke them open and swallowed the cotton inside. “It was a sexual high,” Bobbie recalls. “It felt like every pore in my body was having its own orgasm at the same time.”
Even so, almost three years ago, Bobbie managed to vanquish those addictions from her life. She checked into her first rehab at age 34; it took nearly a quarter century and several suicide attempts before she could stay clean for any significant period. That recovery was made possible by a larger, deeper shift: only 10 days after she finally decided to live as a woman, she also discovered the will to stop the drinking and drugs.
Cigarettes, however, may still kill her. “This is harder,” she sighs, then coughs. Though her red hair pulled back in a headband and dainty white sneakers bespeak a younger woman, Bobbie is 58. She is also overweight, has diabetes, and has had several heart attacks. And a year and a half ago she was diagnosed with emphysema. Since then it has progressed, leaving her sometimes short of breath, other times coughing so hard she falls to her knees. Her emphysema medications sit beside a bottle of opalescent nail polish on the table in her tiny studio in Hell’s Kitchen.
Quitting isn’t easy, as smokers— and their survivors— have been arguing in lawsuits across the country. And it’s that much harder when you have virtually no spare cash to get help and life is a constant struggle. Though her self-acceptance has amounted to a new lease on life, Bobbie still gets depressed. “Sometimes I just feel really old and, even though it’s just a thing, a cigarette is like the companion of my life.”
Last Saturday night, she tried to end that relationship for good. “I took one out of the pack, I looked at it, smelled it, I had it in my mouth. Then I looked at it again, crushed it up, and threw it in the garbage. That happened three times. Then I decided to take the whole pack, crush it up, throw it in the garbage in a plastic bag, and throw it down the chute.” But 24 hours later, she went to the store and bought another pack. Since then she has been smoking about 10 a day, down from her usual two packs.
It’s not as if she wants to keep up this madness. Cigarettes are now about $3.25 a pack, which means that, if she quit, she could save enough to afford electrolysis— which costs about $60 per session— to remove her remaining facial hair. And smoking deepens her voice, which she would like to move into a higher register so she could talk— and sing— more like a biological woman. (Bobbie fantasizes that if she could “somehow get in on one of those smoking suits,” she might also be able to pay for a sex-change operation to complete her transition.)
So far, though, no such luck. On her fixed income of $935 per month, Bobbie is able to afford little more than her $528 rent. This past month, she paid $40 to join a smoking cessation support group run by the American Cancer Society. It didn’t make her a nonsmoker, but it did help strengthen her resolve to the point where she’s at least crumpling packs. She also bought nicotine patches ($28 a pack), which have stayed affixed to her arm while she puffs away on her long More cigarettes. A wretched jar of soggy cigarette butts, which she keeps to remind her that smoking is revolting, has also failed to break her habit. “If I really want one, I just don’t smell it,” she laughs.
What might work, she thinks, is being forced to stay away from cigarettes. Her longest smoke-free period since she started smoking at 10 was a 35-day hospital stay a few years ago. “I have thought about going into the hospital again, just to get off the cigarettes,” she says, “just to be where I couldn’t see or smell them.”
Medicaid, of course, doesn’t cover such in-patient treatment. It won’t even pay for a new nicotine replacement device that sends the drug through the lungs. Since she feels most attached to the inhaling part of smoking, Bobbie thinks that might help. Her doctor prescribed it. But, at around $50 for a month’s supply, it was out of her range. At some point in the future, money from the settlement of several states’ lawsuits against tobacco companies may help subsidize such expenses— a plan Bobbie heartily approves of. But, for now, she is pretty much on her own.
Even without such assistance, Bobbie assumes she will quit smoking eventually. “The new me is not a drinker, the new me is not a drug addict,” she reflects. When will this new woman become a nonsmoker? Bobbie considers. She is planning a trip down to the county clerk’s office soon to change her name to Roberta. Maybe then. “I could change my name and at the same time stop smoking,” she says, big eyed. “That’d be fantastic.”