I Quit Smoking at 65 After a Stroke Nearly Took Everything

I’m Bill Hartley. I’m 65 years old, I live in Nashville, Tennessee, and I smoked for 43 years before a stroke scared the life into me. I’ve been cigarette-free for thirteen months, and every single day of that feels like borrowed time that I intend to use well.

Forty-Three Years

I lit my first cigarette in 1980. I was 22, fresh out of the Army, working at a print shop in East Nashville. Pall Mall non-filters, because that’s what the old guys at the shop smoked, and I wanted to be taken seriously. Later I switched to Pall Mall Reds with filters when non-filters got hard to find. Then I settled on Camel Blues for the last twenty years or so, and that’s what I was smoking when I had the stroke.

Forty-three years. I’ve been smoking longer than most people reading this have been alive. I started when Jimmy Carter was president and I didn’t stop until Joe Biden’s term was almost over. I smoked through the birth of my three kids. I smoked through my first marriage falling apart and my second marriage to Patty. I smoked through the deaths of both my parents, my brother’s cancer diagnosis, two job changes, and a move from one side of Nashville to the other. Cigarettes were the one constant in my life. Whatever else changed, I’d have my Camels.

I smoked a pack a day, sometimes a little more on weekends or when I was fishing. I’d estimate I smoked somewhere around 470,000 cigarettes. If you lined them up end to end, they’d stretch over fifteen miles. I try not to think about what that amount of tar and carbon monoxide did to the inside of my body for four decades. The stroke gave me a pretty good idea.

Previous Attempts

I tried to quit three times before the stroke.

The first was in 1998 when my oldest daughter, Julie, was born. Patty asked me to quit before the baby came. I used the Nicoderm patches and lasted about three weeks. I remember standing in the nursery at 2 a.m. with Julie screaming and sleep deprivation cracking me open, and I walked to the gas station in my pajama pants and bought a pack. The combination of nicotine withdrawal and a newborn was more than I could handle. Patty didn’t say anything when she saw the pack on the counter the next morning. She just looked away.

The second time was in 2008. My doctor was getting on me about blood pressure and cholesterol and said smoking was making everything worse. I tried cold turkey and made it nine days. The constipation was brutal, the headaches were relentless, and I gained six pounds in nine days because I was eating nonstop. Chips, candy bars, anything to fill the void. I decided the weight gain was just as unhealthy as smoking, which is not true at all, but addiction will tell you anything to get you back.

The third time was around 2015. I tried the nicotine inhaler, the one that looks like a plastic cigarette. It worked okay for the hand-to-mouth habit, but the nicotine delivery was weak and I kept needing more hits than the recommended dose. After two weeks, I was frustrated with it and went back to Camels. By then I’d convinced myself that I was too far gone, that the damage was already done, and quitting at that point wouldn’t make a difference. That was a lie I told myself for another nine years.

The Stroke

January 14, 2025. A Tuesday. I was sitting at the kitchen table drinking coffee and reading the news on my phone. I reached for my mug and my right hand wouldn’t close around it. The mug fell and coffee went everywhere. I tried to say Patty’s name and the word came out garbled, like my mouth was full of cotton. The right side of my face felt heavy and numb.

Patty was in the next room. She heard the mug shatter and came in. She took one look at me and called 911 immediately. She told me later that the right side of my face was drooping, my speech was slurred, and I kept trying to stand up but my right leg wouldn’t support me.

The paramedics got me to Vanderbilt University Medical Center within forty minutes. They gave me tPA, the clot-busting drug, which has to be administered within a certain window. I was lucky on the timing. The stroke was ischemic, a blood clot blocking blood flow to part of my brain. They told me later that smoking is one of the biggest risk factors for exactly this type of stroke. Smoking thickens the blood, damages blood vessel walls, and promotes clot formation. I’d been building toward this for 43 years.

I spent four days in the hospital and another two weeks in outpatient rehab. The right side of my body was weak. My grip strength was poor. My speech was slightly slurred for the first week, though it cleared up. I was fortunate. The neurologist told me that many people who have the type of stroke I had end up with permanent disability or worse. He used the word “lucky” more than once, which is a strange word to hear when you’re in a hospital gown learning to grip a ball with your right hand.

On the second day in the hospital, my neurologist sat at the edge of my bed and said, “Mr. Hartley, if you keep smoking, you will have another stroke. And the next one will very likely kill you or leave you permanently disabled.” He wasn’t trying to scare me. He was stating a medical fact. The risk of recurrent stroke in smokers who continue after a first event is enormous. He said quitting was the single most important thing I could do to prevent a second stroke, more important than any medication he could prescribe.

I didn’t have a cigarette with me. Patty had thrown out every pack in the house while I was in the hospital. My Camels, my lighters, the ashtray on the back porch. All of it, gone. When I came home and reached for the spot where I usually kept my pack, there was nothing there. That empty space on the counter felt like a hole in the world.

Quitting from a Hospital Bed

I put on my first nicotine patch in the hospital, prescribed by my discharge team. NicoDerm CQ 21mg. They also started me on a baby aspirin and a statin, plus blood pressure medication. My medication organizer suddenly had five compartments filled. I was 64 years old and taking more pills than I could keep track of.

The first weeks at home were complicated because I was dealing with stroke recovery and nicotine withdrawal simultaneously. The physical therapy exercises for my right hand and leg took concentration that the withdrawal was constantly trying to steal. I’d be squeezing a rubber ball, trying to rebuild grip strength, and my brain would be screaming for a cigarette.

Patty was my rock. She’d been through my three previous failed attempts and she knew the signs. When I got irritable, she didn’t engage. She’d put a glass of ice water in front of me and leave the room. When I couldn’t sleep, she’d sit with me and we’d watch old episodes of Gunsmoke until I dozed off. She never lectured me. She just made sure the house stayed cigarette-free and that I had what I needed to get through each day.

My kids rallied too. Julie, who’s 27 now, called me every evening to check in. My son Matt drove down from Clarksville on weekends. My youngest, Sarah, who’s 19 and at UT Knoxville, sent me a text every morning that just said “Proud of you, Dad.” I still have every one of those texts saved.

The Hardest Moment

About five weeks in, I was doing well. The patch was managing the worst of the cravings, my right side was getting stronger, and I was starting to feel like maybe this time would stick. Then I went to my buddy Roy’s house to watch the Super Bowl.

Roy smokes. His wife smokes. His house smells like an ashtray and it always has. I walked in the door and that smell wrapped around me like a blanket. Familiar. Warm. Inviting. My mouth watered. My fingers twitched. Forty-three years of conditioning firing all at once.

Halftime came and Roy went out to the carport to smoke. I followed him out. I stood there in the cold and watched him light a Marlboro Red and I could feel the pull in my chest, almost physical, like a hand reaching inside me and tugging.

Roy offered me one. He said, “Come on, Bill, you’ve earned it. One won’t hurt.”

And I stood there for what felt like a full minute, looking at that cigarette in his hand, and I thought about the hospital bed. I thought about my right hand not closing around that coffee mug. I thought about Patty’s face when the paramedics loaded me into the ambulance. I thought about the neurologist saying “the next one will very likely kill you.”

I said no. I went back inside and ate a plate of wings and watched the second half. My hands were shaking the whole time. But I didn’t smoke.

I haven’t been back to Roy’s house since. That might sound extreme, but I know my limits, and being inside a house that smells like cigarettes is beyond what I can handle right now. Maybe someday. Not yet.

What Recovery Looks Like

Thirteen months out, my body has changed in ways I didn’t think were possible at my age.

My blood pressure has dropped from 162/98 to 138/84 with medication. My doctor says the smoking cessation is a major factor. My blood oxygen levels are consistently at 97-98%, up from the low 90s when I was smoking.

My grip strength on the right side is back to about 90% of normal. The speech is completely clear. I passed my six-month neurological follow-up with good results. The MRI showed no new damage, and my neurologist said the risk of recurrent stroke drops significantly in the first year after quitting.

I can walk two miles without getting winded. I walk the greenway along Shelby Bottoms near our house three or four times a week. Some mornings I take my granddaughter Lily with me in her stroller. She’s Julie’s daughter, born last August. When she grabs my finger with her tiny hand, I think about how close I came to not being here for this.

I can smell the honeysuckle along the greenway. I can taste Patty’s cornbread. I sleep through the night without waking up coughing. These sound like small things but after 43 years of numbing my senses with cigarette smoke, they feel enormous.

I stepped down from the 21mg patch to 14mg after six weeks, then to 7mg, then off completely by month three. The last step off the patches was tough. About a week of heightened cravings and irritability. But by then, the behavioral habits were broken. I’d built new routines that didn’t include cigarettes, and the physical withdrawal was something I could power through.

What I’d Say

I’m not going to pretend I have any authority to tell anyone how to live. I smoked for 43 years. I ignored every warning, every cough, every worried look from my wife and kids. It took a stroke to get through to me, and even then, my first thought in that hospital bed was wondering when I could have a cigarette.

But I’ll tell you this. I almost died. I almost left Patty a widow and my kids without a father and my granddaughter without a grandfather. All because I couldn’t put down a pack of Camel Blues. If you’re reading this and you’re still smoking, please hear me when I say: you do not want to learn this lesson the way I learned it. You do not want to be lying in a hospital bed, unable to move the right side of your body, being told that the thing you’ve done every day for decades is the reason you almost didn’t wake up.

Quit now. Not after the next pack. Not after the holidays. Not when things calm down at work. Now. Because the stroke doesn’t call ahead to schedule an appointment. It just shows up.

It’s never too late. I was 64 years old with 43 years of damage behind me, and my body is still recovering, still improving, still finding its way back. If there’s room for me to heal, there’s room for you.

You are not alone. There are people who will help you. Doctors, counselors, quitlines, family members who are waiting for you to say the word. Say the word.

I’m 65. I’m alive. I’m breathing. And for the first time in 43 years, I’m free.