I Smoked Since I Was 16. At 60, Nicotine Gum Finally Worked.

I Smoked Since I Was 16. At 60, Nicotine Gum Finally Worked.

I started smoking before I could legally drive. I’m 60 now. That’s 44 years of cigarettes. Forty-four years of Marlboro Reds and then Marlboro Lights and then whatever was cheapest at the gas station when money got tight. Forty-four years of morning coughs and stained fingers and the same New Year’s resolution I broke every January by the 3rd.

My name is Al Russo. I live in Pittsburgh, born and raised. I worked at the Edgar Thomson steel plant in Braddock for 28 years before they cut my department. Now I drive for Uber part-time, mostly evenings and weekends, and I collect a modest pension that keeps the lights on.

I quit smoking eight months ago. I’m still surprised I can say that.

The Kid Who Started at 16

In 1982, I was 16 years old and everybody smoked. My dad smoked Camels. My uncle Frank smoked Pall Malls. Half the guys on my block smoked. It wasn’t a rebellious thing. It was just what men did, especially in a steel town, especially in the early ’80s.

I stole my first few cigarettes from my dad’s pack in the kitchen drawer. He caught me once and smacked me on the back of the head but didn’t say much else. He knew he couldn’t say a whole lot about it considering he had a lit one in his hand at the time.

By 17 I was buying my own packs with money from my after-school job stocking shelves at the Shop ‘n Save on Braddock Avenue. A pack cost maybe a dollar fifty back then. You could smoke and still have money for gas and pizza and a Saturday night out. It was cheap and easy and everyone around me did it, so why wouldn’t I?

I graduated high school in 1984 and went straight to the steel mill. My dad got me in. Almost everyone on the floor smoked. We’d take breaks and stand around outside the mill entrance, and the air was already so thick with industrial particulate that cigarette smoke seemed like nothing. I know how that sounds now. But that was the thinking. The mill is worse than these, we’d say, tapping our packs. We were wrong about that, but we didn’t know and we didn’t care.

Decades of Failing to Quit

I tried to quit for the first time in 1995. My wife, Donna, was pregnant with our first kid, Anthony. She asked me to stop. I said I would. I lasted eleven days. She was disappointed but she didn’t push it. She had her own stress and morning sickness and a husband who was working doubles at the plant. Smoking fell off the priority list.

I tried again in 2001. Cold turkey. Made it about three weeks and then my buddy Ray and I went to a Steelers game and he offered me one in the parking lot and that was that. One turned into five turned into a full pack by Monday.

In 2007 I tried the patch. The Nicoderm CQ. I wore it for about two weeks. It gave me vivid, wild dreams. I’m talking full-color nightmares about things that made no sense. One night I dreamed I was trapped in the blast furnace at work and woke up soaked in sweat. I ripped the patch off and went outside and smoked. That was the end of that.

I tried Chantix in 2012. That one actually worked for a while. I quit for almost three months. But the side effects got to me. I felt off. Moody in a way I couldn’t explain. My wife said I was a different person, and not in a good way. I stopped taking it and within a week I was back to a pack a day.

After that, I kind of gave up. I figured I was a lifer. Some people smoke their whole lives and make it to 85, I told myself. My grandpa smoked until he was 78 and died of a heart attack, not lung cancer. I used that as permission to keep going.

The Diagnosis That Changed Everything

In March 2025, I went to see my doctor at UPMC for a cough that wouldn’t go away. I’d had it for weeks. Deep, wet, productive cough. I figured it was a cold that just wouldn’t clear. My doctor, Dr. Patel, ran some tests. Breathing tests. Spirometry, they call it. You blow into a tube as hard and as long as you can.

My numbers were bad. He sat me down and told me I had moderate COPD. Chronic obstructive pulmonary disease. He showed me the numbers on a chart and explained what they meant, which is that my lungs were functioning at about 65% of what they should be for a man my age and size.

He was direct about it. He said, “Al, if you keep smoking, this gets worse. It doesn’t get better. We can slow it down, but only if you stop.”

I sat in that exam room and stared at the poster on the wall about hand hygiene and felt something I hadn’t felt in all those other quit attempts. Fear. Real fear. Not the abstract “smoking is bad for you” fear that you can push aside. The specific, personal, this-is-happening-to-you fear of a doctor with your chart in his hands telling you that your lungs are failing.

He asked me about my quit history and I told him. All the attempts. The patch, the Chantix, the cold turkey failures. He nodded and said he wanted me to try a combination approach. Nicotine patch for the baseline, nicotine gum for the cravings that break through. He said the combination was more effective than either one alone, especially for heavy long-term smokers.

I said I’d tried the patch before and hated the dreams. He told me to take it off before bed. Simple as that. I’d been wearing it 24 hours like the box said, but he said plenty of his patients wore it only during waking hours and it still worked fine. He also said the gum had come a long way since the ’90s. Better flavors, better delivery. He wrote it all down on a piece of paper because I’m not great with remembering medical stuff.

The Money Problem

Here’s the thing about quitting when you’re on a fixed income: the tools cost money too. Nicorette gum isn’t cheap. A box of 100 pieces of the 4mg (which is what Dr. Patel recommended because I smoked within the first 30 minutes of waking up) runs about $50 at Rite Aid. The patches were another $35 to $40 for a two-week supply. I was already spending about $10 a day on cigarettes, which is over $300 a month, but that money was baked into my budget. I knew where it came from. The gum and patches felt like a new expense on top of everything.

My daughter-in-law, Maria, is the one who told me about the CVS store brand. Same active ingredient, same dosages, about 30 to 40% cheaper. I went to the CVS on Murray Avenue and found their generic nicotine gum, 4mg mint, for around $33 for 100 pieces. That’s a real difference when you’re watching every dollar. I bought that and a box of the CVS nicotine patches, which were $28 for a 14-day supply of the 21mg.

Later I found out that the Walmart Equate brand was even cheaper for the gum. I’d drive to the Walmart in West Mifflin and stock up. Nobody needs to buy name brand for this stuff. The nicotine is the same. The delivery is the same. Your body doesn’t know the difference.

Starting the Combo

My quit date was April 14, 2025. I remember because it was a Monday and it was raining and I figured if I could get through a rainy Monday in Pittsburgh without smoking, I could get through anything.

I put the patch on my upper arm after my morning coffee. Then I waited. The patch takes a while to kick in, maybe 30 to 45 minutes before you feel any effect. During that wait, the cravings hit. That’s where the gum came in.

The first piece of 4mg gum was strong. Stronger than I expected. It had a peppery bite and I could feel the nicotine hitting my gums and the inside of my cheek. I’d read the instructions this time, front to back. Chew a few times, park it, wait, chew again. Don’t chew it like Juicy Fruit. I made that mistake with the gum back in the ’90s, just chomped on it and got nauseous and threw the box away. This time I did it right.

The combination worked in a way nothing else had. The patch gave me a steady, low-level supply of nicotine all day. It took the edge off the constant baseline craving. And the gum handled the spikes. The after-meal urge. The after-coffee urge. The boredom-in-the-car urge while waiting for an Uber pickup. When a craving surged, I’d pop a piece of gum and within a few minutes it would back off.

The First Month

I won’t lie to you. The first two weeks were miserable. Not as miserable as cold turkey, not by a long shot, but still hard. I was irritable. I snapped at Donna over nothing. I couldn’t focus when I was driving for Uber and had to take a few days off because I didn’t trust myself to be patient with passengers.

I gained about five pounds in the first month because I was eating everything in sight. Pretzels, sunflower seeds, hard candy. My mouth needed to be doing something when I wasn’t chewing the gum. Donna started keeping a bowl of baby carrots in the fridge, which I ate by the handful and felt ridiculous about.

But I didn’t smoke. Not one cigarette. Not one drag. Not even when my old buddy Ray came over to watch the Pirates play and lit up on my back porch. I sat inside and chewed my gum and watched through the screen door. Ray thought I was being dramatic. I told him the doctor said my lungs were at 65% and he got quiet after that.

The Grandkids Factor

I have three grandchildren. Anthony’s two boys, Lucas and James, are 8 and 5. My daughter Christina’s girl, Sophia, is 3. They’re the reason I wake up most mornings.

Before I quit, the boys knew I smoked. Lucas once told me I smelled like a campfire. He didn’t mean it as a criticism, he was just being honest the way kids are. But it stuck with me. James has asthma. Mild, but real enough that he carries an inhaler in his little Spider-Man backpack. Every time I smoked before seeing them, I’d change my shirt and wash my hands and chew a mint. I knew about thirdhand smoke, the residue that sticks to your clothes and skin. I knew I was probably bringing it around him.

After the COPD diagnosis, I thought about James and his inhaler and me and my inhaler, because yes, I have one now too. An albuterol rescue inhaler that I use when the shortness of breath gets bad. And I thought about what kind of example I was setting. How could I tell those boys to make good choices when I was killing myself slowly and they could see it?

When I told Lucas I quit smoking, he gave me a high five. He’s been checking on me ever since. Every time I see him he asks, “Grandpa, are you still not smoking?” And I say yes. And he says good. That kid’s approval means more to me than anything any doctor could say.

Stepping Down

After three months on the patch and gum combo, Dr. Patel had me step down the patch from 21mg to 14mg. Then to 7mg. Then off the patch entirely by month five. The gum I kept using, but I gradually cut back. From 10 or 12 pieces a day to 6 or 7, then down to 3 or 4.

I’m at eight months now. I still chew 2 or 3 pieces of gum a day. Usually first thing in the morning and after dinner, those are my stubborn craving times. Dr. Patel says that’s fine. He says long-term gum use is infinitely safer than smoking and if I need it for a while longer, there’s no rush.

My lung function hasn’t improved dramatically, he told me that with COPD the damage doesn’t reverse, but it hasn’t gotten worse. It’s stable. And my cough is better. Not gone, but better. I can walk up the stairs to my bedroom without stopping halfway. I can play in the backyard with the grandkids without needing to sit down after five minutes.

What 44 Years of Smoking and 8 Months of Not Smoking Taught Me

I wasted a lot of years. I don’t say that for sympathy, I say it because it’s true. I started smoking before I understood what it meant and I kept smoking long after I did. Every failed attempt made the next one feel more pointless. I told myself I was too far gone, that the damage was done, that quitting at 55 or 58 wouldn’t matter.

That’s a lie. It matters. Dr. Patel showed me the data. Even at 60, quitting slows the decline. It reduces the risk of heart attack and stroke almost immediately. The carbon monoxide clears your blood within a day. Your circulation starts improving within weeks. No, I’m not going to get my 20-year-old lungs back. But I’m going to keep the lungs I have working as long as possible.

The gum was the thing that made the difference this time. Not because it’s magic, but because it fit my life. I drive for Uber. I can’t wear a patch and sit in a car with passengers and suddenly need to pull over because a craving hits. The gum gives me something to do in the moment. It’s active. I’m choosing to respond to the craving instead of just enduring it.

If you’re an older smoker who’s tried everything and failed, I get it. I was you for decades. But the combo approach, patch for the baseline, gum for the spikes, was different. It covered the whole problem instead of just part of it. And the generic brands work just as well as the expensive stuff. Don’t let the price of Nicorette stop you. Walk into any CVS or Walmart and buy the store brand. Your lungs don’t care about the label.

I’m 60 years old. I smoked for 44 years. And I’m eight months free. If I can do this, I promise you, anyone can.