Many people pick up habits during military service that stick with them into civilian life. According to the CDC, one of those is smoking, with people in the military and veterans still using tobacco products at higher rates than the general population.
Just over a week after her 18th birthday in 1972, Anita Carr was on her way to start a career in what was then known as the Women’s Army Corps.
“It's looking out for each other,” she said, remembering the relationships she formed with other female soldiers. “It's supporting – there's good times and bad times, and that's what the women did in the Women Army Corps. That's what we did.”
They made up less than 2% of the Army’s ranks, but Carr remembers the camaraderie being high between men and women alike when they were eventually integrated.
“It wasn't until 1975, when I came back from Germany, that they integrated me in with males,” Carr said. “Most of these men that I served with were like brothers. We all had the same job to do and to complete. Some didn't like to be in. Some got out of the service after three years.”
Carr spent more than seven years in the Army total, and while it was by no means required, she said smoking was fairly normalized.
“When I got to Germany, they rationed cigarettes, and cigarettes were $2 a carton, which was really reasonable if you were a smoker,” she said. “And I know Vietnam Veterans, they were shipped MRE packages with cigarettes in them.”
Even as far back as her basic training in Alabama, it was part of socializing.
“If I smoked, it was a pack every week and a half or something,” said Carr. “But as we went through classes and stuff every break, the smokers would all group together and smoke. So my habit started to pick up, because that's what we did on any break we had.”
Then, life happened: Carr was a new mother on top of balancing her Army career.
“I had five years in the service. My husband was also in the service at the time and he got out a year before I did, not long after our daughter was born,” Carr said. “And then my daughter was 15 months old. Her father and I separated. So I was looking for places to rent, I was having babysitting issues.”
Eventually, she made the decision to take a hardship discharge.
“I gave them all I could and it reached a point that no, this child needs me more than the service does,” said Carr. “I had to really think about it. And I said, ‘No, motherhood is important to me.’ And I chose that route.”
While the expenses of raising a child meant cutting down on smoking for a while, Carr said she still smoked after transitioning to civilian life and eventually finding herself in an administrative health-care role as part of the Michigan prison system.
“The last winter was really hard on me there, in 1997,” she recalled. “And I made a decision to move to Arizona, leave my job and come to the land of sunshine.”
Warmer air meant breathing was easier for a little while. But close to ten years after that particularly tough winter, Carr was diagnosed with chronic obstructive pulmonary disease (COPD).
It was a struggle to breathe during everyday tasks, like grocery shopping, showering or driving herself to appointments.
“I had a couple COPD exacerbations – that's where you really can't breathe. And you end up in the hospital and they give you steroids, everything to help you breathe,” Carr said. “My last exacerbation, I almost died.”
It was then she decided to sit down with her pulmonologist for a serious conversation about getting on the waiting list for a lung transplant.
“I had a wonderful support system that stood behind my decision with whatever I chose,” Carr said. “But I was more excited to have a different life than what I was living.”
Dr. Sofya Tokman is a transplant pulmonologist at Saint Joseph’s Norton Thoracic Institute.
“About 80% of people who are diagnosed with COPD have a history of tobacco use and it's by far and away the most common risk factor for this condition,” said Tokman. “And in fact, smoking cessation is probably the most important therapy for COPD.”
Tokman said more older patients now rely on lung transplants to treat end-stage lung disease.
“We help people that otherwise there's no hope for,” she said, adding that lung transplant is meant as a last resort when other treatments fall short. “That's incredibly gratifying because our patients face the prospect of passing away, face the prospect of debilitating shortness of breath and an impaired quality of life. And with lung transplant, they can breathe again.”
Tokman emphasized that although it can be a harder recovery process for them, lung transplantation is a more viable option for older patients than many may realize.
“There are a lot of referring enologists – even around the country – that won't refer patients for lung transplant because they seem too old,” said Tokman. “There used to be an age cutoff of 65 for lung transplantation, but now many centers are transplanting older adults. And so I would urge both patients and doctors to really speak to a transplant pulmonologist before writing off lung transplant due to an older age.”
During her own recovery, Carr’s now-adult daughter was by her side.
“She took FMLA from work and took care of me for a good 45 days,” Carr said, adding that the two are still very close. “I can’t stress enough how much caregivers help people that have had a transplant.”
But, she said, her improved quality of life is well worth it: “It's like being 18 again, having lungs that can breathe.”
Even eight years later, Tokman said Carr’s life will be different in some ways – just like anyone else who’s undergone an organ transplant.
“The degree of immunosuppression we require does decrease over time,” said Tokman. “Lung transplant recipients and other people who are immunosuppressed have to pay attention to their surroundings permanently, so they can take a lot more care than other people to avoid getting sick.”
Veterans or not, Carr encouraged everyone to consider becoming an organ donor and other smokers to consider quitting sooner than later.
“Don’t give up quitting,” she said. “If you want to be around to see grandchildren, to see the future, to see whatever – then you really need to look at your health and quit.”
And despite picking up her smoking habit there, she looks back on her military service fondly.
“Many of them weren't volunteers,” Carr said of her fellow soldiers. “They were drafted. But the female veterans all volunteered, whether they were the Nurse Corps or in another position. We need to honor our veterans. They served our country.”
