(Originally published at on 5/26/2013)

It turns out, as my mother reminds me, there’s another “Ike” in my life who gave up smoking cold turkey. My grandfather, Isaac, the patriarch, the heart and force in my extended family, was a smoker. He smoked 2 ½ packs per day back when cigarettes were unfiltered, and warnings were nowhere to be found. He was strong as an ox, and smoked at a time when cigarettes symbolized vitality – think Marlboro Man.

My mother was 10 years old, living with her parents and two younger sisters in Brooklyn (which I learned from an early age was apparently the best place on earth). She’d probably prefer I didn’t say the year. They were in the kitchen when my grandfather came home for dinner. He said, “I gave up something of the devil today.” They were supposed to guess what he had done, and it was my mom who figured it out. “Yup,” he said. “I quit smoking today.”

He had visited a customer – he owned a paper goods distributor and was generally out on the road selling all day at that time – and he noticed his customer was fidgety, watching the office clock. Apparently the conversation went something like this:

My grandfather asked why he was watching the clock. “In 10 minutes, I can have a cigarette,” the customer said.

My grandfather: “Why?”

The customer: “My doctor said I should give up smoking.”

My grandfather: “If you want to give up smoking, just give it up!”

The customer: “You son of a bitch. You’re standing there smoking a cigarette and telling me I should just give it up!”

My grandfather: “You’re right.” And he decided to quit. Just like that.

Though my grandfather was 33 at the time, and as far as I know never had another cigarette, he died almost 50 years later of metastatic lung cancer. But the quality of life until he got sick was outstanding, and he no doubt added years to his life through the sheer force of will that led him to quit.

What was it about these two Ikes that gave them the will to stop smoking? Can this behavior be taught? Or augmented? Or is it simply innate? According to the American Cancer Society, 70% of smokers want to quit altogether, yet only 40% will try this year, and even fewer will succeed. Only 7% of smokers succeed in quitting on their first try, and only 3.5% quit cold turkey. These data suggest my grandfather and the namesake of my fellowship were rare indeed, and that making healthy decisions is damn hard. We can’t necessarily sit back and count on consumers to make “the right choice.” We need to be realistic about how hard it is, and then help people translate good intentions into effective actions.