when i worked in a respiratory icu the following was a daily scenario:
a veteran (most were veterans) is admitted to the icu in dire distress, struggling for every breath, close to death and in a severe panic, much like it must be to drown.
he is taken care of, makes it through alive.
as soon as he is able to get around, he takes his iv pole, goes outside of the hospital, lights up his unfiltered cigarette, holds it to his tracheostomy and puffs away, one cigarette after the other.