The U.S. Senate made history a couple of weeks ago when senators, recognizing that smoking tobacco can kill you, voted overwhelmingly to give federal regulators new power to limit nicotine in cigarettes. Nearly half a million people die from smoking, at a cost of about $100 billion, every year. Do you think this new legislation means people will stop smoking? Of course not, it will only change how we deliver the addiction…and it’s already begun.

Say hello to the new, tobacco-free, nicotine delivery system the electronic or e-cigarette. The e-cigarette is the newest online marketing sensation; hundreds of thousands of people are flocking to the internet to buy them. The e-cigarette looks like a real cigarette, except it’s battery operated. You can buy a starter kit for $100-$150 which includes the cigarette and replaceable cartridges that contain nicotine (in varying strengths), flavoring (tobacco, menthol, cherry), and propylene glycol. Propylene glycol is used to create artificial smoke or fog in theatrical productions. It’s also a food moisturizer, industrial solvent and antifreeze. When the user inhales on the e-cigarette, a sensor heats up the vaporizing chamber which produces the smoke and delivers the nicotine.

Is inhaling propylene glycol healthy for you? The FDA say’s it’s generally recognized as safe as an additive to foods, but they have no idea about whether it’s safe to inhale. The marketers are selling the idea that it’s a healthier alternative to smoking cigarettes. They say e-cigarettes deliver nothing more than nicotine and water vapor, and there are no carcinogens. But will inhaling propylene glycol lead to chronic obstructive pulmonary disease? Or will high doses of nicotine in your body have any long-term genetic effects? Nobody knows.

This new legislation will legitimize a new industry that delivers nicotine without tobacco. This is the scenario: pharmaceutical companies will finance massive advertising to encourage television viewers to see their doctors because they may be experiencing depression, anxiety, social withdrawal, irritability, and maybe even murderous rage. The ad will tell you to ask your doctor if “drug X” is right for you (side effects may include dependency, lung disease, genetic abnormalities, autoimmune disease, depression, suicide in children, and should not be taken during pregnancy).

The best way to treat an addiction is to find a way to turn whatever you’re addicted to into a teaching. Whatever it is that is stringing you out has something to teach you. But once you’ve learned the lesson, you can move on. If you can’t feel good without depending on a drug, then it’s doing you — you’re not doing it.

We have to come to addictive substances as sacraments; if you can’t use them sacramentally, don’t use them at all. The Jews used wine as a sacrament, but were not alcoholics. Native Americans used tobacco in the same sacramental way: a sacred plant, smoked together in a circle in a sacred pipe. As part of the ceremony, a blessing is given, “Thank you for the gift of sharing our life breath as we come together in this sacred circle with one heart, one tongue and one breath. I say thank you for all my relations.” The pipe gets passed around the circle, everyone gets several puffs and then passes it on, and it only comes around once.

That’s tobacco as sacrament. A sacrament requires ceremony — the creation of a special time and place, with a ritual of meaning. When you can just knock out a cigarette from the pack and do it 20-40 times a day, you are no longer appreciating its holiness, it’s an addiction.

I say no to e-cigarettes because they feed nicotine addiction. If you can’t come to smoking as a ceremony, stop doing it. Recognize the teaching that there are some things before which you stand powerless, and let it go.

This week I am coming to you for help; it’s been a decade since my last book was published. I thought I’d said everything I had to say, and that anymore would be redundant. Then I got old and discovered that to age successfully means finding the courage to look at your current reality and let go of old familiar images that keep you from loving who, what, and where you are.

To come to every day with joy requires a willingness to look again at old certainties. So my new book, Kindling Spirit, is the continuing tale of discovery about healing others and oneself and about looking at those certainties through the wisdom of age.

The story is told through my experiences with indigenous people, explorations in altered states of consciousness, and the healing power of ritual, ceremony and community.

I am considering publishing Kindling Spirit in a nontraditional way. My idea is to send paying subscribers one chapter a month for a year. Subscribers could make comments, ask me questions, or add their own stories which could be shared with others. In my imagination, I see us gathered around the fireside in a healing circle, each of us with a story to tell, needing to hear the stories of others. It is in sharing our stories that we make sense of our lives, as they are today, at this place on our journeys.

To help me decide if I will publish the book in this way or through a traditional publishing model, I am asking for your candid participation in this brief, anonymous survey. Your honest answers (my wife begs you not to simply tell me what you think I want to hear) will help me craft a book that kindles the healing spirit in all of us.

To all my relatives, thank you for your responses to the following five short survey questions which you will find on a tab “Kindling Spirit Survey” in the upper right hand corner of my homepage (www.healingdoc.com).

Eight percent of the American population is diabetic, and that rate is expected to double in the next 10 years because more and more young people will develop the disease as a result of epidemic obesity.

At a recent three-day medical meeting in Los Angeles on diabetic feet, doctors reported that the rates of foot amputations as a complication of diabetes have soared over the last 15 years. Every year, 100,000 diabetics are getting their feet cut off; these are people who are generally ignored in our society because they are old, overweight, and often a racial minority;

The statistics make my blood boil because we have to stop cutting off feet as a model of healthcare delivery. The current interventional model that treats diseases when people get sick is inefficient, costly and ultimately ineffective. The future of medicine is about moving from intervention to prediction and prevention.

Here is a perfect example of what a new model of healthcare could do. Treating diabetes-related surgical complications in this country costs $40 billion a year. That cost is in addition to the $116 billion it costs just to the treat uncomplicated diabetes. For less money, we could invest in mobile vans, staffed by skilled professionals, who would set up diabetic clinics in high-risk neighborhoods. Every week, at the same predictable time, in parking lots and senior centers, patients could come in to be checked by clinicians who would look at their skin before it broke down and got infected. The dependable presence would allow patients to develop relationships with clinicians, which is a critical element in getting patients to change their unhealthful behaviors. Professionals who are liked and trusted can inspire patients to become the principal agents in their own healing. If we paid some loving attention to these isolated patients, they would eat better, exercise more, and stress less.

If we spent only half of what we currently do on amputations, the savings would buy mobile clinics in every city in America, with money left over to support local gymnasium programs to encourage weight loss and fitness. That, in turn, would help reduce the number of symptomatic diabetics which would save additional billions. That money could be used for other mobile clinics that address maternal and child health, and the treatment of the chronically mentally ill who now walk aimlessly on downtown streets.

This is transformational, paradigm-shifting health-care reform which will move us from an interventional, illness-based model to one that will allow patients to walk away from amputation through healthful participation.