Smokers, chewers, sniffers, shooters, drinkers and pill takers are surprised to learn that that the struggle in becoming clean and sober s not between them and the toxic agents they are sending into their bodies.  It is a struggle between them and their own precious brains!  And just like in the old western movies, they need to "pull out the arrow,  get on their horse and ride for help!"
 
This model provides a graphic illustration of where and for what each employee is responsible. In general, the toxic agent is the medical staff's responsibility,
e.g. medical assessment, detoxification, withdrawal, and other medication management.  The clinical staff is responsible for the susceptible host; for retraining the addictive pathways of the brain, addressing the emotional and psychological aspects of the addiction, and tending to the spiritual and self-worth issues that accompany most addictions.  The executive board and administration are responsible for the environment: for financial, administrative, training and personnel support, quality assessments and setting the policies and procedures to assure a continuing positive outcome. 

In a small town in the Rockies a handout shopping guide advertised a gift shop that sells raw tobacco. They have a machine that loads the tobacco into empty paper cigarette tubes. The tubes are $10.00 for 200, enough tobacco to fill them is $15.00.  The establishment can only sell the "makin's" according to law.  There is no expensive federal or state tax on the "makin's", just on manufactured tobacco products.  So, how does the buyer escape these high taxes and attempt fill the equivalent of a carton of cigarette tubes successfully with tobacco? 
 
The store has a machine for the customer to lease for $30.00.  It is as big as a freezer and can fill 200 tubes in approximately 8 minutes.  Tobacco goes in the top and the tubes are placed in a tray near the bottom. Loosely packed cigarettes come out the bottom into another box that is big enough to hold a carton.   BUT, the store clerk, or any other store employees, is not allowed to even touch the machine.  Directions are attached to the machine.  If the clerk loads the ingredients, runs the machine or sells the resulting product to the customer, they are then considered to be in the sales AND the manufacture of cigarettes.  They would be liable for over $50.00 per carton in state and federal taxes.  The customer had to pay $45.00 per carton and "Roll his own" to avoid the extra $50.00 cost. There is a video on YouTube showing a very busy machine. The machine was labeled RYO (Roll Your Own).
 
Two young 20 year old men were standing there watching the machine crank out these $4.50 packs of cigarettes for a trapper type guy.  The youngest one, with an "I belong..." cigarette travelling behind his ear, said that the gas station next door was now up to $95.00 per carton for Newport Lites!   He said he was having trouble affording them.  I said to him, "Wow, almost $100.00 per carton! You must really love to smoke!" He shifted his eyes from the machine to me with an expression that cut to my soul.  His eyes said, "LOVE to smoke? I HAVE to smoke and there is nothing I can do... I HAVE NO CHOICE."  He continued to look at me with a pleading stare that seemed to say, "Is there something I can do?"   Then he and his buddy walked out before I could give him an "I Don't Smoke!" business card...