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This book is about the protagonist's, Paul Undres's, preoccupation with a nasty habit, cigarette smoking. While having beaten the drinking habit unlike his girlfriend, Chili Onion, he will do anything to quit smoking except quit on his own willpower. He goes to a noted doctor, a Frankenstein of medicine who has a total disregard for accepted medical practice. The man is a butcher. But Paul has a coupon from the back of a pack of Lucky Strikes that entitle him a free operation under Dr. Saw. HIs lungs are replaced with douchebags with osmotic nipples and his groin is removed. The good doctor is also a psychiatrist who counsels Paul on his affair with Chili Onion who is a crack whore and blackout drinker. AA is not enough for either character, nor is Dr. Saw. Much transpires with Paul and Dr. Saw and Chili while the high heavens and lowly hells monitor the saga. In the end, Paul's brain explodes with a smoke related aneurism during his wedding ceremony with Chili and he has but one request. That you'll have to discover for yourself.