This is Paul's exclusive preoccupation with the horrors of smoking cigs. It starts with his consultation with Dr. Saw, a noted surgeon, who operates with total disregard for accepted medical procedures. His first operation on Paul is a set of douche bags replacing his scarred lungs and removal of his sex organ for purposes of eliminating his tendency to misuse it.
Paul then deals with his unfortunate involvement with Chilli Onion, a crack whore and blackout drinker, who refuses to accept his philosophy based on the Twelve Steps and Twelve Traditions. But the Twelve Steps and Twelve Traditions only bring him further into the blight of the unrecovered.
Not only does Paul drag her around with him, but he takes her to meet his family. Basically, she is the only one who loves him. They make a pact to marry, but Duffus, Chilli's roommate, and once she has abused most stands in the way.
The High Heavens and Low Hells monitor this sad saga.
Meanwhile, Dr. Saw continues to operate. Paul's lungs have a chemical reaction and need a new set. His missing sex organ, which had caused phantom urges, was replaced with the original equipment. In the interim, Paul goes to the unemployment office for kicks, and later Paul has a dream of losing his head, the only thing that is still missing. The merry-go-round with Chilli and the fruitlessness of their affair culminated in a big day ahead.
Dr. Saw adds from his arsenal, a tracheal tube for Paul to stop smoking and a cork down Chilli's throat to stop her drinking. Meanwhile, Duffus dies, freeing Chilli to marry. The book comes to an abrupt conclusion with a stroke and Paul's beloved head exploding on all the guests on his wedding day.