When Augustus takes out a cigarette after support group and puts it in his mouth, Hazel is mortified by the thought of a cancer survivor actively partaking in an activity that is known to cause cancer. But Augustus’ explains the cigarettes are a metaphor—he stays in close contact with the carcinogenic cigarettes, but never lights them, simply keeping them between his teeth. The ability to keep the cigarette in his mouth, but never light it stands as an act of control. Metaphorically, the cigarettes become a means through which Augustus gains a sense of control over his cancer. The cigarettes, however, become a source of control for more than just Augustus’ cancer, as he uses them in different situations to feel control in light of a number of different fears. The presence of cigarettes diminishes as Augustus loses control over his cancer and slips toward his death at the end of the novel. When Hazel finds Augustus at the gas station shortly before his passing attempting to buy cigarettes, he has lost control over his body because of his cancer—he no longer walks on his own, he is incontinent, and he has vomited on himself. His condition in conjunction with his attempt to buy cigarettes and ultimately failing suggests that he has finally succumb to his cancer, and there is no more controlling the outcome of his life.