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Clinical Crossroads |

A 36-Year-Old Woman Who Smokes Cigarettes

Nancy A. Rigotti, MD
JAMA. 2000;284(6):741-749. doi:10.1001/jama.284.6.741.
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DR DELBANCO: Ms V is a 36-year-old woman considering an attempt to quit smoking. Married, with 3 children, she lives near Boston and works at the public counter of a federal agency. Two of her children have asthma. Ms V has commercial, managed care insurance and receives primary care from Dr K, a general internist at the Beth Israel Deaconess Medical Center.

Since age 9 years, Ms V has smoked cigarettes, and by age 12 years, she was consistently smoking 1 pack daily. Currently, she uses 1 to 2 packs per day, smoking closer to 2 packs per day during times of stress. She smokes the bulk of her cigarettes during her long commute to and from work. She also enjoys tobacco after a meal and when out with friends. Ms V's husband is a former smoker.

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