To the Editor:—
Dr. Seltzer's thoughtful and well-documented review of "Smoking and Coronary Heart Disease" (203:193, 1968) makes no reference to personality factors. Perhaps there are no research data about personality differences of the cigarette smoker in contrast to the pipe or cigar smoker, but popular attitudes generally suggest that the pipe or cigar smoker is more phlegmatic and less likely to suffer from tension states. A striking difference in the incidence of coronary disease is found between the two groups. Apparently the Surgeon General's Advisory Committee on Smoking and Health (quoted by Dr. Seltzer) in its list of predisposing factors mentioned only "occupations involving—stress" and ignored individual personality factors basic to psychomatic disturbances, which may predispose to coronary heart disease.