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Smoke Screens

William R. Barclay, MD
JAMA. 1978;240(12):1271. doi:10.1001/jama.1978.03290120065033.
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Tobacco generates many kinds of smoke, some of which screen the special interests of a diverse number of groups. It is a major source of tax revenue on which politicians depend for dispensing their largess. It is a major US crop and, therefore, is bread and butter for many farmers. It is the principal product of a large industry, which translates into jobs and stock dividends. Finally, it is a major cause of illness and helps to keep the physician's appointment book filled. Recent announcements by the media exposed these many fascinating facets of tobacco and for a few days generated more heat than smoke in our editorial office.

Most physicians regard cigarette smoking as a major contributing factor to the occurrence of lung cancer, emphysema, myocardial infarction, and several other diseases we would prefer did not exist. The best advice that a physician can give to a patient is,


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