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ARTICLE |

Another Kick in the (Cigarette) Butt

Samuel Vaisrub, MD
JAMA. 1979;242(11):1175. doi:10.1001/jama.1979.03300110047026.
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So many disorders—bronchitis, bronchogenic carcinoma, ischemic heart disease, peripheral vascular disease, male infertility, osteoporosis, even impaired fetal growth—point their fingers at cigarette smoking as a culprit, or an accomplice, that one cannot help but feel self-conscious when commenting on yet more accusing fingers. Metaphoric digits turn, as it were, into feet that kick someone who is already down. Still, one is constrained to mention two disorders in which smoking has been recently implicated: malignant-phase hypertension and subarachnoid hemorrhage.

Comparing the smoking habits of 48 sufferers from malignant hypertension with those of 92 nonmalignant hypertensive patients, Bloxham et al1 noted that 68.75% of the former group and 36.96% of the latter were smokers when their conditions were first diagnosed. Even though the sample was small and the two groups are not strictly comparable—the first were consecutive admissions to hospital in six years, the second attended an outpatient clinic at the

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