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Smoking Drivers: Standard or Optional?-Reply

Joseph R. DiFranza, MD
JAMA. 1987;258(15):2062-2063. doi:10.1001/jama.1987.03400150054018.
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In Reply.—  I agree with Dr West that the inclusion of cigarette lighters and ashtrays as standard equipment in vehicles is an example of the tacit approval that our society gives smoking. Whether removing them represents good preventive medicine is debatable. Smokers have 50% more traffic accidents than nonsmokers, in part because they are distracted while lighting and manipulating their cigarettes.1 Making it more difficult to smoke while driving might result in more accidents. Similarly, eliminating ashtrays from vehicles could increase the number of fires caused by cigarettes thrown from vehicles. For these reasons, it seems that a ban on smoking while driving would have to precede the elimination of lighters and ashtrays.Still, I share Dr West's concern that smoking has come to be accepted as normal in our society. One would not expect that a disease that causes one out of four deaths would be treated with


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