Sleeplessness and Smoking

Joseph R. Thurn, MD
JAMA. 1988;260(11):1551-1552. doi:10.1001/jama.1988.03410110059013.
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To the Editor.—  The May 27,1988, issue of JAMA contains two articles concerning the findings of sleep researchers dealing with chronobiology, circadian rhythms, and work shifts.1,2 The photographs are of interest. The first depicts a person who finds herself "staring at the clock" instead of sleeping. The nightstand is otherwise uncluttered. The second photograph, which asks if short-acting drugs are sometimes an appropriate choice to induce sleep for shift workers, contains some changes. The clock is no longer visible. Am open book and a prescription bottle are visible. Unfortunately, another addition is depicted that is hardly appropriate. Perhaps the pack of cigarettes, the matches, and the ashtray were included to indicate anxiety over the inability to sleep. The addition suggests that smoking is a normal response to stress and the inability to sleep. That smoking is a major health hazard and cause of fires and results in significant morbidity,


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