Smoking

Most of our thoracic surgery cases are a result of smoking. One of the most common indications for lobectomy is lung cancer, a direct consequence of longstanding tobacco use. The smoking history also makes the surgeries higher risk because they cause comorbidities such as COPD, cardiovascular disease, and hypertension. Yet despite this, the addictive nature of tobacco and its psychological dependence is overwhelming; I've had one patient who we took for resection of her lung cancer who adamantly refused to give up her smokes. This habit has devastating health consequences and a significant societal cost.

As a physician who doesn't have any family or friends who smoke, it's hard for me to understand why it still exists. I certainly come from one end of the spectrum, who abhors cigarettes, who has seen patients suffer and die from its consequences, who can't fathom why anyone would even want to smoke. But I stand firm. To me, there aren't any redeeming factors about tobacco; there's certainly no medical justification. The cost, for individual patients, society, health care systems, and the government, is not only exorbitant, but also avoidable. If we are really serious about improving health care and reducing the cost of medicine in this country, we need to address the epidemic of smoking.

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