Smoking in Europe

Between finishing fellowship and starting my job, I spent a few weeks in Germany and the Czech Republic. One thing that really struck me was the prevalence of smoking, especially among the youth. Frankly, it was shocking, especially coming from California. I think I had the same reaction I get when I encounter lifestyles that we don't see often in California, such as vociferous anti-gay or pro-gun activists. While I know people like that exist, my social circles just don't include any. In any case, the number of smokers really got to me. I think most doctors have some sort of large-scale grand health-related wish: vaccinations, improved care to HIV/AIDS patients, attention to peripartum morbidity, clean water in third-world countries, tacking social inequity in health care delivery, etc. Mine used to be reduction of waste in health care systems (both physical waste and unnecessary tests, procedures, and medications). But now I think stopping smoking would be a close second.