Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Are smokers to blame for the damage they do to their bodies?

James C. Salwitz, MD
Conditions
May 12, 2012
Share
Tweet
Share

He had yellow nails, leather neck, stained teeth and a deep cough. He wheezed slightly, breathed too quickly and occasionally sprinkled the white handkerchief red. No surprise his ticket to my office was a lung mass to match. We talked about tests, treatment and prognosis.  About the future, probably short.  Devastated, he was not surprised.  He was reaping the reward of 30 smoking years.  He sadly admitted, “I knew better, but I was bad.”

Bad? Guilty?  At fault?   He had committed himself to a short life ending in misery.  Of course, he had been “bad.”  Someone had to be at fault for this sick 54-year-old man!  He had walked a short road to the grave.  He was an adult, after all.  An independent soul.  He had been weak, frail and bad. Now he would reap a horrid harvest.

This is a TV defense lawyer’s trick.  “She was wearing a short skirt.”  “The door was wide open.”  “There was no fire alarm.”  “He asked for it.”  Forget personal responsibility.  Lead humans like swine.  Blame the victim.

Does this make sense? Are smokers ”bad” because of the habit and the damage they do to their bodies?  Is there really “fault” in the tobacco tragedy?  I would propose that when it comes to smoking there is indeed bad.  There is evil.  There is murder, mayhem, and terror.  However, to convict smokers of personal homicide makes no more sense then to blame the house for the arsonist.

Smoking cigarettes is not like other “bad habits.”  It is not the same as sunburn in mid-day July, driving 90 mph on a mountain road or scaling an electric fence.   In these activities, there is choice.  No one is forcing stupid behavior upon us. We voluntarily, of free will, elect to test mortality.   For most “bad” behaviors, the attacker and attackee are one.  Not so tobacco.  Smoking cigarettes is entirely different.  It is a behavior beyond free will.  It is addictive.

Nicotine is one of the most addictive chemicals known to man.  Milligram for milligram, dose for dose it is more addictive than cocaine or heroin.  More then 90% of people exposed a single time cannot stop.  This addiction means that a biological change occurs in the victim’s brain.  A chemical tattoo to the cortex. This short-circuits free will.  It becomes chemically almost as important to a smoker as food, warmth or even breathing.

It makes no sense to blame the smoker for the behavior or the health consequences, which follow.  They are hooked junkie cigarette zombies.  Without massive efforts to quit or medical care, they will continue to smoke until they die 10 years too soon.   However, we are left with a quandary.  With millions of people world wide suffering and dying in a horror show that rivals the killing fields of both World Wars, someone must be to blame!

I say convict the pushers.   The suppliers of seed, the tillers of fields, the manufacturers, the packagers, the shippers, the marketers, and the sellers.  Any politician, who protects the murderous monopoly.  Any banker who payrolls mass slaughter.  This system of production, which uses an addictive product to reap dollars from death, is criminal.  Can we convict the 16-year-old high school student, as she is chemically mutated into 40-year cash machine?  How about the 34-year-old father, already stressed trying to support his family?  Perhaps accuse the gasping emphysema patient who still cannot quit.  The tobacco industry makes “bad” seem gentle.  They are monsters that commit murder with the immorality of the worst fascists in all history.

Tobacco users are victims and to blame them is to create false pariahs.  They need support, help and care.  They need to do everything possible to quit.  However, accusing smokers makes treating their addiction hard and their unneeded guilt delays therapy.  It also distracts us from the overwhelming need to destroy the drug dealers who sell nicotine products.  For them there should be no quarter, no mercy, and no consideration.  For them there should be nothing but blame.

James C. Salwitz is an oncologist who blogs at Sunrise Rounds.

Submit a guest post and be heard on social media’s leading physician voice.

Prev

The unholy alliance between Big Pharma and the medical profession

May 12, 2012 Kevin 8
…
Next

Becoming an organ donor requires more thought than a Facebook click

May 12, 2012 Kevin 6
…

Tagged as: Oncology/Hematology

Post navigation

< Previous Post
The unholy alliance between Big Pharma and the medical profession
Next Post >
Becoming an organ donor requires more thought than a Facebook click

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

More by James C. Salwitz, MD

  • Each line on the radiology list is a patient’s line in the sand

    James C. Salwitz, MD
  • The broader mission for hospice care

    James C. Salwitz, MD
  • Is the medical profession at its end?

    James C. Salwitz, MD

More in Conditions

  • How collaboration saved my life from a rare disease doctors couldn’t diagnose

    Tami Burdick
  • Why your emotions are your greatest compass in therapy and life

    Maire Daugharty, MD
  • Patients are not waiting: What MCDA twin parents teach us about shared decision-making

    Stephanie Ernst
  • Health workers deserve care too: How to protect their mental health

    Corey Feist, JD, MBA & Kim Downey, PT
  • Why the words doctors use matter more than they think

    Erin Paterson
  • How AI helped me reclaim my creative mind with ADHD

    Risa Schulman, MD
  • Most Popular

  • Past Week

    • A world without antidepressants: What could possibly go wrong?

      Tomi Mitchell, MD | Meds
    • Why no medical malpractice firm responded to my scientific protocol

      Howard Smith, MD | Physician
    • Navigating physician non-competes: a strategy for staying put [PODCAST]

      The Podcast by KevinMD | Podcast
    • When doctors die in silence: Confronting the epidemic of violence against physicians

      Muhamad Aly Rifai, MD | Physician
    • Doctors speak out: Why we’re saying no to burnout

      Aisha Quarles, MD | Physician
    • Avoiding leadership pitfalls: strategies for success in health care [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • What happened to real care in health care?

      Christopher H. Foster, PhD, MPA | Policy
    • The silent crisis hurting pain patients and their doctors

      Kayvan Haddadan, MD | Physician
    • How to build a culture where physicians feel valued [PODCAST]

      The Podcast by KevinMD | Podcast
    • How the CDC’s opioid rules created a crisis for chronic pain patients

      Charles LeBaron, MD | Conditions
    • Are quotas a solution to physician shortages?

      Jacob Murphy | Education
  • Recent Posts

    • Navigating physician non-competes: a strategy for staying put [PODCAST]

      The Podcast by KevinMD | Podcast
    • In the absence of physician mentorship, who will train the next generation of primary care clinicians?

      Kenneth Botelho, DMSc, PA-C | Education
    • Fear of other people’s opinions nearly killed me. Here’s what freed me.

      Jillian Rigert, MD, DMD | Physician
    • What independent and locum tenens doctors need to know about fair market value

      Dennis Hursh, Esq | Physician
    • Health care’s data problem: the real obstacle to AI success

      Jay Anders, MD | Tech
    • What ChatGPT’s tone reveals about our cultural values

      Jenny Shields, PhD | Tech

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 21 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • A world without antidepressants: What could possibly go wrong?

      Tomi Mitchell, MD | Meds
    • Why no medical malpractice firm responded to my scientific protocol

      Howard Smith, MD | Physician
    • Navigating physician non-competes: a strategy for staying put [PODCAST]

      The Podcast by KevinMD | Podcast
    • When doctors die in silence: Confronting the epidemic of violence against physicians

      Muhamad Aly Rifai, MD | Physician
    • Doctors speak out: Why we’re saying no to burnout

      Aisha Quarles, MD | Physician
    • Avoiding leadership pitfalls: strategies for success in health care [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • Internal Medicine 2025: inspiration at the annual meeting

      American College of Physicians | Physician
    • What happened to real care in health care?

      Christopher H. Foster, PhD, MPA | Policy
    • The silent crisis hurting pain patients and their doctors

      Kayvan Haddadan, MD | Physician
    • How to build a culture where physicians feel valued [PODCAST]

      The Podcast by KevinMD | Podcast
    • How the CDC’s opioid rules created a crisis for chronic pain patients

      Charles LeBaron, MD | Conditions
    • Are quotas a solution to physician shortages?

      Jacob Murphy | Education
  • Recent Posts

    • Navigating physician non-competes: a strategy for staying put [PODCAST]

      The Podcast by KevinMD | Podcast
    • In the absence of physician mentorship, who will train the next generation of primary care clinicians?

      Kenneth Botelho, DMSc, PA-C | Education
    • Fear of other people’s opinions nearly killed me. Here’s what freed me.

      Jillian Rigert, MD, DMD | Physician
    • What independent and locum tenens doctors need to know about fair market value

      Dennis Hursh, Esq | Physician
    • Health care’s data problem: the real obstacle to AI success

      Jay Anders, MD | Tech
    • What ChatGPT’s tone reveals about our cultural values

      Jenny Shields, PhD | Tech

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Are smokers to blame for the damage they do to their bodies?
21 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...