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Elliot Wineburg MD Headshot

The Good and the Bad of the Tobacco Suit

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To psychiatrists the term DENIAL, DENIAL, DENIAL is noted everyday. Big tobacco also practices this faulty mechanism. Think of the Marlboro man astride his mount or from decades past, white coated physicians with a lighted Camel in hand. Tobacco's effective advertising leading to hundreds of thousands of deaths yearly is okay for them. But the fatal effects of smoking on a poster, they deem offensive. I trust the courts will apply rational thinking to refute the insane mockery by the tobacco industry.

As much as I wish the city's messages will be more than marginally effective, people don't quit smoking simply by looking at a poster. Rational thought doesn't do it no matter how graphic the photos.

One of my colleagues, a professor of pathology and someone who holds dead tissue daily, was a smoker. Putting up posters and giving out the patch for free are not nearly as effective as treating smoking addiction like the medical condition that it is. No physician would use a single program to treat an ulcer, asthma, cancer or any other disease.

While the city's efforts have been valiant and any initiatives to get individuals to quit smoking should be applauded not challenged, they don't often work and can be dangerous. For example, giving the patch to someone with high blood pressure can be detrimental. Additionally, the dosage of the nicotine should be different for every smoker. Nicotine dependency is a specific illness requiring one on one, selective treatment for each patient. One treatment does not fit all.

Doctors and behavioral therapists have the tools and they are effective. However, most medical insurance programs do not pay for smoking cessation therapy. Some patients are covered because unfortunately, they already have a diagnosis such as chronic bronchitis or emphysema caused by smoking. These insurers will put out $200,000 for lung replacement but not a penny to prevent smoking-related diseases such as, lung and other cancers, heart disease, skin conditions and a new ailment from smoking comes to light virtually every year.

Medicine has the ultimate solutions to the fatal smoking scourge destroying hundreds of thousands of lives yearly. Perhaps the city should use their smoking cessation funds on individuals and not posters.