Can we exercise some rationality?
Smoking does not equate to death and cancer, but it does up your risk. Many smoke their entire lives without major health effects, while some smokers die at 55 of a cause directly related to their smoking. How much you smoke, your genetic predisposition to certain cancers, along with when you quit, is actually a much bigger deal than people seem to think.
And people need to get a grip on the whole second hand smoke thing. Parents smoking in the home & car with small children? Yeah, that's second hand smoke, and it's a problem. Someone smelling and possibly partially being exposed to a small cloud of cig smoke (gasp!) on their one night out per year? Grow up.
The whole "smell" thing is definitely a big deal, but do you know how easy it is for someone to avoid? You really think that someone enjoying a cigarette on their patio with their morning coffee, before showering, brushing their teeth, and changing into their clothes is going to smell? Nah.
I used to bartend in undergrad, and as a consequence of that industry, bad vices were hard to avoid. I never smoked a ton, but it was something I'd do once in a while. Smoked a heater or two on nights out in college. Stopped smoking in med school. Wasn't too hard for me. However in fall of M1, some particularly traumatic personal stuff went down in my life. I was going through a very bad time and I started smoking more than ever. I had been smoking in my apartment, maybe 10 cigarettes a day for two weeks. My girlfriend is one of the hyper acute noses, who does that dramatic cough when she smells smoke. Disgusts and repulses her. The day before she came, I opened my windows, lit a candle, did a quick clean, and she didn't smell a single thing. And some of you guys think that you can smell smoke on someone who smokes a cigarette or 3 per day outside, and exercises proper hygiene? You can't.
My view is this: No one should ever smell smoke on you in a hospital or clinic. If you wake up, read the news (or Twitter), drink your columbian dark roast, and enjoy a Marlboro in the morning before you shower, get dressed and brush your teeth - no one should have the right to deny you freedoms and joys in life. If someone can smell smoke on you in the hospital, it's a problem. If you counsel a patient on quitting and you smoke two cigarettes at home each night? No problem. If you tell a patient to quit and they see you outside burning one 20 minutes later? Problem.
There is a reason people smoke. Smoking sparks brain synapses. It's a very mild stimulant. Some like the taste. And it's a vice that you can partake in while also functioning at a high level. As long as someone knows the consequences, they have a right to smoke. It absolutely does not mean they should, but it is their right. And if they can get away with it without anyone in the hospital ever knowing aside from a pee test, it's not fair to ruin someones career over it.
A year ago I was out in a different town for a friend's birthday. Had a few drinks in me. Somehow started BSing with a vascular surgeon attending. He was with three other docs. One ortho, another vascular, and an anesthesiologist. He bought me a drink. We talked and shared a few laughs. We all went out and had a cigarette together. They're all still alive and employed to my knowledge. They trained for years, they're intelligent human beings, they practice medicine, they all seemed in shape, and they're also human. Crazy, huh.
Don't ever act like smoking the occasional social cigarette (if one can keep it that way) is a horrible nasty dangerous vice, if you partake in other vices yourself.
And if someone does choose to smoke pack after pack til they die, at least they'll have died with style. As Kurt Vonnegut once said, "smoking is the only honorable form of suicide".
