Smokers in Medicine

[Dr. Lawyer]

If you are a smoker applying to medical school, and assuming you will continue to smoke, how would you rationalize the oddity that would be your decision to pursue specialization in Pulmonary and Critical Care Medicine?

Smoking obviously has a range of health consequences, but its deleterious effects are nowhere as patent as in the pulmonary system. It would seem to me that most smokers would not enter this specialty. It's interesting that they have effectively limited the potential scope of their medical practice as a result of their behavior.

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[CRAZYTERP]

This may not have anything to do with the thread but as a smoker who is currently trying to quit, rather unsuccessfully, i have to say that at all my interviews I have seen a lot more kids than I thought smoking. I don't know if its just stress, or maybe they just don't want to give it up. I told myself I would quit when i got itno my first school, Well... I am doing my best... but I wouldnt say i have gotten over the habit yet.

 

[LizardKing]

I've also seen chain-smoking oncologists. Just doesn't make sense. Oh well.

 

[DW]

my lab window is right across the street from the American Cancer Society HQ, and i see people walking out smoking on their breaks.

.......its like ra-i-ain....on your wedding day......

 

[Bounty]

Originally posted by DW
my lab window is right across the street from the American Cancer Society HQ, and i see people walking out smoking on their breaks.

.......its like ra-i-ain....on your wedding day......

Heheheh DW you crack me up. Remember how when that song came out, people on the radio would talk about how all those things weren't "ironic" and really, they were just "bummers". heheheh

 

[Dr. Lawyer]

"Ironic" is much like "anxious" is that it is almost always incorrectly used, according to the official definition. Nonetheless, these words are incorrectly used often enough that people begin to believe they mean something they don't. Anxious does not mean excited, or eager; rather, it means nervous, worried. However, usage of the word in the latter form is very common.

I guess the bottom line here is that smokers should not become doctors. Hippocrates argued that opulent living is the cause of most illness, and that it is the duty of the physician to assist his patients in adopting healthier life practices. Kinda hard to preach that when you're a smokestack...

 

[Cerberus]

Originally posted by Dr. Lawyer
"Ironic" is much like "anxious" is that it is almost always incorrectly used, according to the official definition. Nonetheless, these words are incorrectly used often enough that people begin to believe they mean something they don't. Anxious does not mean excited, or eager; rather, it means nervous, worried. However, usage of the word in the latter form is very common.

I guess the bottom line here is that smokers should not become doctors. Hippocrates argued that opulent living is the cause of most illness, and that it is the duty of the physician to assist his patients in adopting healthier life practices. Kinda hard to preach that when you're a smokestack...

yea yea smokers should not become doctors and neither should people who eat red meat, drink soft drinks, drink alcohol, run less than 5 miles a week, so on and so forth

 

[nina512]

"Do as I say, not what I do" hehe

I'm a smoker trying to quit. Got it down to only 3 smokes a day!

However, the whole app process, an break-up with my long-term boyfriend, and the thought of moving back in with my parents has brought me back up to half-a-pack a day.

Since I work in a hospital, I just try to hide the fact that I smoke, and if someone gives me s@#t, I just think to myself that being overweight, eating fried foods, and high cholesterol and blood pressure are also health risks

No one's perfect!

 

[athena21]

Smoking though, is something that hurts both yourself AND the people around you.

I feel sorry especially for asthmatic children whose parents smoke. Permanent damage is done to both the parent's and the child's lungs. If I were a doc, I don't think I could justify smoking and preaching at the same time in these types of situations.

 

[CRAZYTERP]

Originally posted by athena21
Smoking though, is something that hurts both yourself AND the people around you.

I feel sorry especially for asthmatic children whose parents smoke. Permanent damage is done to both the parent's and the child's lungs. If I were a doc, I don't think I could justify smoking and preaching at the same time in these types of situations.

Point well taken Athena. If only that first cigarette of the day didnt make me fell sooo good, or the next one with my cup of coffee, or the one after my dinner, OR the one I have with my first beer... ugh, hopefully I will forget how great smoking is soon and kick the habit.

 

[daisygirl]

Originally posted by athena21
Smoking though, is something that hurts both yourself AND the people around you.

Point taken on the asthma scenario, however, I think it is a bit bold to ONLY mention that smoking, which is an addictive behavioral problem, is a problem that affects you and those around you. Obesity is a HUGE problem in this country, and it is also a huge MEDICAL burden. The dietary and lifesyle habits of the obese are usually also impinged on their children. It is not a shock that there has been an increase in the number of obese children in this country, especially when you take into the account the staggering number of obese adults in this country.

There are plenty of addictive behaviors that not only affect those who participate in them, but also those who are surrounded by those who are partaking in these unhealthy behaviors. It seems that it is quite in vogue to single out smokers- and by my saying that I am not marginalizing the unhealthy consequences of smoking.

 

[ljube_02]

hm i wonder if im addicted to either smoking or drinking? i mean i used to smoke and drink most of the days in the wk (a lot), but i never had a trouble to quit. I never smoke by myself (i dont even have any cigarette packs now) and hardly ever drink (like once a week).
but when some friends come over, we each have more than enough.
so should i be worried about anything?

p.s. i think most doctors realize that if they're slim but they smoke, they're still a zillion times more healthy than some fatso.

 

[TroutBum]

Hey all, I work at an institution that is dedicated to treating pulmonary disease, and I see lots of employees who smoke. Fortunately however, very few of them are doctors, they are mostly lab researchers and non-medical personnel. I respect each person's right to autonomy when it comes to their own decisions, but I'm not sure how a doctor could legitimitely tell their patients to stop smoking if he or she smokes also. Actions speak louder than words. It's not that smokers shouldn't be doctors (I'm not saying that at all!) but that doctors who smoke will probably have less authority when dealing with patients who really need to stop smoking.

A word of advice to anybody trying to quit: cutting down DOES NOT WORK! You have to quit COLD TURKEY! (Sorry to have to bring up that phrase--I have about five pounds of the stuff in the fridge right now. . .) And I feel I'm qualified to say this because I used to smoke a fair bit, but I've been nicotine-free for a while now. Cold turkey is the only way to go.

 

[Mikdoc]

Originally posted by Dr. Lawyer
If you are a smoker applying to medical school, and assuming you will continue to smoke, how would you rationalize the oddity that would be your decision to pursue specialization in Pulmonary and Critical Care Medicine?

Smoking obviously has a range of health consequences, but its deleterious effects are nowhere as patent as in the pulmonary system. It would seem to me that most smokers would not enter this specialty. It's interesting that they have effectively limited the potential scope of their medical practice as a result of their behavior.

What people know and do are two completely separate things...isn't that interesting.

 

[abw]

Hey!
This doesn't directly relate, but i thought it was weird. At one of my interviews, the interviewer asked me if i wanted a cigarette as soon as i sat down. I thought he was joking - at least i hope he was.

 

[Random Access]

At least for the smoking thing...lots of people do it because of the stress factor. At least, most people I know who smoke light up a lot more when they're stressed. And the people I know who used to smoke sometimes light up if they're stressed. That might explain the oncologists, among other specialties.

Also remember that smoking messes up a lot more than just lungs. It really leaves a visible trail through many organs, as I remember when someone's mom who is a doctor visited my high school bio class. She brought a few organs, and lots of stuff gets pretty tarred up and shows deterioration. It's not just about lungs...

-RA

 

[Adcadet]

Originally posted by nina512
"

I'm a smoker trying to quit. Got it down to only 3 smokes a day!

However, the whole app process, an break-up with my long-term boyfriend, and the thought of moving back in with my parents has brought me back up to half-a-pack a day.

Since I work in a hospital, I just try to hide the fact that I smoke, and if someone gives me s@#t, I just think to myself that being overweight, eating fried foods, and high cholesterol and blood pressure are also health risks

No one's perfect!

Yeah, but smoking is probably your single largest risk factor for all-cause mortality.

People are great in compensating. In general you can reduce the amount a person smokes by ~75% and not actually reduce the amount of nicotine and CO they are exposed to.

And from what I've seen, people who get down to a few cigarettes per day will often work their way back up to multiple packs per day given time and stress. This, and the amazing compensation that people can do argues nicely against the harm reduction theory.

 

[Adcadet]

Originally posted by ljube_02
hm i wonder if im addicted to either smoking or drinking? i mean i used to smoke and drink most of the days in the wk (a lot), but i never had a trouble to quit. I never smoke by myself (i dont even have any cigarette packs now) and hardly ever drink (like once a week).
but when some friends come over, we each have more than enough.
so should i be worried about anything?


dont' know. Talk to your doctor. There are some people("chippers") who can go for years or decades doing just what you're doing. But then there are those who do what you do and become regular smokers. Either way, it's not good for you.


p.s. i think most doctors realize that if they're slim but they smoke, they're still a zillion times more healthy than some fatso.

1. Fatso is offensive. How do you feel when people make derrogatory remarks about smokers?

2. I'd have to look up the numbers, but I suspect in terms of cardiovascular mortality (for example) smoking (taking the mean pack-years of current smokers) is a much greater risk factor than obesity (taking the mean BMI of those with a BMI >30). For all-cause mortality I'd rather be obese than a smoker.

 

[Adcadet]

Originally posted by TroutBum

A word of advice to anybody trying to quit: cutting down DOES NOT WORK! You have to quit COLD TURKEY! (Sorry to have to bring up that phrase--I have about five pounds of the stuff in the fridge right now. . .) And I feel I'm qualified to say this because I used to smoke a fair bit, but I've been nicotine-free for a while now. Cold turkey is the only way to go.

I believe the 2000 Surgeon General's report on Treating Tobacco Dependence mentions that going cold-turkey vs. slowly cutting down has been found to be equally effective. But cutting down still exposes you to a load of toxins and you always risk escallating.

 

[Adcadet]

Originally posted by Random Access

Also remember that smoking messes up a lot more than just lungs. It really leaves a visible trail through many organs, as I remember when someone's mom who is a doctor visited my high school bio class. She brought a few organs, and lots of stuff gets pretty tarred up and shows deterioration. It's not just about lungs...

-RA

Good point. The largest risk factor for bladder cancer is smoking.

 

[Raptor]

I don?t mean this comment as derogatory but I am always amazed at the number of obsess doctors. I always thought
doctors are supposed to represent ultimate health so their patients can look at them as great models. However, how
can a doctor have good credibility with his word when he tells his patients not to eat a BigMac but then he has eaten
three BigMac in the past two hours, and his/her cholesterol is way higher then the patient. I am trying to be the best
doctor that I can be physically as well as mentally. Because I believe that I want to be a model for optimal
health/mind. Just my 2 cents. Please this is just my opinion.

 

[Adcadet]

Perhaps I should explain...

I'm currently doing research on the nicotine vaccine, and am thinking of continuing this as the basis for a PhD thesis in addition to the MD. My master's (MPH) thesis involves a clinical study of post-cessation weight gain among people with schizophrenia, and my master's field experience involves being involved in the county hosptial's tobacco dependence clinic (in addition to a few other things; for example, I spent today at Hazelden).

Oh, and I smoke cigars occasionally (1-4/month). Since starting my research, I have been feeling progressively worse about this, and will probably give it up entirely pretty soon. I doubt I meet anybody's definition of dependence, though I realize there is no level of safe smoking, even if I don't inhale.

 

[nina512]

I pretty much agree with what everyone is saying. Smoking is bad.

As for doctors, are they all supposed to be perfect models for healthy behavior? Yes, ideally they are. Is that reality, no.

I retrospect, I wish all those "truth" campaign ads were around when I picked up the habbit senior year in high school. I may not be a smoker today. The egg in the frying pan depicting my brain on drugs likely deterred me from trying anything worse than plain old cancer sticks.

Hopefully all these PSAs on TV will continue to cause a decline in adolescent smoking, and thus adult smoking in the future.

 

[MDwillneverbe]

To all you smokers out there who light up before an interview-
Do you really think the adcoms can't smell the tobacco smoke on your clothes or in your hair?
Don't you think that this might hurt you in the admissions process in addition to being a major health hazard to you and your family?
Nobody comes out of a long term smoking relationship unscathed- Besides COPD and Lung cancer there are alot of other cancers that are impacted by smoking (kidney and bladder to name two)
You can rationalize your self destructive behavior in anyway you like but the bottom line is that you are killing yourself - very slowly and it is immature to think that you can continue smoking and that "nothing" will happen to you

 

[galen]

Originally posted by Adcadet
Perhaps I should explain...

I'm currently doing research on the nicotine vaccine, and am thinking of continuing this as the basis for a PhD thesis in addition to the MD.
------
Tres interesting...Will the vaccine make people sick and nauseous when they light up? Or will it cause them to not have physical cravings?
BTW-- I quit little by little using the nicotine gum ( for a while I became addicted to the gum itself.) No cigs or gum for over 9 months now!!

 

[PluckyDuk8]

I just had to share...I was volunteering in a cardiology dept. in a hospital abroad...I brought a chest x-ray down to a radiologist to interpret. As she was looking at the chest x-ray she was smoking in her little hole of an office (which happened to be in the basement of the hospital, with no ventilation whatsoever). It was so bad down there I could barely stay in the room! The stress of the staff in that hospital is x100, so I could understand, but as was said before, the irony! BTW, smoking is banned there.

 

[Adcadet]

Originally posted by galen

Originally posted by Adcadet
Perhaps I should explain...

I'm currently doing research on the nicotine vaccine, and am thinking of continuing this as the basis for a PhD thesis in addition to the MD.
------
Tres interesting...Will the vaccine make people sick and nauseous when they light up? Or will it cause them to not have physical cravings?
BTW-- I quit little by little using the nicotine gum ( for a while I became addicted to the gum itself.) No cigs or gum for over 9 months now!!

The vaccine will prevent the person (well, rat so far) from feeling the effects of nicotine by binding to nicotine and preventing it from crossing the blood-brain barrier. I also hope to use it to prevent nicotine from crossing the placenta and crossing the fetal blood-brain barrier. So far it looks like it does.

 

[eschauberger]

At the medical center my father works at, that health and wellness employee and staff director (the one who sets up the programs to keep everyone healthy who are supposed to take care of those to keep the rest of society healthy) sets up programs to help those who smoke quit. The comical part of it is she is a heavy smoker and is always at the But(t) hut.
-=Eric

 

[Adcadet]

Originally posted by eschauberger
At the medical center my father works at, that health and wellness employee and staff director (the one who sets up the programs to keep everyone healthy who are supposed to take care of those to keep the rest of society healthy) sets up programs to help those who smoke quit. The comical part of it is she is a heavy smoker and is always at the But(t) hut.
-=Eric

There are now more ex-smokers than smokers in the US. The predominant (well, from everybody I know) theory is that the low-hanging fruit has already been picked, leaving the difficult to treat cases of toabacco addiction behind.