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Editorials |

Tobacco Dependence Treatment : Time To Change the Paradigm

David P. L. Sachs, MD
Author and Funding Information

Affiliations: Stanford, CA
 ,  Dr. Sachs is Director, Palo Alto Center for Pulmonary Disease Prevention, Palo Alto, and Clinical Associate Professor of Medicine, Division of Pulmonary and Critical Care Medicine, Stanford University Medical Center, Stanford, CA.

Correspondence to: David P. L. Sachs, MD, Palo Alto Center for Pulmonary Disease Prevention, 145 North California Ave, Palo Alto, CA 94301-3911; e-mail: dplsachs@pacbell.net



Chest. 2006;129(4):836-839. doi:10.1378/chest.129.4.836
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Extract

Fifty years ago, I asked my radiologist father why many of my grade school friends shunned another who had asthma. “Well, David,” he responded, “most people, and many physicians, believe that a psychiatric disorder or a personality flaw causes asthma, even though the scientific evidence does not support that.”

Last summer, while presenting “Medical Management of Tobacco Dependence” at the house-staff noon conference at Stanford Medical, I related this story. Their eyes popped. Jaws dropped. They were astounded that 50 years ago anyone could have thought asthma was a psychiatric disease. After they recovered from their shock, I said I hoped that 20 years hence no one would believe the use of cigarettes was a manifestation of a flaw in character or a weak will. Rather, everybody—physicians and nonphysicians—would approach tobacco dependence for the chronic medical disease it is, and recognizing cigarette use as the primary symptom of tobacco dependence.


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