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- Why stop at tobacco?Show More
Schultz et al. do the medical world a great service and illustrate the power of ethnographic research in their investigation of smoke-free policies in Canadian hospitals. Having recently spent a clerkship rotation on an acute care medical service, I can attest that having to deal with patients' wishes to continue smoking poses a very real and often frustrating conundrum, one that is only compounded by complicating issues...
Competing Interests: None declared. - Conscientious professionals must stop perpetuating the ''nicotine addiction'' theoryShow More
It is unfortunate and even a tragedy that so many, if not most, health professionals bought into nicotine being the only substance responsible for addiction in people who smoke. Unbiased studies have consistently shown that NRT has a 93 - 98% long term failure rate to help people stop smoking. Already this should be ringing loud bells. Isn't it time that the medical community who would like us to believe that they car...
Competing Interests: None declared. - Re:Crucial Distinction: Smoking is not addictive (Nicotine is)Show More
Two big thumbs up to Dr. Kreisman, the one and only health-care professional I'm aware of who truly 'gets it!'
I would only add that, while smoking is "just a habit" (as opposed to an addiction), we must recognize that, in combination with the addictiveness of nicotine (and with the smoker having full knowledge of the long-established consequences of smoking), it is, indeed, a very powerful habit, ranking very h...
Competing Interests: None declared. - Crucial Distinction: Smoking is not addictive (Nicotine is)Show More
The distinction between smoking (which is just a habit) and nicotine (which is the addictive drug) becomes blurred at several points in this article and the responses to it. It is very important that we, as health professionals, avoid this trap of convenience. Viewing smoking as addictive, which most of the population superficially does, plays directly into the hands of "smokers' rights" advocates and their claims that s...
Competing Interests: None declared. - Reduction of Harm Caused by Hospital PoliciesShow More
Sirs,
The article would have been much more interesting had the issue been examined in the context of "harm reduction" as illustrated by the issue of the Insite Supervised Injection Site (see http://supervisedinjection.vch.ca/). Clearly, hospital policies requiring patients who choose to smoke to go outside in minus-35 degree weather inflict more harm than could possibly be caused by a few cigarettes.
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Competing Interests: None declared. - Re:We need to treat our hospitalized tobacco addicted patients betterShow More
Dr. Oyston, thank-you for sharing your passion and ideas about treating hospitalized patients who use tobacco. While the compassionate position of designating a space for people to smoke was heard among study participants, we identified a quieter voice suggesting that more treatment is necessary. That is, instead of accommodating ongoing tobacco use and delivering stronger messages about the health risks of smoking, why n...
Competing Interests: None declared. - Qualitative investigation of smoke-free policies on hospital property
There should be some method to allow addicted patients to smoke when their life expectancy is limited ( eg palliative care). I have never smoked, have tried to stop patients from smoking since the 50's, but I think the current militancy of the non smokers is intolerable at times.
Conflict of Interest:
None declared
Competing Interests: None declared. - We need to treat our hospitalized tobacco addicted patients betterShow More
I congratulate Dr. Shultz et. al. for their excellent documentation of the ways in which two Canadian hospitals are failing to provide effective and compassionate care for patients who smoke (CMAJ 2011. DOI:10.1503/cmaj.110235). They note that patients do not have easy access to nicotine replacement therapy and have no alternative but to risk going outside the hospital to meet the needs of their tobacco addiction. I am...
Competing Interests: None declared.