Great American Smokeout
There's more to November than turkey and trimmings. It is also the month when smokers in the workplace and at home complain of being harassed by nonsmoker coworkers or family members who, for all the right reasons, offer chewing gum as replacement for cigarettes and stickers proclaiming abstention from their deadly habit for a day as part of the American Cancer Society (ACS) "Great American Smokeout." This annual effort is aimed at helping smokers give up cigarettes for at least 1 day, in the hopes that they will quit forever.

That, at least, has been my experience over the years as I have set my sights on one person that I really care about who, puff by puff, pollutes his or her internal environment (not to mention the air that I breathe), thereby laying a solid foundation for vascular disease, heart disease, lung disease, and numerous types of cancer. There really isn't much in the human body that is not adversely affected by smoking cigarettes.

Try answering the questions in the box below. The answers will probably become blatantly obvious after you've read the first few.

Q: What do arsenic, xylene, and chromium have in common?

A: They are all carcinogens in cigarette smoke.

Q: What do paint stripper, toilet cleaner, lighter fluid, rocket fuel, and the gas chamber have in common?

A: All contain substances found in cigarettes.

Q: What do nail polish remover, rechargeable batteries, automobile exhaust, DDT, and candle wax have in common?

A: All contain substances found in cigarettes.

Q: What do fiberglass, urine, industrial solvent, mothballs, embalming fluid, and swamp gas have in common?

A: All contain substances found in cigarettes.

Q: What do PVC pipe, fabric preservative, gasoline additive, and disinfectant have in common?

A: All contain substances found in cigarettes.

And my personal favorite:

Q: What do cow farts have in common with cigarette smoking?

A: Methane gas, of course; you get the picture.

Would you go into your garage and inhale the fumes of just about everything in there upwards of 100 times a day? Of course not. So why, then, do so many people -- especially healthcare workers -- continue to systematically and predictably puff their way into cardiac or pulmonary rehabilitation or, worse, the grave? In 2004, cancer of the lung and bronchus accounted for 32% of cancer deaths in men and 25% of cancer deaths in women in the United States. What part of these grim statistics do they not understand?

I don't know how many people have found the Great American Smokeout to be a life-altering event, but I do believe that the challenge to us all is to resist being dissuaded by that cranky diehard smoker that you care about or the patient that you care for. Instead, be a cranky (optional) diehard advocate of quitting smoking. If you are so inclined, this year, you can attend the Smokeout on November 17. For information on Smokeout activities near you, click on http://www.cancer.org/docroot/PED/content/PED_10_2x_Local_Smokeout_Resources.asp?sitearea=PED.

What are the implications beyond the obvious for transplant clinicians? Quite simply, transplant recipients, like everyone else, should not smoke -- ever. Smoking in transplant recipients is associated with the same health risk factors as in the general population, although possibly to a greater extent. And let's face it, in the eyes and minds of most, the stakes are even higher. But the message doesn't stop there. A history of cigarette smoking in an organ donor is also a risk factor for decreased graft and recipient survival, which has potential implications for donor screening -- just what we don't need at a time of donor shortages.

If you have comments or questions about the site, please contact me at slsmith@medscape.net .