Addictive smoking

I am writing in reference to Piero Ronci's letter (Jan. 31) which said that "smoking is an individual's free choice". In my medical practice, however, I see a lot of patients with respiratory problems and smoking. They would love to quit smoking, but invariably failed in their attempts. More than 90 percent of the smokers that actually stopped smoking said they had to start smoking again within a year. These people are proof that they are addicted and hence have no "free choice" to quit smoking for good.

Even with a severely limited household budget, smokers confess they would put other more important necessities aside. There may not be enough money to buy daily foodstuffs at the market, to pay school fees or the doctor's bill, but smoking must go on.

Ronci also wrote that "taking drugs is addictive, while smoking is nothing more than a habit". This is just an underestimation, very commonly made by smokers. Ronci would be surprised to learn that drug addicts who also smoke, find it is much easier to get rid of heroine than tobacco. Nicotine in tobacco keeps people smoking hence risking their own and other people's lives.

However, people may stop smoking after their life is threatened. After a heart attack for instance, many patients would stop smoking. Keeping in mind that cigarette smoking is addictive, heart surgeons in England refused to conduct heart surgery on patients that do not intend to quit smoking. In this regard, I recall a picture of a man who continued smoking even after both his legs and one arm had been amputated due to smoking-related arterial disease.

Cigarette smoking is the biggest killer based on health reports from developing and technically advanced countries. The main three causes of death include cancer (predominantly of the lungs), heart disease and stroke. Whereas famine (Ronci said "famine is the worst scourge of modern-day society") is never classified as a major cause of death in modern-day society nor in any medical report.

Finally, Ronci's idea that a "drag on a cigarette is a breath of fresh air" for people standing at a bus terminal where bus drivers keep their engines running, is certainly not true for non-smokers. It is of course only true for addicted smokers, craving for that very special taste of nicotine.

DR MUHERMAN HARUN

Jakarta