An Indelible Stain
The Inuit are native people who have lived for more than a thousand years in the frozen tundra of the Canadian Arctic. When necessary, they have to be flown to Montreal for advanced medical care, approximately a 1,300-mile flight. I remember my first encounter with an Inuit man who was referred for aortic valve replacement surgery. Although he lived as a seal hunter in a remote settlement, far from anywhere, his first request upon arrival in the big city was to find someone to deliver his government-issued smoking allowance, a carton of cigarettes. One look at his tobacco-stained fingers said it all. Tobacco wreaks havoc everywhere. It leaves an indelible stain—on hands, in mouths, lungs, hearts, arteries and even in joints. But sometimes, when it destroys credibility, its stain is invisible.
Simon M. Helfgott, MD, is associate professor of medicine in the Division of Rheumatology, Immunology and Allergy at Harvard Medical School in Boston.
References
- Stanford research into the impact of tobacco advertising. http://tobacco.stanford.edu/tobacco_main/images.php?token2=fm_st115.php&token1=fm_img3416.php&theme_file=fm_mt009.php&theme_name=It’s%20Toasted&subtheme_name=It’s%20Toasted.
- Jackler RK, Samji HA. The price paid: Manipulation of otolaryngologists by the tobacco industry to obfuscate the emerging truth that smoking causes cancer. Laryngoscope. 2012 Jan;122(1):75–87.
- Flinn FB. Some clinical observation on the influence of certain hygroscopic agents in cigarettes. Laryngoscope. 1935;45:149–154.
- Camel cigarette ad. http://171.67.24.121/tobacco_web/images/tobacco_ads/target_doctors/j_icons/large/icons_11.jpg.
- Camel cigarette ad. https://www.youtube.com/watch?v=D-y_N4u0uRQ.
- Legacy Tobacco Documents Library. http://legacy.library.ucsf.edu.
- Petticrew MP, Lee K. The ‘father of stress’ meets ‘big tobacco’: Hans Selye and the tobacco industry. Am J Pub Health. 2011;101(3):411–418.
- How drugs affect neurotransmitters. The Brain from Top to Bottom. http://thebrain.mcgill.ca/flash/i/i_03/i_03_m/i_03_m_par/i_03_m_par_nicotine.html#drogues.
- Vessey MP, Villard-Mackintosh L, Yeates D. Oral contraceptives, cigarette smoking and other factors in relation to arthritis. Contraception. 1987 May;35(5):457–464.
- Klareskog L, Stolt P, Lundberg K, et al. A new model for an etiology of rheumatoid arthritis: Smoking may trigger HLA–DR(shared epitope)–restricted immune reactions to autoantigens modified by citrullination. Arthritis Rheum. 2006 Jan;54(1):38–46.
