Thank You for Smoking

I hope readers get a chance to see Thank You for Smoking, a recently released film adapted from Christopher Buckley's book of the same name. In the film, a Tobacco Institute lobbyist uses his charm, good looks, and a careful turn of phrase to combat the terribly flawed data that relates cigarette smoke to cancer and other diseases. Smoking, of course, is about freedom and the courage to make a choice. And if you noticed the tongue in my cheek in the statements above, you may also suspect that several turns and twists in the film make his world more complicated than he expected. I recognized the satire, but didn't notice one fascinating element until I heard the crowd murmuring while walking out of the theater: no one in the movie smoked. This lack of smoking in a film whose (anti)hero defends smoking projects a powerful message from an amoral construct: smoking is no longer socially acceptable, at least not among the demographic this movie targets. And statistics suggest that the message is getting out. This year witnessed a decrease in the incidence of lung cancer in men and women and a decrease in mortality for men.1 Fewer people are starting to smoke, and more people are quitting. Not all the news is good, however. Too many young people still take up this habit, and the prevalence of smoking outside the United States is alarming. A quick search shows that 20% of male Chinese medical students smoke.2 I was interested,...

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Christopher E. Desch, MD, is the National Medical Director of the NCCN and Co-Editor in Chief of JNCCN. As National Medical Director, Dr. Desch serves as the clinical leader for the broad spectrum of NCCN programs, including the NCCN Clinical Practice Guidelines in Oncology™. Dr. Desch previously served as hematologist/oncologist and Research Director for Virginia Cancer Institute. He is Chair of the Health Services Committee at the American Society of Clinical Oncology and has been a member of the American College of Physicians, the American Society of Hematology, and the Virginia Society of Hematology/Oncology.
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