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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 June 23; 334(7607): 1324.
PMCID: PMC1895664
From the Frontline

Stubbed out

Des Spence, general practitioner, Glasgow

I went to the launderette fortnightly. It wasn't that I had lots of clothes—I didn't. But a wet sponge and steam iron works wonders. As I ironed, the steam billowed from my PolymixPubJob shirt, carrying the sweet smell of stale beer and cigarettes. The final touch to my shirt was aftershave. In the 1980s this was all produced in Middlesbrough by ICI to a classified cold war formula—a tiny splash of Brut Musk could conceal weeks of unwashed clothes. To this day it still seeps from my pores when I sweat. But the modern bartender will soon be spared the need to wear cheap aftershave, for England is to ban smoking in confined public spaces.

The risks of smoking have been clear for many decades, but when I grew up in the 1970s smoking was common—vast ornamental ash trays and coffee table lighters were the order of the day. People puffed away in sitcoms and in Hollywood's blockbusters, and Formula One cars were cigarette packets on wheels. As an adult in the 1980s I smoked occasionally but regularly in a way that has become known as “social smoking”—on nights out and sometimes during the day. In the conformist sausage factory that is medicine it was my youthful (and stupid) act of defiance to stand outside the exam hall smoking one of those foreign brands that newsagents would sell only to card carrying students. The dire warnings printed on the packets were meaningless to risk obsessed youth. I am lucky, for I was able to resist the terrible pull into the tornado of addiction that smoking is.

But by middle age, life matters—I don't want to die. Half of all smokers die from their addiction, and on average smokers live 10 years less. But quitting is not easy. For me, smoking is bound to the extremes of my life—the good and the bad.

Smoking is pernicious. I have witnessed too many men and women in their 40s die from the many manifestations of vascular disease and seen others consumed by lung cancer. But worse still is the decades spent on an oxygen mask, confined to your home. Smoking has left great wounds slashed into the lives of children, husbands, wives with the needlessly and prematurely death of their loved ones. It is harder still for families to accept the injustice of the loss of a victim of secondhand smoking.

My attitude towards smokers remains passive. If smokers choose to smoke, then so be it. In the cockpit of life the control panel is jammed with self destruct buttons—smoking is merely one among many. Smoking is in terminal decline, and banning smoking in public is long overdue. Whether we do likewise with 1980 aftershaves is another issue.

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