Chapter 38 Miscellaneous

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Poison control centers report that there are 15,000 cases each year in the U.S. of

children under age 6 who swallow cigarette butts or whole cigarettes. Many of these

end up with nicotine poisoning.

Dean Edell, MD, ABC TV, San Francisco, March 1, 1996

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Glamour magazine in November 1993 ran a cover story "Health Payoffs: 20 little

changes to make now." In order to avoid problems like heart disease and cancer, the

magazine recommended measures including drinking pure water, wearing

sunglasses, seeing a dentist, and devoting time to your feet. But avoiding smoking did

not make the list.

Tobacco Control, Summer 1994, p. 103

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In the early 1990's, it was estimated that the Veterans Administration and Medicaid

paid $210 million a year for home oxygen therapy, or 15% of the $1.4 billion annual

cost. In a study of VA patients on supplemental home oxygen, 21.3% of the veterans

who knew that they were coming to the hospital to re-certify for oxygen had recently

smoked tobacco, as indicated by a carboxy-hemoglobin level of greater than 2.5%.

The study authors posed two questions: "Is it cost-effective for the VA to continue to

fund long-term supplemental oxygen for their patients who continue to smoke

cigarettes? Would it be unreasonable to insist that hypoxemic patients who continue

to smoke cigarettes and wish to use home oxygen assume the cost through private

pay?"

Federal Practitioner, October 1997, pp. 62-63

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Up to half of patients on home oxygen admit to smoking. In a study from Johns

Hopkins, 21 patients on home oxygen suffered severe burns when their oxygen

delivery system ignited while they smoked.

Burns 24:658, 1998

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Monday, July 24, 2000

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