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Clinical Crossroads Update
May 23/30, 2001

A 36-Year-Old Woman Who Smokes Cigarettes, 1 Year Later

Author Affiliations

From the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, LY318, Boston, MA 02215.

JAMA. 2001;285(20):2636. doi:10.1001/jama.285.20.2636

In April 2000, at Medicine Grand Rounds, Nancy A. Rigotti MD, discussed a 36-year-old woman who was addicted to cigarettes. Ms V, the patient, described a pattern of heavy smoking dating back to the age of 12 years. She tried to quit several times, including quitting "cold turkey," using nicotine patches and gum, and trying hypnosis. None of these methods worked for her, and her longest cigarette-free interval was 9 days. Using bupropion hydrochloride and the nicotine patch, she abstained from smoking for 24 days. Her medical history was notable for type 1 diabetes mellitus, hyperlipidemia, and frequent bouts of bronchitis and sinusitis. Ms V stated that she could not imagine herself without a cigarette and perceived cigarettes as an "old friend." Nevertheless, she described disliking her addiction and the criticism from family and friends.

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