To the Editor.—
The findings of Jacobson et al (218:180, 1971) do not warrant the conclusion that "correlation between smoking and the occurrence of duodenal ulcers, may be at least partly explained by the simple lack of buffer." Wilkinson and Johnston1 found a significant inhibition of pentagastrin-stimulated gastric acid secretion in humans after they had smoked a single cigarette. Therefore, if smoking causes significant reduction of acid secretion, obviously less buffer will be required to maintain the same pH.
Chopra D. "Smoker's Ulcer". JAMA. 1971;218(13):1945. doi:10.1001/jama.1971.03190260059024