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April 11, 1986

Tobaccoism Is the Disease—Cancer Is the Sequela

Author Affiliations

University of Texas Medical Branch Galveston

JAMA. 1986;255(14):1923. doi:10.1001/jama.1986.03370140121036

A lesion that follows or is caused by a disease is a sequela according to Dorland's dictionary.1 We, the physicians of this country, are guilty of losing sight of the distinction between disease and sequela when it comes to the pandemic of the disease of tobaccoism and its sequelae of cancer, emphysema, and cardiovascular disease. For the past two decades, the focus on cancer and the neglect of research on tobaccoism have contributed to the inappropriate allocation of national resources.

The purpose of this editorial is to express three strongly held opinions in regard to tobaccoism:

  1. We frequently focus on the wrong target in health care politics. We and our government tend to grab hold of the wrong end of the bat and flail away, wondering all the while why we are having so much trouble getting a solid hit.

  2. As a society, we have not awakened