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November 4, 1974

Much More Ado About Tobacco Smoke

JAMA. 1974;230(5):672. doi:10.1001/jama.1974.03240050020013

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To the Editor.—  Dr. Szasz has once again attained a forum by attacking psychiatry. His "Special Contribution" demonstrated his well-known prejudices more clearly than usual.As an example of his non sequitur arguments, he attacks those on the panel with him for smoking (while he had a sore throat) and for not discussing nicotinism as a mental illness, as he precipitately requested from them. They apparently (and understandably, considering they did not know that Dr. Szasz would have a sore throat) did not come prepared to discuss the psychiatric intricacies of nicotine use or abuse. Szasz, however, generalizes from this lack of preparation that "psychiatrists thus speak of `alcoholism'... as a mental illness... but do not speak of `nicotinism' and do not regard it as a disease." The reason for this, in Szasz's view, is that "psychiatrists disapprove of alcoholism but approve of—and indeed encourage... nicotinism." This unsupported logic leads