I've just finished going through the medical file of a workers' compensation claimant, a guy who has undergone six back surgeries for various lumbar disk problems. He now, in his early 50s, has had to apply for social security disability benefits because of his back condition. I rarely see such a parade of horribles as I have seen in this man's file. I will be surprised if his social security claim is rejected.
The medical file dates back to the mid-1990s. Doctors noted continuously that the man was a smoker, but only within the past couple of years did they note their advice to the man to quit smoking. One doctor reported that he had told the man that smoking directly contributed to his back problems. The man had responded with bafflement; he knew that smoking can cause lung cancer. He had no idea it caused other problems.
This sort of bafflement I see not infrequently in my work. When I was a practicing lawyer, clients would bring me medical records detailing awful back problems. Usually, the records showed that they had degenerative disk disease, thereby setting up the workers' compensation issue to what extent that disease was responsible for their disability or need for treatment. Not infrequently, the records would reek of tobacco smoke. I would visualize the clients reading through their medical files while cigarettes dangled from their lips. When I'd ask them if they ever had connected smoking to their bodily problems, they almost always said they had not. "What do you mean," I remember one client asking me, "How could smoking affect my back?"
Research shows that smoking is a leading risk factor for degenerative disk disease, and smoking is heavily linked with chronic low back pain. Perhaps the news about the link between smoking and back pain is getting out. Perhaps some smokers will stop smoking once they appreciate the reality of the link. Many likely have not and will not. And therein lies my bafflement: How is it that the tobacco merchants still (mostly) get away with selling their poison?
This question is not for me just rhetoric. As time has passed, I've become genuinely puzzled that our society still permits the sale of cigarettes. We don't permit tobacco merchants to kill or disable people by whacking them with tire irons. Given what we now know about tobacco, there must be a basic societal disconnect going on, probably one related to the disconnect that enables gun merchants to arm criminals and the mentally disturbed. Oh, wait, another topic there. Same theme though: I'm baffled.
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