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Stephen J. Jay, MD

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The excellent study by Bates and colleagues¹ found evidence that smoking is a risk factor for tuberculosis (TB) infection and TB disease. The authors state that it has long been suggested that tobacco smoking may affect the risk of developing TB and cite a single study by Lowe² in 1956 that drew this conclusion. However, history reveals much earlier observations of this relationship. A signer of the Declaration of Independence, Dr Benjamin Rush, attributed pulmonary consumption in a 17-year old male patient to "intemperate use of cigars."³ Statistical reports were made in the early 1900s.^4-5 The fourth (1907) and fifth (1908) reports of the Phipps Institute of Philadelphia for the study and treatment of TB countered the "preposterous claim" that tobacco prevented TB, suggesting that "the increase of tuberculosis in man runs parallel with the increase of the consumption of tobacco."^4(p53) Approximately 75% of male patients . . . [Full Text of this Article]

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