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Cigarette Smoking (cont.)

Exams and Tests

Diagnosing tobacco use or tobacco-related illness is not difficult.

Doctors should ask people about tobacco use at every visit and provide counseling about quitting.

Most people who smoke admit doing so, in part because smoking carries less social stigma than use of other substances, such as alcohol or illicit drugs. Smokers should be honest and not underestimate how much they smoke and for what length of time (for example, a pack a day since age 16), as this information helps the doctor understand the risk for tobacco-related disease.

Upon a physical exam, a doctor may find various conditions associated with chronic tobacco use.

  • Nicotine causes a characteristic brown staining of the hard palate, teeth, fingers, and fingernails.
  • A smoker's skin may wrinkle prematurely.
  • Smokers have a typical odor to their hair and clothing.
  • People with emphysema may have a large, barrel-shaped chest and a chronic cough that produces thick green sputum.

Occasionally, a smoker may have pulmonary function tests performed to help determine the amount of damage done to the lungs by smoking. For young teens, it may be best for physicians to ask the teen about his or her cigarette smoking history with the parents or caregivers out of the room.

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