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Smoking history is clinically determinative and should be recorded

Bernard W Stewart
Med J Aust 2010; 192 (6): . || doi: 10.5694/j.1326-5377.2010.tb03549.x
Published online: 15 March 2010

To the Editor: The debate raised by Sitas and colleagues about whether smoking status should be recorded on death certificates1 represents data acquisition at the last point. What needs to be considered is not the merits of the proposal, but the systematic failure to record this crucial data in patients’ clinical records. The argument I present here concerns cancer, but may be extrapolated to other smoking-related diseases.


  • Cancer Control Program, South Eastern Sydney and Illawarra Public Health Unit, Sydney, NSW.



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  • 4. Eberhard DA, Johnson BE, Amler LC, et al. Mutations in the epidermal growth factor receptor and in KRAS are predictive and prognostic indicators in patients with non-small-cell lung cancer treated with chemotherapy alone and in combination with erlotinib. J Clin Oncol 2005; 23: 5900-5909.
  • 5. Weir BA, Woo MS, Getz G, et al. Characterizing the cancer genome in lung adenocarcinoma. Nature 2007; 450: 893-898.
  • 6. Secretan B, Straif K, Baan R, et al. Special report: policy. A review of human carcinogens. Part E: tobacco, areca nut, alcohol, coal smoke, and salted fish. Lancet Oncology 2009; 10: 1033-1034.
  • 7. Gritz E, Dresler C, Sarna L. Smoking, the missing drug interaction in clinical trials: ignoring the obvious. Cancer Epidemiol Biomarkers Prev 2005; 14: 2287-2293.

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