Doctors are often asked whether it is harmful to smoke three cigarettes a day, or five, or fourteen, or a pack; people seem to want a standard measurement. If they exceed it, that would be bad; if they smoked fewer than the standard, that would be all right. But no such figure can be set. For some people, one cigarette a week would be too many cigarettes.

A better way to respond to questions about cigarette smoking, then, is to speak not of quantities but of habit patterns. You are smoking to excess if you do any one (or more) of the following:

Reach for a cigarette the first thing in the morning, or the last thing at night.

Light a cigarette without realizing it, find yourself smoking, and wonder why you lit it and when.

Claim that you are unable to enjoy certain situations without a cigarette—your morning coffee, food, reading the paper, playing cards, and so on.

Feel it necessary to explain the number you smoke with such phrases as "They help me relax" and "I only take a puff or two, forget it, and then light another."

Become severely upset when you find yourself in a "no smoking" area—certain theatres and public buildings, for example—and feel compelled to "duck out for a quick cigarette," or are ready to risk public disapproval or punishment by "sneaking" a few puffs.

Find it almost unbearable when you are out of cigarettes and are unable to tolerate the situation; instead are willing to go to some lengths (dressing, walking to the corner store, stopping a stranger) to get a cigarette.

Feel that you have to smoke to show that (a) you are one of the gang, or (b) "adult."

If with any degree of regularity you act or react in any of the ways described above, you are smoking to excess.

"Excess" means "more than what is right, proper or necessary." When used in medicine, it means "more than is good for continued good health/' We can eat too much, work too much, drink too much (including non-alcoholic liquids), sleep too much, and so on; and while any such excess is potentially troublesome, some excesses are worse than others.

Smoking must be put in that category, because it has vastly increased the incidence of lung cancer and coronary artery diseases, and because it plays a significant role in increasing the mortality rate in other pathologies.

There is therefore very little doubt that ANY amount of smoking is too much, and it is in our own best interest to not smoke at all. If you are a smoker already, the best option is to quit.

Chris Haycock