When I rotated at the VA, it seemed like 9 out of 10 patients reeked of cigarette smoke. Now I'm not a primary care doctor and the last thing I want to do is to lecture a patient on the dangers of smoking. So I don't. They can smoke all the cigarettes they want and eat a dozen Big Macs for all I care.
But if you're going to be shut in a room with a patient who just was outside smoking, you may as well go hang out in a smoky bar because it's just as bad. I'm not allergic to cigarette smoke or anything, but it still makes my throat scratchy and my eyes burn. And I come out of the room smelling like I was smoking. And the room stinks for the next hour.
I'm not a smoker (obviously) so I really don't know: do people who smoke think about the fact that the person they're going to be trapped in a room for the next half hour with someone who likely isn't going to appreciate the smell of smoke? I think it's obnoxious. I mean, when I eat something garlicky for lunch, I always eat a mint after for the benefit of others.
I'm not a militant anti-smoker by any means. In college, I used to occasionally have a cigarette when I was out drinking. In fact, I remember once when I was about twenty, I was sharing a cigarette with a friend on a street corner at like 11PM between bars (ahh, crazy youth) and some woman came all the way down the block to yell at us that the smoke was bothering her. So I feel a little bit of sympathy for the plight of smokers. But at the same time, I really don't like smoke, especially when I'm already sick (which is always, these days) and my eyes are already irritated from lack of sleep (which is also always).
In fact, I know that even many smokers don't like smoke. When I was a kid, I got stuck in the smoking section during an international flight (due to poor planning) and people kept coming back from the non-smoking section to smoke. When my dad challenged some guy about it, he said he didn't like sitting in smoke.
I remember in med school, there was a rotation where my attending used to always go out and have a smoke right before our team meetings. She was often like 5-10 minutes late to the meeting and would breeze in stinking very strongly of smoke. We were in this tiny room, so it was unpleasant anywhere you sat, but especially unpleasant if I ended up sitting right next to her. So I'd actually scheme to figure out where she was going to sit so I could sit somewhere else.
I never entirely understood how a doctor who routinely treated patients with serious complications that were at least in part from smoking could still smoke. I felt sort of bad for her too, because that's surely what everyone else was thinking too. I guess nicotine is pretty addictive.