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MUSC Health Blog

Keyword: smoking
Head shot of Dr. Bunt

Guest post by:
Christopher Bunt, M.D.
Family Medicine
MUSC Health Primary Care Ben Sawyer

Primary care is full of uncertainty. A patient comes in with a chief complaint, we ask some questions, perform an exam, maybe order some tests, and then we come up with a possible answer for our patient. It is rare that we are 100 percent certain about a diagnosis. 

It can be frustrating for patients and physicians to have this level of uncertainty. “I don’t know” does not reduce stress in someone’s life, let alone in a doctor’s office. But, that is the nature of most interactions in the health care system.

However, there are some things in primary care, and in this case, all of medicine, that are 100 percent certain.

Here is one three-part certainty that can save a life:

1a. If you smoke tobacco, STOP! 

1b. If you don’t, NEVER START! 

1c. If you are a health care provider who interacts with a patient who smokes, TELL THEM TO STOP!

Yes, behavior change literature says that we should assess whether or not someone is ready for change. But if we as healthcare professionals don’t make a strong statement about the benefits of quitting tobacco, who will? 

You might be thinking, how big of a problem is tobacco? Yes, over the last ten years, the number of smokers in the US has declined, and now sits at 15 percent (36.5 million people) of the population.

However, cigarette smoking remains the leading cause of preventable death in the US, causing over 480,000 deaths (one in every five deaths) per year. Moreover, 16 million Americans live with a smoking related disease.*

Some patients have made the transition to e-cigs, because they are hopeful that they are a healthier alternative.  We don’t have long term data since they are relatively new.  However, we do know that e-cigs contain multiple harmful chemicals, including those that cause cancer.  They are not the ultimate answer, and often just switch one addiction for another.

It is well understood that what doctors recommend matters. Unfortunately, our message can get lost in all of the other issues that we focus on in a primary care visit. 

If we can get our patients to stop smoking, we will save more lives from this success than all of the treatments we recommend to control diabetes, hypertension and high cholesterol, COMBINED!

So, if you are a provider, please give as strong a statement as you can to your patient who smokes that they NEED to quit.

If you are a patient, anticipate that providers will be telling you to stop every single time they interact with you!  Maybe it is frustrating, or even irritating to hear this every visit.  But, aren’t you going to the doctor for answers?  Most of the time, that answer is uncertain.  But not always, and not in this case. 

This certainty will save a life.  Maybe even your own. 

Ready to quit? Ask your primary care provider for help.  We have multiple different strategies that work.  And we are committed to helping you quit!

Need additional help or have questions?  Call the national tobacco cessation quitline, 800-QUIT-NOW.

*CDC Stats: Smoking and Tobacco Use

Lung cancer is the number one cause of cancer death for both men and women. If you are between the ages of 55-77 and have a 30 pack-year* history of smoking – even if you’ve quit – don’t take a chance. Safe, low-dose spiral CT (LDCT) scans have proven to reduce lung cancer deaths by twenty percent. Early detection can add years to your life and improve the quality of life for you and your loved ones.

Is Lung Cancer Screening Right for Me?

If you have all of these risk factors, you should consider being screened:

• 55–77 years old and

• * 30 pack-year history of smoking (this means 1 pack a day for 30 years, 2 packs a day for 15 years, etc.) and

• Are a current smoker, or have quit within the last 15 years

Not everyone who meets the initial criteria will be eligible for screening. Our team will help guide you as to whether screening can benefit you or not.

Does Lung Cancer Screening Make a Difference?

The National Lung Screening Trial has shown that screening current or former heavy smokers with LDCT decreases their risk of dying from lung cancer. During the research study, 53,454 current and former smokers were randomly assigned to be screened once a year for 3 years with low-dose CT or chest X-ray.

Based on the research, if a group of 1000 people were screened once a year for 3 years, 3 fewer people in 1000 would die of lung cancer after 6 years. This means that, instead of 21 people, 18 people per 1000 would die of lung cancer.

Scheduling an Appointment

Your doctor may refer you for lung cancer screening, or you may refer yourself by calling 843-792-1178.

The MUSC Health Lung Cancer Screening Coordinator will walk you through the evaluation process, which includes smoking cessation counseling if you are still smoking. We may also be able to direct you to clinical trials that are appropriate for your concerns or your condition.

Screening Cost

Talk with the Lung Cancer Screening Coordinator about potential costs for lung cancer screening. Medicare and most private insurance plans offer coverage for those who qualify.


You can choose from three different MUSC Health locations for your LDCT scan and clinical consultation:

Downtown Charleston
Rutledge Tower
135 Rutledge Avenue, Suite 128, Charleston, SC 29425

Mount Pleasant
East Cooper Medical Pavilion
1600 Midtown Avenue, Mount Pleasant, SC 29464

North Charleston
North Charleston Medical Pavilion
8992 University Boulevard, North Charleston, SC 29406

Smoking Cessation

Regardless of your decision about screening, avoiding cigarettes is the most important thing you can do to lower your chance of dying from a variety of diseases, not just lung cancer. Quitting smoking helps with emphysema and heart and vascular diseases as well.

If you are still smoking and need help quitting, talk with your MUSC Health care team, call our MUSC Tobacco Treatment Program at 843-792-9101, or call 1-800-QUIT-NOW (1-800-784-8669).


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