Article Content

As a home care nurse extremely concerned about the toll that tobacco-related diseases have on patients, I had the opportunity to speak out against the devastating effects of smoking last April when history was made as nurses from across the nation attended Atria's (formerly Phillip Morris) annual stakeholder meeting. Members of the Nightingales, an advocacy group that focuses attention on the tobacco industry's behaviors, we attended the meeting to ask the tobacco company to voluntarily stop marketing tobacco products to smokers and nonsmokers.


San Francisco RN Ab Brody expressed the views of the nurses while addressing one of the shareholder resolutions:"Altria talks about smoking as an 'adult choice,' but nobody ever 'chooses' to suffocate and die in pain and terror. That wasn't a choice they made. No; they chose the tobacco industry's image of cool, fun, glamour. And that's a big, fat lie."


During the shareholder meeting, Sharon Brown, a nurse from Arizona, requested that the shareholders observe 30 seconds of silence in honor of her father. "I came because this would have been my Dad's 74th birthday, except he died from lung cancer from this company's products. I'm here to honor him and to try to keep this company from taking away somebody else's Dad."


After the shareholder meeting, the nurses convened outside of Altria's office to read excerpts of letters written to Phillip Morris from the company's internal documents which are now available to the public. A letter from Ohio stated: "Thanks, but no thanks for the Birthday card from Marlboro country." We all thought: Why would you send a birthday card to someone hooked on something that you label "causes lung cancer, heart disease, emphysema"?


A letter writer from Tennessee stated, "You can now remove Adrian from your advertising computer-he is dead. He smothered to death because his lungs could no longer provide his body with life giving oxygen...My father was never a 'loyal' customer. He was a 'nicotine addicted' customer. Those of us who knew him miss him greatly. We love him still. Don't ever send tobacco related advertisements to this address." These two letters are representative of the many letters nurses read aloud after the shareholder meeting.


Nightingale organizer, Ruth Malone, RN, PhD, stated, "We're here to say that this can't go on. The tobacco industry spends more than $1 million an hour, 24/7, on making their deadly, addictive products look fun, cool, and glamorous-but these letters show the terrifying, painful reality of what cigarettes actually do."


What Can Clinicians Do?


1. Provide patients smoking cessation information, there are medications, support groups, and research studies in most cities. If your state has a quit smoking hotline, provide patients with that number. Go to to find out if your state has a quit line.


2. Understand that patients are addicted to tobacco. The average person will try to quit smoking five to six times before finally quitting; encourage them to continue to try to quit smoking.


3. Learn about tobacco cessation at or


4. Support 100% smoke-free workplaces. For more information visit


5. Support full coverage for tobacco cessation in health insurance plans. Nurses who smoke and other smokers should have all possible assistance in quitting smoking. Visit or to find out more about tobacco cessation coverage and managed care.


6. Join the Nightingales in speaking out against the marketing of tobacco. Contact for more information.