Using a model that predicts when their 10 year risk of lung cancer gets above a certain level . We're gonna recommend that they stop smoking . So we're gonna look at their age , their sex , their family history , some biomarkers that might help us , we're gonna even do scans of their lungs .
Of course , it would be the latter , not the former . It would be idiotic to suggest that we endorse smoking until you cross a certain threshold . Well , this now becomes the germane question .
What if I said to you , Andrew , this is going to be our new philosophy around smoking cessation . You're , you're , I'm gonna anoint you the czar of smoking cessation . So , um , if people pick up smoking , no problem , we're gonna let the smoke , but we're going to assess their risk for lung cancer .
Or would be better to say , given that we know cigarettes are causally related to this ? How about you never start smoking ? And the minute you do , we pull the cigarette out of your mouth and explain to you that you're doing something that is causally related .
Like most of the day , on some level , I sit around thinking about causality . And I think the hardest part about studying medicine with respect to human beings is how difficult it is to infer causality for most things that we do So if you believe that smoking is causally related to lung cancer , then smoking cessation reduces the probability of lung cancer . That is a , that is a logical equivalency .
