Occasionally, my life is much more complicated.

Recently I had to go to Home Depot to obtain whatever was needed to fix several broken cabinet hinges at the house. I walked into the place and was fascinated by all the alien household repair stuff. I saw unidentifiable tools that made me nervous. I thought to myself, “Does every household have a Shop-Vac and a toolbox with 30 sizes of socket wrenches?”

My curiosity got the better of me. I began asking perfect strangers about the items in their cards. “Sir, excuse me. What is that tool in your cart and what are you going to do with it?” I received some reserved comments from a few folks as they clutched their carts and checked to see that the children were safe.

A helpful employee eventually directed me to an aisle with the massive banner reading “Fasteners.” I knew I was in trouble and asked for more help. I was asked about the type of cabinets and the size, country of origin and age of the hinges. I blinked and offered from my pocket a small cabinet screw, which serves as the only evidence of my domestic problem. The employee took pity, made several suggestions, but eventually boiled the solution down to the absolute minimal actions needed to fix my cabinets.

Thanks to other new developments, my life as a physician has now become even simpler. Doctors are trained to promote health and save lives. For all the years of training, the tons of texts read and exams taken, the single best way to have the greatest impact on life and health is: GET PATIENTS TO STOP SMOKING.

The recently published U.S. Public Health Service report “Treating Tobacco Use and Dependence: A Clinical Practice Guideline” requests that all physicians take steps to get patients to stop all tobacco use. For the first time in history, we have this data:

1. Conclusive evidence that smoking is the greatest cause of heart disease death, stroke and lung cancer death, and chronic lung disease death.
2. Seventy percent of smokers would like to stop.
3. Effective smoking cessation therapy is available in the form of nicotine patches, gums, nasal sprays and the sustained-release bupropion anti-depressant.
4. Cessation of smoking at any age substantially reduces a smoker’s risk of death from heart attacks, lung cancer, stroke, and chronic lung disease.

The guidelines ask every physician to identify every smoker in their practice, strongly advise them to quit, offer nicotine replacement therapy with or without bupropion therapy, and regularly and consistently support efforts to stop smoking.

A pattern of multiple smoking cessation attempts before success is normal for this addiction; physicians and patients should therefore be prepared to continue efforts with modifications of the program as needed.

It may be morally unacceptable for a physician to have an encounter with a smoker and fail to actively promote cessation of the greatest known cause of ill-health and death now that effective therapy exists.

We have our work cut out for us by this report, but there is something calming in the simplicity of the solution to a leading cause of death in the country and the world.

I can save lives, but I may not be able to repair those cabinets. Admitting my domestic failings, if you see me at the Home Depot, please help. If you smoke, please stop or ask your doctor for help.