Wednesday, July 12, 2006

Smoking in Halacha

The RCA Halacha Committee has published a ruling prohibiting smoking (ruling - PDF; RCA press release). Although this Teshuva was published last week and has been discussed elsewhere, I wanted to bring it to the attention to the members/readers of the NMHS Blog. Much of the discussion has focused on why this topic and why now? (Ironically, the RCA ruling just preceded the Florida Supreme Court decision to throw out a $145 billion liability suit against Big Tobacco.) But there is another aspect to the issue that relates to the phycisian directly.
Every H & P form asks whether the patient smokes/ed and the hospials I have worked at have a policy that these patients should receive smoking cessasion counselled (albeit usually mere lip service). Usually we view smoking cessasion as "risk factor modification" just as we counsel patients to eat less fat and cholesterol or encourage diabetics to attain better glycemic control.
However, if there is a halachic prohibition to smoke, perhaps, there is a halachic obligation for Jewish phycisians to seriously encourage smoking cessasion for their patients--le'hafrisho me'issur. Beyond the patient's family, one's phycisian is best positioned to affect this change in prohibitted practice. But remember hocheyach to'chiach and le'hafrisho me'issur requires the proper approach, time and place.

My father, Dr. Steven Oppenheimer wrote an excellent article (I can't help but be biased) on the the topic of preventative health in which he quotes the Chafetz Chaim:

It is amazing that even before the strong medical evidence against smoking that exists today, the saintly Chafetz Chaim wrote the following regarding smoking (this would also apply to any activity that might endanger a person){:

"I said to the smokers, who gave you permission to get into the habit (of smoking)? While it is true that our sages said, One who harms himself, even though it is not allowed, he is exempt, they still said that it is not allowed to harm oneself. First, because (the torah commands us) ve'nishmartem le'nafshoteichem. Moreover, the world and its inhabitants belong to the Almighty, who created us for His glory and in His mercy gives each and everyone the proper amount of energy to devote to Torah and this world. How can the servant permit himself to do whatever he wants when he belongs to his Master? If smoking saps a persons vigor, in the end he will be made to answer for this, for he did this on his own and not because of coercion. Therefore, when one reflects upon the harm one brings upon onself, one will find the strength to avoid the habit." (Likutei Amorim, chapter 13. See also Rambam, Hilchot Sanhedrin, 18:6 and the commentary of Radvaz.)

IY"H I'll post the full article later to the website.
Avi Oppenheimer


At 12:21 AM, Blogger Judah Goldschmiedt said...

Just a thought:
Would this requirement of hochacha also extend to any aspect of non-observance (kashrus, taharas hamishpacha, shabbos). I wonder if medical counseling is unique at all.
Perhaps the difference here is that all sources regarding the mitzva of hochacha due stress the need for the message to be heard by the recipient and there be a chance of him/her righting his ways. Where that is not the case we apply the rule of "mutav sheyehai shogigin"- better to let them act unintentionally. Perhaps the doctors role and his/her advice because it is taken as authoritative and has been shown to be effective, simply strengthens the hochacha vs. "mutav.." point. As such, smoking may hold a different prospect than other non-observance.
(See Beitza 30a, Orach Chaim 608:2 and mishna brura/biur halacha there)

At 1:14 PM, Anonymous The Truth said...

Now that smoking has gotten the attention of some the the mainstream rabbinic authorities, maybe its time to ask why cigs, dont need a hechsher, as far as i know, no kashrus agency has given them a hechsher, so how can they be smoked? maybe theres a more simple reason for them be assur. DEVELOPING....

At 6:22 PM, Anonymous Anonymous said...

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At 10:28 PM, Anonymous Avi said...

Certainly Hochacha applies to all aspects of non-observance. The point I was stressing is the very fact that smoking falls into the category of Hochacha just like Kashrut, Shabbos observance etc.)Therefore, smoking cessation is different than other risk reduction aspects of medical advice such as a low salt diet or a statin for a patient with CAD.

At 6:23 PM, Blogger Evan said...

And how about the halachic obligation to avoid obesity? And the halachic obligation to drive below the speed limit? And the halachic obligation not to drive when tired? And the obligation to quit driving when reflexes get slower.... ad infinitum! Is this an appropriate usage of rabbinical resources? The previous writer's point is valid, and maybe that is the reason to forbid smoking... it plays no useful role even in moderation.


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