Acne 1f.

While running for President in 2008, he said he would quit, and that he was chewing Nicorette. His wife disclosed that, in exchange for giving her permission for him to run, she required that he quit 3. According to a February 2008 report, he quit smoking "several weeks" earlier 3.

Comment: Obama's total exposure to cigarettes, measured in "pack-years," has not been released. Any competent physician would elicit this information from the patient. It is so important that some physicians have called it a new "vital sign" (that's silly, but it makes the point). The quantified smoking exposure is important, among other reasons, in estimating the risk of various diseases. Although it appears as if the information was deliberately suppressed, I hope a reader can supply a pointer to the data.

In reports of his physical examinations while President, Obama's tobacco usage was described as "smoking cessation efforts" in 2010, "tobacco free" in 2011, and "remains tobacco free" in 2014 and 2016 4.

Comment: There is nothing inherently wrong with summarizing 21 years of medical history on one page -- if the patient has been healthy. Even so, this letter leaves a bad taste in Dr. Zebra's mouth, for several reasons: (1) It is undated. Putting a date on a document is as automatic as breathing for a physician. Why was there no date? (2) The characterization of "intermittent" smoking is unprofessional. Physicians speak in terms of "pack-years" of smoking. (3) The statement that Obama maintains a "good intake" of fluids rings false. Except for patients with various diseases, there is no call to measure fluid intake. It sounds like the physician was trying to fill space.