Intended for healthcare professionals

Rapid response to:


The mortality of doctors in relation to their smoking habits: a preliminary report: (Reprinted from Br Med J 1954:ii;1451-5)

BMJ 2004; 328 doi: (Published 24 June 2004) Cite this as: BMJ 2004;328:1529

Rapid Response:

Biophysical Semeiotic Constitutions, Single Patient Based Medicine, and Tobacco Smoking.


The impact of tobacco smoke on health remains under dispute
nothwitstanding data of EBM. In my opinion, this issue will remain
controversial for a long time, until we decide to take into account
not only EBM, but also SPBM, i.e., “Single Patient Based Medicine” (1). In
fact, although unfortunately overlooked all around the world, Biophysical
Semeiotics Constitutions do really exist, as I referred in my earlier
Rapid Response, as well as
on my HONCode site 233736,; Biophysical-
Semeiotic Constitutions. SPBM, URL:

Certainly, in individuals without, e.g., “Hypertensive, diabetic END
dyslipidemic Constitutions neither arterial hypertension nor diabtes type
2 will surely not occur, even in lasting presence of environmental risk
factors, under whatever prevention measures. In a few words, we can nowadays easily recognize at the bed-side subjects with particular inherited
constitution(s), who can be affected by defined diseases under
environmental risk factors. For example, there is convincing evidence that
cigarette smoking is a risk factor for cancer. Cigarette smoking has been
consistently associated with a relatively small but significantly
increased risk of lung malignancy (and diabetes type 2 in both men (2)
and women (3) in large prospective cohort studies). However, only
individuals with both “diabetic “ and “dyslipidemic” constitutions, as
regards diabetes mellitus type 2, as well as those affected by
Oncological Terrain biophysical-semeiotic constitution can suffer from
diabetes and respectively from cancer, solid or liquid, as allows me to
state a 46-year-long clinical experience (1, 4, 5).

1) Stagnaro-Neri Marina, Stagnaro Sergio. Introduzione alla Semeiotica
Biofisica. Il Terreno oncologico”. Travel Factory SRL., Roma, 2004.

2) Rimmm EB., Chan J., Stampfer MJ., et al. Prospective study of cigarette
smoking, alcohol use, and the risk of diabetes in men. BMJ 1995; 310 555-

3) Rimmm EB., Manson JE., Stampfer MJ., et al. A prospective study of
cigarette smoking and the risk of diabetes in women. Am.J Public Health
1993; 83:211-214.

4) Stagnaro S., Diet and Risk of Type 2 Diabetes. N Engl J Med. 2002 Jan
24;346(4):297-298. letter [PubMed –indexed for MEDLINE].

5) Stagnaro S., Stagnaro-Neri M. Valutazione percusso-ascoltatoria del
Diabete Mellito. Aspetti teorici e pratici. Epat. 32, 131, 1986.

Competing interests:
None declared

Competing interests: No competing interests

28 June 2004
Sergio Stagnaro
Specialistin Blood, Gastrointestinal, and Metabolic Disesaes. Researcher in Biophysical Semeiotics.
Via Erasmo Piaggio 23/8 16037 Riva Trigoso (Genova) Italy.