Re: Smoking

Issue: BCMJ, vol. 45, No. 4, May 2003, Page 168 Letters

It’s a funny old world. In my clinic this afternoon I was showing a patient a page in our fee guide, stating the fee for lifestyle advice. My patient is involved in federal initiatives for tobacco cessation. She was surprised (as was I, when I arrived in BC) to find that an MSP fee is not payable for lifestyle advice, including smoking cessation.

When I queried this in 1994, the then-minister wrote me a nice letter, explaining that in BC there existed an extensive public health and education system. Patients could and should attend there for lifestyle advice, whilst doctors got on with doctoring. Since arriving in BC my health unit seems to be otherwise too preoccupied to fulfill this mandate.

This evening I read my BCMJ to find Dr Bass’s exhortation on page 86 [BCMJ 2003;45(2):86]. I hope new and enthusiastic graduates don’t follow his advice closely. Unless they are very altruistic or independently wealthy, they could find themselves in conflict with MSP. That is unless their smoking patients are able to pay the $105 per half hour fee suggested by the BCMA fee guide. With the price of cigarettes today, that’s unlikely.

I confess to mentioning that smoking is not good for my patients and even offering advice on quitting. Fortunately most of my smoking patients come in with other diseases needing doctoring, often a consequence of their habit. The smoking cessation advice is complimentary. However I am unable to (or rather specifically forbidden to), provide the extensive motivation, counseling, prescription monitoring, and long-term follow-up recommended by Dr Bass under the Medical Services Plan. That’s a pity.

—Ralph Jones, MB

Ralph Jones, MD. Re: Smoking. BCMJ, Vol. 45, No. 4, May, 2003, Page(s) 168 - Letters.

Above is the information needed to cite this article in your paper or presentation. The International Committee of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.

About the ICMJE and citation styles

The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.

An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.

BCMJ standard citation style is a slight modification of the ICMJE/NLM style, as follows:

  • Only the first three authors are listed, followed by "et al."
  • There is no period after the journal name.
  • Page numbers are not abbreviated.

For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit

BCMJ Guidelines for Authors

Leave a Reply