This issue of the BDJ contains three research papers that have a common theme running through them — the effects of tobacco and alcohol. However, despite the common theme the content of the three papers is completely different. One is about the attitude of general practitioners to providing smoking cessation advice, one is about the role of primary healthcare professionals in oral cancer detection and the third is about the use of drink and drugs in vocational dental practitioners. To my mind the thread that links the three papers is the attitude that UK society has to both smoking and alcohol consumption. By this I mean both the attitude of society in general, and also the attitude of health professionals, and perhaps most surprisingly the similarity between the two. When it comes to smoking and drinking, dentists would appear to behave as illogically as everyone else.

It is apparently a fact that 330 people die from smoking-related diseases each day in the United Kingdom, the same number as would die if a jumbo jet crashed every day killing everyone on board. Imagine if the latter had happened, every day for the last few decades. As a society would we be incensed, would the the media be screaming for someone to do something about it, would the Government be invoking emergency powers? Or would we be so used to it that complacency would have set in and we would accept it as a risk when flying? It is an interesting thought, and perhaps what has happened with smoking.

Smoking, it appears, is considered reasonably acceptable. If people want to increase their chance of dying so be it, and it seems that personal freedom is so important here that if they want to take some of the non-smokers with them (passive smoking) then that is all right too. After all, we still argue about banning smoking in public places in the UK. Yet, while personal freedom seems so important in the case of tobacco, it is not the same if I decide to drink and drive. What is the logic here?

Society's attitude to drinking alcohol is also illogical. We may frown at drinking and driving, but seem less concerned about the alcohol-related health risks. We rationalise the evidence that suggests a little alcohol is good for us (or so some people say) because we want to ignore it. After all, it somehow seems inappropriate to mention excessive drinking when we see it, rather like keeping quiet when we know someone is having an extra-marital affair. We consider it none of our business.

Perhaps that is why the paper on smoking cessation in this BDJ reveals only 30% of dentists discuss the health risks of smoking with patients, as if the remaining 70% felt intrusive giving advice. It is apparently all right to discuss diet but not tobacco. It seems that losing one's teeth is much more serious than losing one's life - or that is how it might appear to someone looking at all of this from a logical point of view.

How can anyone imagine logic enters into the equation when people happily pollute themselves with nicotine from a packet containing a warning that smoking can kill them?

But then who said we ought to be logical? We obviously are not, and we demonstrate this daily in the way we behave. How can anyone imagine logic enters into the equation when people happily pollute themselves with nicotine from a packet containing a warning that smoking can kill them? It obviously is not as simple as that. In our separate ways we all demonstrate similar illogical behaviour, whatever we do.

And that, I suppose, is the real difficulty. As individuals we have to justify to ourselves what right we have to interfere with other people's private lives (and their habits) when we are also guilty of our own weaknesses and foibles? But is this still true if we are involved in healthcare? Do people expect dentists to play a role in promoting good health, even if that means providing advice on smoking and drinking? I suspect they do, and I believe they are right. We do have a responsibility to help people avoid doing things that damage their health, and not to do so is perhaps as unethical as actively harming them. After all, both alcohol and tobacco are linked to oral diseases and thus part of our direct responsibility.

But the real problem, I suspect, is the fact that we are not logical but simply human, full of emotional baggage we inherit from society. And when it comes to logic versus feelings — feelings always win.