Reconsidering the Term "Smoker" in Clinical Settings - A survey of doctors in clinical practice

An ongoing debate among tobacco researchers suggests moving away from the term "smoker" due to its lack of uniformity of use, imprecision regarding substance and quantity, and association with stigma. While academic discourse advocates for person-first language ("people who smoke") and standardised terminology, there is limited data on how doctors perceive and utilize these terms.

An online survey was distributed to a renal medicine department in March 2025. In total, 37 out of 60 (62%) doctors responded to the survey. The survey explored current language use, assumptions about what constitutes "smoking," perceptions of bias regarding the term "smoker," and views on the importance of standardised language.

Most respondents (92%) primarily use "smoker" with minimal person-first language adoption. Significant inconsistencies exist in recording smoking history. Doctors often assume filtered cigarettes when "smoker" is used yet readily apply the term to shisha or cannabis users. There was little consensus on correct labelling of less common smoking methods such as shisha, cigars and vapes. Opinions on the inherent bias of "smoker" were split, but indirect questioning suggested some recognition of negative stereotypes. A consensus favoured standardising smoking-related language.

There is a notable incongruence between academic recommendations for person-first language and current clinical practice. The lack of standardised, precise terminology for smoking status poses risks for miscommunication, inconsistent patient care, and potential bias, highlighting a need for consistent, descriptive documentation.