Anecdotally we've observed that after being together for a while, many people end up looking like their dogs.

Or their spouses.

If people end up physically resembling other creatures simply by spending time with them, it seems reasonable that over time they might begin acting like them, too. Which is what medical researchers are now verifying. Apparently infections are no longer limited to viruses. We now have social infections: namely, obesity and tobacco abuse. In a July 2007 New England Journal of Medicine article, we learned that obese people who spend time with other obese people are likely to continue being obese. An article published in yesterday's New England Journal of Medicine found that the same was true of people who smoke.

According to Drs Christakis and Fowler, of the 12,067 people studied as part of the Framingham Heart Study:

* Smoking cessation by a spouse decreased a person's chances of smoking by 67%.
* Smoking cessation by a sibling decreased the chances by 25%.
* Smoking cessation by a friend decreased the chances by 36%.
* Among persons working in small firms, smoking cessation by a coworker decreased the chances by 34%.

This is good news and bad news. Bad news because it means we must now take into consideration an obese or tobacco-addicted individual's entire social network when offering treatment.

Good news because it means we must now take into consideration an obese or tobacco-addicted individual's entire social network when offering treatment (which, fortunately, organizations such as Maine's Center for Tobacco Independence are already doing).

Good or bad, the concept of social connections impacting one's health is not really even 'news.' In family medicine (as in other primary care and related specialties), we have always been trained to take the needs of the family into consideration, even as we seek to treat the individual. In preventive medicine and public health, we look for ways to improve the health of the community, as a way to indirectly impact the health of individuals. These are two slightly different ways of acknowledging the same idea: that we humans are actually connected to one another. And we are connected to our environments. For better or for worse. As John Muir once said, "When we try to pick out anything by itself, we find it hitched to everything else in the Universe."

Instead of picking out--and picking on--obese and tobacco-addicted individuals, let's find out who they are hitched to. Let's continue to talk about tobacco-free Maine communities, and try to 'love the smoker,' though we may 'hate the smoke.' Let's work with people within the context of their lives, as we seek to solve these social infections.

Then maybe we can figure out how to keep people from looking like their spouses.

And their dogs.

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