TO THE EDITOR: A recent article by Steinberg and colleagues (1) argues that tobacco dependence should be considered a medical disease, like asthma or diabetes. Steinberg and colleagues argue that the smoking habit deserves chronic disease status, and that long-term drug treatment, despite being an off-label use, should be reimbursed. Smokers should be encouraged and supported to quit smoking, with short-term pharmacologic aids if necessary. Long-term use of products that have not been tested or approved for long-term use, however, is inconsistent with public health goals while being consistent with pharmaceutical marketing goals. We note that 2 authors of the commentary are on the speaker’s bureau of Pfizer and are consultants to Pfizer, Novartis, GlaxoSmithKline, and Celtic Pharma. Pfizer makes Chantix (varenecline) and Nicotrol nasal spray. GlaxoSmithKline makes Nicorette gum, Commit nicotine lozenges, Nicoderm nicotine patches, and Zyban (bupropion, also sold as Wellbutrin). Novartis makes Thrive, a nicotine chewing gum. Celtic Pharma is developing TA-NIC, a nicotine vaccine. Perhaps smoking cessation aids are being repositioned as longterm maintenance medications in order to expand the market. We think it a shame that Annals provided legitimacy to that goal by publishing the recent article.