title: A smoking related triad: PAD, COPD and CCF.
abstract: BACKGROUND
  Tobacco smoking is the modifiable risk factor responsible for the greatest burden of disease (loss of health and premature mortality) in Australia.
  
  
  OBJECTIVE
  This article discusses the complexities of management of a patient suffering from a smoking related triad of illnesses: peripheral arterial disease, chronic obstructive pulmonary disease and ischaemic heart disease related congestive cardiac failure.
  
  
  CONCLUSIONS
  As well as considering optimal management of the individual conditions, the patient's mental health and overall quality of life needs to be considered. Even at this late stage, smoking cessation is critically important. The patient is likely to require 6-8 medications, creating the potential for interactions and confusion, so careful medication management and patient education is required. The support of a multidisciplinary team will be required, with coordination of care being the key. Care planning and case conferencing between the general practitioner, the patient and other health professionals is essential for optimal care.
authors.affiliation: School of Public Health and Community Medicine, University of New South Wales. m.f.harris@unsw.edu.au
authors.forename: Mark
authors.initials: M
authors.lastname: Harris
mesh_terms: D001521:Behavior Therapy / Q000379:methods; D005194:Family Practice / Q000379:methods; D006333:Heart Failure / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team / Q000458:organization & administration; D016491:Peripheral Vascular Diseases / Q000209:etiology* / Q000628:therapy; D029424:Pulmonary Disease, Chronic Obstructive / Q000209:etiology* / Q000628:therapy; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation / Q000379:methods; D000074606:Smoking Prevention