[Playing with fire...].

Cigarette smoking is the most common cause of domestic fires leading to death from burns. A 63-year-old woman is described, who smoked more than 250 pack-years and developed chronic obstructive pulmonary disease, cor pulmonale, acute myocardial infarction and 2 strokes. She continued to smoke even after tracheostomy and constant oxygen therapy was instituted. She had been admitted for acute respiratory failure following 2nd and 3rd degree burns of her right cheek, neck, arm, forearm, and thigh. We draw attention of physicians and nursing staff to the potential danger of smoking during oxygen therapy. Patients who want to smoke despite oxygen therapy should have noninflammable linens and there should be smoke detectors in rooms of patients who smoke.