The American Medical Association refused to divest itself of $1.4 million worth of stock in Tobacco companies today even though the AMA has long been on record as against smoking and opposing cigarette advertising.

"Smoking is the No. 1 preventable cause of death and disease in the country," said Donald Winston, a resident physician speaking in favor of a resolution asking the AMA to divest itself of stocks in R.J. Reynolds and Phillip Morris companies, at the AMA annual meeting.

An AMA committee which looked at the issue recommended that the 283 doctor delegates vote against giving up the stock because the selection of investments "should not be directed by 'social' purposes." John J. Coury of the AMA board of trustees also said that AMA lawyers had told the board that instructing their investment company on which stocks to hold or sell would be against the law, but he said the AMA could get out of the investment by changing investment companies.

During the debate, delegate Clair C. Conrad of Dodge City, Kan., said that if this action were taken, next the AMA would have to give up stocks in coal companies for environmentalists and stocks in pharmaceutical companies for those who may be against birth control.

Ronald Davis, a medical student from Chicago and one of those in the AMA lobbying for action against the tobacco industry, said "in certain cases moral questions take precedence over financial issues. In this case we believe strongly that the moral question is overriding." It is estimated that about 320,000 persons die each year from smoking-related illnesses, he said.

In other action, the AMA reaffirmed its opposition to federal help for Health Maintenance Organizations, in which patients pay an annual fee to cover all or most of their medical treatment rather than pay each time they need treatment.