Tobacco Diseases. Facts
- Globally, nearly one-third of the population over the age of 15 smokes. Cigarette smoking causes one in five deaths worldwide each year. In Poland, about 80,000 smokers die annually. Smoking is mainly associated with lung disease, especially lung cancer. Meanwhile, in Europe, smoking accounts for 12.3% of all medical conditions. And as many as 50% of smokers will die from tobacco-related diseases. In Poland, smoking is the cause of every second death among men aged 35-69 - says Andrzej Dąbrowski, MD, PhD, from the Chair and Department of Internal Medicine, Pulmonary Diseases and Allergology MUW. Cigarettes contribute to chronic obstructive pulmonary disease, oral and laryngeal cancer, asthma, chronic bronchitis. They have an impact on the development of cardiovascular diseases: ischemic heart disease, hypertension, stroke, peripheral vascular disease, atherosclerosis, aortic aneurysm. They cause gastrointestinal diseases: esophageal cancer, gastric and duodenal ulcers, periodontal disease, leukoplakia. Malignancies of the renal pelvis and ureter, pancreas, and osteoporosis as well as cataracts should also be added to this long list. - We cannot ignore the reduction of women's fertility and disorders of the fetal development, because about 30% of smoking women reach for cigarettes during pregnancy - adds Dr. Dąbrowski.
According to the experts from the Chair and Department of Internal Medicine, Pulmonary Diseases and Allergology MUW, adult patients with health complications due to smoking or passive exposure to tobacco smoke constitute about 80% of patients hospitalized in the pulmonary ward of the Department.
What tests and how often should a smoker take?
Smokers should visit their primary care physician once a year. Experts from the Department of Internal Medicine, Pulmonary Diseases and Allergology MUW, also recommend having a spirometry test once every 3-5 years. A blood count and urine test are also important. If there are signs of any disease, e.g. cardiovascular disease, tests should be done for them.
- Early detection of tobacco-related cancers, particularly lung cancer and laryngeal cancer, is very important. That is why the appearance of alarming symptoms, such as chronic cough, hemoptysis, chronic hoarseness should prompt you to visit a pulmonologist or an ENT specialist - says Professor Rafał Krenke, Head of the Department of Internal Medicine, Pulmonary Diseases and Allergology of the Medical University of Warsaw. Unfortunately, in a large proportion of cases, the onset of symptoms already indicates an advanced disease process. In Poland, only about 20% of patients are detected in the early stage or in the local stage (there are no signs that the cancer has spread to other tissues), which allows doctors to apply radical surgical treatment. That's why testing to detect lung cancer before symptoms appear is so important. - The primary examination with which hopes have been raised is the chest X-ray. Unfortunately, it has been shown that repeated x-rays every 1-2 years do not provide a significant improvement in the detection of early-stage lung cancer. This is due, among other things, to the low accuracy of this examination. In the last 10 years it has been shown that low-dose computed tomography of the lung (LDCT), which is much more accurate than X-ray, should be used as a screening test. Poland already has a lung cancer screening program using LDCT for patients at increased risk for this type of cancer (https://pacjent.gov.pl/programy-profilaktyczne/profilaktyka-raka-pluca). The primary group eligible for this program are individuals aged 55-74 with tobacco smoke exposure greater than or equal to 20 pack-years and a tobacco abstinence period of no more than 15 years, adds Prof. Rafal Krenke. Doctors emphasize that nicotinism is an addiction. Therefore, it is important to inform the patient at every medical visit about the possibilities for overcoming the addiction.
Poles find it hard to quit smoking
According to the aforementioned Eurobarometer report, only 12% of smokers in Poland have stopped smoking. This is one of the three lowest percentages in the EU (apart from Hungary and Romania). According to our experts, there are several reasons for this. The first is the smoker’s lack of adequate knowledge about the smoking cessation process. Equally important is the lack of active support from the health care system. The end result is also influenced by the help from the loved ones. If they don’t get it, it is very difficult to achieve success. The patient's own motivation is also very important. - The level of this motivation varies at different times of smoking, and for the weaning process to be effective, you should aim to start when you are strongly motivated. In any case, this motivation must be continually fostered in the patient. Patients should not be discouraged after an unsuccessful attempt; on the contrary, they should have the knowledge that, just like learning to write or play an instrument, success usually does not come right away. Additionally, it requires persistence and making repeated attempts until success is achieved. Pharmacological support is a separate and broad issue, which should depend on e.g. the nature and extent of nicotine dependence and patient's preferences - estimates Prof. Krenke.