GET OVER with tobacco, breaking the last cigarette once and for all saves life and saves money. It is difficult, of course, but it can be done. And the World Health Organization for the World No Tobacco Day 2021 edition, which is celebrated all over the world on May 31, has chosen as its theme “Commit to Quit”, or “committed to quitting”: a message and an invitation, potentially directed to one billion and 300 million people as there are smokers and smokers globally, and above all to those 780 million – 60% – who have the intention to undertake a path of quitting smoking. Which, beware, is not just a vice, but a chronic and relapsing disease. Which claims many victims. Every year the victims attributable to smoking are almost 8 million, 7.7 to be precise. And 200 million have been the deaths caused by tobacco use in the last 30 years, according to three studies published close to the No Tobacco day its The Lancet e The Lancet Public Health and made on the basis of 3,625 surveys conducted in 204 countries.
Pathologies
In 2019, according to the three publications on The Lancet, Smoking has been associated with 1.7 million deaths from ischemic heart disease, 1.6 million from COPD (or chronic obstructive pulmonary disease), 1.3 million from lung and respiratory tract cancer, and just under 1 million from stroke. It has been calculated that one in two long-term smokers dies from causes directly related to smoking and that those who smoke have an average life expectancy of less than 10 compared to non-smokers. Globally, the average age at which one starts smoking is 19, with a minimum in Denmark (16.4 years) and a maximum in Togo (22.5 years). About 87% of deaths attributable to tobacco smoking occur among current smokers. Only 6% of those who have quit smoking for at least 15 years. And this is an interesting fact, it is the good news among the many bad ones. Because it tells us the benefits of smoking cessation are there. And they are also fast.
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The quick benefits of termination
After just 20 minutes from the last cigarette, the heart rate decreases. Within 12 hours, the carbon monoxide in the blood (the toxic product of combustion that binds to hemoglobin and displaces oxygen) drops to physiological levels. Within 2-12 weeks, circulation and lung function improve and within 9 months, cough and shortness of breath decrease. Within 5-15 years, the risk of stroke is reduced to that of a non-smoker. Within 10 years, the death rate from lung cancer halves that of smokers. And within 15 years, the risk of heart disease is equal to that of non-smokers (source WHO).
Italy
In Italy, smokers are about 10 million, with a higher prevalence in the 25-40 age group. It is estimated that in our country over 93,000 deaths a year are attributable to tobacco smoking, more than 25% of these deaths are between 35 and 65 years of age. As for lung cancer, one of the main smoking-related diseases, in our country mortality and incidence are decreasing among men but increasing among women. Cigarette smoking is more frequent among the most disadvantaged socio-economic classes (less educated and / or with greater economic difficulties) and in men. Average daily consumption is around 12 cigarettes, however nearly a quarter of smokers consume more than one pack. “An interesting national data is the one concerning the average age of those who need to stop using tobacco products, which is 20 years higher than that of initiation into the consumption of the product”, he says. Roberta Pacifici, director of the National Center for Addiction and Doping of the Higher Institute of Health. In short, like saying that it takes 20 years of smoking to decide to quit. Or try to do it.
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How to quit, the new guidelines
Here, in fact, try to quit. But how and what tools do we have today to support those who want to do it? “In collaboration with the epidemiological observatory of the Lazio region and with many others stakeholder we are working on the drafting of the new national guidelines for smoking cessation – continues Pacifici -. The document is being drafted but to date all national and international guidelines indicate that the most effective strategy is the association between drugs and psycho-behavioral support. Drugs are different, they have different mechanisms of action and also different levels of effectiveness: and they are essentially either nicotine substitutes or molecules that act on craving “.
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Will is not enough
“The fact is that quitting smoking is not just a matter of will. Of course, the person must want to do it, but he must be put in a position to reach the goal, and this can be done by trained professionals and the appointed structures, that is, the anti-smoking centers. In Italy we have about 220 distributed throughout the country where specialists who know how to customize the intervention work. By calling the toll-free number (800.554.088) which is on all cigarette packets, the smoker gets in touch with psychologists who evaluate his motivation and direct him to the nearest and most suitable anti-smoking center. Smoking is a chronic relapsing disease, if you want to reach the final goal you have to get help from professionals who have the tools and skills to do it. These structures must be increased and encouraged ”, adds Pacifici.
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Encourage termination
“The tools to be put in place to encourage cessation, the WHO has identified for many years – the ISS expert continues – the most effective is the increase in the price of cigarettes: when tobacco products cost a lot, people are encouraged to stop and discourage you to start. But this seems unattainable for us: in Italy it is not possible to increase excise duties, in Australia cigarettes cost a lot, and in fact the number of smokers has significantly decreased. A second strategy – adds the expert – is precisely to invest in anti-smoking centers and the staff who work there ”.
Le fake news
“In addition to this, it is necessary to start a serious battle against fake news. Today we have a big problem which is that of the presence on the market of new tobacco products, electronic cigarettes and heated tobacco, which are tell yourself as products with fewer adverse health effects. Electronic cigarettes are even said to be able to help stop smoking, news that is not supported by any scientific evidence – Pacifici says – The reality is that these products represent a disincentive to quit for those with a strong addiction, functioning as a distracting factors from the goal of getting rid of nicotine. It’s kind of like the smoker switched to e-cigs because they hurt so much less, but in this way it postpones, delays smoking cessation ”.
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Smoking in the pandemic
The COVID-19 pandemic has led millions of tobacco users to decide to enter a smoking cessation process, so much so that the WHO has made available to the willing the possibility of signing an online promise to quit smoking by signing it. simple indications to help you in your goal. Speaking of the pandemic, the Higher Institute of Health on the occasion of the 2020 anti-smoking day published the results of a survey carried out in April last year. The sense was to grasp the effects of lockdown on the smoking habits of Italians. From survey, carried out through anonymous online questionnaires, it emerged that people who were unable to quit smoking during the period of confinement at home, increased the daily number of cigarettes. And that smokers of traditional cigarettes have decreased but those of heated tobacco and electronic cigarettes have increased.
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Between smoking and Covid
The prevalence of smokers during the lockdown went from 23.3% to 21.9%: 1.4 percentage points less which correspond to about 630,000 fewer smokers (about 334,000 men and 295,000 women). With respect to the age groups, about 206 thousand young people between 18-34 years old, 270 thousand between 35 and 54 years old and about 150 thousand between 55 and 74 years have stopped the consumption of cigarettes. In addition, another 3.5% of the population, while not completely ceasing the consumption of tobacco products, has decreased the quantity consumed.
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