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Smoking cessation measures get tougher

No smoking symbol aids smoking cessation strategies

No smoking symbol: the UK banned smoking in public places several years ago

The Lancet Respiratory Medicine April 2013 issue

The Lancet Respiratory Medicine April 2013 issue

The Lancet Respiratory Medicine’s article “The UK walks the walk in the war against tobacco”, looked at the achievements made by Britain compared to other countries and its plans for the immediate future.

Dr Neal Navani, who was asked to contribute expert comment for the feature, supports the use of a rage of smoking cessation strategies in individual patients.

Plain cigarette packaging to be introduced in Scotland

Dr Navani welcomes the move by the Scottish Government, announced at the end of March, to put cigarettes and other products in plain packets with no branding, just prominent health warnings. Australia made plain packaging legal last year and more countries are expected to follow suit, including other parts of the UK.

Data on the real-life effects is being collected but a considerable amount of evidence already exists that using plain packaging changes smoking rates and perceptions, particularly in young people. This is based on interviews with smokers, including major projects done at Stirling University and Bristol University.

Smoking cessation aids

Many smokers find it helpful to use products such as nicotine gum, nicotine patches and the newer electronic cigarettes, which deliver nicotine but not the other tobacco ingredients directly into the lungs. Dr Navani supports the use of different aids and says that their benefits by far outweigh their risks when compared to the harm caused by continued smoking.

Reducing passive smoking

The Lancet Respiratory Medicine article describes recent research that shows Britain leading the way in the fight against smoking. However, there is still the need to take things further and Dr Navani welcomes efforts to reduce children’s exposure to second hand smoke, particularly in the home and in private cars.

He also agrees with some NHS Trusts that are banning smoking anywhere on their premises, including grounds and car parks. Hospitals are already technically smoke-free zones but many smokers flout the rules and smoke close to entrances and in car parks, prompting a stricter ban by some authorities.

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Lung cancer screening recommended in the USA

Lung cancer screening recommended in the USA

The National Health Service in the UK does not currently perform lung cancer screening but it is available in the private sector. Evidence for its benefits have been growing for some time and, in May 2012, four major learned societies reviewed three of the largest and most highly regarded recent trials, concluding that early lung cancer detection through CT screening did help boost survival rates.

The four societies involved, the American Society of Clinical Oncology (ASCO), the National Comprehensive Cancer Network (NCCN), the American Cancer Society (ACS) and the American College of Chest Physicians (ACCP) looked several studies, but the largest was the National Lung Screening Trial.

This followed a huge number of patients – over 53,000 – which means that its findings are likely to be accurate. The researchers found that screening annually using CT scans reduced the risk that people with lung cancer would die of their disease earlier.

In the USA, heavy smokers aged between 55 and 74 are now screened for signs of lung cancer using low dose CT scans every year. If anything suspicious is detected, they are then followed up quickly and treated.

The recommendations made by the US-based experts stress, however, that screening should always be carried out by doctors who have good experience in detecting early stage lung cancers.



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Adults in the developing world are big smokers

The Global Adult Tobacco Survey took a detailed look at adult tobacco use in 14 low and middle-income countries.

An X-ray of the chest showing smoke curling through the airways

Until now, very little has been known about how people in China, Turkey, Mexico, Bangladesh, the Philippines, Brazil, the Ukraine, Egypt, Russia, India, Thailand, Poland Vietnam and Uruguay use tobacco products on a daily basis. In total, that means 852 million smokers worldwide, with China topping this particular list with 301 million smokers.

A much higher number of men in these countries (48.6%) were using tobacco, but only 11.3% of women reported doing so. One of the highest rates of men’s smoking was seen in Russia, where 60.2% said they smoked. In Egypt, only 0.5% of women were smokers.

Very few adults in these regions of the world are motivated to stop smoking with quit rates across the board standing at less than 20%. There were also signs, when findings were compared to previous surveys that now, women and men start smoking at around the same age. In the past, women started smoking later.

Taken as a whole, the report paints a depressing picture of smoking rates in middle and low-income countries, highlighting the need for urgent and effective smoking cessation programmes.



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