Cigarette smoking constitutes a huge and growing public health burden globally. Currently, millions of people die annually due to tobacco smoking, and the estimates based on current trends indicate that this number will increase in the next 20 years. Tragically, an increasing number of deaths will occur in low- and middle-income countries. Physicians are aware that tobacco smoking is not only the major environmental factor related to lung diseases but is also the main potentially preventive cause of lung disease. In this sense, the last issue of the series Hot Topics in Respiratory Medicine provides an extensive report that briefly comprises the current knowledge required to develop an optimal and updated clinical practice on tobacco cessation.
In the first chapter, Dr. L. Shahab, a recognized epidemiologist, nicely analyzes the sociodemographic and cultural aspects of tobacco consumption. After a brief history of smoking practices and a review of the economic and psychological aspects of smoking, including nicotine dependence, the author describes smoking prevalence and its secondary costs and suggests some measures to implement effective tobacco control policies.
The second chapter focuses on specific aspects of smoking habits in our respiratory patients. Connecting to this issue, Dr. C. A. Jiménez-Ruíz analyzes smoking characteristics and provides a most effective assessment of the major diseases directly caused by chronic tobacco consumption: chronic obstructive pulmonary disease and lung cancer. Finally, the author proposes some therapeutic interventions and practical recommendations based on his own experience as well as the most relevant studies to date.
The third and final chapter complements the previous one by analyzing the pharmacological agents available to treat smoking dependence on that subgroup of patients. Drs. M. A. Chandler and S. I. Rennard report on this difficult issue in an updated and comprehensive manner. After describing both nicotine and non-nicotine replacement therapy (mainly bupropion and varenicline), the authors analyze the cost-effectiveness ratios of these interventions, to end up with an interesting review concerning future directions on smoking cessation pharmacotherapy.