Smoking cessation as a therapeutic and preventive intervention: a meeting report

In November 2000, a meeting took place on "Smoking cessation as a therapeutic and preventive intervention". The venue of the meeting was Venice, in the old Monastery of the Isola San Giorgio, and it was jointly organised by the Italian Association of Hospital Pulmonologists (AIPO) and the European Section of the Society for Research on Nicotine and Tobacco (SRNT--Europe). The meeting was also sponsored by the European Respiratory Society (ERS). The importance of the topic cannot be underestimated. According to the World Health Organisation (WHO) tobacco smoking is the most important cause of preventable death in the industrialised world. When tobacco smoking constitutes a repetitive and compulsive behaviour, for instance when a person continues smoking when suffering from a smoking related disease, it is due to tobacco dependence, which both WHO and the American Psychiatric Association classify as a disease. Tobacco smoking is not only a disease in itself but can also cause other diseases, such as chronic obstructive lung disease, lung cancer and cardiovascular disease, and can worsen pre-existent disease, e.g. asthma. In the WHO European region, according to WHO estimates, tobacco smoking causes at least 1,200,000 deaths each year (14% of all deaths). So far, a preventive strategy based on protection of children and adolescents from initiation has not worked in decreasing the prevalence among young generations. Even with the best educational programs success is partial and ephemeral. Smoking cessation with behavioural and pharmacological aid is a well established therapeutic intervention, supported by strong scientific evidence. But smoking cessation can also be a preventive intervention, because it can reduce the prevalence of smokers in a community. Obviously, smoking cessation is to be used together with all other interventions recognized as effective in tobacco control (cigarette and tobacco product pricing, regulatory approaches, smoking bans, health education).