[Tobacco and nicotine prevention-Safeguarding the future of Germany]

Tobacco smoking is still one of the most important avoidable risk factors for early morbidity and mortality. Smokers lose roughly one decade of life, whereas the cessation of smoking leads to an increase in the quality of life and years of life. In Germany the life expectation is disproportionately low in view of the well-developed social security system and the number of heathy years is reduced in the younger generations. An essential reason is considered to be the previous focus on curative instead of preventive medicine, among others caused by the lack of a superordinate strategy for prevention. In the past measures for individual prevention were shown to be less effective than measures for behavioral prevention, such as tobacco tax and smoking bans. The cessation of smoking is an essential component of secondary prevention but is currently insufficiently promoted and implemented by those responsible in the healthcare system and is additionally poorly funded. New products containing nicotine are infiltrating the market, which among other things are unsuitable for smoking cessation due to the high potential for dependency and the cardiovascular and pulmonary risk profiles. Additional measures, such as the limitation of the influence by the tobacco industry, the implementation of the "Strategy for a tobacco-free Germany 2040" and the complete remuneration of costs for tobacco cessation are necessary in the future to fulfil the minimum standard for prevention, to sustainably reduce the foreseeable cost explosion in the healthcare system and to enable a sustainable society.