Prevention of smoking-associated forms of cancer: harm reduction concept
Authors: D.G. Zaridze, A.F. Mukeria
Smoking is the main cause of chronic noncommunicable diseases, mortality from which is 75–80% of total mortality in Russia. At the same time, smoking is number one among the preventable causes of death. Smoking not only increases the risk of cancer, but also affects the survival of cancer patients. Despite the fact that smoking prevalence is decreasing in Russia, 49% of men and 14% of women still smoke. The most effective way to prevent smoking related illness is, to completely, abandon this habit. In the, long run, smoking should be, completely, eliminated. However, in the short term, for smokers with a strong nicotine addiction who cannot give up smoking, it is advisable to switch to electronic nicotine delivery systems (ENDS). ENDS aerosol contains significantly less toxic and carcinogenic substances than cigarette smoke and most likely does less harm to consumers than cigarettes. Given the effectiveness of ENDS for smoking cessation, the transition to them for many smokers will be only a stage for a complete cessation of smoking. For cancer patients, the transition to ENDS eliminates the negative effect of smoking on the outlook. The Russian experience presented in the review of reducing tar levels in cigarettes, which was accompanied by a drop in mortality from lung cancer and other cancers associated with smoking; a decrease in lung cancer mortality among young British men who switched to filter cigarettes; epidemiological studies that proved that lung cancer risk depends on the level of tar confirm that tobacco harm reduction leads to a decrease in the incidence and mortality from cancers caused by smoking. Evidence-based prevention is the most effective method for reducing mortality from all causes.