Smoking cessation: a European perspective

Eva Králíková, Guest Editor

Institute of Hygiene and Epidemiology, and Tobacco Dependence Treatment Centre of the 3rd Medical Department, First Faculty of Medicine, Charles University and the General University Hospital of Prague

 

Burden of disease

The medical community has only recently begun to accept tobacco dependence as a disease rather than a vice. The rate of clinical acceptance is slow, given that the World Health Organization (WHO) recognized tobacco dependence as a condition in its own right in 1992 in its International Classification of Diseases (ICD-10) (WHO 1992).

Tobacco dependence is a chronic, relapsing disease. In 2003, the WHO estimated that tobacco use would be responsible for approximately 5 million deaths worldwide. At the time of estimation, tobacco use was already responsible for 1 in 10 adult deaths, a figure that is expected to rise to one in six by 2030 (WHO 2003). If current trends persist, more than half a billion people will die through tobacco dependence this century (WHO 2003). In 2000 alone, tobacco use was responsible for 655,000 deaths among the European Union’s (EU) 25 member states. The main causes of death included: cancers (285,000); cardiovascular disease (183,000); respiratory disease (113,000) and various other conditions (74,000) (Peto et al 2006).

Despite high tobacco-related mortality rates, a significant proportion of smokers fail to recognize or accept the dangers of their tobacco dependence. Moreover, many remain unaware that intensive treatment is available that could significantly improve their chances of quitting successfully. In Europe, the United Kingdom (UK) leads the way in smoking cessation provision through its National Health Service (NHS). Unfortunately, the benefits of smoking cessation as an effective healthcare intervention are not equally recognized throughout all EU member states. While some countries offer support as part of their normal healthcare systems, it is sadly not the case across the continent.