No help for tobacco withdrawal worldwide

    

    

Doctors newspaper online, 26.07.2019

    

        
        
        

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World Tobacco Report

Tobacco use is harmful, stopping is good for your health. Who smokes, knows that mostly, but getting out is still hard. The World Health Organization has concrete ideas that can help.

Whether it is a home-made or a cigarette packet: Worldwide, there is no help in quitting nicotine addiction – even in Germany, the WHO complains in its latest World Tobacco Report.

© Robert Schlesinger / zb / dpa

Although non-smoker protection is growing worldwide and smoking is becoming more expensive and more difficult in most countries – but there is still a lack of help with weaning. This is the conclusion of the World Health Organization (WHO) in its new World Tobacco Report. She introduced him on Friday in Rio de Janeiro, because Brazil is only the second country in the world after Turkey that has fully implemented all of WHO's recommended tobacco control measures. Not only can tobacco be smoked, it can also be snorted or chewed.

In Germany, the WHO criticizes that there are still too few strict rules for smoke-free public spaces. She also sees a need to catch up with helping smokers who want to get rid of nicotine addiction. Likewise, there must be more effective campaigns against smoking in the media. Advertising bans should be tightened and taxes increased.

"Quit smoking is one of the best things one can do for one's own health," said WHO boss Dr. Tedros Adhanom Ghebreyesus.

Eight Million Tobacco Deaths

Further Facts and Figures from the WHO Report:

• The proportion of smokers in the total population is falling worldwide. However, population growth remains constant at around 1.1 billion.
• Eighty percent of smokers live in low- and middle-income countries.
• Eight million people die from tobacco use every year.
• The economy is losing $ 1.4 trillion a year in health costs and lost work.
• Europe's statistics show that in Georgia, nearly 57 percent of men smoke (2016), in Germany 29 percent (2013) and in Iceland 15 percent (2015).
• Six out of ten people live in countries that have taken at least one measure against tobacco use. This is four times as many as in 2007. Almost half of the people live in countries that have "nausea-pictures" on packs.
• However, only 2.4 billion people live in countries that support people who smoke with tobacco

For this support, the WHO recommends, for example, hotlines for instant telephone counseling or the corresponding online or mobile services. In addition, family doctors should address smokers and point out aids in quitting. For this, experts recommend the "Five A of minimal intervention" (see box). Also, nicotine replacement therapies should be funded, writes the WHO. Handicap in Germany: So far, drug support by the so-called "Lifestyle Paragraph" 34 in SGB V is exempted from the reimbursement. The treatment of tobacco dependence is one of the most cost-effective measures, and thus higher consequential costs could be prevented by treatments for smoking-related diseases.

WHO warns against cigarette replacement

Incidentally, WHO also warns in its report about cigarette substitutes, such as e-cigarettes and products that heat tobacco instead of burning it. All are harmful to health.

Just last week, the German Cardiac Society – Cardiovascular Research also critically commented on e-cigarettes and tobacco heaters. The company complained that statements on the harmfulness of health were only conditionally resilient, since there were no well-founded results on the long-term effects of e-cigarettes. However, there are first disturbing indications of serious late damage caused by e-cigarettes, explained Professor Harm Wienbergen in a statement from the company.

The Society also criticized studies that use e-cigarettes and tobacco heaters as aids to weaning. In February, a study by British researchers led by Professor Peter Hajek of the Queen Mary University of London attracted attention that claimed that electronic inhalation products were twice as effective as smoke evacuation aids than the nicotine replacement products recommended by the guidelines ( N Engl J Med 2019, online January 30 ). But actually, the study results suggested the exact opposite.

Not for weaning

Scientists investigated whether more smokers succeed in quitting smoking by using nicotine replacement products (NRTs) or e-cigarettes instead. Result: with e-cigarettes, 18 percent of smokers were able to exit, with NRT managed to ten percent. Hajek and colleagues concluded that "e-cigarettes are more effective in smoking cessation than nicotine replacement products."

The fact that this statement is simply false is clear when you look at the results on nicotine abstinence: 80 percent of the subjects who had denied their smoking cessation with the e-cigarette still used it after one year. Of the group of participants who had used NRT, nine percent still used the tool.

The conclusion of the study should therefore be rather: Four percent of e-cigarette users overcame their nicotine addiction compared to nine percent of smokers with NRT. When it comes to success in coping with addiction, NRTs are the better tool. (mmr / dpa)

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