European Code against Cancer, 4th Edition: Tobacco and cancer.
Tobacco use, and in particular cigarette smoking, is the single largest preventable cause of cancer in the European Union (EU). All tobacco products contain a wide range of carcinogens. The main cancer-causing agents in tobacco smoke are polycyclic aromatic hydrocarbons, tobacco-specific N-nitrosamines, aromatic amines, aldehydes, and certain volatile organic compounds. Tobacco consumers are also exposed to nicotine, leading to tobacco addiction in many users. Cigarette smoking causes cancer in multiple organs and is the main cause of lung cancer, responsible for approximately 82% of cases. In 2012, about 313,000 new cases of lung cancer and 268,000 lung cancer deaths were reported in the EU; 28% of adults in the EU smoked tobacco, and the overall prevalence of current use of smokeless tobacco products was almost 2%. Smokeless tobacco products, a heterogeneous category, are also carcinogenic but cause a lower burden of cancer deaths than tobacco smoking. One low-nitrosamine product, snus, is associated with much lower cancer risk than other smokeless tobacco products. Smoking generates second-hand smoke (SHS), an established cause of lung cancer, and inhalation of SHS by non-smokers is still common in indoor workplaces as well as indoor public places, and more so in the homes of smokers. Several interventions have proved effective for stopping smoking; the most effective intervention is the use of a combination of pharmacotherapy and behavioural support. Scientific evidence leads to the following two recommendations for individual action on tobacco in the 4th edition of the European Code Against Cancer: (1) "Do not smoke. Do not use any form of tobacco"; (2) "Make your home smoke-free. Support smoke-free policies in your workplace".
International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69008 Lyon, France. Electronic address: secretariat-cancer-code-europe@iarc.fr.
Maria E
ME
Leon
Tobacco Free Initiative, Department of NCD Prevention, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland.
Armando
A
Peruga
National Addiction Centre, UK Centre for Tobacco and Alcohol Studies (UKCTAS), Institute of Psychiatry, King's College London, 4 Windsor Walk, London SE5 8AB, United Kingdom.
Ann
A
McNeill
Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic; Centre for Tobacco-Dependent Patients, Third Department of Medicine - Department of Endocrinology and Metabolism, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic.
Eva
E
Kralikova
International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69008 Lyon, France.
Neela
N
Guha
Piedmont Centre for Cancer Prevention, AOU Città della Salute e della Scienza di Torino, Turin, Italy.
Silvia
S
Minozzi
International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69008 Lyon, France.
Carolina
C
Espina
International Agency for Research on Cancer (IARC), 150 Cours Albert Thomas, 69008 Lyon, France.
Joachim
J
Schüz
D000328:Adult; D002273:Carcinogens; D005062:European Union; D017408:Guidelines as Topic / Q000592:standards*; D006801:Humans; D009369:Neoplasms / Q000209:etiology / Q000517:prevention & control*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation; D014026:Nicotiana
D002273:Carcinogens
Cessation; Europe; Lung cancer; Nicotine; Primary prevention; Second-hand smoke; Smoke-free home; Smokeless; Smoking; Snus