2 96
five
As
(ask,
advise,
assess,
assist,
arrange)
and
the
Ask,
Advise,
and
Connect method
that
encourage
quitting
and
the
use
of
effective
cessation
treatments
can
increase
quit
rates.
Tobacco
control
has
made
a
unique
and
substantial
contribution
to
public
health
over
the
past
half
century.
However,
despite
the
success
of
tobacco
control
efforts
in
reducing
premature
deaths,
smoking
remains
a
significant
public
health
problem.
Although
global
estimated
age-
standardized prevalence of daily
tobacco
smoking declined
by
25%
for men
and
by
42%
for women
between
1980
and
2012,
substantial
population
growth
over
this
period
contributed
to
a
41%
increase
in
the
number
of male
daily
smokers
and
a 7%
increase
of
female
smokers.
The number
of cigarettes
consumed worldwide
increased by 26% during
the
same period, confirming
that
the global
tobacco market
continues
to
grow
[3].
In
the
United
States,
since
the
first
Surgeon
General’s
Report
on
Smoking
and Health
(issued
on
January 11, 1964),
smoking
rates
have
decreased
by
more
than
half
(from
42.4%
in 1965
to 18%
today)
and per
capita
consumption of
cigarettes
by
>
70%.
This
is
not
the
case
for
Europe
with
some
countries
like
Austria
and
Croatia
even
seeing
a
relative
increase
in
the
prevalence
and
rate
of
smoking.
In
Europe,
variations
in
laws
and
behaviors
have
allowed
somewhere between a
third and a
fifth of adults
to continue
smoking,
and
smoking
continues
to
claim
hundreds
of
thousands of
lives annually. No other behavior
comes
close
to
contributing
so
heavily
to
the
mortality
burden
of
Western
countries.
A potential
factor
that may offset
the
gains
estimated
in
this
study
is
the
recent
increase
in use,
particularly
among
young
adults,
of
noncigarette
forms
of
tobacco
such
as
smokeless
tobacco,
cigars,
hookahs,
and
e-cigarettes.
If
these
products
are
used
instead
of
cigarettes,
the
adverse
health
effects
are
likely
to be
considerably
less
than
that of
cigarettes. However,
if used
in
combination with
cigarettes,
these
products may
offset
some
of
the
potential
benefits,
especially
as
these
young
adults
reach
ages when
smoking
begins
to
claim
its
toll.
Past
successes
of
tobacco
control
have
relied
primarily
on
tax
increases, media
campaigns,
laws
regulating
smoke-free
air,
and
advertising
bans.
As
urologists,
we
must
accept
the
responsibility
and
better
counsel our patients about
the detrimental effects of
smoking
and
assist
them
in
cessation
efforts
to
improve
their
health
and
lives.
Too many
of
our
patients
have
been
maimed
or
have
died
prematurely
from
smoking.
Tobacco
use
still
remains
the
leading
cause
of
preventable
death
in
Europe.
This
is
a winnable
fight,
and we
need
to
be
on
the
frontlines
fighting
for
our
patients
against
tobacco
con-
sumption. We
need
to
eliminate
the
use
of
cigarettes
and
create
a
tobacco-free
generation!
Conflicts
of
interest:
The
authors
have
nothing
to
disclose.
References
[1]
Centers for Disease Control, Prevention (CDC). Annual smoking- attributable mortality, years of potential life lost, and economic costs–United States, 1995–1999. MMWR Morb Mortal Wkly Rep 2002;51:300–3.[2]
Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ 2004;328:1519.[3]
Ng M, Freeman MK, Fleming TD, et al. Smoking prevalence and cigarette consumption in 187 countries, 1980–2012. JAMA 2014; 311:183–92.[4]
The ASPECT Consortium. Tobacco or health
in
the European Union:
past,
present
and
future.
Luxembourg:
Office
for
Official
Publica-
tions
of
the
European
Communities;
2004.
European
Commission
Web
site.
http://ec.europa.eu/health/ph_determinants/life_style/ Tobacco/Documents/tobacco_fr_en.pdf.
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