1 96
Focus
Editorial
There
Are
Cooler Ways
to Die
Than
Smoking: Urologists
of
the
World, Unite Against
This Health
Care
Tragedy
Shahrokh
F.
Shariat
a , b , c , * ,James W.
Catto
d ,Tobias Klatte
a ,Gianluca
Giannarini
e ,Alberto
Briganti
fa
Department
of Urology,
Comprehensive
Cancer
Center, Medical
University
of
Vienna,
Vienna
General Hospital,
Vienna,
Austria;
b
Department
of Urology,
Weill
Cornell Medical
College,
New
York-Presbyterian
Hospital,
New
York,
NY,
USA;
c
Department
of
Urology,
University
of
Texas
Southwestern Medical
Center, Dallas,
TX, USA;
d
Academic Urology Unit, University
of
Sheffield,
Sheffield, UK;
e
Urology Unit,
Academic Medical
Centre Hospital
Santa Maria
della
Misericordia, Udine,
Italy;
f
Department
of Urology,
Urological
Research
Institute,
San
Raffaele
Scientific
Institute, Milan,
Italy
Tobacco
use
is
a
major
preventable
cause
of
premature
death
and
disease
worldwide.
Smoking
is
the
best
established
individually
amenable
risk
factor
for
the
development of
>
18
types of
cancer
and
the
cause of death
from
many
nonmalignant
diseases.
A
robust
body
of
evidence
today
documents
the
health
consequences
both
from
active
smoking
and
exposure
to
secondhand
smoke
across
a
range
of
diseases
and
organ
systems,
especially
cancers.
There
is
strong
evidence
that
tobacco
has
the
potential
to harm nearly every human organ. Approximate-
ly
5.4 million
people
die
each
year
due
to
tobacco-related
illnesses,
a
figure
expected
to
increase
to
>
8 million
a
year
by
2030.
In
the
United
States,
the
Centers
for
Disease
Control
and
Prevention
estimates
that
443 000
citizens
die
each
year
from
smoking-related
illnesses,
and
each
day,
thousands
of
teenagers
try
their
first
cigarette.
In
the
enlarged
European
Union
(EU25),
smoking
kills
>
650 000
people
every
year,
and
13
million
Europeans
currently
have
tobacco-related
chronic
diseases.
If present patterns of use persist,
tobacco use could cause
as many
as
1
billion
premature
deaths
globally
during
the
21st
century.
Male
and
female
smokers
lose
an
average
of
13.2
and
14.5
years
of
life,
respectively
[1,2].
In
the
United States alone,
the direct medical costs of smoking add
up
to
>
$130
billion
per
year,
along
with
$150
billion
in
annual
productivity
losses
from
premature
deaths
[3].
In
the EU25 countries,
the annual economic cost of
smoking
is
somewhere
between
s
97.7
and
s
130.3
billion
[4] .These
sobering
statistics underline
the urgent need
to
reduce
the
morbidity
and mortality
from
tobacco use.
It unfortunately
remains one of
the most
important public health challenges
of
the
last
and
current
century.
That
is
why
we
decided
to
dedicate
the
first
issue
of
EU
Focus
to
the
effects
of
smoking
on
urologic
health.
This
topic
should
underline
and
enforce
the
aims
of
this
new
journal:
to
help
integrate
teaching
and
learning,
advance
the
knowledge base
through
research
and
scholarship,
and
provide
leadership
in
service and outreach. We
see
it as our
obligation
to
raise
the
awareness
that
smoking
remains
a
leading
contributor
to
urologic
health
problems
and
premature
death. As
outlined
in
the
elegant
articles
in
this
issue,
smoking
is
associated
with
the
development
and
prognosis
of
prostate,
bladder,
and
renal
cell
carcinoma.
In
addition,
smoking
leads
to
erectile
dysfunction,
and,
although
there
is
heterogeneous
evidence,
it
seems
to
be
associated
with
lower
urinary
tract
symptoms
including
benign prostate hyperplasia,
chronic prostatitis, and
chron-
ic
pelvic
pain
syndrome.
It
is
evident
that
smokers
today
have
a much
higher
risk
of
developing
urologic
diseases
than
smokers
in
the 1960s, probably because of
changes
in
the
design
and
composition
of
cigarettes
over
time.
What
can we as health
care providers and
researchers
in
urology
do? We must
counsel
our
patients
regarding
the
detrimental
effects
of
smoking
because
by
not mentioning
it
we
signal
our
acceptance. We
also
need
to
assist
our
patients
in
their
attempts
to
stop
smoking.
For
many
patients, a cancer diagnosis
represents a
teachable moment
to
quit
smoking
successfully.
In
addition,
urologic
patients
are willing
to
quit
smoking with
some
education
and
help
from
their
physicians.
Physician
interventions
such
as
the
E U R O P E A N U R O L O G Y F O C U S 1 ( 2 0 1 5 ) 1 – 2ava il abl e
at
www.sc iencedirect.comjourna l
homepage:
www.europeanurology.com* Corresponding
author. Department
of Urology, Medical University
of
Vienna, Wa¨hringer Gu¨ rtel
18-20,
A-1090
Vienna,
Austria.
Tel.
+43
1
40400
26150;
Fax:
+43
1
40400
23320.
address:
sfshariat@gmail.com(S.F.
Shariat).
http://dx.doi.org/10.1016/j.euf.2014.12.0042405-4569/
#
2015
European
Association
of Urology.
Published
by
Elsevier
B.V.
All
rights
reserved.