[Influence of tobacco smoking on quality of life in patients with lung cancer]

Tobacco smoking is the leading cause of lung cancer. This cancer is the most specific indicator of the effects of tobacco on health. Regardless of the type of lung cancer and the stage of the disease, continued smoking has a negative impact on its development and its treatment. For this reason, smoking cessation is an essential step in the management of patients with lung cancer who smoke. It has been clearly demonstrated that quality of life is worse in smokers than in non-smokers. The aim of this general review is to study the relationship between tobacco use and quality of life specifically in patients with lung cancer. Among the twelve studies selected, six of them clearly demonstrate a deleterious effect of continued smoking tobacco or a beneficial effect of smoking cessation on the quality of life in patients with lung cancer. These findings should lead clinicians to offer support to smokers with lung cancer in order to assist them to quit smoking.

[Smoking cessation and social deprivation: current state of knowledge and proposals for optimization]

Tobacco smoking is a major public health issue. One in two lifelong smokers will die from a disease related to tobacco use. Recent data show an increase in the prevalence of smoking in the lowest socioeconomic population. It induces a higher morbidity and mortality in this group of people than in the general population; however, stopping smoking induces an equal benefit in terms of reducing disease and mortality for everyone. Improving tobacco control requires a greater understanding of smoking and cessation in this population. The aim of this article is to review the relationship between socioeconomic status and smoking cessation. Outcomes about the intentions and behaviour of stopping and maintaining abstinence are presented. Some ways to improve smoking cessation in lower socioeconomic smokers are proposed.

[Influence of tobacco smoking on the risk of developing asthma]

The aim of this general review is to investigate the influence of active and passive smoking on the development of asthma in children and adults. Passive smoking during and after pregnancy facilitates the onset of childhood asthma and wheezing. In particular, smoking during pregnancy is associated with the occurrence of wheezing prior to the age of 4 years. In contrast, the results of studies on the relationship between parental smoking in the post-natal period and the onset of asthma or wheezing are discordant. Exposure to passive smoking during childhood facilitates the occurrence of asthma in adulthood. In adults and adolescents, active smoking appears to be a factor favoring the development of asthma. On the other hand, non-smoking adult subjects without history of asthma exposed to passive smoking have a risk of asthma. The pathophysiological mechanisms by which tobacco smoke is the cause of asthma are still poorly known. Smoking cessation is an essential component in the management of asthmatic subjects who smoke, facilitating the control of the disease.

[Smoking cessation in smokers with chronic obstructive pulmonary disease]

One out of two smokers who smoke throughout their lifetime will die from a disease related to smoking. Tobacco smoking therefore represents a major global public health issue. Smoking is the leading cause of chronic obstructive pulmonary disease (COPD). Projections for 2020 indicate that by then, COPD will have become the third cause of death and the fifth cause of disability worldwide. Stopping smoking reduces the risk of developing COPD and is an essential treatment for this inflammatory disease. Smoking cessation decreases the prevalence of respiratory symptoms, number of hospitalizations, and decline in FEV1, as well as exacerbation frequency and overall mortality. Among the patients, 38-77% with COPD are smokers. Their daily cigarette consumption and level of nicotine dependence are often high. The combination of high intensity behavioral interventions and medication treatments (nicotine replacement therapy, varenicline, bupropion) is the most effective strategy for smokers with COPD. In contrast, behavioral interventions without medication are not more effective than simple advice to stop. Two factors seem to predict the success of the attempt to quit in smokers with COPD: a strong motivation to quit and the use of smoking cessation medications.

[Cannabis smoking and lung cancer]

Cannabis is the most commonly smoked illicit substance in the world. It can be smoked alone in plant form (marijuana) but it is mainly smoked mixed with tobacco. The combined smoking of cannabis and tobacco is a common-place phenomenon in our society. However, its use is responsible for severe pulmonary consequences. The specific impact of smoking cannabis is difficult to assess precisely and to distinguish from the effect of tobacco. Marijuana smoke contains polycyclic aromatic hydrocarbons and carcinogens at higher concentration than tobacco smoke. Cellular, tissue, animal and human studies, and also epidemiological studies, show that marijuana smoke is a risk factor for lung cancer. Cannabis exposure doubles the risk of developing lung cancer. This should encourage clinicians to identify cannabis use and to offer patients support in quitting.

[Smoking cessation and social deprivation]

Smoking is a major of public health policy issue; one in two lifelong smokers will die from a disease related to tobacco use. In France, smoking is responsible for more than 70,000 deaths every year. The benefits linked to stopping smoking include reduced mortality and morbidity related to the use of tobacco. Recent data show an increase in the prevalence of smoking in the lowest socioeconomic population. Tobacco control needs a better understanding of the determinants of smoking in this population, which are also factors in the failure of cessation attempts. Based on international literature, this review specifies the educational and socioeconomic factors involved in tobacco smoking and in the result of an attempt to quit. Its aim is to propose ways to improve the management of smoking cessation in a socially deprived population.

[Helping the highly dependent smokers]

Many smokers have difficulty in stopping smoking, either motivated to stop or forced for health, economic or statutory reasons. They have in common a heavy tobacco dependence and a high level of cigarette consumption. Often they combined factors impairing success in the attempt to stop smoking : e. g. anxio-depressive disorders, use of psychoactive substances, socio-economic deprivation. Smoking cessation specialists must optimize their interventions in order to improve the care of these highly dependent smokers.

[Variations of time perspective by social deprivation, what are the effects on smoking cessation?]

Smoking represents a major public health problem because of its high morbidity and mortality rates. Nearly half of the deaths in the lower class are caused by smoking. The socially deprived are physically and psychologically vulnerable. The instability of their situation increases the difficulty to invest in smoking cessation and certain time orientations linked to this social deprivation represent negative factors in the prognosis. Socially deprived populations do not understand the consequences of smoking unless they are in denial of the risks. The motivation to stop is essentially financial. The perception of smoking cessation is taken as a deprivation of pleasure. Independently of the social deprivation factors, taking into account the time perspective conveys necessary information of appropriate care.