Editorial

By Hrubá, Drahoslava | Central European Journal of Public Health, March 2012 | Go to article overview

Editorial


Hrubá, Drahoslava, Central European Journal of Public Health


More than 60 years ago, in 1951, two important epidemiological studies introduced by R. Doll et al., and J. Wynder et al., using modern scientific approach demonstrated clear relationship between smoking and lung cancer. More than 10 years later, the U.S. Surgeon General's Report on Smoking and Health described in a more comprehensive way serious damages of human health caused by smoking. In 1988, another U.S. Surgeon General's Report branded smoking as a highly addictive behaviour, and nicotine as a strong psychoactive substance with similar potency to develop dependence as heroine and cocaine. Each year, hundreds of studies present new results about - formerly not anticipated - risks of smoking for health. The newest research described nicotine as a human neuroterratogen with significant potency to increase the risks of conduct and cognitive disorders, ADHD and vulnerability to drug abuse and addiction among children exposed in utero. According to FOAD hypothesis (fetal origin of adult disease), maternal smoking during pregnancy causes permanent fetal adaptation to sub-optimal uteral environment in structure, physiology, and metabolism. Such re-programming is beneficial for short-term fetal survival but might be the risk for obesity, type 2 diabetes, and cardiovascular diseases in adulthood. A substantial progress has been made in knowledge about health risks of smoking for children and adults involuntarily exposed to environmental tobacco smoke (secondhand, thirdhand smoke).

This special issue of the Central European Journal of Public Health includes some new aspects of smoking. Toxicological methods evaluated and described variations in nicotine yields in particular cigarettes (Goniewicz M. et al.), and also large variability in lead and arsenic content in tobacco and cigarettes (Lazarevic K. et al.). These findings influence the level of smokers' exposure to harmful bioactive chemicals, which are associated with specific, direct health risks. Authors propose continual monitoring of levels of some important chemical compounds to improve more accurate exposure evaluation.

The results of the experimental study have found clear inflammatory and cytotoxic responses in lung tissues after exposure of bronchoalveolar cells to particulate matters corresponding to daily smoking of 8 cigarettes. The study contributes to understanding of the pathways of lung injury at the beginning of disease development (Hurbánková M. et al.).

Commonly accepted theses that smoking damages not only active but also passive smokers, sustain two epidemiologic studies from Serbia: exposure to environmental tobacco smoke enhanced the frequency of respiratory symptoms and illness among women and their more frequent absences from work (Stankovic A. et al.). Significantly higher number of cases of wheezing, bronchitis, headache, and fatigue have been found in children exposed to household smoking (Stosic L. et al). Higher morbidity of children caused by parental smoking at homes and cars is really serious problem, as legislative bans of smoking in public places are not applied for private environment. Involuntarily exposed children cannot leave polluted spaces and protect themselves from dangerous chemicals.

Tobacco control strategies were developed and declared in the WHO Framework Convention on Tobacco Control (WHO FCTC). This document offered wide range of information and recommendations to governments, non-government organizations, and health professionals. Many countries worldwide have ratified FCTC and implemented the recommendations into their national anti- tobacco laws; in European Union, only politics from the Czech Republic refused ratification. Many countries have made progress in adopting legislation for tobacco control, however, the tobacco epidemic continues. The tobacco industry has launched multimillion dollar campaigns to combat rules and laws for tobacco control.

As some publications in this special issue described, the results of implemented tobacco control are inconclusive (Padjenl. …

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