The oncologist spoke about the catastrophic consequences of stopping the fight against smoking

The number of lung cancer diagnoses may soon rise sharply

Famous Russian oncologist David Zaridze believes that the fight against smoking in Russia has gone downhill. And if you do not take emergency measures, soon the number of oncological diagnoses will begin to go off scale. He proposes to include medical assistance in quitting addiction in clinical guidelines and to treat nicotine addiction according to compulsory health insurance.

Famous Russian oncologist David Zaridze believes that the fight against smoking in Russia has gone downhill. And if you do not take emergency measures, soon the number of oncological diagnoses will begin to go off scale. He proposes to include medical assistance in quitting addiction in clinical guidelines and to treat nicotine addiction according to compulsory health insurance.

Corresponding Member of the Russian Academy of Sciences, Professor David Zaridze believes that the most promising areas for cancer prevention today are smoking cessation, reduced alcohol consumption and vaccination against carcinogenic viruses. The most effective way to reduce morbidity and mortality is smoking cessation. “However, unfortunately, the decrease in the prevalence of smoking in Russia is extremely slow, and in recent years it has completely stopped. Thus, the frequency of smoking among Russian women, which has been gradually decreasing since 2009, has risen again and returned to the figure of 2009, i.e. to 21% – these are the data of VTsIOM. These figures are confirmed by the increase in the incidence of lung cancer: since 2012, the incidence among women began to increase for the first time since 1993, and by 2018 it increased by 29%,” says Professor Zaridze.

The expert notes that the state of smoking prevention among men does not arouse enthusiasm either. From 2009 to 2016, the prevalence of smoking among men decreased to 47% and remained unchanged in subsequent years. At the same time, according to David Zaridze, the reduction in incidence and mortality from lung cancer since 1993 is the result of a decrease in the concentration of tar in the tobacco smoke of Russian cigarettes, i.e. reduce the harm of smoking, and therefore in no way reflects the dynamics of smoking in our country. “The sale of cigarettes in Russia more than doubled between 1996 and 2006, and the incidence and mortality from lung cancer were declining. All of the above indicates, to put it mildly, a “stagnation” in the prevention of smoking in the country and casts doubt on the possibility of achieving the goal set by the President of Russia to reduce mortality from neoplasms,” the expert says.

What to do? “We must continue to focus on reducing the prevalence of smoking. First, it is required to improve the tax policy, namely, to increase the excise rate on cigarettes. This measure, according to WHO, is the most effective in the fight against smoking. Secondly, it is necessary to create a network of affordable medical centers for the treatment of tobacco (nicotine) addiction, staffed by qualified narcologists and psychotherapists; thirdly, to treat nicotine addiction according to compulsory health insurance. Considering that, according to the results of studies conducted in the Department of Clinical Epidemiology of the N.N. N.N. Blokhin, smoking not only causes cancer, but also negatively affects the prognosis of patients with lung and kidney cancer, smoking cessation should be included in clinical recommendations. Smoking cessation of patients should become an obligatory component at all stages of anticancer therapy. Oncologists in collaboration with psychotherapists and narcologists should motivate their patients, help them quit smoking, offering various methods of nicotine replacement therapy and nicotine replacement,” continues David Zaridze.

Another risk factor affecting cancer statistics in the country is alcohol abuse. According to the Minister of Health Mikhail Murashko, over the past 10 years, alcohol consumption in Russia has decreased by about a third in terms of ethanol (from 15.7 liters to 9.1 liters). However, alcohol continues to have a “colossal” impact on the mortality of the Russian population, especially for men. “Alcoholic” contribution to male mortality in the country is up to 75%. In addition, 80% of the working population in Russia has more than one risk factor for developing non-communicable diseases, among which is excessive consumption of alcohol and tobacco.

What to do in this situation? Zaridze believes that it is necessary to tighten the control of alcohol circulation, to develop and implement evidence-based recommendations for the safe consumption of alcohol, based on WHO recommendations. In addition, the oncologist proposes to introduce mass vaccination against viruses that affect the development of certain types of cancer (for example, human papillomavirus). “It is necessary to solve as much as possible the issue of organizing mass HPV vaccination of adolescents aged 9–14 years and screening based on HPV DNA testing 2 times during life, at 35 and 45 years. Such a measure will significantly reduce the incidence and mortality from cervical cancer and other cancers associated with the human papillomavirus,” says David Zaridze.

Published in the newspaper “Moskovsky Komsomolets” No. 28881 dated October 3, 2022

Newspaper headline:
The country is smoking again