Leaving aside other major diseases, like airways disease and heart disease, ceasing to smoke will prevent the development of many lung cancers, mouth and throat cancers and bladder cancers. We would also expect to see reductions in kidney cancer and invasive prostate cancers. Stomach, pancreas and bowel cancers would be less frequent and even the incidence of lymphomas and leukaemias should decrease.
There must be several parts to a strategy to prevent smoking. Clever advertising that targets vulnerable groups such as adolescents must be limited. The power of advertising has been adequately demonstrated by the way the social customs of women have changed from non-smoking to smoking, with the subsequent impact on their death rate from lung cancer.
At the same time as decreasing advertising, public education about the dangers of smoking must be increased. Non-smokers must be protected from the harmful effects of passive smoking by limiting smoking in enclosed spaces. Many offices and public transport vehicles in various parts of the world ban smoking. This is not necessarily because of enlightenment, but fear of litigation due to the harmful effects of passive smoking. Nonetheless, it has been an important step.
Education of individuals who give up smoking is important. Cutting down on the number of cigarettes smoked is not a good strategy. There is an addiction to nicotine which means that at times of stress the number of cigarettes is likely to climb again. Indeed, ‘stress’ is sometimes being caused by the nicotine withdrawal and responds to nicotine. Nor is changing to low-tar cigarettes very successful because it leads to longer and deeper inhaling to achieve the same fix. Also, the same cancer-causing chemicals are still being inhaled.
Patients should be encouraged to stop smoking right away rather than putting it off. They will need support, perhaps from a quit program, and may be helped by replacement nicotine as patches or gum. Negative perceptions about giving up should be countered. Weight gain, for example, is not mandatory unless food is sought as solace for the lack of cigarettes.
Positive benefits of giving up include having extra money for other pursuits. Even the old tale that there is no point to cancer patients giving up since it is like closing the stable door after the horse has bolted is incorrect. The chances of head and neck and lung cancer recurring may be decreased by stopping smoking.
Chewing tobacco, a habit of some sportsmen, is also dangerous because it exposes the lining of the mouth to cancer-causing agents. In India, tobacco and betel nut are often combined in the mouth and both can promote cancer.