Smoking is the second most common cause of death in the world. Among the dangerous consequences of smoking are at least 17 cancers, lung cancer first and foremost, followed by cancers of the oral cavity and throat, esophagus, pancreas, colorectal, bladder, prostate, kidney, breast, ovaries and some leukemias. Smoking is also linked to cardiovascular (myocardial infarction) and cerebrovascular (cerebral stroke) diseases, asthma, chronic obstructive pulmonary disease, periodontitis, infertility in women, impotence in men and many other disorders.

Dr. Giulia Veronesi, Head of the Robotic Surgery – Thoracic Surgery Section at Humanitas, guest in the studio at La7, L’ora della salute, spoke about the fight against smoking and the importance of early diagnosis of lung cancer.


Carcinogenic substances contained in cigarettes

“Contrary to what some people think, nicotine is not the carcinogenic substance contained in cigarettes. Tar and the thousands of other substances that are released from the combustion of tobacco are carcinogenic. Nicotine is an alkaloid contained in tobacco leaves and biologically serves to protect plants from herbivores because it is a toxic substance. In smaller doses however, it activates some neurotransmitters in the brain, which is why it has been used to develop addiction in cigarette smoke,” explains Dr. Veronesi.

“The addiction that is established is physical and psychological and suspended nicotine intake create symptoms that take a few weeks before they are compensated for”.


Stress and smoking

Another necessary clarification concerns the link between stress and smoking: “It is not true that smoking reduces stress, on the contrary, some scientific data show the opposite. The person who quits smoking has experienced a decrease in stress, because addiction itself is a source of stress, just as the intake of nicotine and other toxic substances helps to increase stress levels,” says the doctor.


After a cancer diagnosis, quit smoking

“Stopping smoking for people with lung cancer is extremely useful. For instance, those who have to undergo surgery, having stopped smoking for at least a month prior to surgery drastically reduces the risk of post-operative complications. In the case of people with advanced disease who still face treatment, it has been shown that among non-smokers there is a greater response to treatment and a reduction in mortality,” explains the doctor. It is always good to stop smoking, even in those diagnosed with lung cancer.


Prevention controls

“Strong smokers with exposure to smoking for more than 30 years and over 50 years of age should undergo chest CT and low contrast. There is strong and confirmed evidence that undergoing CT screening reduces mortality in smokers. These data come mainly from American studies, although we already have confirmation from European studies. CT should be performed annually or at varying intervals depending on personal risk, which also varies relative on age and exposure.

We try to identify pre-symptomatic tumors, about 1-2 cm large, treatable with a minimally invasive surgery and which show higher survival rates.

In the United States, screening for heavy smokers is already a practice and we are fighting to ensure that action is taken in Europe to make screening available to citizens,” concluded Dr. Veronesi.