2023-07-06 11:05:00
“We smoke for nicotine and die from the carcinogenic products of combustion. Smoking is bad for you, it should be avoided, but for those who can’t quit, the lesser evil could be switching to non-combustion products. The production of harmful substances”. Let me be clear, “zero risk does not exist, not even with these products. You need to stop smoking, but you also need to be practical. Reducing risk is an important result for hardened smokers, who are quite a few, if you consider that, for example, about half of people with lung cancer continue to smoke a year after diagnosis.” Vincenzo Montemurro, cardiologist, general secretary of the Italian Heart Foundation of the Sic (Italian Society of Cardiology) and head of the Cardiology service of the Casa della Salute ‘Scillesi d’America’ of Scilla, in the province of Reggio, explains it to time.news Salute Calabria.
“We must be realistic – says Montemurro – Smoking is bad and there is no discussion about it. Every doctor must remember and explain it, but in 2018 the American College of Cardiology issued a position paper in which, faced with the evidence of the failure of attempts to stop smoking in a large percentage of smokers, notes that in heavy smokers a reduction in risk factors is a goal to be considered. Institutions should take note of this reality and make common sense decisions”, underlines the cardiologist . “There is no zero risk, nicotine remains – he specifies – but it is not carcinogenic and reducing the damage from toxic substances by 90% is an important result in this population”.
“The habit of smoking is linked to addiction to nicotine – recalls Montemurro – but the damage is due to the products of combustion: metals and polyclinic and aromatic hydrocarbons classified as carcinogenic substances. Combustion produces at least 4,000 harmful substances. There is acetone, which is a solvent, methanol and pyrene which are known carcinogenic substances, mothballs, cadmium, vinyl chloride, carbon monoxide, polonium, DDT: all harmful substances produced by combustion. carcinogenic – continues the expert – the link of benzopyrene with skin and lung cancer is known.4-aminobiphenyl is proven to be the cause of bladder cancer, polonium gives off alpha radiation in the alveoli which modify the DNA of the cells of the mucosa bronchial”. Montemurro observes: “Traffic stops in cities when Pm10 exceeds 50 micrograms per cubic meter of air. A cigarette produces 400 micrograms per cubic meter and, in an environment such as a car, the concentration ranges from 700 to 1,200 micrograms”.
The smoker who has a habit of smoking cigarettes “continuously and constantly absorbs the addictive nicotine – explains the cardiologist – It is absorbed in 10-15 seconds, reaches the nucleus accumbens of the brain, where there are nicotinic receptors, and from here the synthesis of dopamine is activated, which gives well-being, euphoria and addiction. Those who stop smoking a cigarette become nervous, depressed, sad, have physical and psychological discomfort because they lack nicotine”. After all, “in products without combustion there is nicotine, which is addictive, but the carcinogenic substances drop by 90% because the system blocks the temperature at 350 degrees, thus avoiding combustion and the same levels are not formed of dangerous substances. Of course, zero risk with these products does not exist – Montemurro reiterates – but the drastic reduction of the substances produced by combustion make their use rational in people who cannot stop. The least damage is chosen”.
The cigarette smoking epidemic is a threat and a challenge to health systems. “Despite all the interventions, in fact, it increases – highlights the specialist – The World Health Organization aimed to bring the percentage of smokers to 19% by 2025, but we are around 24-25% and 50% of smokers die in average 14 years earlier than non-smokers. These are very important statistical data and in line with what is recorded in Italy. A few weeks ago, the Higher Institute of Health reported that, if in May 2021 23.7% of the population smoked, in In 2023 the value rose to 24.6%, despite the anti-smoking campaigns and the measures in place.Furthermore, only 30-33% start to quit smoking and only 9% do it permanently.What is striking are the 90,000 deaths smoke-related per year: there are 246 a day, 10 every hour. It’s like a plane crashing every day: how do we avoid these deaths?”, asks the expert. “I tell everyone to stop, but when I find that, after a year, 50% of those diagnosed with lung cancer and 70% of those who have had a stroke continue to smoke, you have to think about the lesser evil”.
While some countries such as England and New Zealand are achieving the best results in the world in terms of combating smoking thanks to the principle of risk reduction and the use of new combustion-free products as a support strategy for heavy smokers, WHO tends equate new products and traditional cigarettes. “In Italy there is a legislative vacuum – reflects Montemurro – after all, health is a regional matter. But the State should give guidelines. I know that the Minister of Health, Orazio Schillaci, is working to give indications to fill this regulatory vacuum “.
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