“The fashion for traditional cigarettes is dead. Its use has drastically declined over the past decade. Now the question is that it should not be replaced by an e-cigarette,” Panagiotis Behrakis, Resuscitation Pulmonologist, MD, FCCP, Former Associate Professor at EKPA and Harvard University, Head of the Hellenic Cancer Society’s SMOKEFREEGREECE initiative. emphasizes the “K”. This year, World No Tobacco Day, after three years of a pandemic, presents the scientific community with new challenges related to the smoking habits of the population, especially young people, which require intensified efforts to get rid of cigarettes in all its forms.

According to Mr. Behrakis, “according to reliable ELSTAT measurements, until 2019 in our country there was a large decrease in the number of smokers of all ages, and especially in the age group from 16 to 24 years.” According to the professor, smoking in this group decreased by 52% between 2009 and 2019. The next relevant and therefore comparable ELSTAT survey is expected in 2024, but describing where our country is today, Mr. Behrakis points out that “throughout the pandemic, the energy crisis and the pre-election period, we have seen a relative weakening in the application of very correct legislation, that our country should reduce smoking. Gone are the days when closed shop windows were dubbed open so that customers could smoke, and smoking was allowed in entertainment venues. The smoking hotline was down, and smoking cessation programs in NHS units, which bore the brunt of the pandemic, were also left behind. We also see e-cigarettes being advertised to children. With the easing of measures, there is a free sale of tobacco products to children. It’s not legal, it’s not ethical, and it’s unfair,” emphasizes the professor.

The most recent (2022) pan-Greek study by the Research University Institute of Mental Health on health-related behaviors of adolescents and students also shows a growing trend towards experimentation and use of e-cigarettes at a young age. According to her, today the electronic cigarette is the most common tobacco product among teenagers. In particular, in a sample of 2391 students of the 1st secondary school (15/16 years old), it turned out that more than two out of five (41.5%) students smoked at least once. Electronic cigarettes are smoked by 38.6% and traditional cigarettes by 28.2%. Every fifth teenager (20%) smoked an electronic cigarette at least once in the last 30 days, and 10.7% smoked at least three times in the last month. In recent years, rates of e-cigarette use among children have deteriorated significantly. In 2018 (at the time of the previous EPIPSY survey), 12% of teens used e-cigarettes at least once in the past 30 days, and 6.6% used at least three times. In contrast, traditional cigarette use seems to be relatively stable compared to 2018, but much less popular compared to 2014 and 2010. Revealingly, 42.3% of teenagers even tried traditional cigarettes in 2010 compared to 28.2% last year. year.

Environment and access

“Let’s explain to the children that this is also an addiction,” says pulmonologist-resuscitator Panagiotis Behrakis to K.

The prevalence of smoking (whether traditional or electronic) is significantly higher among adolescents who have at least one parent who smokes, which is also commented by the research supervisor of the study, emeritus professor at the Faculty of Medicine of the EKPA, Ms. Anna Kokkevi. As he notes, “recent data on teen smoking further underscores the importance of the environment in enabling teens to engage in and continue behaviors that put their health at risk. Because, on the one hand, teenagers, as it were, retain relatively unhindered access to products in our country that, by law, are intended only for adults, on the other hand, a large percentage of teenagers grow up in families where at least one of the parents smokes.

Switching to alternative tobacco products does not mean reducing health risks. The Hellenic Lung Society, in consultation with the European Lung Society and the World Health Organization, considers e-cigarettes to be another form of smoking that can have harmful effects on the body and is also addictive.

When asked how one can prevent the use of electronic cigarettes, as well as traditional cigarettes, in childhood, Mr. Behrakis emphasizes that he “explains to children that this is also an addiction. Tell them they have to choose whether they want to live free or become slaves to a habit from their teenage years. Model a teen leader, an attractive teen who doesn’t smoke, eat right, and exercise. We at SMOKEFREEGREECE have chosen this strategy.”

A few days ago, on May 25, 2023, Mr. Behrakis as an expert in smoking cessation was awarded by the World Health Organization at a special event in Ljubljana, Slovenia. Last May, SMOKEFREEGREECE was awarded by the European Commission as the most successful cancer prevention awareness campaign in Europe for 2021. “All this time we continue actions in schools in order to prevent smoking among children. In the current academic year, we have carried out 215 interventions in schools and reached more than 10,000 children. We also organized seminars for health professionals and teachers on smoking prevention in the student community,” emphasizes Mr. Behrakis.

He is optimistic that the anti-smoking efforts started by the previous government will continue under the next government. “We are in a good position. The political will is there, we have the know-how, we must move forward,” he concludes.

“We need people to go get checked”

“Smoking is responsible for at least one in four diagnosed cancers. Sixteen cancers are associated with smoking, most notably lung cancer, but also other cancers such as bladder, pancreas, and ovarian cancer. Even malignant neoplasms in children are associated with secondhand smoke both during pregnancy and after birth.” These figures were presented yesterday by Paraskevi Katzaunou, Associate Professor of Pulmonology at EKPA School of Medicine and Head of the Department of Pulmonology and Respiratory Insufficiency of the 1st KETH Evangelism, to highlight the enormous value of quitting smoking, the chances of success. of which are increasing as it is done in special clinics operating within the NHS units.

This value does not decrease even if the smoker has already suffered from his habit. As the professor noted, “about 40% of smokers who are diagnosed with lung cancer continue to smoke at the time of diagnosis. In Europe, although 44% of lung cancer patients are diagnosed in the early stages, only 14-58% (depending on the country) quit smoking after being diagnosed with malignancy. This results in them exposing themselves to increased postoperative risk, decreased response to chemotherapy and radiation, and increased risk of recurrence or new primary cancer.”

About 8,000-9,000 new cases of lung cancer are diagnosed annually in our country, and in most cases, the diagnosis is made at an advanced stage of the disease. On the occasion of today’s World Tobacco Day, the Hellenic Society of Pulmonologists presented the state’s proposed lung cancer screening process in Greece, which was developed in collaboration with the Hellenic Society of Radiology, Hellenic Society of Thoracic Medicine. Cardiac surgeons – Aggeion and Hellenic Cancer Federation.

As described by pulmonologists Georgia Hardavella and Yiannis Giozos, the proposal concerns early detection of lung cancer through low-dose chest CT, to which high-risk populations will be referred annually or every two years. These are people aged 50 to 80, current or former smokers who have quit smoking within 15 years and have smoked/smoked a pack of cigarettes or more for at least 20 years. Tools such as electronic prescription and electronic personal physician records will be used to identify people who are candidates for the program. Specially trained and certified physicians will refer candidates, after informing them of the benefits and necessary procedures and obtaining their consent, to specialized centers for low-dose chest CT scans. After the examination, an appointment with a doctor will take place, at which the results of computed tomography will be evaluated. If there is no suspicion of lung cancer, the frequency of the examination will be determined. If there are results, additional tests, imaging, or even invasive studies will follow to make a definitive diagnosis.

Numerous benefits

“The benefits are very important to the patient,” said AUTH Professor of Thoracic Surgery Christoforos N. Foroulis. “If lung cancer is diagnosed, it will most likely be at an early stage, when the five-year survival rate is very high. In stage 1, it can exceed 80%. In addition, resection of small neoplasms will be performed in the highest percentage by minimally invasive methods with corresponding multiple benefits for patients,” he said.

“People need to be persuaded to get screened,” said Mina Gaga, a former deputy health minister and pulmonologist, stressing that experience with such programs seems to have little participation. The president of the Hellenic Pulmonological Society, Professor Stylianos Loukidis, pointed out that in the United States, where a similar program is being implemented, only 5.8% of the candidate population ends up participating. “There is fear, whether it be additional tests or possible surgeries. And often smokers do not want to admit that they have a high risk of getting lung cancer, ”he said.

Numbers

2 out of 5 teenagers smoked electronic cigarettes, while at least one in four smoked traditional cigarettes and hookahs.

1 of 9 smoked more than three electronic and traditional cigarettes in the last 30 days.

1 of 5 smoked an e-cigarette more than three times in the last 30 days;

1 of 12 smokes a traditional cigarette daily and 1 in 9 smokes weekly.