Pneumologie 2007; 61(1): 11-14
DOI: 10.1055/s-2006-954989
Positionspapier der DGP
© Georg Thieme Verlag Stuttgart · New York

Rauchen und pneumologische Erkrankungen, positive Effekte der Tabakentwöhnung

Smoking and Pulmonary Diseases, Positive Effects of Smoking CessationT.  Raupach1 , D.  Nowak2 , T.  Hering3 , A.  Batra4 , S.  Andreas5
  • 1Abteilung Kardiologie und Pneumologie, Georg August Universität Göttingen
  • 2Institut und Poliklinik für Arbeits- und Umweltmedizin, Klinikum der Universität München
  • 3Pneumologische Praxis Berlin
  • 4Universitätsklinikum für Psychiatrie und Psychotherapie, Tübingen
  • 5Fachklinik für Lungenerkrankungen Immenhausen
Further Information

Publication History

Publication Date:
23 January 2007 (online)

Zusammenfassung

Der Raucheranteil in der deutschen Bevölkerung beträgt etwa 30 %. Über die Hälfe der regelmäßigen Zigarettenraucher sterben an den Folgen des Rauchens, und die Lebenserwartung von Rauchern ist im Vergleich zu derjenigen von Nichtrauchern um 10 Jahre reduziert. Tabakrauchen ist der wesentliche Risikofaktor für das Bronchialkarzinom, die chronisch obstruktive Lungenerkrankung (COPD) und begünstigt die Entstehung einer Vielzahl weiterer Lungenerkrankungen.
Ein Entwöhnungskonzept, das sowohl pharmakologische als auch psychosoziale Unterstützung umfasst, hat sich für COPD-Patienten als überaus effektiv erwiesen. Die Beendigung des Tabakrauchens birgt sowohl akute Vorteile als auch längerfristige positive Effekte auf lungenfunktionelle Parameter, Symptomatik und auf die Sterblichkeit.
Insgesamt ist die Tabakentwöhnung eine der effektivsten medizinischen Interventionen. Sie sollte daher prioritär gefördert werden.

Abstract

More than 30 % of the German population are regular smokers, over half of whom will eventually die of smoking-related diseases. Life expectancy is abridged by 10 years in smokers compared to non-smokers. Smoking tobacco is the main risk factor for lung cancer and chronic obstructive pulmonary disease (COPD) and predisposes to a number of other lung diseases.
A smoking cessation programme including pharmacological as well as psychosocial support is highly effective in COPD Patients. Smoking cessation improves lung function, symptoms and mortality.
In conclusion, smoking cessation services are among the most effective medical interventions. Thus, a sufficient supply of smoking cessation services on a population level must be ensured.

Literatur

  • 1 Bundesamt S. Leben und Arbeiten in Deutschland - Ergebnisse des Mikrozensus 2003. Wiesbaden: Statistisches Bundesamt 2003
  • 2 The Health Consequences of Smoking .A Report of the Surgeon General. 2004, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion. Atlanta, GA: Office on Smoking and Health
  • 3 Raupach T, Schafer K, Konstantinides S. et al . Secondhand smoke as an acute threat for the cardiovascular system: a change in paradigm.  Eur Heart J. 2006;  27 386-392
  • 4 European Respiratory Society. Lifting the smokescreen. Brussels: European Respiratory Society 2006
  • 5 John U, Hanke M. Tobacco smoking attributable mortality in Germany.  Gesundheitswesen. 2001;  63 363-369
  • 6 Doll R, Peto R, Boreham J. et al . Mortality in relation to smoking: 50 years' observations on male British doctors.  Bmj. 2004;  328 1519
  • 7 Parrott S, Godfrey C, Raw M. et al . Guidance for commissioners on the cost effectiveness of smoking cessation interventions. Health Educational Authority.  Thorax. 1998;  53 Suppl 5 Pt 2 1-38
  • 8 Behr J, Nowak D. Tobacco smoke and respiratory disease. In: European Respiratory Monograph (7) The impact of air pollution on respiratory health. S. Holgate Editor 2002, ERS: 161-179
  • 9 Xu X, Dockery D W, Ware J H. et al . Effects of cigarette smoking on rate of loss of pulmonary function in adults: a longitudinal assessment.  Am Rev Respir Dis. 1992;  146 1345-1348
  • 10 Ryu J H, Colby T V, Hartman T E. et al . Smoking-related interstitial lung diseases: a concise review.  Eur Respir J. 2001;  17 122-132
  • 11 Janson C, Künzli N, de Marco R. et al . Change in active and passive smoking in the EU respiratory health survey.  Eur Respir J. 2006;  27 517-524
  • 12 Partnership S F. Lifting the smokescreen - 10 reasons for a smoke free Europe. Brussels: European Respiratory Society 2006
  • 13 Vineis P, Airoldi L, Veglia P. et al . Environmental tobacco smoke and risk of respiratory cancer and chronic obstructive pulmonary disease in former smokers and never smokers in the EPIC prospective study.  Bmj. 2005;  330 277
  • 14 Eisner M D, Klein J, Hammond S K. et al . Directly measured second hand smoke exposure and asthma health outcomes.  Thorax. 2005;  60 814-821
  • 15 Hughes J R. Four beliefs that may impede progress in the treatment of smoking.  Tob Control. 1999;  8 323-326
  • 16 Rigotti N A. Clinical practice. Treatment of tobacco use and dependence.  N Engl J Med. 2002;  346 506-512
  • 17 West R, McNeill A, Raw M. Smoking cessation guidelines for health professionals: an update. Health Education Authority.  Thorax. 2000;  55 987-999
  • 18 Balfour D J. Neural mechanisms underlying nicotine dependence.  Addiction. 1994;  89 1419-1423
  • 19 Stein E A, Pankiewicz J, Harsc H H. et al . Nicotine-induced limbic cortical activation in the human brain: a functional MRI study.  Am J Psychiatry. 1998;  155 1009-1015
  • 20 US Department of Health and Human Services .The health benefits of smoking cessation (DHHS Publication No. (CDC) 90 - 8516). USA: US Department of Health and Human Services, Public Health Service, Centers for Disease Control, Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health 1990
  • 21 Moller A M, Villebro N, Pedersen T. et al . Effect of preoperative smoking intervention on postoperative complications: a randomised clinical trial.  Lancet. 2002;  359 114-117
  • 22 Scanlon P D, Connett J E, Waller L A. et al . Smoking cessation and lung function in mild-to-moderate chronic obstructive pulmonary disease. The Lung Health Study.  Am J Respir Crit Care Med. 2000;  161 381-390
  • 23 Wagena E J, Meer R M van der, Ostelo R J. et al . The efficacy of smoking cessation strategies in people with chronic obstructive pulmonary disease: results from a systematic review.  Respir Med. 2004;  98 805-815
  • 24 Kanner R E, Anthonisen N R, Connett J E. Lower respiratory illnesses promote FEV(1) decline in current smokers but not ex-smokers with mild chronic obstructive pulmonary disease: results from the lung health study.  Am J Respir Crit Care Med. 2001;  164 358-364
  • 25 Anthonisen N R, Skeans M A, Wise R A. et al . The effects of a smoking cessation intervention on 14.5-year mortality: a randomized clinical trial.  Ann Intern Med. 2005;  142 233-239
  • 26 Simmons M S, Connett J E, Nides M A. et al . Smoking reduction and the rate of decline in FEV(1): results from the Lung Health Study.  Eur Respir J. 2005;  25 1011-1017
  • 27 Meer R M van der, Wagena E J, Ostelo R WJG. et al .Smoking cessation for chronic obstructive pulmonary disease (Cochrane Review) In: The Cochrane Library. Chichester, UK: John Wiley & Sons, Ltd 2004
  • 28 Fiore M C. Treating tobacco use and dependence: an introduction to the US Public Health Service Clinical Practice Guideline.  Respir Care. 2000;  45 1196-1199
  • 29 Jorenby D E, Leischow S J, Nides M A. et al . A controlled trial of sustained-release bupropion, a nicotine patch, or both for smoking cessation.  N Engl J Med. 1999;  340 685-691
  • 30 Wagena E J, Zeegers M P, Schayck C P van. et al . Benefits and risks of pharmacological smoking cessation therapies in chronic obstructive pulmonary disease.  Drug Saf. 2003;  26 381-403
  • 31 Jimenez-Ruiz C A, Masa F, Miravitlles M. et al . Smoking characteristics: differences in attitudes and dependence between healthy smokers and smokers with COPD.  Chest. 2001;  119 1365-1370
  • 32 Konietzko N, Fabel H. Weißbuch Lunge 2005. Stuttgart, New York: Georg Thieme Verlag 2005
  • 33 Ruff L K, Volmer T, Nowak D. The economic impact of smoking in Germany.  Eur Respir J. 2000;  16 385-390
  • 34 Rasmussen S R, Prescott E, Sorensen T I. et al . The total lifetime costs of smoking.  Eur J Public Health. 2004;  14 95-100
  • 35 Rasmussen S R, Prescott E, Sorensen T I. et al . The total lifetime health cost savings of smoking cessation to society.  Eur J Public Health. 2005;  15 601-606

Prof. Stefan Andreas

Lungenfachklinik Immenhausen, Kreis Kassel

Robert Koch Straße 3

34376 Immenhausen

Email: sandreas@lungenfachklinik-immenhausen.de

    >