Tobacco, respiratory diseases, cardiovascular risk, and cancer: Classical approaches and new alternatives

Smoking tobacco is the main preventable aetiological factor of mortality worldwide, with a significant impact on respiratory and cardiovascular diseases and cancer. Smoking cessation and prevention must be prioritized in health care and legislative initiatives to reduce mortality and associated complications. To date, pharmacological treatments and behavioural therapies, along with community strategies, have been shown to be the most effective methods, especially when used in combination with a coordinated approach. However, their efficacy remains suboptimal and diminishes over time due to the high frequency of relapse. Data from the survey on alcohol and other drugs in Spain (EDADES) of the Spanish National Health System showed that the percentage of smokers has hardly decreased in recent decades and that many smokers do not intend to give up smoking, even those who have already suffered from some complications. In this context, the development of new products such as electronic cigarettes and heated tobacco may have some application in the population. The FDA recognition of risk-modifying products, the British Health System reports on electronic cigarettes, and the recommendations of the American College of Cardiology expert consensus on smoking cessation, among others, indicates the need to consider updating the multifactorial and multidisciplinary approach of smoking and its consequences.