Smoking, Smoking Cessation, and Lung Cancer Screening in the NELSON Trial

More than one billion people around the world currently smoke tobacco. The use of tobacco kills more than 5 million people yearly. If this trend continues, it is expected that more than 8 million people will die annually from tobacco-related diseases by 2030 and more than 1 billion people during the 21st century. The potential health effects of smoking were predicted as early as the 19th century. Nevertheless, it was not until the 1950s that study results associated smoking with lung cancer. Nowadays, it is known that tobacco smoke consists of many chemicals, of which more than 60 are confirmed or suspected carcinogenic substances, and that it affects nearly every organ in the body. Smoking is a risk factor for six of the eight leading causes of death worldwide, with the top three: 1) lung cancer, 2) Chronic Obstructive Pulmonary Diseases, and 3) cardiovascular diseases.5 The chance that a lifelong smoker will die prematurely from a tobacco-related disease is about 50%, and smokers who continued smoking will die on average ten years earlier than lifelong non-smokers. For these reasons, the use of tobacco is the most important cause of preventable disease and premature death worldwide. The economic burden of tobacco use has been estimated at US$ 500 billion globally and US$ 98-103 billion for the European Union.

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