PolmoniAMO_INGL

13 PolmoniAMO tant to change and are more unlikely to give up smoking. Unfortunately, the journey for those who want to stop smoking and seek help from a stop-smoking centre is riddled with obstacles: in Italy there is no national network of stop-smoking centres and no up- to-date list of contacts to refer to. There is also a shortage of human resources allocated to these centres, particularly pulmonologists and specialists in smoke-related diseases. These difficulties are exacerbated by the fact that in Italy, unlike in other countries such as Great Britain, the cost of stop-smoking drugs is fully borne by the citizen even though these expenses would not be an excessive burden to the SSN given the relatively low cost of active ingredients such as cytisine. Another huge part of the problem is the consider- able increase in adolescents, particularly women, who take up cigarette smoking at a very early age. This age group does not recognise the risk posed by smoking cigarettes, and sees smoking as a way to gain acceptance and social independence. In Italy, this trend is particularly worrying considering that the percentage of adolescents who smoke is higher than the European average [17]. Despite the development and implementation of anti-smoking campaigns, there are ap- proximately 11 million smokers in our country (26% of men and 17% of women) [18]. The PASSI (Progress of Health Authorities for Health in Italy) surveillance data for the period 2017-2020 gives an alarming overview. One in 4 people smokes and 1 in 6 is a former smoker. The average daily consumption is about 12 cigarettes, yet almost a quarter of smokers consume more than a pack a day [19]. In addition to the poor effectiveness of anti-smoking campaigns is the lack of attention paid by healthcare professionals to the smoking habits of their patients: only 1 in 2 smokers report hav- ing been advised to stop smoking by a doctor or healthcare professional among those encountered in the last 12 months [19]. There is a lack of attention on the part of health professionals, starting with general prac- titioners (GPs), who, often overburdened by their daily workload, forget to include tobac- co use in the list of risk factors in each patient’s personal records. By failing to record such important information, the doctor is neither alerted to the need to encourage the patient to stop smoking nor to consider him or her eligible for further cardiopulmonary assess- ments in light of the risk associated with smoking-related diseases. Finally, an aspect that is still often overlooked is the role of genetic predisposition in the onset of lung cancer, which could be postulated by the GP and then verified, where appropriate, by a specialist. Although the impact of passive smoking is considerably less than that of active smoking, it is not insignificant in terms of social and health implications. In the decade 2005-2015, passive smoking from a family member was responsible for an increase in the number of deaths (29,000 vs. 22,000); the impact of passive smoking in the workplace has been estimated to be about three times as high [20]. Finally, it should be borne in mind that the latency time between exposure and onset of smoking-related cancer is approximately 15-20 years and epidemiological estimates of lung cancer rates accurately reflect trends