What is the relationship between smoking and lung cancer, and e-cigarettes are less harmful than traditional cigarettes? Expert Answers

May 31st this year is the 33rd World No Tobacco Day. This year's theme is "Protect young people from tobacco industry manipulation and prevent them from using tobacco and nicotine", what is the relationship between smoking and lung cancer, Are e-cigarettes less harmful than traditional cigarettes? What are the latest prevention and treatment methods for lung cancer? These issues related to tobacco control have once again attracted public attention. A reporter from the Yangcheng Evening News interviewed Professor Zhi Xiuyi, head of the popular science department of the China Anti-Cancer Association and chairman of the China Thoracic Surgery Lung Cancer Alliance.

Lung cancer and smoking are closely related

According to the official report of the World Health Organization, smoking is a hazard factor for various diseases such as cancer and chronic obstructive pulmonary disease. Tobacco harm has become one of the most serious public health problems in the world.

Respiratory diseases such as lung cancer and chronic obstructive pulmonary disease are common and frequently occurring diseases in China, which seriously endanger people's health. Among them, lung cancer ranks first in the incidence of malignant tumors in China, with a number of 794,000. The situation of lung cancer prevention and control is grim.

"Smoking seriously affects lung health and is one of the high-risk factors that can lead to lung cancer in the medical community. Lung cancer is positively correlated with smoking intensity (smoking volume) and duration." Zhi Xiuyi introduced that China has a huge global presence. There are 350 million smokers and 740 million people are exposed to secondhand smoke. There are more than 7,000 chemical substances in tobacco, of which 69 are clearly carcinogenic. The risk of developing lung cancer increases with the increase in the number of cigarettes smoked per day and the prolongation of smoking age.

It is worth noting that, according to the pathological classification of lung cancer, about 80% are non-small cell lung cancer, and 15%-20% are small cell lung cancer. "The relationship between smoking and small cell lung cancer is particularly close, and smoking is the primary risk factor for small cell lung cancer. Among the patients diagnosed with small cell lung cancer, more than 95% have a history of smoking," Professor Zhi Xiuyi pointed out.

According to reports, small cell lung cancer is a biologically complex malignant tumor with a high degree of malignancy. It can metastasize to distant sites in the early stage, and the probability of liver metastasis, brain metastasis and bone metastasis is much higher than other types of tumors. . "Many small cell lung cancers are not found in the lungs, but are found to be small cell lung cancers after sudden brain metastases, blindness, and hemiplegia."

What is even more serious is that, despite the continuous innovation of lung cancer treatment methods and the continuous improvement of treatment effects, the treatment of small cell lung cancer is still the most difficult bone to crack. Although patients are sensitive to chemotherapy, they are prone to relapse once the drug is discontinued, and most patients often develop drug resistance soon, with a survival period of less than one year and poor prognosis. The global demand for small cell lung cancer treatment is still far from being met.

E-cigarettes can also lead to nicotine dependence

Many people think that e-cigarettes will be a "healthier" alternative to ordinary cigarettes. In this regard, Zhi Xiuyi said that e-cigarettes are a nicotine delivery system that evaporates a solution containing nicotine into aerosol for users to inhale. electronic appliances.

"The original intention of e-cigarettes was to target those middle-aged and elderly smokers who have become addicted to nicotine as a substitute. But now the taste has changed, and the sales target are more for teenagers, allowing people who have never smoked tobacco to smoke nicotine, That's tantamount to making teens nicotine dependent, which is already a crime."

Zhi Xiuyi pointed out that e-cigarettes may become a way for young people to develop the habit of smoking. With heavy marketing and the use of various mint, coffee or fruit flavored additives, e-cigarettes are doubly attracting teenagers to nicotine exposure and addiction.

It is worth noting that at the end of last year, the State Tobacco Monopoly Administration and the State Administration for Market Regulation issued a circular to further protect minors from e-cigarettes, urging e-cigarette brands to close Internet sales channels, withdraw Internet advertising, and urge e-cigarettes. The platform shuts down e-cigarette stores in a timely manner and removes products from shelves in a timely manner.

"Our survey found that many electronic cigarette products on the market have actual nicotine content that exceeds the content of their labels, and the competent authorities should also increase control measures. To protect young people, it is necessary to stay away from both traditional cigarettes and electronic cigarettes with high nicotine content.” Zhi Xiuyi.

Lung cancer can also be diagnosed and treated early

Lung cancer has few symptoms in the early stage. Most patients are diagnosed in the middle and late stages, and the treatment effect is poor. Therefore, early detection, early diagnosis and early treatment are the keys to improve the cure rate of lung cancer and reduce the mortality rate. A research report published by the Chinese Center for Disease Control and Prevention shows that in recent years, the incidence of lung cancer has gradually become younger.

Professor Zhi Xiuyi said: "Smoking is the clearest preventable cause of lung cancer death in the world today. Effective tobacco control can reduce the incidence of lung cancer. Tobacco control can play a preventive role in many diseases, from 'treating one's own disease' to '' "Treat the disease before it's too late", and move the real barrier forward."

Zhi Xiuyi said that for smokers, the smoking index can be used to determine whether they belong to high-risk groups. The smoking index refers to "the number of cigarettes smoked per day × the number of years of smoking". If you smoke an average of 20 cigarettes a day and have a smoking history of 20 years, then the smoking index is 400, and if it exceeds 400, you have to pay attention.

Zhi Xiuyi suggested that high-risk groups should have a low-dose chest CT scan once a year to keep abreast of the health of the lungs, so that early detection, early diagnosis, and early treatment can be truly achieved.

According to Professor Zhi Xiuyi, scientists around the world have been working hard to develop various innovative drugs for small cell lung cancer. Although the vast majority of trials have ended in failure, it is encouraging that in recent years, in the field of immunotherapy, two PD-L1 immunosuppressants for first-line treatment of extensive-stage small cell lung cancer have achieved breakthroughs Among them, in March this year, the FDA officially approved durvalumab in combination with chemotherapy for the first-line treatment of extensive-stage small cell lung cancer without systemic therapy, bringing new hope to patients with small cell lung cancer.

"I hope that after the end of the new coronavirus epidemic, the work of early diagnosis and early treatment of lung cancer can be promoted, and new technologies, new drugs, and new methods in the field of lung cancer diagnosis and treatment can be applied. Through early prevention and early diagnosis, effective treatment can be obtained." Zhi Xiuyi said.

Source | Yangcheng Evening News ● Yangcheng School

Editor in charge | Sun Jing

Checking and signing | Zeng Minyan

Intern | Li Caiyi