Every May 31, the World Health Organization marks World No Tobacco Day by highlighting the toll that smoking is taking on people's health, reminding governments that smoking is the single most preventable cause of death around the world, killing up to half of smokers through cancer, heart attacks, strokes and other causes.
Here's a look at three simple ideas that could encourage more smokers to quit.
Lung cancer screening
Many older smokers who have been lighting up for years are reluctant to quit, perhaps feeling there's little point to give up the habit so late in life.
But quitting improves health and reduces lung cancer risk no matter what age smokers stop. Brock University epidemiologist Martin Tammemagi wanted to know whether performing a CT scan (computer tomography) on smoker's lungs, and showing them what effect their smoking had, would encourage them to quit.
His team used data from the U.S. National Lung Screening Trial (NLST), a large study that has already found that annual CT chest scans can spot lung cancer early, and reduce death rates. Tammemagi's team focused on close to 15,000 current smokers, aged 55 to 70 years old, with a 30 or more "pack year" smoking history. (A pack year is defined as 20 cigarettes smoked every day for one year.)
Some of the scans came back normal; others showed small problems that weren't suspicious for lung cancer, while others revealed significant abnormalities either with the lungs, or other areas of the chest. The team excluded smokers who developed lung cancer within five years.
No matter what the tests showed, many smokers decided to quit smoking within a year of seeing the results. Their smoking rates continued to fall with each year after the scans. But what Tammemagi's team found was, the more worrisome the CT results were, the more likely smokers were to quit.
In relative terms, those who had a result that was the most worrisome and that looked suspicious for lung cancer were 13 per cent more likely to quit smoking than smokers whose results were normal.
Tammemagi tells CTVNews.ca his results suggest that cancer screening can be "a teachable moment" to talk to smokers about their habit and encourage them to quit. It's also, he says, a great chance for doctors to offer smokers information on what tools and medications are available to help them butt out.
But there are no annual screening programs for current and former smokers in Canada. That's because studies are only recently beginning to show the screening tests are effective at lowering death rates.
The biggest hurdle for bringing in nationwide screening programs is cost, Tammemagi says ; annual CT scans are not cheap. There have also been questions about the safety of the scan's radiation, and concerns about the psychological cost of "false positives."
But with the NLST study showing screening cuts cancer deaths by 20 per cent, and with the influential U.S. Preventive Services Task Force formally recommending CT lung cancer screening for older current and former smokers, lung cancer screening could soon become a reality.
Smartphone app
Plenty of young people want to quit smoking, but find it difficult when the temptation to light up is all around them. Enter the Crush the Crave app, designed by researchers at the University of Waterloo with funding from Health Canada and support from the Canadian Cancer Society.
The smartphone app lets smokers who are trying to quit to create a customized plan complete with an end-goal date. They can then share their quit progress and gain support from friends online through Facebook, Twitter and other social media.
They can also hit the app when they have a cigarette craving and monitor their own craving patterns and triggers. The app reminds them of how much money they've saved and how much their health is improving. Or users can amuse themselves with videos or chat with friends online to distract them until a craving passes.
Catherine Burns, a systems design engineering professor at the University of Waterloo says the app is ideal for young smokers because so many younger smokers carry smartphones with them everywhere. She says the app cleverly encourages users to come back regularly to re-engage with the app by offering rewards for each day smokers go without smoking.
"We're taking the techniques that are appealing to young people in other apps and using it for their health. I think that's exciting," she says.
Burns says her team is now beginning a study on the effectiveness of the app as a medical intervention, comparing its success at getting smokers to quit for one month with other smoking cessation techniques.
With young people forming the largest proportion of smokers, the Waterloo team says they hope the app can help smokers break their habit while young, saving them from the health effects of a lifelong addiction.
Raise tobacco taxes
The World Health Organization says there's no simpler and more effective way to encourage smokers to quit than by raising the price of cigarettes through taxes.
The WHO says raising the price of tobacco by 10 per cent cuts smoking rates by 4 per cent in high-income countries, and by approximately 5 per cent in low- and middle-income countries.
If all countries boldly raised taxes on tobacco by 50 per cent, the WHO estimates the number of smokers around the world would be cut by 49 million within three years -- 38 million fewer adult smokers and 11 million fewer future smokers. That would ultimately save 11 million lives, they say.
High prices are particularly effective in discouraging young people from taking up smoking, because they often have more limited incomes than older adults, says Dr. Douglas Bettcher, the director of the Department for Prevention of Noncommunicable Diseases at WHO.
France, for example, tripled its cigarette prices through higher taxes between the early 1990s and 2005. That led to a 50 per cent drop in sales. Within a few years, the number of young men dying from lung cancer in France also started to decline.
And yet, only 32 countries - representing less than 8 per cent of the world's population -- have tobacco tax rates greater than 75 per cent of the retail price.
The WHO calculates that if all countries hiked tobacco taxes by 50 per cent per pack, governments would earn an extra US$101 billion in global revenue. These additional funds could - and should - be used to advance health programs, says Bettcher.
"Tax policy can be divisive, but this is the tax rise everyone can support. As tobacco taxes go up, death and disease go down," he said in a statement this week.
