Chemoprevention of lung cancer. Problems and progress.

taxation. We have to create much more awareness of the smoking problem among health professionals than before, and one of the most important messages is the following: smoking cessation treatment is not only a matter of prevention, it is also a part of regular treatment of diseases and rehabilitation.2 At the 6th World Conference on Smoking and Health (November 1987), it was stated that cessation now has enough scientific background to be implemented much more than before. Cessation means offering a wide variety of techniques and methods for different target groups and different organizational structures with different levels of assistance for the smoker. A diversified system of techniques to help the smoker to stop includes: (1) methods to help the already highly motivated, low-dependent smoker (mass media assisted techniques, simple brochures, self-help techniques); (2) methods to help the motivated, rather highly dependent smokers (nicotine replacement therapy); and (3) basis for all the other intervention techniques are methods to create and maintain motivation (health education, public information, public education). The 1988 Report of the US Surgeon General states very clearly that the use of tobacco products is not a matter of free choice, but is the result of an addiction as scientifically valid as addiction to heroin and other narcotics. Many pharmaceutical approaches have been tried to treat nicotine dependence in man (tranquilizers and stimulants, anti-cholinergic drugs, Lobeline and Anabasine, alkalizing the urine with sodium bicarbonate, silver acetate). Early work on fluoxetine (a serotonine reuptake-blocker) has started, and some work has been done with clonidine, an a2-adrenoceptor. Nicotine itself has, however, so far been the only drug found to be effective in treating nicotine dependence according to scientific standards and many controlled studies.56