Daily Report| Tabaccologia

Article

On 7^th and 8^th October 2022, the 18^th National Congress of the Italian Society of Tobaccology (SITAB) was held at the University of Milan, ending with a discussion time dedicated to the National School of Medical Tobaccology (NSMT), under the leadership of Dr. B. Tinghino, as a continuation of the work begun in 2019 with the establishment of the NSMT’s distance learning and on-site training.

This year’s theme was “Tobacco Control”, an extremely important public health issue. Tobacco smoking is the leading cause of avoidable death from non-communicable diseases and, according to estimates by the World Health Organisation (WHO), is the cause of more than 8 million deaths worldwide each year. Moreover, smoking represents ‘the greatest threat to health’ (WHO) today, as it is estimated that more than 1 billion people worldwide smoke, half of whom will die prematurely due to smoking-related diseases. Hence the desire to focus the congress on the key topics of ‘Tobacco control’: monitoring, management and prevention of tobacco use, through targeted guidelines and policies, as well as improving cessation pathways and screening for smoking-related diseases, all while paying particular attention to new tobacco products, a major threat to the spread of smoking among young people, but also a source of risk of relapse for ex-smokers.

All conference lectures were particularly appreciated by the 130 participants, who admired the multidisciplinary nature of the topics, which has always characterized the conferences of our society, constituting not only a boast but also a specific mission of SITAB, which considers this event an invaluable source of cultural exchange to be preserved in view of the transversal nature of tobacco smoking in the various disciplines.

Below we publish the Congress Proceedings with the abstracts of the papers that participated in the fourth edition of the SITAB - Umberto Veronesi Foundation Aword for Research in Tobaccology.

The first three winners were:

1. 1^st place - Dr. Mario Cristina, from the Department of Molecular Medicine, Sapienza University of Rome in agreement with IRCSS San Raffaele, with the research “Nicotine in combination with SARS-CoV-2 affects cell viability, inflammatory response and ultrastructural integrity”;
2. 2^nd place - Dr. Alessandra Lugo, from the “Mario Negri” IRCSS Pharmacological Research Institute, with the research “Exposure to second-hand smoke in closed environments among European non-smokers: results of the TackSHS Project”;
3. 3^rd place - Dr. Anita Vergatti, from the Department of Clinical Medicine and Surgery of the Federico II University of Naples, with the research “Association between passive smoking and osteoporosis in postmenopausal non-smoking women subjected to dual-energy X-ray absorptiometry”.

On the same day, the national journalism prize “Tobacco and Health” was also awarded on the occasion of the 2^nd edition of the SITAB - Umberto Veronesi Foundation Award for the best articles (press and web, video and audio) published in the last 12 months:

The press and web category were awarded to Dr. Valentina Meschia, journalist for the online newspaper , with the article “From Maya to e-cig: smoking an ancient habit, but quitting is possible”. Dr. Antonella Cignarale, journalist for Report (RAI3), was instead awarded for the video category with the investigation “Full of smoke”. Lastly, for the audio category, Dr. Chiara Caretoni, a journalist from Radio LatteMiele and the National Radio Network Circuit (CNR), received the award with her report “Smoking: do you know all the damage you do to your bones?”.

There were countless high-profile speeches during this two-day event in Milan, starting with the heartfelt introduction by Prof. Sirchia who, as honorary president of the congress, emphasized the importance of tobacco control legislation and the need for its implementation, also in the light of the emergence of new tobacco products, which are substituting the traditional cigarette and whose use threatens particularly young people, a category to which future Tobacco Control efforts must be particularly devoted.

During the first session, “Tobacco Control in Italy”, four extremely topical reports were presented: from the Italian guidelines on tobacco (Dr. Roberta Pacifici), to the CCM projects for tobacco control (Dr. Daniela Galeone), passing through the role of the tobacco industry on scientific research (Dr. Silvio Garattini), up to the pioneering lectio magistralis by Dr. Cristiano Chiamulera on tobacco and artificial memory. Crucial was the speech by Dr. Pacifici of the Italian National Institute of Health, who illustrated the Report 2022 on smoking in Italy and presented the new Italian Guidelines on smoking, emphasizing the exponential increase in sales of heated tobacco products and electronic cigarettes, which in the years 2017-2021 saw an increase of 1831% and 779% respectively, becoming a threat to health that must be tackled promptly with new regulations, also recalling what Prof. Girolamo Sirchia had previously discussed. Dr. Pacifici also pointed out that after the pandemic, probably also because of the psychological impact of the pandemic, the prevalence of smoking has risen from the previous 16.5% (2019) to the current 18.5% (2022), with an increase among both women (22.0% in 2019 vs 24.2% in 2022) and men (28.0% in 2019 vs 30.2% in 2022).

During the congress, there was also time to focus on “COVID-19, nicotine and Big Tobacco” during the second session, lively animated by a scientific debate on the critical issues emerging from research in this field, which is still too recent to be able to draw clear-cut conclusions on the subject, requiring targeted studies and scientific rigor, as shown in the three papers presented by Dr. Lugo, Prof. Massimo Galli and Dr. Silvano Gallus.

Session III, “Hot Topics in Tobaccology”, was full of important innovations in the field of tobacco science, starting with the results presented by Dr. Giovanni Pistone on the role of heavy metals in tobacco smoke, moving on to the hypothesis of radioactive pathogenesis of lung cancer linked to the metabolites of tobacco smoke illustrated by Prof. Maria Sofia Cattaruzza, ending with Dr. Luciano Ruggia’s lectio magistralis, focused on the risks of electronic cigarettes and heated tobacco products for the younger generations. Dr. Ruggia warned the audience about the negative implications of a market that is gaining new customers, meaning new future victims of smoking-related diseases, especially among young people, who are often not adequately supervised by their parents and teachers and are badly informed about the dangers of these products.

During the fourth and last session of the day, before the presentation of the SITAB – Umberto Veronesi Foundation awards mentioned above, the focus was on the link between ‘smoking and polyaddition’. The central core of this session was the lectio magistralis of Dr. Lugo, who presented the final analysis of the economic impact of smoking-related diseases in Italy, showing how smoking impacts society not only in terms of health, e.g. by reducing productivity as a result of deaths and smoking-related diseases but also in economic terms, as a net health cost for the national health system and as an element with a high environmental impact.

Before Dr. Lugo, Dr. Liborio M. Cammarata presented an interesting talk on the treatment of patients with tobacco and cannabis co-dependency; Dr. Daniel L. Amram gave a detailed historical-scientific excursus on the theory of nicotine as a gateway drug and Dr. Tiziana Fanucchi talked about the comparison of tobacco and alcohol addiction, and their respective treatment paths.

The day ended with brief oral communications, in which Dr. Valentina Conti, Dr. Martina Antinozzi, Dr. Fabio Dominici and Dr. Valentina Galli presented their research in the tobacco field, with a focus on the covid-19 and tobacco, therapeutic possibilities in cessation plans and health promotion through interventions aimed at cessation among young people.

The second day of the congress, Saturday 8th of October, focused on current clinical aspects and future therapeutic perspectives in the field of tobaccology.

The theme of the first session was the effects of smoking on the respiratory system, with an emphasis on the various aspects of smoking-related diseases. This was followed by Dr. Paola Martucci, who focused on smoking and cough; Dr. Antonella Serafini, who reported on smoking and oxygen therapy; Prof. Pierachille Santus, whose speech focused on smoking and COPD and, in conclusion, Dr. Francesco Tarantini, who presented a paper analyzing the interactions between smoking and asthma.

During a second very interdisciplinary session, Dr. Biagio Tinghino gave a speech about nicotine replacement therapy, showing the importance of brief motivational counselling on smokers to be implemented by every health professional and at all levels of care. The speech was then followed by two reports in the urological field, focusing on the role of smoking in the pathogenesis of impotence (Dr. Luca de Toni), on the link between smoking and urinary tract cancer (Dr. Nicola Nicolai), ending with the presentation of the SMILE project on the early diagnosis of lung cancer associated with tobacco smoke (Dr. Ugo Pastorino). The session was closed with Dr. Ernesto Burgio’s lectio magistralis on the impact of tobacco smoke on the genetics and epigenetics of the foetus/infant, in which it was explained how parental smoking can cause damage as early as the gamete maturation stage, and how it is then responsible for the increase in chronic endocrine-inflammatory pathologies in the children of smokers, who are then among the subjects most exposed to the development of numerous chronic diseases such as diabetes and obesity.

Session III, “The Misunderstood Effects of Tobacco”, saw a succession of speeches ranging from the link between smoking and insulin resistance (Prof. Giovanni Targher) and between smoking and the cardiovascular system, with reports by Dr. Desideri and Dr. Paola Vallerio, concluding with Dr. Giulia Veronesi’s speech illustrating the usefulness of screening in the early diagnosis of lung cancer.

The congress ended with the fourth and last session, completely dedicated to the National School of Medical Tobaccology directed by Dr. Biagio Tinghino, who opened the session by illustrating the school’s activities and future perspectives. Following this, Dr. Massimo Baraldo closed the proceedings by presenting the pharmacological treatment lines for smoking cessation.