If scientific knowledge on the causes of cancer could be translated into successful preventative measures, it is estimated that we can reduce the number of cases of cancer in Europe by up to half.
The European Code Against Cancer details 12 evidence-based recommendations that we can all take to reduce our risk of developing cancer.
The most important recommendations are the first two, and these are: “Firstly do not smoke, and secondly, make your home smoke free, supporting smoke free policies in your workplace.”
Cigarette smoking is the single biggest preventable source of cancer in Europe, and all tobacco products contain a remarkable array of carcinogens, ranging from polycyclic aromatic hydrocarbons, specifically benzo(a) pyrene, to tobacco-specific N-nitrosamines, among many others.
Cigarette smoking is an established cause of cancer at multiple sites of the body, such as but not limited to the kidney, bladder, oesophagus, ovary, oral cavity, pancreas, liver, stomach and bladder; it is responsible for more than eight out of every 10 cases of laryngeal cancer, and eight out of every 10 cases of lung cancer. Smoking alone may be responsible for 32 to 37 per cent of all cases of cancer.
Smoking alone may be responsible for 32 to 37 per cent of all cases of cancer
Moreover, through the generation of second-hand smoke, smoking has harmful effects on non-smokers. Second-hand smoke is a confirmed cause of lung cancer in people frequently exposed to second-hand smoke. Furthermore, one should not merely brush over the other impacts smoking has on human health, ranging from chronic obstructive pulmonary disease (COPD) to coronary heart disease, to cerebrovascular disease and other health outcomes with more acute onset, such as the exacerbation of asthma. Smoking truly leaves a trail of destruction in its wake.
Nor should one forget the environmental impact tobacco smoking has. Cigarette butts are the single largest source of litter found globally, accounting for between 30 to 40 per cent of all litter, and each butt takes between 10 and 12 years to degrade. I can vouch for that statistic myself, having spent October 27 of last year clearing Għajn Tuffieħa and Golden Bay of cigarette butts.
Nor should one forget the impact tobacco growing and curing has on the planet. Since 1970 an estimated 1.5 billion hectares of (mainly tropical) forests have been lost worldwide, contributing to an inability to limit the rise of CO2 emissions and the tragic loss of biodiversity on a massive scale. Growing tobacco contributes to both, with forests cleared for tobacco plantations and wood burned to cure the tobacco leaves.
Hence, if the number of people who smoke falls, we would not only tangibly reduce the incidence of cancer but also help the planet. Lowering smoking rates will continue to need a mix of both personal and group measures.
For smokers, the most effective intervention is a mix of pharmacotherapy and behavioural support.
Collectively as a group we need to protect each other from second-hand smoke and recognise the harmful impact of tobacco not only as a health threat, but also as a threat to human development as a whole. Having smoke-free zones is an effective way to protect people from second-hand smoke and reduce smoking rates, and hence I would like to propose expanding our smoke-free areas, starting with converting our sandy beaches into smoke-free areas.
The remainder of the recommendations of the European Code Against Cancer vary from participating in organised screening programmes for bowel, breast and cervical cancer, to participating in vaccination programmes against Hepatitis B and human papillomavirus (HPV), to encouraging physical activity, limiting alcohol intake and consuming a healthy diet featuring plenty of whole grains, vegetables and fruits.
Further information on the 12 recommendation on the European Code Against Cancer may be found at https://cancer-code europe.iarc.fr/index.php/en.
The more recommendations that are followed, the lower the risk of developing cancer.
Steven Bajada is a medical student and a Youth Ambassador for the European Code Against Cancer.