Tobacco smoking

Background: Smoking is the leading risk factor for lung cancer and chronic obstructive pulmonary disease (COPD). Objectives: Description of smoking prevalence, health consequences of smoking, tobacco dependence, smoking cessation and strategies for tobacco prevention. Material/methods: Analysis of the recent pertinent scientific literature. Results: Although the smoking prevalence is declining in Germany, just below a third of the population is still smoking. New tobacco and nicotine products such as waterpipes and e‑cigarettes are attractive especially to young people. Waterpipe smoking entails similar health risks as cigarette smoking. E‑cigarette aerosol has a much lower concentration of toxicants than tobacco smoke, probably reflecting a harm reduction. However, the amount of this harm reduction currently cannot be estimated in a reliable way. Waterpipe smoking and e‑cigarette use may cause addiction. Smoking cessation markedly reduces the risk for secondary health effects. To support smoking cessation, behavioural therapy in combination with nicotine replacement therapy is recommended. Conclusions: To further decrease the smoking prevalence, motivation for smoking cessation must be increased and regulatory policies are needed to support non-smoking and smoking cessation. © 2018, Springer Verlag. All rights reserved.