Tobacco (23) Q1: Do people understand the harms of using tobacco products? (7) The role of health professsionals

28 February, 2023

Thank you for starting this discussion with these provocative questions, on a topic so important as the tobacco epidemic.

Today, more smokers are aware of the damage caused by tobacco than a few decades ago, but most of them have a poor idea of its magnitude. They know that smoking causes lung cancer, but not that at least 8 out of 10 of these cancers are due to tobacco. Nor are they very clear about the relationship between tobacco and heart disease, and even less that the maximum increase in cardiovascular damage is observed with very few daily cigarettes.

Even less is the knowledge between smoking and Stroke, and smoking and diabetes. But many times, not only smokers are not properly informed, but also health professionals.

So, to your question about how we could do to increase the awareness of the population, and especially of smokers, about that harm, my answer is: first, educate health professionals about the problem of tobacco and effective measures for its control, as well as on how to help to quit smoking.

Regarding your question about what matters to smokers? Here we should separate the population approach - that is, the information to the entire population - and the individual approach.

The more information the general population and smokers receive about the different damages caused by smoking, the greater the probability that some message will become relevant to a given individual or group of individuals. A practical and effective way of informing are graphic health warnings on cigarette packs and the other is holding communication campaigns.

But when approaching a person who smokes, we should not "lecture" him/her on the harms of tobacco, but rather try to identify what they don't like about their smoking, what fears they have about risk to their health, and then clarify or provide further information about that.

Finally, I wish to emphasize that just knowing about the damage is not enough. If it were so, no doctor would smoke.

The information provided should aim to change the environment that promotes tobacco addiction, through tobacco control policies.

These are my first thoughts on your first questions.

Congratulations on the initiative, and keep going!

*Dr. Eduardo Bianco*

Director, International Policy Education


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*Chair, WHF Tobacco Expert


HIFA profile: Eduardo Bianco is a medical doctor and Cardiologist, Certified Tobacco Cessation Expert with a Master’s in Prevention and Treatment of Addictive Disorders. Currently, he is Chair of the World Heart Federation Tobacco Expert Group. Dr. Bianco’s research examines tobacco control and cessation, and he is a prominent member of several organizations that address tobacco control in Latin America. Dr. Bianco has worked for 25 years in Uruguay and Latin America to promote and train in smoking cessation treatment and tobacco control policies. He is also the former Regional Coordinator for the Americas of the Framework Convention Alliance and former Technical Director of the MOH Center for International Cooperation for Tobacco. He is a member of the HIFA working group on substance use disorders. Email: ebianco AT