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Both tobacco cessation and low-dose CT screening in at-risk individuals reduce lung cancer-specific and all-cause mortality. As part of a national screening program for the early detection of lung cancer, smoking cessation must be a mandatory part of the counseling given to participants. This increases the cost-benefit effectiveness of the screening program. As part of the initial consultation evidence-based measures for smoking cessation must be offered to smoking participants of the screening program in form of a minimal intervention. If participants do not want to participate in a quit smoking measure they must actively refuse (opt-out rule). The costs of quitting smoking, including the costs of withdrawal-inhibiting medication, have to be fully covered by statutory health insurance for participants in the lung cancer screening program., Competing Interests: Alexander Rupp ist Berater der Firma Sanero Medical GmbH Stuttgart, die eine Internetplattform und eine digitale Gesundheitsanwendung (DiGA) zur Tabakentwöhnung betreibt.Christa Rustler ist Leiterin des Büros des Deutschen Netz rauchfreier Krankenhäuser und Gesundheitseinrichtungen (DNRfK), welches zur Implementierung des „rauchfrei tickets“ Zuwendungen der Bundeszentrale für gesundheitliche Aufklärung (BZgA) erhält.Die anderen Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Objective: Tobacco control measures are relevant also in child and adolescent psychiatric institutions and their implementation in Germany will be assessed in this study., Methods: In an online survey, n=78 leading staff members responded to standardized questions assessing how smoking in patients was dealt in such institutions., Results: The majority of institutions (70-87%) had smoking bans in the psychiatric clinic buildings and premises. Depending on the type of psychiatric ward, exceptions were in place in the form of a designated smoking area (38%), smoking pavilion (19%), or when patients suffered from certain mental disorders (28%). Documentation of violations of the ban varied with the type of ward (30-79%), while in most cases violations led to consequences (84-93%) including confiscation of smoking utilities (42-63%) or a curfew (25-38%). Smoking cessation aids were reported by 78% of the institutions, most often as consultations (64%). Pharmacological treatments for smoking were provided in inpatient wards (71-83%). One in two institutions documented the result of cessation attempts (54%). Smoking-related working groups (14%) or the use of standardized diagnostic instruments (0-4%) were much less frequently reported., Discussion: We provide a first look at tobacco control policy measures in child and adolescent psychiatric institutions on a national scale. This allows us to derive future areas for tobacco control., Competing Interests: Die Durchführung der Studie erfolgte ohne finanzielle Zuwendung durch Tabakindustrie oder öffentliche/universitäre/private Drittmittelgeber. Die Autoren erklären, dass sie bezogen auf die vergangenen 3 Jahren folgende Interessenkonflikte berichten: SKP ist freiberuflicher Mitarbeiter an einer universitären Raucherambulanz und erhielt Vortragshonorare durch den Berufsverband Pneumologen Sachsen und ein Konsortium von Tagungssponsoren (AbbVie Germany, Almirall Hermal, Belano medical, Celgene, Janssen-Cilag, LEO Pharma, Lilly Germany, Novartis Pharma, Pfizer Pharma, UCB Pharma). SM ist Gesellschafter und Geschäftsführer einer Psychotherapeutischen Hochschulambulanz mit angebundener Raucherambulanz und steuert verantwortlich Studien zur Umsetzung möglicher Strategien für die breite Anwendung von Tabakentwöhnung innerhalb der Gesundheitsversorgung (Förderer: AOK PLUS, Deutsche Krebsstiftung, Sächsische Landesregierung, Spitzenverband GKV). CR ist angestellt im Deutschen Netzwerk Rauchfreier Krankenhäuser und Gesundheitseinrichtungen e.V. und erhielt Unterstützung bei der Kongressteilnahme durch den Veranstalter des Deutschen Suchtkongresses sowie Honorare für die Durchführung einer klinischen Auftragsstudie (Bundesministerium für Gesundheit). TR erhielt Vortragshonorare (Pfizer Pharma, Johnson+Johnson, Sanofi) und Zuschüsse zur Koyngressteilnahme (Pfizer Pharma, Johnson+Johnson). MT, KL, VR, MNS, AR berichten keine Interessenkonflikte., (Thieme. All rights reserved.)

Tobacco smoking is the greatest preventable health risk. The effects are serious, both individually and societal. Nevertheless, the current prevalence of tobacco smokers in Germany is still high at around 35 %. A recent strong increase in actively smoking adolescents (14- to 17-year-olds, current prevalence approx. 16 %) and young adults (18- to 24-year-olds, current prevalence approx. 41 %) is also a cause for concern. About a third of all inpatients continue smoking while being treated. The hospitalization of active smokers in acute and rehabilitation hospitals serves as a "teachable moment" for initiation of cessation offers. An intervention that begins in hospital and continues for at least a month after discharge results in about 40 % additional smokefree patients. It is scientifically well-researched, effective and cost-efficient. After initiation in hospital these measures can be continued via ambulatory cessation programs, rehabilitation facilities, an Internet or telephone service. In Germany, there are structured and quality-assured cessation offers, both for the inpatient and for the outpatient area. The biggest obstacle to broad establishment of such offers is the lack of reimbursement. Two feasible ways to change this would be the remuneration of the existing OPS 9-501 "Multimodal inpatient treatment for smoking cessation" and the establishment of quality contracts according to § 110a SGB V. An expansion of tobacco cessation measures in healthcare facilities would reduce smoking prevalence, associated burden of disease and consecutive costs., Competing Interests: Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

Non-smoker protection and tobacco cessation Abstract. Objective: Whereas, on the one hand, employees in child and adolescent psychiatric institutions (CAP) have to enforce smoking bans among patients, on the other hand, they have a high likelihood of being smokers themselves. Little data are available on the enforcement of smoking regulations and what cessation support is offered by CAP institutions. Method: = 78 senior staff members or directors of German CAP institutions (41.9 % of all addressed CAP institutions) responded to questions on smoking regulations, exceptions, and cessation support for employees. n = 78 senior staff members or directors of German CAP institutions (41.9 % of all addressed CAP institutions) responded to questions on smoking regulations, exceptions, and cessation support for employees. Results: The enforcement of comprehensive smoking bans is rarely reported (<20 % of CAP institutions). Employees are exempted or allowed to smoke mostly outside of the building (e. g., in designated smoking areas: 69-78 % depending on ward type). Cessation support was offered by less than half of the CAP institutions (47%). Conclusions: The data presented point toward future areas for tobacco control in CAP care, including transparent regulations, staff training, and dissemination of support for occupational smoking cessation.

Tobacco smoking is associated with severe health risks. In 2020, the WHO estimated that 8 million people have died due to smoking. Furthermore, smoking tobacco is a well-known risk factor for various infectious pulmonary diseases. The question raised, whether smoking is facilitating SARS-CoV-2-infections and increases adverse outcomes of COVID-19. To answer these questions a narrative review was conducted, finally including 7 systematic reviews with meta-analyses published in January and February 2021. Tobacco smoking was associated with an increased COVID-19 disease severity (odds ratio range of active vs. never smokers 1.55-2.19 and former vs. never smokers 1.20-2.48) and an increased COVID-19 in-hospital mortality (odds ratio range of active vs. never smokers 1.35-1.51 and former vs. never smokers 1.26-2.58). Beside immediate pulmonary toxic effects through active smoking, the cumulative livelong tobacco exposition and subsequent tobacco-associated diseases seem to predominantly predict adverse outcomes in patients with COVID-19. Data regarding an increased risk of infection among smokers is conflicting. However, a large observational study from England with 2.4 million persons reported an association between tobacco smoking and typical symptoms of COVID-19. For e-cigarettes and vaping less data exist, but experimental and first clinical investigations also suggest an increased risk for adverse outcomes for their use and SARS-CoV-2 infections. Especially during the current SARS-CoV-2 pandemic with limited therapeutic options it is particularly important to advise smokers of their increased risks for unfavourable COVID-19 outcomes. Evidence based support for smoking cessation should be offered. In Germany, the existing and well-established methods to support tobacco cessation need to be reimbursed by statutory health insurances., Competing Interests: R. Bals erhielt Forschungsunterstützung durch das BMBF, Wilhelm Sander Stiftung, Deutsche Krebshilfe, Mukoviszidose e. V., Schwiete Stiftung sowie Zuwendungen für Advisory Boards oder Vorträge von AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Novartis, CSL Behring.W. Pankow hatte Einkünfte aus Beratungstätigkeit für Pfizer Deutschland GmbH.C. Rustler: Geschäftsführung im Deutschen Netz Rauchfreier Krankenhäuser & Gesundheitseinrichtungen, Zuwendungen zur Implementierung des „rauchfrei tickets“ zur Vermittlung in die Rauchstoppberatung am Telefon der BZgA, Mitgliedschaft im Wissenschaftlichen Aktionskreis Tabakentwöhnung WAT e. V., Mitautorin der S3-Leitlinie „Rauchen und Tabakabhängigkeit: Screening, Diagnostik und Behandlung“ (2021).Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht., (Thieme. All rights reserved.)

The DNRfK (German Network for Tobacco-Free Hospitals & Health-Care Services) is based on the Code of the ENSH-Global Network for Tobacco-Free Health-Care Services. To evaluate the project, a total survey of network members using an online questionnaire (78 items) was carried out (n=181; 67.4% response rate). At the time of the recording period, 17% achieved the silver level of certification, 43% the bronze level and 40% had not been certified. Various smoking cessation methods are offered (motivational interviewing, 47%; brief interventions, 45%; individual counselling, 45%). Smokers received pharmacological support in 63% of the hospitals. Smoking cessation services are mainly carried out by physicians (63%), nursing staff (51%) and psychologists (51%). Guideline-oriented smoking cessation is offered by 36% of participants (69% silver level, 33% bronze level, and 32% in clinics without certification). The Code has been widely accepted and, consequently, well implemented by members. The quality of the tobacco control measures and evidence-based smoking cessation treatments increases with duration of membership and certification level or is validated through this. Some deficiencies were found with respect to training-the-trainer qualifications and follow-up measurements., (© Georg Thieme Verlag KG Stuttgart · New York.)

"Smoke-free hospitals" are--at least in the public's perception--regarded as a matter of course since the laws to protect non-smokers came into effect. A professional understanding of addictive diseases treatment and clinical practice indicates that healthcare services must offer more than bans to fulfill their responsibilities. They must also systematically integrate smoking cessation, motivation, and counselling in their treatment program. In a pilot project, the Federal Ministry of Health supported the development of a "Network of Smoke-free Hospitals and Healthcare Services", so that these requirements could be achieved by silver-certified facilities on the basis of European standards.

In Germany, smoking rates among women have been slightly declining since 2003. However, smoking rates among young women and girls are high and are reaching the smoking rates of their male counterparts. Only about half of pregnant smokers below the age of 25 stop smoking. Women and girls with low education and low level jobs, those who are unemployed, as well as single parents have the highest smoking rates. The tobacco industry promotes smoking behavior of women and girls through marketing campaigns, thus, systematically counteracting smoking prevention activities. Within the framework of the annual conference 2008 of the Federal Drug Commissioner on the theme of "Women and Smoking", recommendations for a gender-specific tobacco control policy in Germany were developed. The main demands relate to the necessity of a targeted policy approach which takes into account the needs and life circumstances of women and girls, the development of integrated prevention programs for pregnant women, improved medical and preventive care, the involvement of women from the media and culture, from health professions and politics to promote a smoke-free culture, gender-specific research, and the improvement of tobacco control legislation. FACT (Frauen aktiv contra Tabak e.V.) actively supports the implementation of these policy recommendations.