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E‑cigarettes are increasingly used to replace tobacco cigarettes and to stop smoking, but mainly in the sense of dual use. There is lively debate about the assessment of the health risks of e‑cigarettes, but so far there are no comprehensive data for direct comparison with tobacco cigarettes. Other points of controversy include the potential for smoking cessation and the risk of moving from e‑cigarettes to tobacco cigarettes (gateway hypothesis). The present overview comes to the conclusion that, in accordance with the health policy already largely implemented in Great Britain, e‑cigarettes represent a greatly reduced health risk compared with tobacco cigarettes and are certainly suitable for giving up smoking.

Smoking is the biggest cause of premature mortality. Almost half of smokers meet the criteria for addiction. Treatment fails primarily because of the lack of reimbursement. Doctors could treat tobacco addiction and with it the secondary diseases with high efficacy if the conditions with behavioral therapy and medication were made available to them., Competing Interests: Thomas Hering: Honorare für Beratung, Vorträge 2016/2017/2018 von AstraZeneca GmbH, Berlin Chemie, Böhringer, Marpinion, Meda Pharma, Novartis GmbH, Pfizer Pharma GmbH, PulmonX, Roche-Pharma AG, Sanofi-AventisAnil Batra: Wirtschaftliche Verbindungen: Verlage: Thieme. Kohlhammer, Elsevier, Fortbildung: FomF, Ärztekammern, Wissentransfer Tübingen, Forschung: Janssen, Pfizer, ParexelStephan Mühlig: Pfizer: Reisekosten und Vortragshonorare, (© Georg Thieme Verlag KG Stuttgart · New York.)

Smoking cessation as a therapeutic intervention has largely not the significance that it should have according to its potential influence on diseases in the pulmonary practice. Barriers against smoking cessation apart from the addiction character of tobacco dependence are mainly the almost complete absence of reimbursement as well as concerns regarding low achievable long-term abstinence. The presented study shows that despite these barriers smoking cessation in pulmonology practice is successful if carried out by using a 2-step motivation of the participants. The long-term abstinence success of 46 % after 12 months (point prevalence) presented here was achieved with the use of behavioral therapy and medical support. Success factors are doctor's office setting and consequent information and encouragement for medical support (mostly varenicline)., (© Georg Thieme Verlag KG Stuttgart · New York.)

Chronic obstructive pulmonary disease (COPD), lung cancer, asthma and pulmonary tuberculosis are common pulmonary diseases that are caused or worsened by tobacco smoking. Growing observational evidence suggests that symptoms and prognosis of these conditions improve upon smoking cessation. Despite increasing numbers of (small) randomised controlled trials suggesting intensive smoking cessation treatments work in people with pulmonary diseases many patients are not given specific advice on the benefits or referred for intensive cessation treatments and, therefore, continue smoking.This is a qualitative review regarding smoking cessation in patients with COPD and other pulmonary disorders, written by a group of European Respiratory Society experts. We describe the epidemiological links between smoking and pulmonary disorders, the evidence for benefits of stopping smoking, how best to assess tobacco dependence and what interventions currently work best to help pulmonary patients quit. Finally, we describe characteristics and management of any "hardcore" smoker who finds it difficult to quit with standard approaches., (Copyright ©ERS 2015.)

Continuous cigarette smoking clearly influences the course and prognosis of diseases like COPD/emphysema and asthma bronchiale in an adverse manner. However smoking cessation as a therapy measure is not a common part of general health-care in Germany as reimbursement of the central component of psychosocial support (behavioural therapy - BT) is allowed only to a minor degree and of pharmacotherapy support (nicotine replacement, varenicline, bupropione) is completely excluded by the legislator. This prospective "real-life" study with 198 participants shows, that with the abolition of the reimbursement barrier for cognitive behavioural therapy in the setting of a pneumological practice/clinic a high long-term abstinence of 45.4 % (point prevalence after 12 months) can be achieved. Apart from the reimbursement of BT, predominant success factors were the implementation of the measure in the practice/clinic, where patients are under long-term treatment and the application of a two-stage motivational model for the participation. Reimbursement of smoking cessation pharmacotherapy was not possible in this study. Thus, pharmacotherapy was applied to fewer than necessary patients and was predominantly too short and in a too low dosage., (© Georg Thieme Verlag KG Stuttgart · New York.)

More than 30 % of the German population are regular smokers, over half of whom will eventually die of smoking-related diseases. Life expectancy is abridged by 10 years in smokers compared to non-smokers. Smoking tobacco is the main risk factor for lung cancer and chronic obstructive pulmonary disease (COPD) and predisposes to a number of other lung diseases. A smoking cessation programme including pharmacological as well as psychosocial support is highly effective in COPD Patients. Smoking cessation improves lung function, symptoms and mortality. In conclusion, smoking cessation services are among the most effective medical interventions. Thus, a sufficient supply of smoking cessation services on a population level must be ensured.