Abstract
•Es bestehen heute keine Zweifel mehr darüber, dass langjähriges Tabakrauchen zu Veränderungen im Respirationstrakt führt, wobei entzündliche Prozesse im Bronchialbereich und in den unteren Lungenabschnitten im Vordergrund stehen. Später ist auch die Ausbildung von Bronchialkarzinomen bei entsprechender genetischer Disposition von Bedeutung.
•Ätiologisch wichtig ist die monate- und jahrelange Exposition gegenüber verschiedenen Inhalationsprodukten des Tabaks wie Benzo[a]pyren, Nitrosamine (NNK, NNN), Lösungsmittel (Benzol, Crotonaldehyd, Formaldehyd) und Polonium- 210. Wenn auch der Filter den eingeatmeten Teergehalt von Zigaretten reduzieren kann, so ist seine Rolle als Schutzfaktor vor dem Entstehen eines Bronchialkarzinoms als untergeordnet anzusehen. Trotz eines jahrelangen Rauchstopps geht das Risiko nicht auf die Ebene eines Nichtrauchers zurück. Während in den USA und andeutungsweise auch in Deutschland die Zahl der Bronchialkarzinome bei Männern zurückgeht, steigt sie bei Frauen permanent an. Dabei sind diese Tumoren zu etwa 90% rauchbedingt.
•Zusammen mit den häufiger gerauchten Light-Zigaretten steigt der Anteil von Adenokarzinomen, die schlechter als Plattenepithelkarzinome zu behandeln sind.
•Nach einer groß angelegten tschechischen Studie sind Krebsvorsorgeuntersuchungen in Form von halbjährlichen Röntgen- und Sputumuntersuchungen nicht geeignet, die Mortalität zu senken [185].
•Die oft jahrelang durch das Rauchen unterhaltene COPD gewinnt sozioökonomisch zunehmend an Bedeutung, weil sie therapeutisch nur aufwändig zu beherrschen ist und noch häufiger als das Bronchialkarzinom auftritt.
•Asthmaerkrankungen, besonders bei Kindern, werden durch das Passivrauchen nicht ursächlich ausgelöst, aber durch den inhalierten Rauch unterhalten und in ihrer Progression beschleunigt. Deshalb sollten Eltern das Rauchen aufgeben, wenn mit ihnen Kleinst- und Kleinkinder im Haushalt leben.
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(2008). Rauchen und Lungenerkrankungen. In: Haustein, KO. (eds) Tabakabhängigkeit. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-73309-6_6
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