Tuberculosis and smoking are responsible for significant mortality worldwide. Smoking is spreading in emerging countries, and its prevalence is high in developed countries among socially disadvantaged populations; it could be the source of a resurgence of tuberculosis in future years. The aim of this review is to clarify the consequences of the association between smoking and tuberculosis, and the benefits of smoking cessation for smokers with tuberculosis.

Smoking rates in Europe are falling steadily among teenagers. The main reasons why young people start smoking are highlighted. Preventing young people from starting to smoke is based on a combination of three approaches: firstly, interventions in schools, incorporating educational programs from an early age; secondly, comprehensive tobacco control measures, such as bans on sales to minors and higher taxes on tobacco products; -thirdly, targeted communication campaigns. Finally, parents and families play an important role in providing a smoke-free environment and setting an example by giving up smoking. Many prevention programmes have been validated, but are still too infrequently deployed. We also need to prevent new modes of consumption that bring nicotine. In this way, we can work by accelerating progress to curb the tobacco epidemics and moving towards the ultimate goal of a smoke-free generation.

In 2020, lung cancer was the cause of 18 % of all cancer deaths; smoking accounting for around 90 % of all lung cancers. Despite advances in lung cancer treatment, tobacco control measures are the most effective in curbing the lung cancer epidemic. Nevertheless, smoking cessation at all stages of the cancer process is associated with benefits in terms of cure, improved life expectancy and quality of life for patients, reduced medical or surgical complications, and reduced risk of recurrence or occurrence of a second primary cancer. Consequently, smoking cessation is an essential component of lung cancer treatment. All healthcare professionals, particularly those involved in the care of lung cancer patients, must help smokers to quit.

Tuberculosis and smoking are responsible for significant mortality worldwide. Smoking is spreading in emerging countries, and its prevalence is high in developed countries among socially disadvantaged populations; it could be the source of a resurgence of tuberculosis in future years. The aim of this review is to clarify the consequences of the association between smoking and tuberculosis, and the benefits of smoking cessation for smokers with tuberculosis.

In the context of smoking cessation, the shared educational assessment (BEP) enables us to assess the smoker's needs, define specific objectives and set up appropriate educational workshops. This multidisciplinary approach helps smokers to maintain their smoking cessation. The BEP is the first step in the educational process, exploring the various classic dimensions of therapeutic patient education (TPE) and then defining an action plan based on the priorities identified.

WOMEN'S PARTICULAR PULMONARY SUSCEPTIBILITY TO TOBACCO:THE EXAMPLE OF COPD . Women are more susceptible to the harmful effects of smoking than men, even with moderate exposure, and this vulnerability begins in childhood. The prevalence of smoking has even increased, in certain age groups of women, in France between 2019 and 2021. The consequences of smoking are chronic obstructive pulmonary disease (COPD), which develops earlier and more severely in women, even with mild exposure to tobacco, frequently leading to comorbidities such as osteoporosis and anxiety-depressive disorders. Several factors, mechanical, genetic, hormonal, and inflammatory, explain the vulnerability of the female lung to smoking. The management of smoking in women requires a gender-specific approach, including early detection of COPD and appropriate smoking cessation methods.

SMOKING AND TUBERCULOSIS. Tuberculosis and smoking are responsible for high mortality worldwide. Tuberculosis causes 9 million incident cases and 1.6 million deaths every year. Smoking increases the risk of infection by Mycobacterium tuberculosis and of severe tuberculosis disease with death or recurrence. Cessation of smoking improves the course of the disease, promoting adherence to anti-tuberculosis treatment and definitive cure. All health-care professionals involved in tuberculosis care must be involved to help smokers with tuberculosis to quit.

In the context of smoking cessation, the shared educational assessment (BEP) enables us to assess the smoker's needs, define specific objectives and set up appropriate educational workshops. This multidisciplinary approach helps smokers to maintain their smoking cessation. The BEP is the first step in the educational process, exploring the various classic dimensions of therapeutic patient education (TPE) and then defining an action plan based on the priorities identified.

Le tabagisme est un facteur de risque majeur de la broncho-pneumopathie chronique obstructive (BPCO). Le diagnostic du tabagisme et la prise en charge de la dépendance tabagique font partie intégrante du traitement de la BPCO. Sa prise en charge associe un soutien psychologique, des traitements validés et l’éducation thérapeutique du patient. Elle est souvent réalisée dans le cadre de la réadaptation respiratoire. L’objectif de cette revue est de rappeler brièvement les principes de l’éducation thérapeutique du patient (ETP), adaptée à la prise en charge du fumeur, de partager des outils pour réaliser, dans le contexte du sevrage tabagique, un bilan éducatif partagé, d’adapter l’éducation selon le stade de Prochaska, de proposer un exemple de plan d’action et de questionnaire pour réaliser l’évaluation des séances. L’ETP facilite le sevrage tabagique. Enfin sont envisagés l’importance d’une éducation adaptée culturellement et le recours aux nouvelles technologies de communication pour l’éducation des patients.

L’usage d’héroïne peut causer des complications respiratoires dont l’asthme, la bronchopneumopathie chronique obstructive (BPCO) et les bronchectasies (DDB). Revue générale de la littérature exposant les données sur la relation entre la consommation d’héroïne et les complications bronchiques les difficultés du diagnostic et de la prise en charge. Medline, période 1980–2022, mots-clés : « asthma » ou « bronchospasm » ou « COPD » ou « bronchiectasis » et « heroin » ou « opiate » ou « opiates », avec les limites « Title/Abstract ». Concernant l’asthme 26 études ont été retenues, 16 pour la BPCO et 5 pour les DDB. La prévalence de l’asthme et de la BPCO est plus élevée chez les héroïnomanes ; ces patients sont moins observants de leur traitement. Une association positive existe entre la fréquence des exacerbations d’asthme, l’admission en soins intensifs et l’inhalation d’héroïne. Le diagnostic de BPCO est tardif ce qui aggrave le cours de la maladie ; la présence d’emphysème et de DDB sont des éléments de mauvais pronostic. Les affections bronchiques doivent être mieux identifiées chez les consommateurs d’héroïne afin d’optimiser leur prise en charge qui comprend l’arrêt de substances toxiques. Heroin use can cause respiratory complications including asthma, chronic obstructive pulmonary disease (COPD) and bronchiectasis (BD). A general review of the literature presenting the data on the relationships between heroin consumption and bronchial complications, while underlining the difficulties of diagnosis and management. Medline, 1980–2022, keywords “asthma” or “bronchospasm” or “COPD” or “bronchiectasis” and “heroin” or “opiate” or “opiates”, with limits pertaining to “Title/Abstract”. Concerning asthma, 26 studies were included, as were 16 for COPD and 5 for BD. Asthma and COPD are more prevalent among heroin addicts, who are less compliant than other patients with their treatment. The authors found a positive association between frequency of asthma exacerbations, admission to intensive care and heroin inhalation. Late diagnosis of COPD worsens the course of the disease; emphysema and BD are poor prognostic factors. Bronchial diseases in heroin users can be identified by means of respiratory function exploration and chest CT scans. These tests should be performed frequently in view of optimizing their care, which includes their weaning themselves from addictive substances.

The correlation between smoking and suicide is well documented in the general population: there is an increased risk of suicide among tobacco smokers. However, the association between smoking and suicidal behaviors (ideations, plans, attempts) in youth is poorly elucidated. This is a systematic review of the literature examined data on the relationship between active and passive smoking and suicidal ideation (SI), suicide planning (SP), and suicide attempts (SA) among youth in the general population.Medline searches were performed for the period 1980-2020. Cross-sectional, case-control, prospective population-based studies of young people (age less than 18 years) were included in this review; studies of specific populations (patients with an identified pathology of any kind) were excluded.This review included 43 studies: 23 studies on the association between active smoking and SI, SI and/or PS, TS; three studies on the association between passive smoking and suicidal behavior, three studies on the association between smoking and suicidal behavior in young people in psychiatric hospital settings, and five studies comparing the suicidal behavior of girls and boys. Analysis of the data collected lead to the conclusion that active or passive smoking is associated with suicidal behavior in young people. Smoking appears to contribute to psychopathological disorders, including depression, the use of other psychoactive substances, or psychosocial suffering which are often associated with an increased risk of suicide in young people. The correlations between smoking and the presence of mental disorders have been highlighted; tobacco use may contribute to the development of depression, anxiety and stress. Further studies are needed to verify the existence of a causal link between smoking and suicide.Smoking is associated with the risk of suicidal behavior in young people; it should be included among the criteria for assessing suicidal risk in youth. Smoking cessation, which improves psychological well-being, should be further integrated into the prevention of suicidal behavior.

Smoking is a major risk factor for chronic obstructive pulmonary disease (COPD). The diagnosis of tobacco addiction and management of tobacco dependence are part and parcel of COPD treatment, especially in respiratory rehabilitation. Management encompasses psycho-logical support, validated treatments and therapeutic education. The objective of this review is to briefly recall the guiding principles of therapeutic patient education (TPE) as it applies to smokers wishing to quit and, more specifically, to present the tools conducive to shared educa-tional assessment and treatment according to the Prochaska's stages of change model. We are also proposing an action plan and a questionnaire through which TPE sessions can be assessed. Finally, culturally adapted interventions and new communication technologies are taken into consideration insofar as they constructively contribute to TPE.& COPY; 2023 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Le cannabis est la substance psychoactive illicite la plus consommée en France. Il peut être responsable de nombreuses complications pulmonaires dont les hémorragies alvéolaires diffuses (HAD). L’objectif de cette revue systématique de la littérature est d’exposer les données concernant la relation entre la consommation de cannabis fumé et les HAD, rarement décrites dans la littérature. Elle a reposé sur une recherche sur Medline pour la période 1980–2022 et rassemblé les données de 10 articles. Le diagnostic repose sur l’association d’hémoptysies, d’anémie et d’opacités alvéolaires diffuses à la radiographie pulmonaire avec la présence de sidérophages dans le liquide de lavage bronchoalvéolaire (LBA). Les 11 patients recensés dans cette revue étaient des fumeurs quotidiens ou réguliers de cannabis ; ils présentaient des hémoptysies récentes ou récurrentes avec anémie dans 4 cas ; l’imagerie identifiait des opacités alvéolaires diffuses chez 10 patients et l’endoscopie avec LBA une hémorragie diffuse dans l’arbre bronchique ; la présence de sidérophages était relevée dans 6 cas. L’évolution était favorable à l’arrêt de la consommation du cannabis, mais sa reprise s’est accompagnée de récidive de l’HAD, un patient est décédé. Le conseil d’arrêt du cannabis avec suivi addictologique doivent être systématiques.

Cannabis is the most widely used illicit psychoactive substance in France. It can be responsible for numerous pulmonary complications, including diffuse alveolar hemorrhage (DAH). The objective of this systematic review of the literature was to present data concerning the relationship between cannabis smoking and DAH, which has rarely been reported in the literature. The review was based on a Medline search covering the 1980-2022 period and utilizing data drawn from 10 articles. DAH diagnosis is based on an association of hemoptysis, anemia and diffuse alveolar opacities on chest radiography with siderophages in the Bronchoalveolar Lavage Fluid (BAL). The 11 patients identified in this review were daily or regular cannabis smokers; in 4 cases they presented recent or recurrent hemoptysis with anemia; imaging revealed diffuse alveolar opacities in 10 of them, while BAL endoscopy highlighted a diffuse hemorrhage in the bronchial tree, and siderophages were observed in 6 cases. While evolution was favorable when cannabis consumption was discontinued, resumption occasioned DAH recurrence, and one patient died. Advice to quit should systematically be accompanied by addictological follow-up.& COPY; 2023 SPLF. Published by Elsevier Masson SAS. All rights reserved.