In addition to the obvious link between tobacco consumption and cancer of the lung and oral cavity, there isincreasing evidence that carcinogens in smoke many also have an impact in many other organ sites. The potentialdamage of second hand smoke, especially to children, also requires stress. While studies of gene polymorphisms forenzymes involved in carcinogen metabolism have pointed to a genetic background to smoking likelihood and clearlyincreased risk of cancer development in many organs for smokers with decreased detoxification potential, the questionof how to make best use of this information for practical prevention remains largely unexplored. Similarly, the factof peer group and family influence in determining initiation of adolescent smoking has yet to be translated into aconcrete strategy based on psychological understanding. Cessation programs for adult smokers on the other handcould make use of positive results from interventions in hospital settings, possibly married to screening programsfor early cancers. Political and socioeconomic questions are clearly very important and putting into action principlesof tobacco control efforts with collaboration between all of the interested parties must now be stressed. Governmentcan play a very positive role by control of sales and marketing, heavy taxation and smoking bans, and provision offunding for research and community interventions, while education and awareness are natural targets of NGOs.The academic research community can perhaps best contribute by further clarifying mechanisms underlying tobaccorelateddisease, possibly with an emphasis on chemoprevention in association with epidemiological assessment ofconfounding factors, and also very importantly the psychosociology of the tobacco habit.
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