DÄ internationalArchive17/2020Lack of Authoritative Measures to Support Abstinence From Nicotine
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The authors clearly pointed out that currently in Germany, fewer and fewer smokers stop smoking, and that several factors can be outlined that further stabilize the social gradient in smoking and health behaviors (1). Chronic obstructive pulmonary disease, which accounts for about one-third of all lung transplantations in Germany, can be explained in the vast majority of cases with tobacco inhalation. It is of note that in the current guideline of the German Medical Association according to paragraph 16 section 1 S.1 Nos 2 and 5 of the German Transplant Act, the only formal requirement is six months’ abstinence before admission to the waiting list. Recent studies have found a smoking relapse rate after lung transplantation of up to 15% (2). In my opinion, comparable authoritative measures from transplantation centers are lacking, which before and especially after a transplantation help patients to maintain abstinence—and which should therefore be funded in advance for each patient and, in particular, independently of the patient’s income, not least in order to meet the legislator’s ambiguous claim in § 1 of the transplant act in each and every possible way: “The aim of the law is to promote willingness to donate organs in Germany.”

DOI: 10.3238/arztebl.2020.0298b

Michael Noll-Hussong, MD
Psychosomatic Medicine and Psychotherapy
Saarland University Medical Center
Kirrberger Str. 100
66421 Homburg
Germany
Michael.Noll-Hussong@uks.eu

Conflict of interest statement

The author declares that no conflict of interest exists.

1.
Kotz D, Batra A, Kastaun S: Smoking cessation attempts and common strategies employed—a Germany-wide representative survey conducted in 19 waves from 2016 to 2019 (The DEBRA Study) and analyzed by socioeconomic status. Dtsch Arztebl Int 2020; 117: 7–13 VOLLTEXT
2.
Hofmann P, Benden C, Kohler M, Schuurmans MM: Smoking resumption after heart or lung transplantation: a systematic review and suggestions for screening and management. J Thorac Dis 2018; 10: 4609–18 CrossRef MEDLINE PubMed Central
1.Kotz D, Batra A, Kastaun S: Smoking cessation attempts and common strategies employed—a Germany-wide representative survey conducted in 19 waves from 2016 to 2019 (The DEBRA Study) and analyzed by socioeconomic status. Dtsch Arztebl Int 2020; 117: 7–13 VOLLTEXT
2.Hofmann P, Benden C, Kohler M, Schuurmans MM: Smoking resumption after heart or lung transplantation: a systematic review and suggestions for screening and management. J Thorac Dis 2018; 10: 4609–18 CrossRef MEDLINE PubMed Central

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