introduction
Since the association between smoking and lung cancer was
first demonstrated [1], the risks of tobacco use have been the
subject of a large number of studies [2–4]. Not only has this
association been confirmed, but the carcinogenic effect of
tobacco use on malignant tumours other than the lung, such as
the oral cavity, larynx, bladder and oesophagus,among others
[5, 6] has also been established.
According to the World Health Organization [7], there
are >1 billion smokers in the world and tobacco use kills
5.4 million people every year. The estimated prevalence of male
smokers in the European region stands at 40% and is
somewhat lower in several Western countries. In the case of
women, 18% are estimated to be smokers, with the
prevalence among Western women being higher [8].
The prevalence of and trends in tobacco use in Spain are
detailed by Regidoret al. [9]. The most important body of anti smoking
legislation in the field of public health ever drafted in
Spain came into force in 2005, with the passing of the Anti smoking
Health Measures Act (Leydemedidas sanitarias frenteal tabaquismoy reguladorade la ventael suministroyla
publicidaddelos productosdeltabaco .
The best indicators of the magnitude of cancer are the cancer
incidence rates as furnished by population-based cancer
registries and mortality records. According to cancer incidence
estimates drawn up for Europe [11], Spain occupies an
intermediate position. Data from Spanish cancer registries for
the period 1998–2002 showed that >20% of malignant tumours
were found in the lung, bladder and larynx [12]. In 2006,
European mortality estimates indicated that lung cancer was
the leading cause of death, and indeed, in that same year, the
lung cancer mortality rate among persons aged