We are in the midst of a persistent pandemic that threatens the health of the population we care for, particularly impacts on the socially disadvantaged, and whose control has been undermined by complacency and failure to generate consensus on adoption of measures to promote behavioral changes to contain its impact. Or perhaps two, because I am now referring to the tobacco pandemic, which in fact continues to be a greater threat than COVID-19. According to the World Health Organization, tobacco kills more than 8 million people a year around the world, 1.2 million of whom are non-smokers being exposed to second-hand smoke [ ]. Nonetheless, tobacco use continues to be rampant, reported by 21% of adults in the U.S [ [2] Cornelius ME Wang TW Jamal A Loretan CG Neff LJ. Tobacco product use among adults - United States, 2019.

MMWR Morb Mortal Wkly Rep. 2020; 69: 1736-1742

], and 26% in Europe (with significant variation among different countries); lower educational status and household income are important risk factors internationally [ [3] Gallus S Lugo A Liu X Behrakis P Boffi R Bosetti C Carreras G Chatenoud L Clancy L Continente X Dobson R Effertz T Filippidis FT Fu M Geshanova G Gorini G Keogan S Ivanov H Lopez MJ Lopez-Nicolas A Precioso J Przewozniak K Radu-Loghin C Ruprecht A Semple S Soriano JB Starchenko P Trapero-Bertran M Tigova O Tzortzi AS Vardavas C Vyzikidou VK Colombo P Fernandez E Tack SHSPI. Who Smokes in Europe? Data from 12 european countries in the TackSHS survey (2017-2018).

J Epidemiol. 2021; 31: 145-151

].