La sigaretta come rifugio : il fumo tra dissonanza e identità : il caso di una paziente in attesa di trapianto

The link between tobacco addiction and access to life-saving care is a complex issue that raises clinical, psychological and ethical questions.Tobacco smoking is recognized as a major risk factor for chronic respiratory diseases, cardiovascular diseases and lung cancer (WHO, 2023; U.S. Department of Health and Human Services, 2014).In particular, in organ transplantation pathways, adherence to rigorous medical criteria is essential to ensure the candidate's suitability, the success of the operation and the patient's long-term survival.In the context of lung transplantation, smoking cessation is an essential requirement.Several studies show that continuing to smoke can compromise the function of the new organ, increase the risk of rejection and reduce post-operative.However, nicotine addiction is a complex condition, rooted at both the neurobiological and psychological levels, and represents a signifi cant challenge for many patients.When addiction hinders the possibility of

transplantation, diffi culties arise not only for the patient, but also for health professionals, who must reconcile the principle of equity with the clinical responsibility to optimize the probability of transplant success.In fact, transplant centers often exclude patients who are active smokers from waiting lists, as they are considered to be at greater risk of negative outcomes.This article addresses the case of a patient with severe respiratory failure, whose possibility of entering the lists for lung transplantation is compromised by her persistent nicotine addiction.The medical and psychological aspects of this condition will be analyzed, with reference to the scientific literature on addictions and behavioral change. [Publisher's text]