中国控烟政策变迁：基于支持联盟框架的分析

中国控烟政策经历了30余年的变迁,控烟成效微弱。本文利用支持联盟框架分析了中国控烟政策变迁机制,认为控烟政策是支持控烟联盟和反对控烟联盟冲突、妥协的产物。控烟政策变迁主要发生在表层信仰层面,政策核心信仰冲突严重,难以调和;外部事件在推动中国控烟政策变迁中起到了重要的作用,但当前的控烟政策只是象征性的政策,不能产生实质性的控烟效果。应当从政策核心信仰层面入手,通过寻求高层支持,自上而下推行控烟;加快控烟立法;重组控烟履约工作小组;加强舆论宣传,扩大支持控烟联盟影响力等途径推进控烟政策变迁。     

我国地方控烟政策:基于政策文本的内容分析

目的 挖掘我国地方性控烟政策的特征，为完善控烟政策和“健康中国”控烟行动提供参考。方法 统计拥有地方立法权的53个城市的控烟政策，并对2005年后立法或修法的24个地方控烟政策进行内容分析。结果 控烟政策的法律效力低；政策规划设计尚需优化；实施层经济型、信息型政策工具运用相对不足。结论 我国地方性控烟政策需提高政策的法律效力；规划层利益主体充分参与，优化控烟政策设计；实施层加强对未成年人的保护，发挥多种政策工具作用；在控烟范围上，逐步建立明确、严谨、统一的标准。     

南宁市控烟现状调查分析

目的了解南宁市控烟现状,开展控烟需求评估、控烟活动效果评估,创建无烟环境、降低被动吸烟的危害。方法根据“迈向无烟中国”项目组“项目基线调查方案”制订南宁市“迈向无烟中国”项目基线调查方案”,对南宁市控烟政策、控烟能力、网络现状,六种场所不同人群控烟知识知晓率,以及烟草企业现状进行调查。结果公共场所禁烟规定有着良好的群众基础,控烟网络建设有待完善,公众对被动吸烟健康危害的认识及对部分公共场所禁烟政策的支持尚有待提高。结论南宁市控烟工作基础薄弱,应积极促使公共场所禁止吸烟相关法规的出台和实施,整合控烟力量。建立控烟网络,创建无烟环境。努力提高南宁市的控烟能力,最终减少被动吸烟的暴露。     

中国控烟进程中媒体报道现状及健康传播对策

<正>2011年1月6日,《控烟与中国未来--中外专家中国烟草使用与烟草控制联合评估报告》发布,报告称:我国控烟效果微弱,吸烟率居高不下,控烟履约绩效得分低,与《烟草控制框架公约》要求差距巨大。在中国履行世界卫生组织《烟草控制框架》五年中,随着中国控烟工作的深入,中国的控烟进展频频出现在媒体报     

中国控烟政策无力

<正>控烟专家近日表示,通过对"金砖五国"近年来控烟政策的横向对比研究后发现,中国的控烟力度最为薄弱:在其他金砖国家均大力控烟的情况下,我国控烟仍踯躅不前,前景令人担忧。据新探健康发展研究中心副主任吴宜群介绍,我国控烟政策的薄弱,主要体现在对《世界卫生组织烟草控制框架公约》的执行力度上。     

从首都高校控烟实践看北京市政府卫生行政职能的转变

北京市自1996年提出争创无烟学校的口号以来，市政府相关部门对高校控烟问题给予了高度重视，并在控烟政策实施过程中加大了对社会活动的卫生行政监督管理力度。首都高校控烟活动取得成绩的关键就在于政府卫生行政职能的转变。笔者通过调查在京6所高校控烟政策的实施情况，分析了北京市政府卫生行政职能转变的现实意义。     

青岛市部分医院医务人员吸烟行为与控烟能力干预效果评价

目的评价控烟干预对医务人员吸烟行为的影响效果,探讨提高医务人员控烟能力的方法,推进医院无烟环境建设。方法以参加无烟城市盖茨中国控烟项目的青岛市5家医院的医务人员为研究对象,经过1年的环境、政策、健康教育等控烟干预手段,评价医务人员吸烟行为和控烟能力干预效果。结果经过1年的干预,医务人员总体吸烟率下降,吸烟量降低;对吸烟和二手烟的认知有了改变;支持无烟政策,在诊疗过程中为就诊者提供烟草危害知识和戒烟服务能力提高。结论针对医务人员控烟的行为是积极可行的,对医务人员进行控烟健康教育措施效果显著,但在戒烟技巧、戒烟政策常态化方面应进一步提高和改善。     

本期专栏导语

<正>烟草使用对健康的危害已经成为当今世界和我国严重的公共卫生问题之一。我国现有吸烟者逾3亿,每年因吸烟相关疾病所致的死亡人数超过100万,烟草控制对于实现"健康中国"目标具有重要意义。2006年1月,世界卫生组织《烟草控制框架公约》(简称《公约》)在我国生效,依据《公约》要求,部分城市开展了地方控烟立法工作,从立法和执法方面都取得了积极进展。本期特约专家撰写了《中国城市控烟法规研究(2006-2019)》,全面描述了我国城市控烟立法现状。本期特约的北京市、兰州市和张     

武警部队控烟的现状与对策

目的 了解武警部队控烟工作现状,探讨武警部队控烟的对策,提高官兵的保障水平.方法 对武警部队的吸烟控烟现状进行总结,分析控烟中遇到的难点,并提出解决对策.结果 部队控烟活动在政策的支持下开始开展,但是控烟范围涉及面窄,难以推广.总结出部队控烟面临缺乏环境和政策的支持、工作及生活环境的特殊性、缺乏戒烟的技术支持等困难；提出了加大健康教育力度,制定控烟的具体政策(控烟网络),充分发挥带队骨干、干部和医务人员的带头作用,提供具体戒烟服务4方面的对策.结论 在部队开展控烟工作有困难也有挑战,探讨在武警部队中控烟的策略对国家履行《烟草控制框架条约》有着积极的意义.     

控烟支持环境的构建与控烟干预策略探讨

吸烟严重危害人体健康,控烟需要干预的不仅是吸烟的"烟民",还包括被动吸烟人群。构建控烟的支持环境和多种控烟干预措施,对控烟工作取得实效显得尤为重要。1当前吸烟环境的客观评价1.1我国吸烟环境现状2010年,由中国疾病预防     

手机戒烟干预和网络戒烟干预的国际进展研究

提供戒烟帮助是控烟工作的重点之一。该文对国际上新显现的手机戒烟干预和网络戒烟干预的发展进行了总结,以期为我国的控烟工作提供借鉴支持。手机和网络戒烟干预方式的共同优势在于：无时间和地域性的限制,范围更广;规避了有些人不愿意面对面交流的忧虑,保护了咨询者的隐私;成本相对较低。二者在可及性、沟通效果、成本效益等方面则各有利弊。     

控烟研究应紧密对接控烟政策与实践

控烟研究在烟草控制中具有重要意义,目前我国真正与控烟政策及实践相关的研究并不多。本文结合减少烟草需求的MPOWER控烟策略,从监测烟草的使用和预防政策、保护人们免受二手烟的危害、提供戒烟帮助、警示烟草危害、禁止烟草广告促销与赞助和提高烟税6个方面提出了每一领域研究的方向思路,为今后控烟领域的相关研究提出建议和参考。     

Tobacco control and household tobacco consumption: A tale of two educational groups

Since the ratification of the World Health Organization Framework Convention on Tobacco Control in 2004, Pakistan has made modest but continued progress in implementing various tobacco control measures. By 2014, substantial progress was achieved in areas of monitoring, mass media antitobacco campaigns, and advertising bans. However, the findings from the 2014 Global Adult Tobacco Survey of Pakistan show significant differences in antitobacco campaign exposure among individuals of different educational attainment. Given this large variation in noticing antitobacco information, this paper analyzes how heterogeneity in treatment exposure may differentially impact tobacco‐use prevalence across household groups. Household‐level tobacco‐use prevalence in 2014 was, respectively, 56% and 48% for the low‐ and high‐education households. The gap in tobacco‐use prevalence between the two educational groups further widens post 2014. We find that, on average, individuals with higher than primary education are 14 percentage points and 6 percentage points more likely to notice anticigarette and antismokeless tobacco information in 2014, respectively. Subsequently, in 2016, high‐education households experienced a 3.6 percentage point higher reduction in tobacco‐use prevalence compared to the low‐education households. These findings motivate policies to enhance the outreach of tobacco control measures across different educational groups.     

中国人群的吸烟率究竟有多高——三项全国烟草流行调查结果比较

目的 比较近年来全国烟草流行调查,筛选最准确可靠的调查数据反映中国烟草流行水平.方法 对比"2002年行为危险因素监测"、"2002年中国居民营养与健康状况调查"和"2003年第三次全国卫生服务调查"中的烟草流行调查数据,筛选出较为可靠的中国烟草流行数据.筛选原则:(1)基于调查结果估计的烟草消费量应与当年的烟草实际供给量相当;(2)根据国际控烟经验,男性现在吸烟率平均每年下降幅度应不超过1%.结果 根据"2002年行为危险因素监测"结果计算的卷烟消费量与实际供给量相差最少(510.7亿支),根据"2002年中国居民营养与健康状况调查"结果计算的卷烟消费量与实际供给量相差次之(629.4亿支),根据"2003年第三次全国卫生服务调查"估计的结果与实际供给量相差最大(2171.1亿支);与1996年全国烟草流行率相比,根据"2002年行为危险因素监测"结果,烟草流行率平均每年下降0.9%,根据"2002年中国居民营养与健康状况调查"结果,烟草流行率平均每年下降2.2%,而根据"2003年第三次全国卫生服务调查"结果,烟草流行率平均每年下降2.0%.因此,"2002年行为危险因素监测"的烟草流行数据更为可靠.结论 "2002年行为危险因素监测"的结果可以用于反映中国烟草流行水平.由于烟草流行率是控烟政策制订必需的关键信息,因此亟需建立一个标准的国家监测系统以监测烟草流行状况.     

State preemption of local tobacco control policies restricting smoking, advertising, and youth access--United States, 2000-2010

Preemptive state tobacco control legislation prohibits localities from enacting tobacco control laws that are more stringent than state law. State preemption provisions can preclude any type of local tobacco control policy. The three broad types of state preemption tracked by CDC include preemption of local policies that restrict 1) smoking in workplaces and public places, 2) tobacco advertising, and 3) youth access to tobacco products. A Healthy People 2020 objective (TU-16) calls for eliminating state laws that preempt any type of local tobacco control law. A previous study reported that the number of states that preempt local smoking restrictions in one or more of three settings (government worksites, private-sector worksites, and restaurants) has decreased substantially in recent years. To measure progress toward achieving Healthy People 2020 objectives, this study expands on the previous analysis to track changes in state laws that preempt local advertising and youth access restrictions and to examine policy changes from December 31, 2000, to December 31, 2010. This new analysis found that, in contrast with the substantial progress achieved during the past decade in reducing the number of states that preempt local smoking restrictions, no progress has been made in reducing the number of states that preempt local advertising restrictions and youth access restrictions. Increased progress in removing state preemption provisions will be needed to achieve the relevant Healthy People 2020 objective.     

Gesetzliche Maßnahmen zur Tabakprävention

Structural measures of tobacco prevention are effective and cost-efficient measures to reduce tobacco consumption and the related health and economic consequences. However, Germany has been very reluctant in implementing tobacco control laws for several decades. Only recently has Germany increased its efforts in tobacco control, which has resulted in a decrease of tobacco consumption and in a decrease of smoking rates, especially in youths. This paper summarizes the evidence-based measures of tobacco prevention as well as the progress of recent German tobacco control policies. Finally, the barriers of further effective tobacco control policies are discussed and illustrated with examples. For decades, politics gave in to pressure and influence of lobbyists of the strong tobacco industry, which deceived the public and politics for their economic interests and in order to establish a high social acceptance of smoking. In addition, there is the phenomenon of “denialism”, which means the convinced denial of scientific findings regarding smoking and smoking prevention in opponents of tobacco control, who are not directly affiliated with the tobacco industry.     

Myths and attitudes that sustain smoking in China

China is a particularly critical country for global tobacco control. It has the world's largest number of smokers and is a prize target for the multinational tobacco companies. This article presents results from 80 focus groups and 30 in-depth interviews on the salient myths and misconceptions concerning active and passive smoking for the purpose of developing appropriate tobacco control policies and intervention strategies to reduce tobacco consumption and secondhand smoke exposure. All participants resided in three counties in Jiangxi, Henan, and Sichuan provinces and were from hospitals, schools, and rural and urban communities. The myths and misconceptions included the identification of smoking as a symbol of personal freedom, the importance of tobacco in social and cultural interactions, the ability to control the health effects of smoking through "reasonable" and "measured" use, and the importance of tobacco to the economy. These myths were found in nonsmokers and smokers alike, in both rural and urban areas, and across the key professional groups. For China to curb its current smoking epidemic, tobacco control efforts will have to persuasively address and counter prevailing misconceptions and social norms surrounding smoking. This article discusses the implications of misconceptions and prosmoking attitudes for tobacco control efforts in China.     

Selected aspects of tobacco control in Bulgaria: policy review

This paper seeks to outline the challenges of tobacco consumption control in the transitional economy of Bulgaria. It focuses on issues of taxation, high unemployment, and smuggling while attempting to meet European Union (EU) requirements for tobacco control legislation that reduces smoking consumption. The issue of tobacco control is not a simple one and requires a multi-pronged approach. While Bulgaria has made some progress in adopting legislation, it needs to strengthen its efforts in terms of enforcement, stronger legislation and increased taxation of cigarettes.