哮喘联盟

   摘要
   自从二十世纪六十年代吸烟风尚衰退以来，50年中，数以百万计的吸烟者已经永久性停止吸烟。其中绝大部分没有依靠药物或专业指导之类的正式协助，这其中包括几百万重度吸烟者。关于全国和全球控烟终极目标的初步讨论认为，从香烟过渡到等效的、顾客可接受的尼古丁剂型将是成功控烟的必由之路。这似乎不加鉴别的假设（1）固化假说：一旦吸烟的流行性低于10%，剩下的吸烟者都是重度瘾君子，很难戒烟，除非他们使用其他“清洁”尼古丁，如电子香烟和其他强效尼古丁替代品。（2）吸烟的过度医疗化提示无协助的戒烟是无效的和非人道的。在本文中，我们对这些假说提出疑问。我们也注意到一些正在经历吸烟流行性下降的先锋国家已经长时间禁止烟烟草和非治疗性尼古丁应用。我们提出质疑，强调在历史提示大规模人群戒烟确实可行时，解除这些禁令存在危险后果。

 

（林江涛 审校）
Tob Control. 2013 May;22Suppl 1:i33-i35. doi: 10.1136/tobaccocontrol-2012-050767.

Large-scale unassisted smoking cessation over 50 years: lessons from history for endgame planning in tobacco control.

Chapman S, Wakefield MA.

Abstract
In the 50 years since the twentieth century's smoking epidemic began to decline from the beginning of the 1960s, hundreds of millions of smokers around the world have stopped smoking permanently. Overwhelmingly, most stopped without any formal assistance in the form of medication or professional assistance, including many millions of former heavy smokers. Nascent discussion about national and global tobacco endgame scenarios is dominated by an assumption that transitioning from cigarettes to alternative forms of potent, consumer-acceptable forms of nicotine will be essential to the success of endgames. This appears to uncritically assume (1) the hardening hypothesis: that as smoking prevalence moves toward and below 10%, the remaining smokers will be mostly deeply addicted, and will be largely unable to stop smoking unless they are able to move to other forms of 'clean' nicotine addiction such as e-cigarettes and more potent forms of nicotine replacement; and (2) an overly medicalised view of smoking cessation that sees unassisted cessation as both inefficient and inhumane. In this paper, we question these assumptions. We also note that some vanguard nations which continue to experience declining smoking prevalence have long banned smokeless tobacco and non-therapeutic forms of nicotine delivery. We argue that there are potentially risky consequences of unravelling such bans when history suggests that large-scale cessation is demonstrably possible.
 

Tob Control. 2013 May;22Suppl 1:i33-i35. doi: 10.1136/tobaccocontrol-2012-050767.