Neeman R L, Neeman M
J Sch Health. 1975 Jan;45(1):17-23. doi: 10.1111/j.1746-1561.1975.tb04459.x.
Cigarette smoking is a many-headed Hydra, which grows new smokers' heads as fast as they are lopped off. Efforts to change smokers' behavior usually reach a point of diminishing returns, as evidenced by experiences in smoking withdrawal clinics and in public anti-smoking education campaigns. Obviously, many smokers are refactory to anti-smoking education, a situation which has generated a great deal of pharmacological, neurochemical, psychological, and sociological research. The National Clearinghouse for Smoking and Health in the U.S.A. has used a "gradualist" or permissive approach in anti-smoking messages, aimed at less hazardous smoking "if you must smoke," rather than at complete cessation, and found this approach to be useful. U.S.A. school-children are exposed to anti-smoking education in lower grades than formerly, when it was offered in high school. Thus a population of as yet non-smoking children is being educated. Perhaps the adult non-smokers should be enlisted in an effort to create a social climate wherein smoking is not an acceptable behavior-an approach reflecting the concept of smoking as a social disease. Health education addressed to the receptive non-smoker would circumvent the refractory smoker. A theme with appeal to non-smokers is the protest against environmental pollution by smokers. It is possible that if a movement by non-smokers against smoking would gather momentum, it could turn the present accepting social climate into one rejecting smoking, thus striking at the regeneration of the Hydra: the incessant recruitment of smokers among ex-smokers and non-smokers. With recruitment below replacement level, the Hydra would in time wither away.
吸烟如同多头的九头蛇，砍掉一批烟民的脑袋，又会迅速长出新的烟民。改变吸烟者行为的努力往往会达到收益递减的阶段，戒烟诊所和公共反吸烟教育活动的经验就证明了这一点。显然，许多吸烟者对反吸烟教育有抵触情绪，这种情况引发了大量药理学、神经化学、心理学和社会学研究。美国国家吸烟与健康信息中心在反吸烟宣传中采用了“渐进主义”或宽容的方法，目标是让吸烟者“如果非要吸烟”选择危害较小的方式，而非完全戒烟，结果发现这种方法很有用。美国的小学生比以前更早就在低年级接受反吸烟教育，以前是在高中才开展。这样一来，就正在对尚未吸烟的儿童群体进行教育。也许应该动员成年不吸烟者，努力营造一种吸烟不被接受的社会氛围——这种方法反映了吸烟是一种社会疾病的观念。针对易于接受的不吸烟者开展健康教育可以避开那些有抵触情绪的吸烟者。一个能吸引不吸烟者的主题是抗议吸烟者对环境污染。如果不吸烟者反对吸烟的运动能够形成势头，就有可能把目前这种宽容的社会氛围转变为一种抵制吸烟的氛围，从而打击九头蛇的再生：在前吸烟者和非吸烟者中不断招募新烟民。当招募人数低于更替水平时，九头蛇最终就会枯萎。
