Bal D G, Lloyd J C, Roeseler A, Shimizu R
Cancer Control Branch, California Department of Health Services, Sacramento, CA 94234-7320, USA.
J Clin Oncol. 2001 Sep 15;19(18 Suppl):69S-73S.
One of every three persons who starts smoking falls ill and dies prematurely because he or she smoked. Smoking has been causally linked to heart disease, cancer, and respiratory diseases and continues to be the number one preventable cause of death in this country. To prevent these deaths and the incidence of these diseases, California's Tobacco Control Program was established in 1989 specifically to reduce tobacco use in the state. The strategy of the program is to "denormalize" tobacco. This strategy emphasizes three areas of programmatic activity: to counter pro-tobacco influences, to reduce exposure to environmental tobacco smoke, and to reduce access to tobacco products, with a focus on both social and commercial sources. A fourth priority area, cessation, is considered more of an outcome. California's Tobacco Control Program has touched the life of every Californian. Adult smoking prevalence in the state has gone from approximately 11% lower than the rest of the nation in 1988 to 20% lower in 1996. There are now approximately one million fewer smokers in California than would have been expected. Overall, per capita cigarette consumption has fallen by more than 50%. Seventy percent of adult smokers reported that they tried to quit in the last year. Exposure to secondhand smoke has plummeted. California's lung and bronchus cancer incidence is already declining at a significantly higher rate than that seen elsewhere in the nation. Youth smoking rates have also declined significantly. However, contrary to the message of its massive public relations campaign, the tobacco industry has not changed its stripes after the national tobacco settlement. They are still aggressively marketing their products to teenagers, ethnic minority groups, and young adults. They need to be combatted with renewed vigor by a vigilant health community.
每三个开始吸烟的人中就有一人会因吸烟而患病并过早死亡。吸烟与心脏病、癌症和呼吸系统疾病存在因果关系，并且仍然是该国可预防的首要死因。为了预防这些死亡以及这些疾病的发生，加利福尼亚州于1989年设立了烟草控制项目，专门用于减少该州的烟草使用。该项目的策略是使烟草“非规范化”。这一策略强调项目活动的三个领域：对抗支持烟草的影响、减少接触环境烟草烟雾以及减少获取烟草制品的机会，重点关注社会和商业来源。第四个优先领域——戒烟，更多地被视为一种成果。加利福尼亚州的烟草控制项目已经影响到了每一位加利福尼亚人的生活。该州成年人吸烟率从1988年比美国其他地区低约11%降至1996年低20%。现在加利福尼亚州的吸烟者比预期少了约100万。总体而言，人均香烟消费量下降了超过50%。70%的成年吸烟者报告称他们在过去一年尝试过戒烟。二手烟暴露量大幅下降。加利福尼亚州肺癌和支气管癌的发病率下降速度已经明显高于美国其他地区。青少年吸烟率也显著下降。然而，与大规模公关活动所传达的信息相反，烟草业在全国烟草和解协议达成后并未改变其本性。他们仍在积极地向青少年、少数族裔群体和年轻人推销其产品。一个警惕的健康群体需要以新的活力与之抗争。
