Bartal M
Department of Respiratory Diseases, CHU Ibnou Rochd, University Hospital, Casablanca, Morocco.
Monaldi Arch Chest Dis. 2001 Dec;56(6):545-54.
Tobacco is still widely consumed in a variety of different ways, mainly as smokeless tobacco and cigarette smoking. Four traits characterize tobacco use whatever the way of using it: 1) addiction linked to nicotine is behind all the tobacco hazards; 2) individual variation in tobacco susceptibility; 3) dose-response relationship; 4) time-lag effect. Smokeless tobacco, chewed or snuffed can lead mainly to inflammation of the oral cavity and oral cancers. Cigarette smoking accounts for 65-85% of global tobacco consumption. Active smoking can cause: 1) respiratory disorders culminating in chronic obstructive pulmonary disease (COPD) and emphysema; 2) cardiovascular hazards by way of increased vascular spasm and atherosclerosis leading to acute and chronic myocardial events, cerebral and peripheral vascular diseases; 3) cancers: twelve types are caused or related to cigarette smoking. Lung cancer is still the leading cause of cancer death in most high-income countries where data are available. An excess mortality is associated with smoking, with a 2-fold greater risk in smokers than in nonsmokers throughout middle age. The exposed pregnant woman subjects herself and her pregnancy to risks, and her fetus to growth retardation and perinatal morbidity and mortality. Passive smoking implicates 20-80% of the whole population. It can be nearly as harmful as active smoking depending upon risk factors, and can lead to short as well as to long-term effects. Children are the most vulnerable population particularly during the first years of life. Passive smoking increases risks for higher and lower respiratory tract illness but a smoke-free environment improves all these disorders. Ischemic heart diseases and lung cancer are the main risks for non smoking adults exposed to cigarette smoke. Tobacco use and exposure is the single most important source of preventable morbidity, disability and premature mortality. But giving up smoking helps at any time, the sooner the better. Health professionals should be the key advocates in tobacco prevention.
烟草仍以多种不同方式被广泛消费，主要是无烟烟草和吸烟。无论使用方式如何，烟草使用都具有四个特征：1）与尼古丁相关的成瘾性是所有烟草危害的根源；2）个体对烟草易感性的差异；3）剂量反应关系；4）时间滞后效应。咀嚼或鼻吸的无烟烟草主要会导致口腔炎症和口腔癌。吸烟占全球烟草消费的65%-85%。主动吸烟会导致：1）呼吸系统疾病，最终发展为慢性阻塞性肺疾病（COPD）和肺气肿；2）心血管危害，表现为血管痉挛增加和动脉粥样硬化，导致急性和慢性心肌事件、脑血管和外周血管疾病；3）癌症：十二种癌症是由吸烟引起或与吸烟相关。在大多数有数据的高收入国家，肺癌仍是癌症死亡的主要原因。吸烟会导致额外的死亡率，在整个中年时期，吸烟者的风险比不吸烟者高两倍。吸烟的孕妇会使自己和胎儿面临风险，胎儿可能发育迟缓以及出现围产期发病率和死亡率。被动吸烟涉及20%-80%的人口。根据风险因素，被动吸烟的危害可能与主动吸烟几乎一样大，并且会导致短期和长期影响。儿童是最脆弱的人群，尤其是在生命的头几年。被动吸烟会增加上、下呼吸道疾病的风险，但无烟环境可以改善所有这些疾病。缺血性心脏病和肺癌是接触香烟烟雾的非吸烟成年人面临的主要风险。烟草使用和接触是可预防的发病、残疾和过早死亡的唯一最重要来源。但任何时候戒烟都有帮助，越早越好。卫生专业人员应成为烟草预防的关键倡导者。
