Slade J
St. Peter's Medical Center, University of Medicine and Dentistry of New Jersey, Department of Medicine, New Brunswick 08903.
J Psychoactive Drugs. 1992 Apr-Jun;24(2):99-109. doi: 10.1080/02791072.1992.10471631.
Tobacco has caused the greatest epidemic of the twentieth century, which is beginning to wane in the United States, but is still growing in much of the world. The epidemic developed as a result of innovations in the tobacco industry and larger cultural changes over the 75 years prior to the introduction of Camel cigarettes in 1913. Factors that set the stage for the epidemic include the development of flue-cured and Burley tobaccos, the mechanization of cigarette production with its consequent concentration of capital in a few companies, the safety match, efficient transportation systems, and innovative advertising. Between 1913 and 1963, the cigarette industry experienced almost unbroken growth in the United States. However, since the early 1950s, increasing evidence that cigarettes cause lung cancer and other diseases has dictated that product innovation concentrate on the appearance of safety. In the late 1960s and for a sustained period since 1973, cigarette consumption has declined in the United States, but in the developing world the epidemic curve of cigarette use is still on the upswing. As tobacco use declines in the United States, it is crucial that the production of tobacco products as well as their consumption be reduced. Otherwise, attempting to control the problem in the United States will not result in a net reduction in mortality around the world.
烟草引发了20世纪最严重的流行病，在美国这种流行病的影响已开始减弱，但在世界许多地区仍在蔓延。这场流行病的出现是烟草行业创新以及1913年骆驼牌香烟问世前75年里更广泛文化变革的结果。为这场流行病埋下伏笔的因素包括烤烟和白肋烟的发展、香烟生产的机械化及其导致的资本集中于少数几家公司、安全火柴、高效运输系统以及创新性广告。1913年至1963年间，美国的香烟行业几乎持续增长。然而，自20世纪50年代初以来，越来越多证据表明香烟会导致肺癌和其他疾病，这使得产品创新集中在安全外观上。在20世纪60年代末以及自1973年以来的一段持续时期内，美国的香烟消费量有所下降，但在发展中世界，香烟使用的流行曲线仍在上升。随着美国烟草使用量的下降，减少烟草制品的生产及其消费至关重要。否则，试图在美国控制这一问题并不会导致全球死亡率的净下降。
