Slama K
Tobacco Prevention Division, International Union Against Tuberculosis and Lung Disease, Paris, France.
Int J Tuberc Lung Dis. 2004 Oct;8(10):1160-72.
Tobacco is the world's biggest preventable killer, but the circumstances of its history, the power and influence of its commerce and the nature of addiction make it a very difficult public health issue. Determinants of smoking are both individual and environmental. Genetics and environment influence to varying degrees all of the steps in a smoker's career. Persistence of use, degree of addiction to nicotine and difficulty in stopping are influenced by inherited traits and nicotine susceptibility, whereas the social environment and the individual's cognitions are the key factors in starting smoking and successfully stopping smoking. The tools available to tobacco control include influencing the social and cultural norms concerning tobacco; legislative and regulatory measures to protect the population and to limit tobacco industry marketing tactics, now encapsulated in the Framework Convention on Tobacco Control; and programmes to enhance the chance of not starting and successfully stopping. Strategies for tobacco control must work at both societal and individual levels, and directions are being taken that include genetic, pharmacological, behavioural, socio-cultural and international approaches.
烟草是全球最大的可预防死因，但鉴于其历史背景、商业势力和影响力以及成瘾的本质特性，它成为了一个极为棘手的公共卫生问题。吸烟的决定因素包括个人因素和环境因素。基因和环境在不同程度上影响吸烟者整个过程的每一步。吸烟习惯的持续、对尼古丁的成瘾程度以及戒烟的难度受到遗传特征和尼古丁易感性的影响，而社会环境和个人认知则是开始吸烟和成功戒烟的关键因素。控烟可用的手段包括影响有关烟草的社会文化规范；采取立法和监管措施来保护民众并限制烟草行业的营销策略，这些现已纳入《烟草控制框架公约》；以及开展相关项目来提高不开始吸烟和成功戒烟的几率。控烟策略必须在社会和个人层面发挥作用，目前正朝着包括基因、药理学、行为学、社会文化和国际等多方面的方向发展。
