Levy David T, Mumford Elizabeth A, Cummings K Michael, Gilpin Elizabeth A, Giovino Gary A, Hyland Andrew, Sweanor David, Warner Kenneth E, Compton Christine
Pacific Institute for Research and Evaluation, Calverton, Maryland, and Department of Economics, University of Baltimore, Baltimore, MD, USA.
Addict Behav. 2006 Jul;31(7):1190-200. doi: 10.1016/j.addbeh.2005.09.010. Epub 2005 Oct 26.
To predict the impact on tobacco use in the US of a "harm reduction" policy that requires that the smokeless tobacco product meet low nitrosamine standards, but could be marketed with a warning label consistent with the evidence of relative health risks.
Low nitrosamine smokeless tobacco (LN-SLT) and cigarette use are predicted by a panel of experts using a modified Delphi approach. We specify a thought experiment to isolate the changes that would occur after the new LN-SLT policy was implemented.
The panel predicted that the new policy would accelerate a decrease in smoking prevalence from 1.3 to 3.1 percentage points over 5 years compared to the current SLT product policy, with greater effects on males than females. Introduction of the new product was also predicted to result in modest additional use of SLT overall, with the greatest increases among males who initiated tobacco use under the new policy.
An overall consensus was reached that the introduction of a new LN-SLT product under strict regulations would increase SLT use, but reduce overall smoking prevalence. This reduction would likely yield substantial health benefits, but uncertainties surround the role of marketing and other tobacco control policies.
预测一项“降低危害”政策对美国烟草使用的影响。该政策要求无烟烟草产品符合低亚硝胺标准，但可附带与相对健康风险证据相符的警示标签进行销售。
一个专家小组采用改良德尔菲法预测低亚硝胺无烟烟草（LN-SLT）和香烟的使用情况。我们设定了一个思想实验，以分离新的LN-SLT政策实施后将会发生的变化。
该专家小组预测，与当前的无烟烟草产品政策相比，新政策将在5年内促使吸烟率加速下降1.3至3.1个百分点，对男性的影响大于女性。预计新产品的推出还会使无烟烟草的总体使用量适度增加，在新政策下开始使用烟草的男性中增幅最大。
总体达成的共识是，在严格监管下推出新的LN-SLT产品会增加无烟烟草的使用，但会降低总体吸烟率。这种降低可能会带来巨大的健康益处，但营销和其他烟草控制政策的作用仍存在不确定性。
