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在我们有生之年,增加对有效戒烟治疗的需求并加以利用,从而充分收获烟草控制科学和政策成果带来的健康益处。

Increasing the demand for and use of effective smoking-cessation treatments reaping the full health benefits of tobacco-control science and policy gains--in our lifetime.

作者信息

Orleans C Tracy

机构信息

Robert Wood Johnson Foundation, Princeton, New Jersey 08543, USA.

出版信息

Am J Prev Med. 2007 Dec;33(6 Suppl):S340-8. doi: 10.1016/j.amepre.2007.09.003.

Abstract

More adults in the United States have quit smoking than remain current smokers. But 45 million adults (20.9%) continue to smoke, with highest rates among low socioeconomic status (SES), blue-collar, and Native American populations. More than two thirds (70%) of adult smokers want to quit, and approximately 40% make a serious quit attempt each year, but only 20%-30% of quitters use an effective behavioral counseling or pharmacologic treatment. The lowest rates of treatment use are seen in the populations with the highest rates of tobacco use. Fully harvesting the last 4 decades of progress in tobacco-control science and policy to increase smokers' demand for and use of cessation treatments represents an extraordinary opportunity to extend lives and reduce healthcare costs and burden in the next 30-40 years. This paper uses the "push-pull capacity" model as a framework for illustrating strategies to achieve this goal. This model recommends: (1) improving and communicating effective treatments for wide population use; (2) building the capacity of healthcare and other systems to deliver effective treatments; and (3) boosting consumer, health plan, and insurer demand for them through policy interventions shown to motivate and support quitting (e.g., clean indoor-air laws, tobacco tax increases, expanded insurance coverage/reimbursement) and efforts to improve treatment access and appeal, especially for smokers who use them least. Innovations recommended by the National Consumer Demand Roundtable for achieving "breakthrough" improvements in cessation treatment demand and use are described.

摘要

美国戒烟的成年人比仍在吸烟的成年人更多。但仍有4500万成年人(20.9%)继续吸烟,在社会经济地位较低、蓝领和美国原住民人群中吸烟率最高。超过三分之二(70%)的成年吸烟者想要戒烟,每年约有40%的人会认真尝试戒烟,但只有20%-30%的戒烟者使用有效的行为咨询或药物治疗。在烟草使用率最高的人群中,治疗使用率最低。充分利用过去40年烟草控制科学和政策方面的进展,以增加吸烟者对戒烟治疗的需求和使用,这是在未来30-40年延长寿命、降低医疗成本和负担的绝佳机会。本文使用“推拉能力”模型作为框架来说明实现这一目标的策略。该模型建议:(1)改进并宣传可供广泛人群使用的有效治疗方法;(2)建设医疗保健和其他系统提供有效治疗的能力;(3)通过已证明能激励和支持戒烟的政策干预措施(如清洁室内空气法、提高烟草税、扩大保险覆盖范围/报销)以及改善治疗可及性和吸引力的努力,尤其是针对使用治疗方法最少的吸烟者,来提高消费者、健康计划和保险公司对这些治疗方法的需求。文中还描述了国家消费者需求圆桌会议推荐的旨在实现戒烟治疗需求和使用方面“突破性”改善的创新举措。

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