Slama K
International Union Against Tuberculosis and Lung Disease, Paris, France.
Int J Tuberc Lung Dis. 2008 Jan;12(1):3-7.
Tobacco smoking is losing adherents in some countries, and a number of international developments may dramatically change the choices people make concerning tobacco. However, the growth of chronic obstructive pulmonary disease (COPD) in the world is nevertheless assured-tobacco consumption is rising globally because of increased consumption in many low-income countries. Risk of COPD is strong wherever smokers are found, and even among former smokers, it remains high for decades. Both COPD and smoking produce lower measurable quality of life assessment, but little attention is given to the association, apart from noting that cessation rates are poor among COPD patients. Tobacco smoking rates vary; men usually smoke more than women in overall consumption and in prevalence. Current available estimates are 49% for men and 8% for women in low- and middle-income countries, and 37% for men and 21% for women in high-income countries. These figures give little information, however, because there can be variations within and across populations. What is important is that about a third of all adults in the world currently smoke, and that it will take a tremendous turnaround to put a halt to the overall growth of tobacco use. Smoking-related COPD rates will continue to be high for some time. The future of COPD is related most dramatically to low- or middle-income countries, where more than four in five current smokers in the world live. The predictable health consequences of smoking, including an enormous burden in COPD, have only begun to emerge.
在一些国家，吸烟人数正在减少，一些国际形势的发展可能会极大地改变人们对烟草的选择。然而，慢性阻塞性肺疾病（COPD）在全球的增长却是必然的——由于许多低收入国家烟草消费的增加，全球烟草消费量正在上升。无论在何处发现吸烟者，患慢性阻塞性肺病的风险都很高，即使是 former smokers，几十年内风险仍然很高。慢性阻塞性肺病和吸烟都会导致可测量的生活质量评估降低，但除了注意到慢性阻塞性肺病患者的戒烟率很低外，很少有人关注两者之间的关联。吸烟率各不相同；总体消费量和患病率方面，男性通常比女性吸烟更多。目前可得的估计数据显示，低收入和中等收入国家男性吸烟率为49%，女性为8%；高收入国家男性吸烟率为37%，女性为21%。然而，这些数据提供的信息很少，因为不同人群内部和不同人群之间可能存在差异。重要的是，目前世界上约三分之一的成年人吸烟，要阻止烟草使用的总体增长，需要巨大的转变。与吸烟相关的慢性阻塞性肺病发病率在一段时间内仍将居高不下。慢性阻塞性肺病的未来与低收入或中等收入国家最为密切相关，世界上五分之四以上的吸烟者生活在这些国家。吸烟可预见的健康后果，包括慢性阻塞性肺病带来的巨大负担，才刚刚开始显现。 （注：原文中“former smokers”直译为“曾经吸烟者”，这里意译为“已戒烟者”更符合语境；另外，“COPD”直接保留英文缩写，因为在医学领域这是常见的专业术语。）
