Avila-Tang E, Apelberg B J, Yamaguchi N, Katanoda K, Sobue T, Samet J M
Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N Wolfe Street, Room W6041, Baltimore, MD 21205, USA.
Tob Control. 2009 Feb;18(1):10-7. doi: 10.1136/tc.2007.024620. Epub 2008 Aug 26.
In Japan, tobacco smoking is one of the main avoidable causes of disease and death. Although the benefits of smoking cessation for reducing disease risk and increasing longevity have been extensively documented, a relatively low proportion of Japanese smokers currently express a willingness to quit. This study attempted to quantify future reduction in the burden of smoking-attributable disease that could result from increases in smoking cessation.
A simulation model was developed to project changes in mortality in Japan associated with increased quit attempts and use of nicotine replacement therapy (NRT) among smokers, incorporating data on smoking prevalence, cause-specific mortality rates, quitting behaviour and NRT use and effectiveness.
Approximately 46 000 lung cancer deaths and 56 000 cardiovascular disease deaths could be avoided over 20 years if the proportion of smokers making a quit attempt per year gradually increased to current US levels over 20 years. If each of these quit attempts were aided by NRT, the estimates of avoidable deaths would increase to 64 000 for lung cancer and 78 000 for cardiovascular disease. In this model, negligible deaths were avoided due to decreased smoking initiation over the 20-year simulation.
Smoking cessation can have measurable short-term impacts on the smoking-related mortality burden in Japan. However, to achieve these gains, tobacco control policies should focus both on increasing smokers' willingness to quit and providing the support and therapies to increase the likelihood that smoking cessation attempts will succeed.
在日本，吸烟是主要的可避免疾病和死亡原因之一。尽管戒烟对降低疾病风险和延长寿命的益处已得到广泛记录，但目前日本吸烟者中表示愿意戒烟的比例相对较低。本研究试图量化因戒烟人数增加而可能导致的未来吸烟所致疾病负担的减轻情况。
开发了一个模拟模型，以预测日本与吸烟者增加戒烟尝试和使用尼古丁替代疗法（NRT）相关的死亡率变化，纳入了吸烟率、特定病因死亡率、戒烟行为以及NRT使用和有效性的数据。
如果每年尝试戒烟的吸烟者比例在20年内逐渐提高到目前美国的水平，那么在20年内大约可以避免46000例肺癌死亡和56000例心血管疾病死亡。如果这些戒烟尝试都得到NRT的辅助，那么可避免的死亡估计数将增至肺癌64000例和心血管疾病78000例。在该模型中，在20年的模拟期内，因吸烟起始率降低而避免的死亡可忽略不计。
戒烟对日本与吸烟相关的死亡负担可产生可衡量的短期影响。然而，要实现这些成效，烟草控制政策应既注重提高吸烟者的戒烟意愿，又要提供支持和治疗方法，以提高戒烟尝试成功的可能性。
