University of California, San Diego, La Jolla, CA 92093-0901, USA.
Tob Control. 2012 Mar;21(2):258-64. doi: 10.1136/tobaccocontrol-2011-050359.
Smoking initiation is a key behaviour that determines the future health consequences of smoking in a society. There is a marked difference in smoking patterns around the world, driven by initiation rates. While a number of high-income countries have seen smoking prevalence decline markedly from peak, many low-income and middle-income countries appear to still be on an upward trend. Unlike cessation where changes are limited by nicotine dependence, rates of smoking initiation can change rapidly over a short time span. Interventions that can be effective in achieving this include increases in the price of tobacco products, mass media anti-smoking advertising, smoke-free policies, smoking curricula in schools, restrictions on marketing opportunities for the tobacco industry as well as social norms that lead to restrictions on adolescents' ability to purchase cigarettes. Comprehensive tobacco control programmes that aim to denormalise smoking behaviour in the community contain all of these interventions. Rapid reductions in smoking initiation in adolescents have been documented in two case studies of comprehensive tobacco control programmes in California and Australia. Consistent and inescapable messages from multiple sources appear to be key to success. However, the California experience indicates that the rapid decline in adolescent smoking will not continue if tobacco control expenditures and the relative price of cigarettes are reduced. These case studies provide strong additional evidence of the importance of countries implementing the provisions of the Framework Treaty on Tobacco Control.
吸烟起始是决定一个社会中吸烟未来健康后果的关键行为。由于起始率的不同，世界各地的吸烟模式存在显著差异。虽然一些高收入国家的吸烟率已从峰值显著下降，但许多低收入和中等收入国家似乎仍呈上升趋势。与依赖尼古丁的戒烟不同，吸烟起始率可以在短时间内迅速变化。能够实现这一目标的干预措施包括提高烟草产品价格、大众媒体反吸烟广告、无烟政策、学校吸烟课程、限制烟草行业的营销机会以及导致青少年购买香烟能力受限的社会规范。旨在使社区吸烟行为正常化的综合烟草控制计划包含了所有这些干预措施。在加利福尼亚州和澳大利亚的两项综合烟草控制计划的案例研究中，青少年吸烟起始率的快速下降得到了记录。来自多个来源的一致和不可避免的信息似乎是成功的关键。然而，加利福尼亚州的经验表明，如果烟草控制支出和香烟的相对价格下降，青少年吸烟的快速下降将不会持续。这些案例研究为各国实施《烟草控制框架公约》的规定的重要性提供了强有力的补充证据。
