Department of Community Health and Health Behavior, School of Public Health and Health Professions, University at Buffalo, State University of New York, Buffalo, NY, USA.
Centre for Health Law, Policy and Ethics, University of Ottawa, Ottawa, Canada.
Addict Behav. 2018 Jan;76:376-381. doi: 10.1016/j.addbeh.2017.01.026. Epub 2017 Jan 25.
Previously, it has been argued that health information efforts need to inform the public about meaningful differential risks from tobacco/nicotine products. The fact of multiple product use by the same individual further supports this need. When the majority of youth, for example, who use smokeless tobacco are also current tobacco smokers, it makes little sense to mount a smokeless prevention campaign that fails to include clear messages about the much greater risks from smoking. In April 2016, The Food & Drug Administration (FDA) announced a $36 million campaign for youth that "smokeless doesn't mean harmless." Research shows the public (a) already knows that smokeless tobacco is not harmless, but are (b) also largely unaware that cigarettes are much more harmful than smokeless. Though not harmless, smokeless tobacco has been estimated to be over 90% less harmful than cigarettes. 'Gateway' fears are made moot by current use of multiple tobacco/nicotine products. When multi-tobacco product use is commonplace among users, usable information on significant differences in risk is crucial for both adult and younger users. The FDA and like campaigns and health information websites should follow established ethical principles and accepted communication methods to inform the public of less-harmful tobacco/nicotine products as well as the greater harms of smoking, in keeping with the Surgeon-General's advice that reductions in smoking in particular will bring about the greatest public health advances.
先前，有人认为健康信息工作需要向公众告知烟草/尼古丁产品的有意义的差异风险。同一人同时使用多种产品的事实进一步支持了这一需求。例如，当大多数使用无烟烟草的年轻人也是当前的烟草吸烟者时，开展一场无烟预防运动却不包含关于吸烟风险大得多的明确信息，这是没有意义的。2016 年 4 月，美国食品和药物管理局（FDA）宣布了一项针对年轻人的 3600 万美元的运动，主题是“无烟并不意味着无害”。研究表明，公众（a）已经知道无烟烟草是有害的，但（b）也很大程度上不知道香烟比无烟烟草危害大得多。尽管不是无害的，但据估计，无烟烟草的危害比香烟低 90%以上。“门户”的担忧在当前使用多种烟草/尼古丁产品的情况下变得毫无意义。当多烟草产品的使用在使用者中很常见时，关于风险显著差异的可用信息对成年和年轻使用者都至关重要。FDA 和类似的运动以及健康信息网站应该遵循既定的道德原则和公认的沟通方法，向公众告知相对低危害的烟草/尼古丁产品，以及吸烟的更大危害，这符合卫生总监的建议，即特别减少吸烟将带来最大的公共卫生进步。
