Rosen Laura J, Rier David A, Schwartz Robert, Talitman Michal, Zwanziger Lior
Department of Health Promotion, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, POB 39040, 69978, Ramat Aviv, Israel.
Center for Global Tobacco Control, Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
Isr J Health Policy Res. 2019 Jan 14;8(1):10. doi: 10.1186/s13584-018-0276-2.
Devastation from the tobacco epidemic continues, with strong government tobacco control policy absent in most countries. Knowledge of the full scope of tobacco harm in populations may form the basis for healthier behavior, de-normalization of smoking, and a consensus about necessary public policy. However, many populations may be poorly-informed about the risks, and this ignorance may undermine both effective policy-making and implementation of tobacco control policies. We present knowledge and risk perceptions about smoking tobacco smoke exposure in Israel.
A nationally-representative phone survey was conducted in Israel (n = 505; response rate = 61%). We assessed knowledge about active and passive smoking using four questions, three of which addressed knowledge about harm, and one of which addressed knowledge of tobacco-related harm relative to knowledge of harm due to traffic accidents. The three questions which addressed knowledge of harm were combined into a composite score. We also asked four risk perception questions concerning tobacco smoke exposure, which were measured on a 7-point Likert scale and then combined. Multivariable logistic regression and linear models were used to identify whether smoking status or socio-demographic variables were associated with knowledge of harm, comparative knowledge of harm, and risk perceptions.
Just two in five respondents, and one in five respondents who were current smokers, accurately answered three simple questions about harms of smoking. Fewer than three in ten respondents, and fewer than one in five smokers, knew that smoking causes more damage than traffic accidents. Many (30.3%) were unaware that tobacco smoke exposure causes both lung cancer and heart disease, 27.7% did not know that smoking both shortens life and injures quality of life, and 31.1% did not know that smoking-attributable health problems will afflict all or most heavy smokers. Overall, risk perceptions regarding tobacco smoke exposure were high (mean = 24.5, SD:4.5, on a scale of 7-28, with 28 the indicating highest level). Smoking status was consistently associated with lower levels of knowledge, comparative knowledge, and risk perceptions, with current smokers having the lowest levels of knowledge and the lowest risk perceptions.
Like many others, Israelis, and particularly Israeli smokers, do not fully grasp tobacco's true dangers. Effective communication of the full range of tobacco risks to the public, with a focus on communication with smokers, is an essential component of comprehensive tobacco control policy.
烟草流行造成的破坏仍在持续，大多数国家缺乏强有力的政府控烟政策。了解人群中烟草危害的全貌可能为更健康的行为、吸烟的去常态化以及关于必要公共政策的共识奠定基础。然而，许多人群可能对这些风险了解不足，这种无知可能会破坏有效的政策制定和控烟政策的实施。我们展示了以色列关于吸烟和接触烟草烟雾的知识及风险认知情况。
在以色列进行了一项具有全国代表性的电话调查（n = 505；回复率 = 61%）。我们使用四个问题评估了关于主动吸烟和被动吸烟的知识，其中三个问题涉及对危害的了解，一个问题涉及与交通事故造成的危害相比，对烟草相关危害的了解。涉及危害知识的三个问题合并为一个综合得分。我们还询问了四个关于接触烟草烟雾的风险认知问题，这些问题采用7分李克特量表进行测量，然后合并。使用多变量逻辑回归和线性模型来确定吸烟状况或社会人口统计学变量是否与危害知识、危害比较知识以及风险认知相关。
只有五分之二的受访者以及五分之一的当前吸烟者准确回答了关于吸烟危害的三个简单问题。不到十分之三的受访者以及不到五分之一 的吸烟者知道吸烟造成的损害比交通事故更多。许多人（30.3%）不知道接触烟草烟雾会导致肺癌和心脏病，27.7% 的人不知道吸烟既会缩短寿命又会损害生活质量，31.1% 的人不知道吸烟导致的健康问题会折磨所有或大多数重度吸烟者。总体而言，对接触烟草烟雾的风险认知较高（平均 = 24.5，标准差：4.5；范围为7 - 28，28表示最高水平）。吸烟状况始终与较低水平的知识、危害比较知识和风险认知相关，当前吸烟者的知识水平最低，风险认知也最低。
与许多其他国家的情况一样，以色列人，尤其是以色列吸烟者，没有充分认识到烟草的真正危害。向公众有效传达全面的烟草风险，重点是与吸烟者进行沟通，是全面控烟政策的重要组成部分。
