Pentz M A, Sussman S, Newman T
Institute for Health Promotion and Disease Prevention Research, University of Southern California, USA.
Addiction. 1997 Sep;92(9):1165-73.
This paper examines policy and ethical implementation issues associated with local drug policies that are aimed at producing a "least harm" approach toward youth, with particular application to tobacco policy as an example of a legal, but addictive drug. Research is reviewed which shows the inconsistencies between federally mandated enforcement of zero tobacco use, the Synar Amendment and local community and school policies which appear to relax enforcement of no-use policies for the purpose of retaining youth in school. The inconsistencies are described from the perspective of a "least harm" approach, in that tobacco use may be considered less harmful than absence from school, or use of other substances. The conflict between law and intent to reduce harm is examined with implications for long-term enforcement of federal policy, and for effectiveness of tobacco and other drug abuse prevention programs and other drug policies. Several strategies for reducing the conflict are recommended. These include provision of support-orientated smoking cessation programs for youth on school campuses and in community organizations, and promoting consistent no-use norms across all drugs and across multiple channels that affect youth-mass media, school, point-of-purchase settings and public settings and events.
本文探讨了与地方毒品政策相关的政策及伦理实施问题，这些政策旨在对青少年采取“危害最小化”方法，尤其以烟草政策为例，烟草是一种合法但会上瘾的毒品。回顾的研究表明，联邦政府强制实施的零烟草使用规定、《西纳尔修正案》与地方社区及学校政策之间存在不一致，后者似乎为了让青少年留在学校而放宽了禁止使用政策的执行力度。从“危害最小化”方法的角度描述了这些不一致之处，因为吸烟可能被认为比辍学或使用其他物质危害更小。研究探讨了法律与减少危害意图之间的冲突，及其对联邦政策长期执行、烟草及其他药物滥用预防项目有效性以及其他毒品政策的影响。文中推荐了几种减少冲突的策略。这些策略包括在校园和社区组织为青少年提供以支持为导向的戒烟项目，以及在所有毒品领域和影响青少年的多个渠道——大众媒体、学校、购买点场所、公共场所及活动中，推广一致的禁止使用规范。
