The global smoking epidemic: a history and status report.
The global smoking epidemic: a history and status report.
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DOI：
10.3816/clc.2004.n.016
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发表时间：
2004-05-01
影响因子：
3.6
通讯作者：
Proctor, Robert N
中科院分区：
文献类型：
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作者：
Proctor, Robert N
世界卫生组织估计，全球每年约有500万人死于烟草，预计到2025年这一数字将翻一番。卷烟消费量从1900年的每年仅几十亿支增长到现在的全球约5.5万亿支。吸烟人数上升的历史原因包括烟道烘烤、安全火柴和卷烟机的发明，但也包括第一次世界大战期间向士兵分发香烟、大规模营销、政府限制消费的失败以及制造商对危害的双重否认。早在18世纪，人们就将唇癌、喉癌和舌癌与烟草联系在一起，但直到20世纪头十年，人们才怀疑吸烟会导致肺癌。流行病学证据在20世纪20年代开始出现，到20世纪50年代，与吸烟的因果关系得到了很好的确立。流行病学研究、动物实验和尸检时肺组织病理改变的研究是三个关键的证据来源。然而，直到20世纪90年代末，烟草业拒绝承认烟草危害的现实。相反，该行业试图以“没有证据”的信息瞄准医生和其他人，使用微妙的欺骗技术，包括资助虚假的研究，两面派的新闻发布，针对医生的宣传努力，以及聘请历史学家构建无罪的叙述。世界卫生组织的《烟草控制框架公约》承诺使全球烟草控制措施标准化，包括限制走私的政策。减少烟草使用的有效手段包括反广告、增加税收、无烟工作场所立法和对烟草业提起诉讼。
The World Health Organization estimates that tobacco causes approximately 5 million deaths annually worldwide, a number expected to double by 2025. Cigarette consumption grew from only a few billion per year in 1900 to present values of approximately 5.5 trillion worldwide. Historical causes for the rise of smoking include the invention of flue curing, safety matches, and cigarette rolling machines, but also the distribution of cigarettes to soldiers during World War I, mass marketing, the failure of governments to limit consumption, and the duplicitous denial of hazards by manufacturers. Cancers of the lip, throat, and tongue were linked to tobacco as early as the 18th century, but a lung cancer hazard from smoking was not suspected until the first decade of the 20th century. Epidemiologic evidence began to emerge in the 1920s, and by the 1950s, the causal link with cigarette smoking was well established. Epidemiologic studies, animal experiments, and studies demonstrating pathologic changes in lung tissues at autopsy were 3 pivotal sources of evidence. However, the tobacco industry refused to concede the reality of tobacco hazards until the late 1990s. Instead, the industry sought to target physicians and others with its message of "no proof," using subtle techniques of deception, including the funding of spurious research, duplicitous press releases, propaganda efforts directed at physicians, and the employment of historians to construct exculpatory narratives. The World Health Organization's Framework Convention on Tobacco Control promises to standardize global tobacco control measures, including policies to limit smuggling. Effective means of reducing tobacco use include counter-advertising, increased taxation, smoke-free workplace legislation, and litigation against the industry.