The reemergence of smokeless tobacco.
The reemergence of smokeless tobacco.
复制标题
无烟烟草的重新出现。
DOI：
10.1056/nejm198604173141605
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发表时间：
1986
期刊：
影响因子：
--
通讯作者：
Hoffmann,D
中科院分区：
文献类型：
--
作者：
Connolly,GN;Winn,DM;Hecht,SS;Henningfield,JE;WalkerJr,B;Hoffmann,D
无烟烟草（鼻烟和嚼烟）正在重新成为一种流行的烟草形式，特别是在男性青少年中。在美国的不同地区，8%到36%的男高中生是经常使用者。使用无烟烟草已被证明会导致口咽癌。最强的联系是与脸颊和牙龈的癌症。白色粘膜病变（白斑病）在18%至64%的使用者中被发现，通常发生在持有烟草的部位。其他的相关性也被认为与食道癌、喉癌和胰腺癌有关。在无烟烟草中发现的高浓度亚硝胺很可能在其致癌性中发挥作用。其他健康问题包括牙周病、血压急性升高和依赖性。1986年初，在州一级采取行动后，国会颁布了一项联邦法律，要求在无烟烟草包装上贴上健康警告标签，并禁止电子广告。其他正在考虑的监管措施包括提高州和联邦消费税，加强对广告的控制，以及禁止向未成年人销售。鉴于这一问题最近有所增长，决策者正在利用这一机会采取预防措施进行干预，以保护新一代烟草使用者。
Smokeless tobacco (snuff and chewing tobacco) is reemerging as a popular form of tobacco, particularly among male adolescents. In different regions of the United States, from 8 to 36 percent of male high-school students are regular users. The use of smokeless tobacco has been shown to cause oral-pharyngeal cancer. The strongest link is with cancers of the cheek and gum. White mucosal lesions (leukoplakia) are found in 18 to 64 percent of users, often at the site where the tobacco was held. Other associations have been suggested for cancers of the esophagus, larynx, and pancreas. Nitrosamines, found in high concentrations in smokeless tobacco, most likely have a role in its carcinogenicity. Other health problems include periodontal disease, acute elevations of blood pressure, and dependence. In early 1986, after action at the state level, Congress enacted a federal law requiring health-warning labels on packages of smokeless tobacco and a ban on electronic advertising. Other regulatory measures under consideration include raising state and federal excise taxes, tightening controls on advertising, and prohibiting sales to minors. In view of the recent growth of this problem, policy makers are taking the opportunity to intervene with preventive measures to protect a new generation of tobacco users.