综述-大学生的吸烟现状及控烟措施
大学生的吸烟现状及控烟措施(综述)
笑嘻嘻
公共事业管理(卫生事业方面)专业09级4小班
摘要:吸烟是当前世界各国非常关注的社会热点问题;大学生是一个国家的未来与希望,而如今,大学生的吸烟问题已日趋突显,备受人们的关注;下面将对吸烟的一个现状及存在的一些问题出发作如下综述。
关键词:吸烟的危害 大学生吸烟的原因 吸烟干预措施
据世界卫生组织报道,如今世界每年有超过500万人死于与吸烟有关的疾病【1】, 已对人类健康构成威胁,世界卫生组织称之为21世纪的瘟疫。中国是世界烟草大国, 烟草、卷烟产量及吸烟人数均居世界首位。因此,吸烟问题在中国也就愈发的突显出来。
2008年我国疾病死亡率排名【2】
另据香港《大公报》报道,吸烟、空气污染以及人口密度增加均是呼吸疾病的诱因。现在,由于吸烟而引起的疾病的死亡率排名在全国已占到了前几位,如此严峻的形势,不容我们的忽视。另外,世界卫生组织署长助理Dr Ala Alwan曾指出:“世界卫生组织的建议是基于事实的并且是非常必要的;每年死于烟草的人超过了500万,每天都有接近100000
的青少年开始吸烟【3】。”与发达国家形成鲜明对比的是,我国香烟的消费在70—90年
代间也上升了260%,吸烟率不断上升;据相关调查显示,我国的青少年的吸烟年龄也在
不断提前,青少年中吸烟的问题日趋严重,其中特别是大学生的吸烟问题凸显,从而引起了
越来越多的人们和国家、社会的关注。
一、吸烟的一些主要危害
【4】由上表我们可以看出,每年由于烟草的使用引起癌症而死亡的人数远远超过了其
他的原因引起的癌症死亡人数。除此之外,吸烟还对我们身体的各个器官都有着不同程度的
损伤作用:
(一)、致癌作用【5】 流行病学调查表明,吸烟是肺癌的重要致病因素之一,特别
是鳞状上皮细胞癌和小细胞未分化癌。吸烟者患肺癌的危险性是不吸烟者的13倍,如果每日
吸烟在35支以上,则其危险性比不吸烟者高45倍。吸烟者肺癌死亡率比不吸烟者高10~13
倍。肺癌死亡人数中约85%由吸烟造成。此外,吸烟与唇癌、舌癌、口腔癌、食道癌、胃癌、
结肠癌、胰腺癌、肾癌和子宫颈癌的发生都有一定关系。估计80%至90%的慢性阻塞性肺病
都是有吸烟引起的。
(二)、对心脑血管的影响 许多研究认为,吸烟是许多心、脑血管疾病的主要危险
因素,吸烟者的冠心病、高血压病、脑血管病及周围血管病的发病率均明显升高。吸烟是导
致缺血性心脏病的最大风险因素之一【6】。
(三)、对呼吸系统的影响 吸烟是影响急慢性支气管炎及其他一些呼吸系统疾病的主
要诱因。
(四)、对消化系统的影响 长期吸烟可破坏消化系统的相关功能,从而引起急慢性食
管炎及反流性食管炎等消化系统疾病【7】。
近年来,中国和许多发展中国家吸烟率大幅度上升,预示下世纪我国由于吸烟引
起的各种疾病死亡率也将显著增加。吸烟已成为我国的一颗“定时炸弹”。
Youth prevalence data (Global Youth Tobacco Survey 2007)【8】
各国的吸烟情况不尽相同,但总的来说,全球的主动和被动吸烟的人数和每年新增的
吸烟人数都在不断攀升,因而由于吸烟而引起的危害也已经在世界各国突显了出来,成为了
人们共同打击的目标,需要我们全球人类的共同努力才能够战胜。
云南省男女青少年1994—1997年吸烟情况一览表【9】
云南省的调查还表明,82.5%的大中学生已大略的知道一些有关烟草有成瘾性和危害性,
他们更多的认同了烟草的社交性;从上表中我们还可以明显的看出,大学生的吸烟人数所占比例远大于中学生,特别是大学男生中,每日都吸烟的人数已达到了中学生的四倍多。那么究竟是些什么原因导致了,大学生们对烟草的危害的认识更多却吸烟的人数反而不减反增
呢?
二、影响大学生吸烟的主要因素
(一)、大学生处于青春期后心理年龄仍未成熟、缺乏自信、虚荣的时期【10】。大学
生们都有着一个共同的心理特征——缺乏自信,觉得自己不够成熟,自己仍还处在成熟与幼稚的交界区,渴望他人认可。所以他们从行为上会表现出过度的自信、摆酷、追求个性和与众不同,喜欢模仿一些貌似成熟的人的行为方式。相对于健康,这类人更关心的是这种心理需求的满足,他们会做出很多对自己身体和前途不利的事情——只要满足他们敏感的心理需
求即可。
(二)、受到外界环境的影响。这是大学生们的吸烟率逐年飙升的一个最主要的原
因;而受到的一些主要的外界影响又包括:我们的周围包括父母、同学、老师等重多人群都在吸烟,我们处在一个烟雾缭绕的世界,我们处在一个烟草大国等等各种外在的环境都在时时刻刻影响着我们的心理与行动。
(三)、自己的心理的影响作用。这是一个极其重要的原因,毕竟意识决定物质嘛!它
主要包括:同学们的好奇心、奇强的模仿力,同学们都有着自己的偶像,但当今的许多影视作品中的英雄人物们大都在吸烟,并且显得是那么得潇洒自如、悠然自得,这些种种现象,无时不在影响着我们的每一名大学生【11】;
除此之外,大学里同学们的课余时间多了,有了更多的由自己去安排的时间,这个时候,
许多同学们能够利用课余时间去读书学习,但是也有那么相当一部分同学对学习或自己的专
业或觉得大学了,不应该再像过去那样苦了,这个时候,他们旺盛的精力无处发泄,他们只得“借烟烧愁”,借此来度过那些他们眼中无聊而烦闷的大学生活;另外,大学里,还存在着另外一种景象,那便是考试前的挑灯夜战,这个时候,由于平时的闲散与不听课,但又为了能够顺利通过考试,他们只能成为“挑灯夜战”一族,借助于香烟的作用来借烟提神。而一旦吸烟成瘾,就会产生一种躯体的和心理的依赖,从而很难戒断。
三、大学生的控烟措施
既然现在大学生的吸烟状况已是如此的严峻,并且我们也了解一些大学生吸烟的原因;又如臧英年所说的:身为世界第一产烟、售烟、吸烟和烟害大国的中国,现在正面临着一个关键和时来运转的时刻【12】。那么我们应该从哪些方面入手来针对大学生进行控烟的相关措施呢?从总的来说还是得从自身和外界两个方面来进行控烟的行动。
(一) 、从自身的角度来说,我们必须去充分认识到吸烟对自己及他人的危害,树立起戒烟的决心和信心,不要认为自己抽烟历史较长而戒不掉,一定要想到:我一定会成功,从心理上去根除烟瘾;同时我们也要有一些系统的控烟措施,比如说一些厌恶疗法和一些世界卫生组织号召采取的九要素控烟策略等【13】。
(二)、另外我们的控烟措施也需要家庭、社会和国家等的支持。需要家庭和同学、朋友们的鼓励与监督,一步一步、一只一只的来进行控烟运动,我们要有一个详细的可行的计划,一天一天的坚持下去;
(三)、同时,我们也应该学会去丰富和充实我们的大学生活,尽可能的使自己变得不再感到无聊、烦闷。
除此之外,作为一名大学生我们还应该懂得,强化是建立任一行为的关键,要想控烟的成功,还需要我们不断地去强化自己的意识,从而达到最终改变相关行为的目的。
参考文献:
【1】 WHO. The tobacco health toll Smoking’s less publicized side
effects
【2】 http://wenda.tianya.cn/wenda/thread?tid=525bc1660a4c30b
9. 2008年我国疾病死亡率排名
【3】 WHO. WHO calls for enforceable policies to restrict smoking in
movies
【4】 WHO. The tobacco health toll Smoking’s less publicized side
effect s
【5】 http://news.xinhuanet.com/health/2006-01/25/content_4098
386.htm 吸烟的危害
【6】 张河川、赵虹. 青年学生健康指导. 云南科技出版社.2004(7):87-92
【7】 崔进,张雅洁. 病理学. 科学出版社.2010(1):97-168
【8】 WHO. Youth prevalence data (Global Youth Tobacco Survey
2007)
【9】 云南省学校健康教育系列研究课题报告
【10】 http://eagon.blog.163.com/blog/static/[***********]52727/
【原创】有效控烟的根本方法
【11】 刘克俭,顾瑜琦. 行为医学. 科学出版社.2003(8):318
【12】 《中国科技财富》. 藏英年:全面控烟任重道远.2008-02-02.
【13】 马骁. 健康教育学.2009(8):238—244
【14】 Who. Why is smoking an issue for non-smokers?
【15】 Who.Heart disease
【16】 Who.Fact Sheet on Gender, Health and Tobacco
【17】 Who.TOBACCO EPIDEMIC: HEALTH DIMENSIONS
【1】The tobacco health toll
Smoking’s less publicized side effects Tobacco use kills more than 5 million people every year Every 6.5 seconds someone dies from tobacco use, says the World Health Organization. Research suggests that people who start smoking in their teens (as more than 70% do) and continue for two decades or more, will die 20 to 25 years earlier than those who never light up. It is not just lung cancer or heart diseases that cause serious health problems and death. Below, some of smoking’s less publicized side effects – from head to toe.
The cancer health toll
Cancer kills nearly 8 million people every year
A global killer
Cancer is a global public health problem. It is the second most
common killer today. With current cancer patterns, the number
of cancer related deaths is projected to rise from 7.9 million in
2007 to 12 million in 2030. The majority of ‘new’ cancer cases
will occur in low and middle income countries.
Cancer is the 4th cause of death in the Eastern Mediterranean
Region following cardiovascular diseases, infectious diseases
and injuries. Over the next 15 years, the highest increase in
cancer incidence among the WHO Regions is likely to be in
the Eastern Mediterranean Region, in which projection
modeling predicts an increase of between 100–180%.
Presently, we know from international experience that at least
40% of cancers can be prevented. Depending on the
availability of resources, it is also possible to detect, at an
early stage, and effectively treat, a further 40% of cancers.
When cancer cannot be cured or held in remission, advances
in the prevention and relief of suffering can greatly improve the
quality of life of 20% of people with cancer and their families.
It is without doubt that the incidence of cancer is rising rapidly
due to increased exposure to a number of ‘preventable’ risk
factors including:
Risk factor Number of Cancer related
deaths/year
Tobacco use 1.8 million
Overweight, obesity and
physical inactivity
274 000
Harmful alcohol use 351 000
Unsafe sex 235 000
Occupational carcinogens 152 000
For more cancer control related information, please visit
www.emro.who.int/ncd/.
Tobacco and cancer
For decades now, it has been well known that tobacco use is
not only capable of damaging nearly every organ of the human
body but also causes at least 15 different cancers and is
single-handedly responsible for 30% of all cancer related
deaths.
Tobacco and tobacco smoke contain thousands of chemicals,
many of which are well known to be toxic, carcinogenic,
atherogenic, teratogenic and addictive.
More than 40 chemicals in tobacco smoke have been shown
to cause cancer. Smokers are some 20 times more likely to
develop lung cancer than nonsmokers. Smoking causes about
90% of lung cancer in men and 80% in women.
According to many studies, the longer one smokes the greater
the risk of developing cancer at several sites including:
【2】WHO calls for enforceable policies to restrict smoking in movies
1 June 2009 -- Backed by evidence that smoking in movies causes youths to want to light up, the World Health Organization is calling upon countries to enact enforceable policies that would severely restrict such depictions.
The report recommends that all future movies with scenes of smoking should be given an adult rating, with the possible exception of movies that reflect the dangers of tobacco use or that depict smoking by a historical figure who smoked.
Studies show that smoking continues to permeate movies, including those rated as suitable for youth. The policies recommended would help ensure that movies that are marketed to youth do not include tobacco imagery.
"Voluntary agreements to limit smoking in movies have not and cannot work," the report says. It continues, "Logic and science now support enforceable policies to severely restrict smoking imagery in all film media."
"The WHO recommendations are evidence-based and very much needed," said WHO Assistant Director-General Dr Ala Alwan. "Tobacco kills more than five million people per year. Each day approximately 100,000 young people take up smoking. Restricting smoking in movies will go a long way towards stemming the tobacco epidemic."
Studies show that smoking in movies misleads youths into thinking that tobacco use is normal, acceptable, socially beneficial and more common that it really is. Studies also show that such movies rarely portray the harm of tobacco, instead portraying the product as conducive of a cool and glamorous lifestyle.
From Hollywood to Bollywood and beyond, movies are a global commodity. National policies to restrict smoking in movies can produce wide-ranging global benefits.
"Smoking does not belong in youth-rated movies", said Dr Douglas Bettcher, Director of WHO's Tobacco Free Initiative. "The more smoking adolescents see on screen, the more likely they are to start smoking. These simple policies can save generations of young people from a lifetime of addiction and an early death from tobacco."
The report also recommends that movie studios should:
certify that they received no payoffs from tobacco companies to display tobacco products or their use
【3】WHO > Features > Online Q&A
Main content
Online Q&A
26 August 2010
Why is smoking an issue for non-smokers?
Q: Why is smoking an issue for non-smokers?
A: There are some 4000 known chemicals in tobacco smoke; at least 250 of them are known to be harmful and more than 50 are known to cause cancer in humans. Tobacco smoke in enclosed spaces is breathed in by everyone, exposing smokers and nonsmokers alike to its harmful effects.
Around 700 million children, or almost half of the world's total, breathe air polluted by tobacco smoke. Over 40% of children have at least one smoking parent. In 2004, children accounted for 28% of the 600 000 premature deaths attributable to second-hand smoke.
In adults, second-hand smoke causes serious cardiovascular and respiratory diseases, including coronary heart disease and lung cancer. In infants, it causes sudden death syndrome. In pregnant women, it causes low birth weight. Neither ventilation nor filtration, even in combination, can reduce tobacco smoke exposure indoors to levels that are considered acceptable. Only 100% smoke-free environments provide effective protection. Contrary to common belief, smoke-free environments are widely supported by both smokers and nonsmokers.
Having a smoke-free environment often saves money for bars and restaurant owners, reducing their risks of fire and consequently their insurance costs. It often results in lower renovation, cleaning and maintenance costs, too. Article 8 of the WHO Framework Convention on Tobacco Control, recognizes that exposure to tobacco smoke causes death, disease and disability, and asks countries to adopt and implement legislation that provides protection from second-hand smoke.
【4】Heart disease
The link between smoking and heart disease has been well described in populations all over the world.
Twenty five year follow up of the Seven Countries Study, (16 cohorts of men aged 40 to 59 at enrolment
in the USA, Finland, the Netherlands, Italy, Croatia, Serbia, Greece and Japan), reported a dose-dependent
increase in risk of death. After 25 years, 57.7% of persons smoking 30 cigarettes per day had died,
compared to only 36.3% of non-smokers1. Additional long-term data come from a 40 year follow up of
British physicianswhich noted that excess mortality from cardiovascular disease was two times higher
Among smokers compared to non-smokers but that this ratio was even more extreme during middle age 2.
The data for men and women differ somewhat but recent work underlines the importance of smoking
as a cause of myocardial infarction in both men and women. As an example, in a Norwegian study, rates of
myocardial infarction were 4.6 times higher in men than in women but rates among women who smoked were
six times higher than non-smokers and rates among men, three times higher than among nonsmokers 3.
Danish investigators concluded that women may be more sensitive to tobacco as risks of myocardial infarction
due to both current smoking and total tobacco exposure were consistently higher in women than men, and
higher for both groups than myocardial infarction rates among non-smokers 4.
【5】October 2003
Fact Sheet on Gender, Health and Tobacco
Introduction
“Gender”, meaning socially-determined roles for each sex, provides the social explanation for sex-linked patterns of tobacco use. However, these social origins are rarely given the attention they deserve, as if these behaviours were natural, rather than learned. Popular interest in “gender and health” is synonymous with “women and health”, with the result that connections between masculinity and risk behaviours are overlooked (Courtenay, 2000). Both sex and gender are relevant for tobacco control.
Tobacco is cultivated around the world and can be legally purchased in all countries. The dried leaf is smoked in the form of manufactured cigarettes, bidis , cigars, kreteks , pipes and sticks. It is chewed throughout the world, but principally in South and Southeast Asia, often together with areca nuts and staked lime (Mackay and Eriksen, 2002).
In 2002, tobacco killed 4.83 million people, 50 percent coming from developing countries. This represents a sharp increase from previous estimates. Unless action is taken to prevent this trend it is likely that the number of deaths will double in the next two decades (Ezzati and Lopez, 2003). It is projected that more than 70 percent of these deaths will be in developing countries (WHO, 2002).
Health behaviour does not occur in a vacuum, but is influenced by normative values, lay health beliefs and the surrounding environment (Milburn, 1996). Tobacco use is generally more prevalent among lower-income populations, those with mental disorders (including depression) and, in most countries, among men and boys (Ernster, 2001:5; WHO, 2000b). What do we know?
Higher prevalence among men in most countries
Comparable data on the prevalence of tobacco consumption (in all its forms) are not widely available and are often misleading due to lack of disaggregation by age and sex (WHO, 2002). World wide, in 1998, there were an estimated 1.2 billion adult smokers (aged 15 years and above) among the world’s 6 billion people (Corrao et al, 2000). However, this may understate the epidemic because many smokers begin before the age of 15, and surveys often exclude non-commercial and/or smokeless tobacco (Morrow and Barraclough, 2003a,b; The Global Youth Tobacco Survey Collaborative Group, 2002).
Nonetheless, available evidence compellingly demonstrates that in most of the world, being born male is the greatest predictor for tobacco use, with overall prevalence about four times higher among men than women globally (48% versus 12%). As can be seen in the figure, sex-linked differences are highest in the Western Pacific Region and lowest in the Americas and European Region, where about one-quarter of women smoke (Corrao et al., 2000a). The most recent data for China show a dramatic sex gap (63% for men and 3.8% for women
[Yang et al, 1999]). A gap persists even among a highly educated sub-group in Chile: 40% of
male doctors and 24% of female doctors smoke (Mackay and Eriksen, 2002).
【6】
Fact Sheet N° 154
May 1997
TOBACCO EPIDEMIC: HEALTH DIMENSIONS Tobacco is a Greater Cause of Death and Disability Than Any Single Disease • There is no longer any doubt that tobacco use worldwide has reached the
proportion of a global epidemic approaching its peak among men in most developed count ries and spreading now to men in developing countries and women in all countries .
* Today, according to WHO estimates, there are approximately 1.1 thousand million smokers in the world, which represents about one-third of the global population aged 15 years and over. Of these, 800 million are in developing countries.
* Over the last ten years, estimated global cigarette consumption has remained relatively steady at over 1600 cigarettes per adult per year.
* However, there has been a shift in the distribution of tobacco consumption in the last two decades. Declining consumption in developed countries has been counterbalanced by increasing consumption in developing countries. * Available data suggest that, globally, approximately 47% of men and 12% of women smoke. In developing countries, 48% of men and 7% of women smoke, while in developed countries, 42% of men smoke as do 24% of women. * Although life expectancy for both sexes is predicted to be on the rise, in many countries, the gap between them is growing significantly due to the larger number of men who smoke and die of tobacco-related diseases.
• In certain regions, the health consequences of tobacco use are particularly devastating.
* In the Former Socialist Economies (FSE), in 1990, around 14% of all deaths were due to tobacco use. This figure is predicted to increase so that in 2020, more than 22% of all deaths in the FSE region will be due to tobacco. ' In this region, smoking is likely to be a major factor underlying the 56% projected increase in male deaths from chronic disease between 1990 and 2020, In fac t, the FSE region is projected in 2020 to have the highest adult male risk of death, even higher than that in sub-Saharan Africa.
'* In absolute figures, the biggest and sharpest increases in disease burden are expected in India and China where the use of tobacco has grown most steeply . In China alone, where there are about 300 mill ion smokers, and the cigarette consumption is estimated at around 1900 cigarettes per adult per year, around 50 million Chinese, who are now under 20 years of age, will eventually be killed by
【7】THE ALCOHOL, SMOKING AND SUBSTANCE
INVOLVEMENT SCREENING TEST (ASSIST):
GUIDELINES FOR USE IN PRIMARY CARE
Draft Version 1.1 for Field Testing
Caveat relating to use of this document
This document was written by Sue Henry-Edwards, Rachel Humeniuk, Robert Ali, Vladimir Poznyak
and Maristela Monteiro and is currently available for use in unpublished draft form only. Copies of
this document are available on the WHO website for clinical and/or research purposes and should
be referenced accordingly. Revisions and changes to this document may occur prior to formal publication. Formal publication of this document by the World Health Organization is anticipated to
occur by 2005.
Suggested reference: Sue Henry-Edwards, Rachel Humeniuk, Robert Ali, Vladimir Poznyak and
Maristela Monteiro. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST):
Guidelines for Use in Primary Care (Draft Version 1.1 for Field Testing). Geneva, World Health Organization, 2003.
This draft document is complemented by:
Sue Henry-Edwards, Rachel Humeniuk, Robert Ali, Maristela Monteiro and Vladimir Poznyak. Brief
Intervention for Substance Use: A Manual for Use in Primary Care. (Draft Version 1.1 for Field Testing). Geneva, World Health Organization, 2003.
Rachel Humeniuk, Sue Henry-Edwards and Robert Ali. Self-Help Strategies for Cutting Down or
Stopping Substance Use: A Guide. (Draft Version 1.1. for Field Testing). Geneva, World Health
Organization, 2003.
Acknowledgements
This draft is based on the data and experience obtained during the participation of the authors in
the WHO Alcohol, Smoking and Substance Involvement Screening Test (WHO ASSIST) Proje