在全球范围内,发展中国家的吸烟率呈上升趋势。 据估计,21世纪将有十亿人死于烟草,除非逆转这种吸烟趋势。[4]Peto R, Lopez AD. The future worldwide health effects of current smoking patterns. In: Koop CE, Pearson CE, Schwarz MR, eds. Critical issues in global health. New York, NY: Jossey-Bass; 2001.
一项 2017 年英国关于成人吸烟习惯的报告发现,在所有成年调查受访者中,吸烟率为 15.1%,相当于英国人口中约有 740 万吸烟者;男性和女性当前吸烟者比例分别为 17% 和 13.3%。[5]Office for National Statistics (UK). Statistical bulletin - adult smoking habits in the UK: 2017. July 2018 [internet publication].https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandlifeexpectancies/bulletins/adultsmokinghabitsingreatbritain/2017
澳大利亚进行的全国家庭调查发现,14岁及以上人口中21%为每日或每周吸烟者。 平均吸烟数为16支/日。[6]Australian Institute of Health and Welfare 2001 National Drug Strategy Household Survey: Detailed Findings. Drug Statistics Series No. 11. 2002. AIHW Cat. No. PHE-41.
在美国,3780 万成年人为当前吸烟者。但是,吸烟率从 2005 年的 20.9% 下降至 2016 年的 15.5%。[7]Jamal A, Phillips E, Gentzke AS, et al. Current cigarette smoking among adults - United States, 2016. MMWR Morb Mortal Wkly Rep. 2018 Jan 19;67(2):53-9.https://www.cdc.gov/mmwr/volumes/67/wr/mm6702a1.htmhttp://www.ncbi.nlm.nih.gov/pubmed/29346338?tool=bestpractice.com
吸烟与心脏病、多种癌症和慢性阻塞性肺疾病相关。在美国,每年有大约 50 万人死于吸烟相关疾病。[8]US Department of Health and Human Services. The health consequences of smoking - 50 years of progress. A report of the Surgeon General. January 2014 [internet publication].http://www.surgeongeneral.gov/library/reports/50-years-of-progress/full-report.pdf 而且据估计,每年烟草消耗约 1759 亿美元的直接医疗费用,并导致 1507 亿美元的生产力损失。[8]US Department of Health and Human Services. The health consequences of smoking - 50 years of progress. A report of the Surgeon General. January 2014 [internet publication].http://www.surgeongeneral.gov/library/reports/50-years-of-progress/full-report.pdf
2018 年的一项研究表明,冠心病和卒中很大比例的风险都来自于吸烟,即使只吸了几支香烟。这对于认为少量吸烟带来的危害很小或没有危害的吸烟者具有重要影响。研究结果表明,相对于每天吸 20 支香烟带来罹患冠心病和卒中的额外风险,每天吸 1 支香烟带来的额外风险大约为 40% 至 50% ,每天吸 5 支香烟带来的额外风险则大约为 55% 至 65% 。对于心血管疾病不存在安全的吸烟水平。[9]Hackshaw A, Morris JK, Boniface S, et al. Low cigarette consumption and risk of coronary heart disease and stroke: meta-analysis of 141 cohort studies in 55 study reports. BMJ. 2018 Jan 24;360:j5855.https://www.bmj.com/content/360/bmj.j5855.longhttp://www.ncbi.nlm.nih.gov/pubmed/29367388?tool=bestpractice.com
吸烟减少吸烟者的中位生存期平均10年,对于大于40岁的吸烟者,每增加一年的吸烟,会额外缩短3个月的寿命。[10]Doll R, Peto R, Boreham J, et al. Mortality in relation to smoking: 50 years' observations on male British doctors. BMJ. 2004 Jun 26;328(7455):1519.http://www.bmj.com/cgi/content/full/328/7455/1519http://www.ncbi.nlm.nih.gov/pubmed/15213107?tool=bestpractice.com 停止吸烟后,患者可降低20%-90%的肺癌和其他疾病的风险,并且提高生存率,即使是50岁后再戒烟时。[10]Doll R, Peto R, Boreham J, et al. Mortality in relation to smoking: 50 years' observations on male British doctors. BMJ. 2004 Jun 26;328(7455):1519.http://www.bmj.com/cgi/content/full/328/7455/1519http://www.ncbi.nlm.nih.gov/pubmed/15213107?tool=bestpractice.com 然而,习惯性吸烟者发现很难成功戒烟。 尽管70%的吸烟者想戒烟,每年40%曾尝试至少1次的戒烟,每年只有3%〜4%的吸烟者在只依靠自己的情况下,能够成功地长期戒烟。[11]Messer K, Pierce J, Zhu S-H, et al. The California Tobacco Control Program's effect on adult smokers: (1) Smoking cessation. Tob Control. 2007 Apr;16(2):85-90.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2598468/http://www.ncbi.nlm.nih.gov/pubmed/17400944?tool=bestpractice.com
2016 年,7.2% 的分娩女性曾在怀孕期间吸烟。20 至 24 岁的女性在怀孕期间吸烟率最高。[12]Drake P, Driscoll AK, Mathews TJ. Cigarette smoking during pregnancy: United States, 2016. NCHS Data Brief. 2018 Feb;(305):1-8.https://www.cdc.gov/nchs/data/databriefs/db305.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/29528282?tool=bestpractice.com
[Figure caption and citation for the preceding image starts]: 戒烟具备重要的生存期益处。改编自 Doll R, Peto R, Boreham J, et al. Mortality in relation to smoking: 50 years' observations on male British doctors.BMJ.2004;328:1519. 获准使用 [Citation ends].