情况介绍 2. 无烟政策

主要情况

• 在二手烟的环境中不存在任何 安全水平。
• 全面执行无烟政策可改善健康，促使烟民戒烟，并有助于降低烟草消费。
• 全球仅有5%的人口受到全面无 烟法律的保护。
• 无烟政策得到公众欢迎。

何为无烟政策？
无烟政策在特定区域禁止吸烟。通常得到法律支持，并对违反规定者进行处罚。全面无烟政策禁止在
以下场所吸烟：工作场所、公共场所、公共交通工具、酒吧及餐馆。如允许在指定吸烟室吸烟，则会
削弱政策的效力。^{(1) (2)}

对无烟政策的需求
在二手烟的环境中不存在任何安全水平。⁽³⁾ 在有二手烟的场所，人们处于严重的污染中，包括一氧化碳污染。研究表明，在允许吸烟的室内场所，其污染程度高于繁忙的公路边、封闭的汽车车库和火灾现场。⁽⁴⁾

被动吸烟引发多种疾病，包括肺癌、冠心病和心脏猝死。对于儿童，则会导致婴儿猝死综合症、中耳炎、急性下呼吸道感染，以及哮喘恶化。受到二手烟污染的风险越高，患上多数疾病的风险就越高。

虽然越来越多国家引入无烟立法，但大多数国家均未制定无烟法律，或相关法律有限或执法不力。约40%的国家并没有保护在校儿童免受二手烟的污染。世界上一半以上的国家允许在政府办公室、工作场所和其它室内场所吸烟。仅有9%的中低收入国家设有无烟餐馆，而高收入国家中则有29%。目前，全世界仅有5%的人口（16个国家）受到全面的无烟法律的保护。

健康改善的实例
以下实例表明，无烟政策能改善健康：

• 苏格兰、意大利及美国发现，自引入无烟法律后，医院接收心肌梗死的病人人数下降。^{(5) (6) (7) (8) (9)}
• 研究表明，无烟法律降低了非吸烟者吸入二手烟的机会。⁽¹⁰⁾ 没有证据显示青少年对二手烟的吸入由于父母在家吸烟的情况增多而增加。⁽¹¹⁾
• 自引进无烟法律后，爱尔兰^{(12) (13)} 、加利福尼亚⁽¹⁴⁾ 、纽约⁽¹⁵⁾ 及苏格兰⁽¹⁶⁾ 酒吧工作者的健康明显改善。
• 1988-1998年期间，加利福尼亚州肺癌和支气管癌发病率的下降速度比美国其它未实行无烟法律的州快6倍。⁽¹⁷⁾

无烟政策的其它好处

• 无烟工作场所有助激励烟民戒烟，激励已经戒烟的人士继续不吸烟。⁽¹⁸⁾ 吸烟率可下降4%。⁽¹⁹⁾
• 有助减少烟草消费。世界银行估计吸烟限制使烟草总消费量降低4-10%。⁽²⁰⁾ 无烟工作场所可能使烟草总消费降低29%。继续吸烟的烟民吸食的香烟数量也可能减少。⁽¹⁸⁾
• 烟草总销量下降，这已经在爱尔兰。⁽²¹⁾ 、挪威⁽²²⁾ 和意大利⁽²³⁾ 等国出现。
• 由于吸烟的成年人减少，儿童吸入的二手烟减少。⁽²⁴⁾
• 无烟政策使得无烟家庭的数量增加。^{(2) (25) (26)}
• 无烟政策不影响商业活动或具有积极的影响。
• 无烟法律不论在何处实行，都受到公众的欢迎，且遵守率极高。^{(27) (28)} 无烟法律往往在实施后得到越来越多的支持。

世界卫生组织在最近公布的 MPOWER一揽子政策中建议，采取循序渐进的措施，创造无烟环境：2(1)向公众和企业介绍二手烟的危害；(2)在无烟公共场所得到广泛支持后，草拟法律，征询公众意见；(3)通过全面无烟法律；(4)无烟法律一经颁布，即通力统一执行，实现令行禁止，为法律提供强有力的支持。

世界卫生组织提出，应强调无烟工作场所旨在保护工作者的健康。同时也强调，反驳烟草行业的错误论点对于赢得对公众无烟法律的支持至关重要。

最佳措施—《烟草控制框架公约》第8条指导方针
《烟草控制框架公约》(FCTC)的第8条包含使公众免于二手烟危害的保护措施。⁽²⁹⁾ 2007年7月，各缔约方一致支持通过第8条指南的草案。
其关键原则如下：⁽³⁰⁾

• 用有效措施防止二手烟的危害,要求在特定场所或环境中全面禁止吸烟和其它烟草产品的使用。
• 通风或指定的吸烟室并不能提供有效保护。
• 所有人都应受到保护免受二手烟的危害。所有室内工作场所、室内公共场所和公共交通均应实行无烟政策。
• 需要立法来保护公众免受二手烟危害。自愿协议收效甚微。
• 要实施和执行有关法律，需要有良好的计划和充足的资源。
• 国内社会团体应成为发展、实施和执行无烟法律的积极伙伴。
• 监管与评估无烟法律，估计其效果，支持可能达到最佳效果的措施。
• 应按需要加强和扩大对二手烟的防止，这可能需要新立法或修订立法，或改进执行的措施。
  指南强调，在定义关键术语（如‘二手烟’、‘吸烟’、‘室内’和‘密闭室’）时，需要特别注 意。’

要了解更多信息，请访问世卫组织无烟倡议行动www.who.int/tobacco/en/，
全球无烟伙伴计划网页http://www.globalsmokefreepartnership.org，以及联合会网页http://www.iuatld.org http://www.tobaccofreeunion.org crc@iuatld.org


⁽¹⁾ Global voices. Working for smokefree air: 2008 Status report. Global Smokefree Partnership. http://www.globalsmokefreepartnership.org
⁽²⁾ WHO report on the global tobacco epidemic, 2008. The MPOWER package. Geneva, World Health Organization, 2008. http://www.who.int/tobacco/mpower/mpower_chinese.pdf
⁽³⁾ The health consequences of involuntary exposure to tobacco smoke: a report of the Surgeon General. Atlanta, GA: Dept of Health and Human Services, Centers for Disease Control and Prevention, National Centre for Chronic Disease Prevention and Health Promotion, Office of Smoking and Health; Washington, DC: 2006. http://www.cdc.gov/tobacco/data_statistics/sgr/sgr_2006/ and at http://www.surgeongeneral.gov
⁽⁴⁾ Invernizzi G, Ruprecht A, Mazza R, Rossetti E, Sasco A, Nardini S, et al. Particulate matter from tobacco versus diesel car exhaust: an educational perspective. Tobacco Control 2004;13:219-21. http://tc.bmjjournals.com/cgi/content/abstract/13/3/219?etoc(abstract)
⁽⁵⁾ http://www.scotland.gov.uk/News/Releases/2007/09/10081400
⁽⁶⁾ http://society.guardian.co.uk/health/news/0,,2166561,00.html
⁽⁷⁾ http://society.guardian.co.uk/health/news/0,,2166561,00.html
⁽⁸⁾ Barone-Adesi F et al. Short-term effects of Italian smoking regulation on rates of hospital admission for acute myocardial infarction. Eur Heart J 2006 ;27:2468-72
⁽⁹⁾ Sargent RP, Shepard RM, Glantz SA. Reduced incidence of admissions for myocardial infarction associated with public smoking ban: before and after study. BMJ 2004; 328:977-80.
⁽¹⁰⁾ Haw S, Gruer L. Changes in exposure of adult non-smokers to secondhand smoke after implementation of smoke-free legislation in Scotland: national cross sectional survey. BMJ 2007;335:549. http://www.bmj.com/cgi/content/abstract/335/7619/549
⁽¹¹⁾ Akhtar P, Currie D, Currie C, Haw S. Changes in child exposure to environmental tobacco smoke (CHETS) study after implementation of smoke-free legislation in Scotland: national cross sectional survey. BMJ 2007;335:545. http://www.bmj.com/cgi/content/full/335/7619/545
⁽¹²⁾ Mulcahy M, Evans DS, Hammond SK, Repace JL, Byrne M. Secondhand smoke exposure and risk following the Irish smoking ban: an assessment of salivary cotinine concentrations in hotel workers and air nicotine levels in bars. Tob Control 2005;14:384-8
⁽¹³⁾ Allwright S, Paul G, Greiner B, Mullally BJ, Pursell L, Kelly A et al. Legislation for smoke-free workplaces and health of bar workers in Ireland: before and after study. BMJ 2005;331:1117 http://www.bmj.com/cgi/content/abstract/331/7525/1117
⁽¹⁴⁾ Eisner M, Smith A, Blanc P. Bartenders’ respiratory health after establishment of smoke-free bars and taverns. JAMA 1998;280:1909-14. http://jama.ama-assn.org/content/vol280/issue22/index.dtl
⁽¹⁵⁾ Farrelly M, Nonnemaker J, Chou R, Hyland A, Peterson K, Bauer U. Changes in hospitality workers’ exposure to secondhand smoke following the implementation of New York’s smoke-free law. Tobacco Control 2005;14:236-241. http://tobaccocontrol.bmj.com/cgi/content/abstract/14/4/236 (abstract)
⁽¹⁶⁾ Semple S, Maccalman L, Naji A, Dempsey S, Hilton S, Miller B, Ayers J. Bar workers’ exposure to second-hand smoke: the effect of Scottish smoke-free legislation on occupational exposure. Annals of Occupational Hygiene 2007. Published online on 10 September 2007 as doi:10.1093/annhyg/mem044. http://annhyg.oxfordjournals.org/cgi/content/abstract/mem044v1 (abstract)
⁽¹⁷⁾ California Department of Health Services, Tobacco Control Section. California tobacco control update. California Department of Health Services; 2002. http://www.dhs.ca.gov/tobacco/documents/pubs/TCSupdate.pdf
⁽¹⁸⁾ Longo DR, Johnson JC, Kruse RL, Brownson RC, Hewett JE. A prospective investigation of the impact of smoking bans on tobacco cessation and relapse. Tob Control 2001;10:267-72. http://tobaccocontrol.bmj.com/cgi/content/abstract/10/3/267 (abstract)
⁽¹⁹⁾ Fichtenberg C, Glantz S. Effect of smoke-free workplaces on smoking behaviour: systematic review. BMJ 2002;325:188. http://www.bmj.com/cgi/content/full/325/7357/188
⁽²⁰⁾ Curbing the epidemic. Governments and the economics of tobacco control. Washington, DC: The World Bank, 1999. http://www1.worldbank.org/tobacco/reports.htm
⁽²¹⁾ http://www.rte.ie/news/2004/0909/smoking.html
⁽²²⁾ http://www.euromonitor.com/Tobacco_in_Norway
⁽²³⁾ http://news.bbc.co.uk/1/hi/business/4195249.stm
⁽²⁴⁾ Jarvis MJ, Goddard E, Higgins V, Feyerabent C, Bryant A, Cook DG. Children’s exposure to passive smoking in England since the 1980s: cotinine evidence from population survey. BMJ 2000;321:343-5. http://www.bmj.com/cgi/content/full/321/7257/343
⁽²⁵⁾ Borland R, Mullins R, Trotter L, White V. Trends in environmental tobacco smoke restrictions in the home in Victoria, Australia. Tob Control 1999;8:266-71. http://tobaccocontrol.bmj.com/cgi/content/abstract/8/3/266 (abstract)
⁽²⁶⁾ After the smoke has cleared: evaluation of the impact of a new smokefree law. Wellington, Ministry of Health, 2006. http://www.hpac.govt.nz/moh.nsf/UnidPrint/MH5599?OpenDocument#information
⁽²⁷⁾ Borland R, Yong HH, Siahpush M, Hyland A, Campbell S, Hastings G, Cummings KM, Fong GT. Support for and reported compliance with smoke-free restaurants and bars by smokers in four countries: findings from the International Tobacco Control (ITC) Four Country Survey. Tob Control 2006;15 Suppl 3:iii34-41.
⁽²⁸⁾ Pan American Health Organization. Conocimiento y actitudes hacia el decreto 288/005. October 2006. http://www.presidencia.gub.uy/_web/noticias/2006/12/informeo_dec268_mori.pdf
⁽²⁹⁾ The Framework Convention Alliance for Tobacco Control. http://www.fctc.org
⁽³⁰⁾ First report of Committee A. Conference of the parties to the WHO Framework Convention on Tobacco Control. Second session. 4 July 2007. http://www.who.int/gb/fctc/PDF/cop2/FCTC_COP2_17P-en.pdf