柳叶刀社论： 中国与烟草业不健康的关系

1 {% I) r. {- i6 T3 q& V, a4 gChina's unhealthy relations with big tobacco
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（Lancet,Vol 377 January 15,2011:180.）
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It sounds like a public health nightmare: a country where smoking is socially acceptable, people can smoke in public places, cigarettes are cheap, cigarette packets are devoid of eff ective health warnings, government officials use public funds to buy expensive cigarettes as gifts, and the tobacco industry sits on public bodies charged with tobacco control. But this is, in fact, the reality in China today, as detailed in a new report by the Chinese Centre for Disease Control and Prevention.

" G& u1 B8 U2 z; X+ [Given this situation, the statistics contained in the report are, perhaps, unsurprising. China has 300 million smokers and around 740 million non-smokers who are exposed to secondhand smoke: tobacco is the country’s biggest killer.

# C$ w* o& q$ m- [/ ^China did ratify WHO’s Framework Convention on Tobacco Control (FCTC) in 2005. But the signing of the FCTC seems largely symbolic. The report finds that the country is doing poorly with implementation, with a performance score of only 37 points of 100 possible points.Underpinning this poor performance is lack of political will to tackle tobacco control and the tobacco industry.
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4 ?( ^# z( i8 L- p/ p$ K9 rAccording to the report, the tobacco industry in China has a Counterproposal and Countermeasure Scheme against the FCTC, it has distorted the Chinese version of the framework, denied the scientific evidence on the health hazards of smoking, abused public powers of government to counteract tobacco control, and encouraged tobacco consumption through covert advertising and sponsorship.

2 C5 v* _; p/ hChina's Government has allowed this situation to prevail because the country’s tobacco industry is seen as a major taxpayer and employer. Although this is true, the report states that an integrated benefit analysis shows the net benefit generated by the tobacco industry is already below zero. In other words, the rapidly growing medical expenditures and loss of productivity from tobacco-related illnesses outweigh the economic benefi ts of the industry.

China has shown it can address health threats such as avian influenza and the HIV/AIDS epidemic. It is now time China tackles tobacco—its biggest health hazard and a serious economic threat.

注：
《控烟与中国未来》报告地址：
http://www.chinacdc.cn/n272442/n ... n4861781/40967.html

“China's unhealthy relations with big tobacco”内容见附件

中国与烟草业不健康的关系
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  n5 @- x: ^& i! L+ G* H; M（Lancet,Vol 377 January 15,2011:180.）


这似乎是一场公共卫生的噩梦：一个国家，吸烟被社会所接受、人们可以在公共场所吸烟、烟草价格低廉、烟草包装盒上缺少有效的健康危害警示、政府人员利用公款购置昂贵香烟作为礼品、控烟的公共机构依附于烟草业。但这些确实是真的，就在今天的中国，详细的内容参见中国疾控中心的一份新报告。

- r5 R) r% Y- U. R了解了上述情况，报告中的统计数据也许就并不令人感到惊讶。中国有3亿烟民、约7.4亿不吸烟者暴露在二手烟的环境中：烟草是中国最大的杀手。
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中国在2005年承诺履行《世界卫生组织烟草控制框架公约》。但《公约》看上去更多是象征性的。报告指出，中国的控烟执行力度不够，在满分为100分的评价指数中，中国得分只有37分。导致这种现象的根本原因是政治上缺乏应对控烟和烟草企业的意愿。如该报告所指，中国的烟草企业为对付《公约》，专门制定了与之对立的建议和措施，这扭曲了中国的控烟形式，包括：否认吸烟危害健康的科学证据、滥用政府公权力对抗控烟、通过隐性广告和赞助鼓励烟草消费。中国政府允许这种现象泛滥的原因在于烟草企业被认为是纳税大户和大雇主。即便这是真的，报告坚持认为，通过整体效益分析，烟草行业产生的净效益已经为负值。换言之，医疗费用的剧增和与吸烟有关疾病所导致的生产力损失，超过了烟草业的经济收益。
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中国已经表示将全力应对如禽流感、艾滋病流行等健康危害。现在到了中国控制烟草（巨大健康风险和经济损害）的时刻了。
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