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【控烟行动】烟草使用下降:世卫组织敦促各国资助更多人戒烟

2021年1116日发布的第四份世卫组织全球烟草趋势报告显示,全球有13.0亿烟草用户,而2015年为13.2亿。预计到2025年这一数字将下降到12.7亿。 

目前,60个国家有望在2010年至2025年期间实现将烟草使用量减少30%的全球自愿目标,而在两年前,只有32个国家步入正轨。

世界卫生组织《烟草控制框架公约》(WHO FCTC)和MPOWER下的有效和全面的烟草控制政策挽救了数百万人的生命——这是抗击烟草流行的一项伟大成就。

世卫组织总干事谭德塞说:“看到每年使用烟草的人越来越少,越来越多的国家有望实现全球目标,这是非常令人鼓舞的。”“我们还有很长的路要走,烟草公司将继续利用每一个技巧来捍卫他们通过兜售致命商品获得的巨额利润。我们鼓励所有国家更好地利用许多有效工具来帮助人们戒烟和挽救生命。”

该报告还敦促各国加快实施世界卫生组织《烟草控制框架公约》中概述的措施,以进一步努力减少有可能因吸烟而患病和死亡的人数。

“很明显,烟草控制是有效的,我们对我们的人民负有道德义务,要积极采取行动以实现可持续发展目标,”世卫组织健康促进司司长Ruediger Krech说。“我们看到许多国家取得了巨大进展,这是实施符合WHO FCTC的烟草控制措施的结果,但这种成功是脆弱的。我们还需要继续前进。”

一个新的世卫组织全球戒烟投资案例强调,每年人均投资1.68美元用于戒烟干预措施,例如简短建议、国家免费戒烟热线和发送戒烟建议短信,到2030年,可以帮助1.52亿吸烟者成功戒烟,挽救了数百万人的生命,并为国家的长期经济增长做出贡献。

为促进这一进程,世卫组织成立了一个戒烟联盟,该联盟将汇集合作伙伴,支持各国扩大戒烟规模。

该报告和投资案例在缔约方大会第九届会议(COP9)之后和消除烟草制品非法贸易议定书缔约方会议第二届会议(MOP2)期间发布。

代表们意在对抗烟草业让数百万人迷恋其产品的雄心,最近的证据还表明,烟草业利用Covid-19大流行在80个国家的政府产生影响力。

世卫组织关于2000-2025年烟草使用流行趋势全球报告的主要发现: 

2020年,全球有22.3%的人口使用烟草,全球男性和女性的比例分别为36.7%7.8%

目标:目前,有60个国家有望到2025年实现减少烟草使用的目标。自两年前的上次报告以来,另外两个地区--非洲和东南亚地区——现在加入了美洲地区,实现了30%的削减目标。

儿童:目前约有3800万儿童(13-15岁)使用烟草(1300万女孩和2500万男孩)。在大多数国家/地区,未成年人购买烟草产品是非法的。目标是实现儿童零吸烟。

女性:2020年使用烟草的女性人数为2.31亿。女性吸烟率最高的年龄组是55-64岁。

区域趋势:

美洲的趋势:在所有世卫组织区域中,美洲区域的流行率随时间下降幅度最大。烟草平均使用率从2010年的21%下降到2020年的16%

非洲区域趋势:该区域的平均烟草使用率最低,2020年为10%,低于2010年的15%

欧洲区域趋势:在欧洲,18%的妇女仍在使用烟草——远高于任何其他区域。欧洲的女性是世界上烟草使用减速最慢的。世卫组织其他所有区域都有望到2025年将女性的烟草使用率降低至少30%

东地中海地区趋势:巴基斯坦是该地区唯一有望实现烟草减少目标的国家。世界上烟草使用增加的六个国家中有四个在该地区。

东南亚区域趋势:该区域目前的烟草使用率最高,约有4.32亿使用者,占其人口的29%。但这也是烟草使用下降最快的地区。到2025年,该地区很可能达到与欧洲地区和西太平洋地区相似的烟草使用率。

西太平洋区域趋势:预计该区域将成为男性吸烟率最高的区域,到2025年仍有超过45%的男性在使用烟草。

政策行动:三分之一的国家可能实现30%的减排目标,而低收入国家目前在烟草方面取得的进展最大。平均而言,中等偏上收入国家在减少烟草使用方面取得的进展最慢。还有大约29个国家,数据质量低或不足以了解趋势,因此需要更多监测。

这些估计背后的数据来自1990年至2020年间由各国进行的1728次全国调查,这些调查总共询问了世界97%的人口的烟草使用情况。WHO FCTC20条强调了开展调查以获取烟草流行证据的重要性,现在已有190个国家至少开展了一项全国性调查——而2004年该条约尚未生效时开展调查的国家为140个。世卫组织及其合作伙伴通过全球烟草监测系统调查、STEPS调查和世界卫生调查为填补低收入和中等收入国家的数据空白做出了巨大贡献。

全球戒烟投资案例的要点

为了实现减少烟草使用的全球目标,需要扩大戒烟服务的规模,同时加强烟草控制措施。提供戒烟服务可以加速烟草使用流行率的下降趋势,挽救更多生命并保障更多人的健康。

人群层面的戒烟干预包括简短建议、全国免费戒烟热线和戒烟短信(通过手机短信支持)。这些干预措施的成本很低,但在10年内可带来显著的投资回报。包括尼古丁替代疗法(NRT)、安非他酮和伐尼克兰在内的药物干预更昂贵,但被证明是有效的。

来自124个低收入和中等收入国家的数据被用于分析。 

编者注

世卫组织的报告涵盖了有烟烟草(香烟、烟斗、雪茄、水烟、雪茄、比迪烟、丁香、加热烟草制品等)和无烟烟草制品(口用和鼻用烟草)的使用。报告中没有分析电子烟的使用情况。

该报告支持对可持续发展目标(SDG)具体目标3.a的监测,该目标呼吁加强实施世界卫生组织《烟草控制框架公约》(WHO FCTC) 

世卫组织的“MPOWER”措施符合世界卫生组织《烟草控制框架公约》,并已被证明可以挽救生命和减少可避免的医疗保健支出的成本,包括:

监测烟草使用和预防政策

保护人们远离烟草烟雾

提供戒烟帮助

警告人们烟草的危害

执行对烟草广告、促销和赞助的禁令

提高烟草税

所有这些措施都具有很高的成本效益、影响力并提供显著的投资回报,因此世卫组织建议全面采用MPOWER一揽子方案。

 

英文原文

Tobacco use falling: WHO urges countries to invest in helping more people to quit tobacco

 

16 November 2021

The fourth WHO global tobacco trends report released today, shows that there are 1.30 billion tobacco users globally compared to 1.32 billion in 2015. This number is expected to drop to 1.27 billion by 2025.

 

Sixty countries are now on track to achieving the voluntary global target of a 30% reduction in tobacco use between 2010 and 2025:  two years ago only 32 countries were on track.

Millions of lives have been saved by effective and comprehensive tobacco control policies under the WHO Framework Convention on Tobacco Control (WHO FCTC) and MPOWER – a great achievement in the fight against the tobacco epidemic

“It is very encouraging to see fewer people using  tobacco each year, and more countries on track to meet global targets,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “We still have a long way to go, and tobacco companies will continue to use every trick in the book to defend the gigantic profits they make from peddling their deadly wares. We encourage all countries to make better use of the many effective tools available for helping people to quit, and saving lives.”

The report also urges countries to accelerate implementation of the measures outlined in the WHO FCTC in an effort to further reduce the number of people at risk of becoming ill and dying from a tobacco-related disease.

“It is clear that tobacco control is effective, and we have a moral obligation to our people to move aggressively in order to achieve the Sustainable Development Goals,” says Dr Ruediger Krech, Director of WHO Department of Health Promotion. “We are seeing great progress in many countries, which is the result of implementing tobacco control measures that are in line with the WHO FCTC, but this success is fragile. We still need to push ahead.”

A new WHO  Global Investment Case for Tobacco Cessation, highlights that investing US$ 1.68 per capita each year in evidence-based cessation interventions such as brief advice, national toll-free quit lines, and SMS-based cessation support, could help 152 million tobacco users successfully quit by 2030, saving millions of lives and contributing to countries’ long-term economic growth.

To facilitate this process, WHO has established a tobacco cessation consortium, which will bring together partners to support countries in scaling up tobacco cessation.

The report and the investment case  are released right after of the ninth session of the Conference of the Parties (COP9) and during the second session of the Meeting of the Parties (MOP2) to the Protocol to Eliminate Illicit Trade in Tobacco Products.

 Delegates meet to counter the ambitions of the tobacco industry to keep millions hooked on its products, , as recent evidence also show that the tobacco industry used the COVID-19 pandemic to build influence with governments in 80 countries.  

Key findings of the WHO global report on trends in prevalence of tobacco use 2000–2025: 

In 2020, 22.3% of the global population used tobacco, 36.7% of all men and 7.8% of the world’s women.

Target: Currently, 60 countries are on track to achieve the tobacco use reduction target by 2025. Since the last report two years ago, two other regions – the African and South-East Asian regions - have now joined the Americas region on-track to achieve a 30% reduction.

Children: Approximately 38 million children (aged 13-15) currently use tobacco (13 million girls and 25 million boys).  In most countries it is illegal for minors to purchase tobacco products. The goal is to achieve zero child tobacco users.

Women: The number of women using tobacco in 2020 was 231 million. The age group with the highest prevalence rate among women  for tobacco use  is 55-64.

Regional trends:

Trends in the Americas: Of all WHO regions, the steepest decline in prevalence rates over time is seen in the Americas Region. The average rate of tobacco use has gone from 21% in 2010 down to 16% in 2020.

WHO’s African Region trend: this region has the lowest average rate of tobacco use at 10% in 2020, down from 15% in 2010.

WHO’s European Region trend: in Europe 18% of women still use tobacco – substantially more than in any other region. Women in Europe are the slowest in the world to cut tobacco use.  All other WHO regions are on track to reduce tobacco use rates among women by at least 30% by 2025.

WHO’s Eastern-Mediterranean Region trend: Pakistan is the only country in this region that’s  on track to reach the tobacco reduction target. Four of the six countries in the world where tobacco use is increasing are in this region.

WHO’s South East Asian Region trend: The region currently has the highest rates of tobacco use, with around 432 million users, or 29% of its population. But this  is also the region where tobacco use is declining fastest.  The region is likely to reach tobacco use rates similar to the European Region and the Western Pacific Region by 2025.

WHO’s Western Pacific Region trend: This is projected to become the region with the highest tobacco use rate among men, with more than 45% of men still using tobacco in 2025.

Policy action: One in three countries are likely to achieve the 30% reduction target, and low-income countries are currently achieving the most progress against tobacco.  Upper middle-income countries are, on average, making the slowest progress in reducing tobacco use. In some 29 countries, data quality is low or insufficient to know the trend, so more monitoring is needed.

The data behind these estimates are from 1728 national surveys run by countries between 1990 and 2020, which together asked 97% of the world’s population about their tobacco use. Article 20 of the WHO FCTC underlines the importance of running surveys to obtain evidence of the tobacco epidemic, and now 190 countries have run at least one national survey - up from 140 in 2004 when the treaty was not yet in force.  WHO and partners have made a large contribution to filling the data gaps in low- and middle-income countries via the Global Tobacco Surveillance System surveys, the STEPS survey and the World Health Survey.

Highlights from the Global Investment Case for Tobacco Cessation

To meet global targets in reducing tobacco use, cessation services need to be scaled up, along with strengthening tobacco control measures. Offering cessation services can accelerate the downward trend in tobacco use prevalence, saving more lives and protecting the health of more people.

Population-level cessation interventions include brief advice, national toll-free quit lines, and mCessation (support through mobile phone text messaging). These interventions cost very little yet deliver significant returns on investment within 10 years. Pharmacologic interventions including nicotine replacement therapy (NRT), Bupropion, and Varenicline are more expensive but are proving effective.

Data from 124 low- and middle-income countries are used to generate the analysis. 

 Editors notes

The WHO report covers use of smoked tobacco (cigarettes, pipes, cigars, waterpipes, cheroots, bidis, kretek, heated tobacco products, etc) and smokeless tobacco products (oral and nasal tobacco). Use of electronic cigarettes is not analysed in the report.

The report supports the monitoring of Sustainable Development Goal (SDG) target 3.a, which calls for strengthening implementation of the WHO Framework Convention on Tobacco Control (WHO FCTC). 

The WHO “MPOWER” measures measures are in line with the WHO FCTC and have been shown to save lives and reduce costs from averted healthcare expenditure, including:

Monitoring tobacco use and prevention policies.

Protecting people from tobacco smoke.

Offering help to quit tobacco use.

Warning people about the dangers of tobacco.

Enforcing bans on tobacco advertising, promotion and sponsorship.

Raising taxes on tobacco.

All these measures are highly cost-effective, impactful and provide significant return on investment and therefore WHO recommends adopting the MPOWER package comprehensively. 

(文章来源:控烟新探索 )