global alliance against respiratory disease primary prevention & health promotion
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全球抗呼吸疾病联盟 一级预防及健康促进. Global Alliance Against Respiratory Disease Primary Prevention & Health Promotion. 爱尔兰全科医学院. 预防及 健康促进. 定义,要点 危险因素 及监测. WG1. Defining the Burden, Risk Factors, & Surveillance. WG2. 认知支持和优先条件. WG3. Prevention, & Health Promotion. - PowerPoint PPT PresentationTRANSCRIPT
Dr. Michael Boland, Irish College of General Practitioners
Global Alliance Against Respiratory DiseasePrimary Prevention& Health Promotion
全球抗呼吸疾病联盟全球抗呼吸疾病联盟
一级预防及健康促进一级预防及健康促进
爱尔兰全科医学院
Dr. Michael Boland, Irish College of General Practitioners
WG1. Defining the Burden, Risk Factors, & Surveillance
WG2. 认知支持和优先条件
W 慢性呼吸病和过敏的控制,可用、价廉的药Control of CRD & Allergies, D
WG3. Prevention,& Health Promotion
WG4. Diagnosisof CRD & Allergies.
儿童哮喘
定义,要点危险因素 及监测
预防及健康促进
慢性
慢性呼吸病和
过敏疾病的诊断
Dr. Michael Boland, Irish College of General Practitioners
Phasing out the Cooking Fires免除烹饪烟火免除烹饪烟火
烹饪烟火污染是非洲烹饪烟火污染是非洲妇女儿童的主要杀手妇女儿童的主要杀手
Dr. Michael Boland, Irish College of General Practitioners
USA Age Standardised Death Rates 美国标化年龄死亡率美国标化年龄死亡率
心脏病
肿瘤
脑卒中
交通事故慢性阻塞性肺病
糖尿病
图图 88 ,美国,美国 66 种主要死因标化年龄死亡种主要死因标化年龄死亡率率
Dr. Michael Boland, Irish College of General Practitioners
The Irish Office of Tobacco Control
Research
Inspect Regulate
Inform
爱尔兰控烟署爱尔兰控烟署
信息信息
观察观察管理管理
研究研究
Dr. Michael Boland, Irish College of General Practitioners
Concerted Action on Tobacco
Since the Irish Office of Tobacco Control was established in 2001 the % of the population smoking has fallen by a quarter (31% to 23.5%).
Smoking is banned in all public places including Bars since 2004.
对烟草的一致行动对烟草的一致行动
自自 20012001 年爱尔兰控烟署建立,居民吸烟率下年爱尔兰控烟署建立,居民吸烟率下降降 1/4 1/4 (从(从 31%31%降到降到 23.5%23.5%))
自自 20042004 年起,在所有公共场所包括酒吧都禁止吸烟年起,在所有公共场所包括酒吧都禁止吸烟
Dr. Michael Boland, Irish College of General Practitioners
0
5
10
15
20
25
30
35
1992 2000 2002 2004 2005
% Smoking
No. of Smokers fallen by 25% ?
‘Slan’ SurveysOTC/MRBI Tracker
Smoking Ban 禁烟令禁烟令
OTC/MRBI的追踪调查
吸烟人数下降了吸烟人数下降了 25%25% 吗?吗?
吸烟率吸烟率
Dr. Michael Boland, Irish College of General Practitioners
Why is cessation so important?
If we focus only on prevention it will be 40 years before the substantial benefits will be fully realised.
Cessation substantially reduces smoking related risks within 1–2 years.
如仅着眼于预防,得提前如仅着眼于预防,得提前 4040 年下年下手才能完全实现实质性效益手才能完全实现实质性效益
禁烟实际上减少吸烟导致的危险禁烟实际上减少吸烟导致的危险,在,在 1-21-2 年内起效年内起效
禁禁烟为什么那么重要?
Dr. Michael Boland, Irish College of General Practitioners
Price Increases can stop teenagers smoking
2% 6%14%
32%
48%
78%
None 10% 25% 50% 100% 250%
8-17 S
提高烟价Price increase
Very Unlikely To Continue Smoking
提高烟价可阻止青少年吸烟提高烟价可阻止青少年吸烟
很难续吸的青少年很难续吸的青少年
(图示:提高烟价(图示:提高烟价 2.52.5倍可使倍可使 78%78%青少年不再吸烟)青少年不再吸烟)
Dr. Michael Boland, Irish College of General Practitioners
Building a National Partnership
Members of the Parliamentary Committee NGOs - Cancer Society, Heart Foundation etc. Public Health leaders focus on ET Smoke The Minister of Health Statutory Agencies
Health & Safety AuthorityEnvironmental Health Office
(The Tobacco Industry - soon excluded)
建立全国性协作组织建立全国性协作组织
议会专家委员会成员议会专家委员会成员非政府组织非政府组织————防癌协会、心脏病基金会等防癌协会、心脏病基金会等关注戒烟的卫生行政领导关注戒烟的卫生行政领导卫生部长卫生部长法定传媒法定传媒卫生及安全部门环保部门
(排除烟草生产厂家)(排除烟草生产厂家)
Dr. Michael Boland, Irish College of General Practitioners
Seven Tier Plan
Educate people about smoking and its effects Provide more help for smokers to quit Further regulate the Tobacco Industry Protect everyone from Passive Smoking (ETS) Don’t just pass laws – implement them Extend ‘ownership’ to the people Use International Co-operation & Advice
七步计划七步计划
吸烟及其后果的教育吸烟及其后果的教育对吸烟者戒烟提供更多的帮助对吸烟者戒烟提供更多的帮助进一步管理烟草生产进一步管理烟草生产保护所有被动吸烟者保护所有被动吸烟者不仅通过法律不仅通过法律————应贯彻执行应贯彻执行要传达到每个人要传达到每个人
利用国际合作协商利用国际合作协商
Dr. Michael Boland, Irish College of General Practitioners
Power to Prohibit & Restrict Smoking
Public Transport Hospitals and Clinics Schools and Colleges Public Offices Places of work Cinemas, Theatres, Concert Halls, etc. Pubs, Bars, Clubs, and Restaurants Other ‘Specified Places’
Offence to smoke or to permit it –
‘Person in Charge’ isGuilty of an Offence
The Tobacco Acts
禁止和限制吸烟的力度禁止和限制吸烟的力度
公共交通设施公共交通设施医院及诊所医院及诊所大中小学大中小学公共办公室公共办公室工作场所工作场所电影院、戏院、歌剧院电影院、戏院、歌剧院酒馆、酒吧、俱乐部及餐馆酒馆、酒吧、俱乐部及餐馆其他特殊场所其他特殊场所
干涉吸烟还是容忍它
—“ 个人负责”是对干预的犯罪
Dr. Michael Boland, Irish College of General Practitioners
Key Influences & Opportunities
An All-Party Committee – disenchanted
The WHO, FCTC, & European contacts
Dedicated Office of Tobacco Control
Workers rights to a smoke-free workplace
Trade Union & (later) Employer Support
A Courageous & Ambitious Minister
A small but highly committed OTC (15 staff)
发生影响和创造机会的关键发生影响和创造机会的关键
了解其危害的各种党派委员会了解其危害的各种党派委员会WHO, FCTCWHO, FCTC 及及欧盟欧盟致力于控烟的机构致力于控烟的机构有关在劳动场所禁烟的劳动法规有关在劳动场所禁烟的劳动法规商业联盟及(其后的)用户支持者商业联盟及(其后的)用户支持者有胆有识的部长有胆有识的部长小而优秀的非处方药店(小而优秀的非处方药店( 1515 人)人)
Dr. Michael Boland, Irish College of General Practitioners
International Support for ETS Ban
WHO & FCTCWHO & FCTC International NGOs, Conferences, Networks. Experience in New York and elsewhere Authoritative Evidence & Research The ‘week-long visit’ = media, public, private Ministerial Visits
All Better Educated
国际支持国际支持
非政府组织,会议,网络非政府组织,会议,网络纽约和其他地方的经验纽约和其他地方的经验专业证据及研究成果专业证据及研究成果每周访谈每周访谈————媒体,公共,私人媒体,公共,私人部长访谈部长访谈
所有受过好教育者所有受过好教育者
Dr. Michael Boland, Irish College of General Practitioners
OTC Preparatory Expert Reports
Expert Report on E.T.S. (Allwright et al.) What do smokers want? (Loscher, MRBI) Productivity Costs smokers and society (Welte)
Statement by Medical Colleges and Deans Irish Women and Tobacco (WHO, Slan, MRBI) Ventilation (James Repace USA)
Economic Effects on the Hospitality Industry
(TNS- MRBI, Durcan/McDowell,UCD)
准备中的专业报告准备中的专业报告
适宜环境工程的经济效益适宜环境工程的经济效益
E.T.SE.T.S 专家报告专家报告吸烟者期望什么?吸烟者期望什么?对吸烟者和社会的生产价值对吸烟者和社会的生产价值医科大学和领导们的陈述医科大学和领导们的陈述爱尔兰妇女和烟草爱尔兰妇女和烟草通风换气通风换气
Dr. Michael Boland, Irish College of General Practitioners
Ventilation
No ‘Acceptable’ level of exposure Effective Ventilation rates are impractical? Ventilation Costs?
Level playing pitch? Tobacco industry hospitality programmes
Ventilation doesn’t address health effects
(Courtesy of Choice; pmoptions)
通风换气通风换气
暴露没有可接受的水平暴露没有可接受的水平通风换气率的效果不切实际吗?通风换气率的效果不切实际吗?通风换气价值?通风换气价值?烟草厂家能接受的程序
(经选择同意)通风换气不能起健康效应通风换气不能起健康效应
Dr. Michael Boland, Irish College of General Practitioners
Key messages: Everyone has the right to live in a clean air
environment. Repeated exposure to environmental smoke
causes incurable COPD, asthma, cardiovascular disease and cancer.
Complete elimination of the harmful smoke is the only way to remove the risk.
This applies to tobacco smoke and all other at risk environments.
关键宣传用语关键宣传用语
人人有生活在空气清新环境的权利人人有生活在空气清新环境的权利
反复暴露于环境污染导致不可治愈的慢性反复暴露于环境污染导致不可治愈的慢性阻塞性肺病和哮喘、心血管病、肿瘤阻塞性肺病和哮喘、心血管病、肿瘤
彻底清除有害烟尘是消除危害的惟一途径彻底清除有害烟尘是消除危害的惟一途径
这些适用于烟草及其他各种危险环境这些适用于烟草及其他各种危险环境
Dr. Michael Boland, Irish College of General Practitioners
Majority obey the law – smokers and non-smokers
Strong support from key stakeholders - unions, health community, policymakers, rep. orgs. (hotel, restaurant, tourism…)
Intensive compliance building locally -
EHO’s - in partnership with business
Building Compliant Environments构建和谐环境构建和谐环境
吸烟者和非吸烟者大多数服从法律吸烟者和非吸烟者大多数服从法律
得到有关部门的强力支持,包括旅馆、得到有关部门的强力支持,包括旅馆、餐厅、旅游业餐厅、旅游业
强化依从性,构建地方商业的伙伴强化依从性,构建地方商业的伙伴关系关系
Dr. Michael Boland, Irish College of General Practitioners
After Two Years Compliance very highCompliance very high Prosecutions to date = only 37Prosecutions to date = only 37 现已通行全国现已通行全国 94% of all workplaces included such as..94% of all workplaces included such as..
93% of hotels; 99% of restaurants; 90% of bars; 97% of other premises
两年后两年后
依从性很高依从性很高原先彻底执行仅原先彻底执行仅 3737
全国全国 94%94% 工作场所,包括:工作场所,包括:93%93% 的旅馆的旅馆99%99% 的餐馆的餐馆90%90% 的酒吧的酒吧97%97% 的其他场所的其他场所
Dr. Michael Boland, Irish College of General Practitioners
Strong Public Support –Still Growing
67% support before the law
89% success – after introduction
Support one year on (inc. smokers)
98% believe workplaces are healthier
(94% of smokers)
96% think law is a success (89% of smokers)
93% think it is a good idea (80% of smokers)
强力的公众支持强力的公众支持————仍在增长仍在增长
有此法律前,支持者有此法律前,支持者 67%67%
其后,其后, 89%89%
一年的支持(包括吸烟者)一年的支持(包括吸烟者)
98%98% 相信工作场所更健康相信工作场所更健康(包括(包括 94%94% 吸烟者)吸烟者)
96%96% 认为是成功的(包括认为是成功的(包括 89%89% 吸烟者)吸烟者)
93%93% 认为是好主意(包括认为是好主意(包括 80%80% 吸烟者)吸烟者)
Dr. Michael Boland, Irish College of General Practitioners
The Possibilityof a Major Breakthrough重大突破的可能性重大突破的可能性
Dr. Michael Boland, Irish College of General Practitioners
That’s all folks !