Introduction Eliminating cancer caused by tobacco use is the highest public health priority of the American Cancer Society (ACS). Cigarette smoking is the leading cause of cancer mortality in the United States, accounting for as much as 98% of all tobacco-related deaths. The 50th anniversary Surgeon General’s Report calls for the rapid elimination of the use of all combusted tobacco products and states: “The burden of death and disease from tobacco use in the United States is overwhelmingly caused by cigarettes and other combusted tobacco products; rapid elimination of their use will dramatically reduce this burden.” (Combustible tobacco and smoking include cigarettes, roll-your-own, cigars, pipe tobacco, bidis, kreteks, hookah tobacco, and any other product that burns tobacco for human consumption.) In 2016, 15.5%—37.8 million—of US adults were current cigarette smokers. Much higher smoking prevalence was found among those living below the poverty level; American Indians/Alaska Natives; those with lower educational attainment; lesbian, gay, bisexual, and transgender persons; Medicaid enrollees; and adults suffering from serious psychological distress. These findings highlight the need for more effective approaches to mitigate the harms of tobacco use in the United States and particularly, as emphasized by the Surgeon General and others, to dramatically reduce and eventually eliminate the use of combustible (burned) tobacco products. In recognition of the disproportionately large role that combustible tobacco use plays in causing morbidity and mortality in the United States, ACS will expand its existing tobacco-control efforts and execute new comprehensive strategies to eliminate all combustible tobacco use, with the goal of substantially reducing cancer incidence and mortality and other adverse health effects. In this rapidly changing tobacco landscape, it is critical that consumers receive accurate information about different tobacco products and the role of nicotine in tobacco-related disease. Many consumers are misinformed about the harms of electronic nicotine delivery systems (ENDS). (In this document, the term ENDS refers to the variety of products that heat, but do not burn, liquids that contain nicotine, water, and other constituents, such as propylene glycol and flavorants.) Many adults believe, erroneously, that ENDS are as harmful as combustible tobacco products, and the level of public understanding has deteriorated over time. In 2012, only 11.5% of respondents to a national survey held this view. By 2015, 35.7% of respondents mistakenly believed that the harm associated with electronic cigarettes (e-cigarettes) was “about the same” as that of smoking conventional cigarettes. At the same time, the Monitoring the Future study reports that, as of 2017, “e-cigarettes have one of the lowest levels of perceived risk for regular use of all drugs, including alcohol” among adolescents. Although many ENDS deliver nicotine, flavor additives, and other chemicals, they do not burn tobacco, a process that yields an estimated 7000 chemicals, including at least 70 carcinogens. Thus, public misunderstanding underscores the urgent need for consumer education about the absolute and relative risks posed by different Vice President, Tobacco Control, and Director, Center for Tobacco Control, American Cancer Society, Atlanta, GA; Senior Vice President, Prevention and Early Detection, American Cancer Society, Atlanta, GA; Vice President, Economic and Health Policy Research, American Cancer Society, Atlanta, GA; Chief Cancer Control Officer, American Cancer Society; Professor, Department of Family and Community Medicine, Thomas Jefferson University, Atlanta, GA

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美国癌症协会关于在美国消除可燃烟草使用的公共卫生声明

简介 消除烟草使用引起的癌症是美国癌症协会 (ACS) 的最高公共卫生优先事项。吸烟是美国癌症死亡的主要原因，占所有烟草相关死亡人数的 98%。卫生署署长 50 周年报告呼吁迅速消除所有燃烧烟草制品的使用，并指出：“美国烟草使用造成的死亡和疾病负担绝大多数是由香烟和其他燃烧烟草制品造成的；迅速消除它们的使用将大大减轻这种负担。” （可燃烟草和吸烟包括香烟、自卷烟、雪茄、烟斗烟草、比迪烟、丁香烟、水烟烟草和任何其他燃烧烟草供人类消费的产品。）2016 年，15.5%—37。800 万美国成年人目前是吸烟者。生活在贫困线以下的人的吸烟率要高得多；美洲印第安人/阿拉斯加原住民；受教育程度较低者；女同性恋、男同性恋、双性恋和跨性别者；医疗补助计划参加者；和遭受严重心理困扰的成年人。这些发现强调需要采取更有效的方法来减轻美国烟草使用的危害，特别是正如外科医生和其他人所强调的那样，大幅减少并最终消除可燃（燃烧）烟草产品的使用。认识到可燃烟草的使用在导致美国的发病率和死亡率方面发挥了不成比例的巨大作用，ACS 将扩大其现有的烟草控制工作并执行新的综合战略，以消除所有可燃烟草的使用，目标是大幅降低癌症发病率和死亡率以及其他不利的健康影响。在这个瞬息万变的烟草环境中，消费者获得有关不同烟草制品和尼古丁在烟草相关疾病中作用的准确信息至关重要。许多消费者对电子尼古丁传送系统 (ENDS) 的危害有误解。（在本文件中，ENDS 一词是指加热但不燃烧的各种产品，这些液体含有尼古丁、水和其他成分，如丙二醇和食用香料。）许多成年人错误地认为，ENDS 是与可燃烟草产品一样有害，随着时间的推移，公众的理解水平已经恶化。2012 年，在一项全国性调查中，只有 11.5% 的受访者持有这种观点。到 2015 年，35.7% 的受访者错误地认为电子烟（e-香烟）的危害与吸食传统香烟的危害“大致相同”。与此同时，监测未来研究报告称，截至 2017 年，“电子烟是青少年经常使用包括酒精在内的所有药物的感知风险水平最低的之一”。尽管许多 ENDS 提供尼古丁、风味添加剂和其他化学物质，但它们不会燃烧烟草，这一过程会产生大约 7000 种化学物质，包括至少 70 种致癌物质。因此，公众的误解强调了迫切需要对消费者进行教育，了解不同的烟草控制副总裁和美国癌症协会烟草控制中心主任所带来的绝对和相对风险，亚特兰大，乔治亚州；乔治亚州亚特兰大美国癌症协会预防和早期检测高级副总裁；美国癌症协会经济与健康政策研究副总裁，佐治亚州亚特兰大；美国癌症协会首席癌症控制官；乔治亚州亚特兰大托马斯杰斐逊大学家庭和社区医学系教授 乔治亚州亚特兰大；美国癌症协会首席癌症控制官；乔治亚州亚特兰大托马斯杰斐逊大学家庭和社区医学系教授 乔治亚州亚特兰大；美国癌症协会首席癌症控制官；乔治亚州亚特兰大托马斯杰斐逊大学家庭和社区医学系教授