《烟草控制框架公约》系列政策在中国的影响和实施现状：国际烟草控制政策评估项目近期的发现 Geoffrey T. Fong, Ph.D. 加拿大滑铁卢大学 加拿大安大略省癌症研究所 第四届两岸四地烟害防制交流会 台北 2011年9月5日 1 1

烟草控制框架公约第9条、第10条 烟草制品成分管制及披露

中国卷烟中的重金属 中国部分卷烟铅、镉含量远高于加拿大卷烟 O’Connor et al., Tobacco Control, 2010

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烟草控制框架公约第8条 防止接触烟草烟雾

工作场所:吸烟以及对全面无烟政策的支持 6 6

餐厅:吸烟以及对全面无烟政策的支持 7 7

中国6个ITC城市餐馆内吸烟率与其他国家/城市实施无烟法规前后的比较: 爱尔兰(04), 苏格兰(06), 法国(08), 德国(07-08), 荷兰(08), 墨西哥城(08), 毛里求斯(09) • • • • 86 29 DE 07- 08 • • • 84 IE Mar 04 2 83 NL Jul 08 5 • • • • • • • MXC Apr 08 9 78 China 87-96% 71 2 FR Jan 08 62 16 MU Mar 09 59 SC Mar 06 % of Restaurants in which there was ANY smoking 8 8 8

酒吧:吸烟以及对全面无烟政策的支持 9 9

烟草控制框架公约第11条 烟草制品的包装和标签

中国于2008年10月修改了烟盒健康警示 旧健康警示: 烟盒侧面，仅有一条信息 新健康警示: 烟盒正反两面，有两条信息

我们的实验性研究的设计 以及中国 2 6 3 10 5 仅有 文字 9 8 1 4 7 文字+ 图形 随机化警示编号

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ITC中国调查的数据证实了前述实验性研究的发现 14 14

健康警示 15 15

健康警示 16 16

烟草控制框架公约第6条 减少烟草需求的价格和税收措施

背景 2009年5月，中国大陆地区上调了卷烟消费税 在批发环节增加了一道5%的从价税 甲类卷烟和乙类卷烟的分界由调拨价50元/条调整为70元/条 调拨价≥70元/条的卷烟：税率由45%调整为56% 调拨价50-69元/条的卷烟：税率由45%调整为36% 调拨价<50元/条的卷烟：税率由30%调整为36% 2011年1月，工信部官员接受采访时称，上述卷烟消费税的上调是我国认真履行《公约》规定义务的举措之一 18

吸烟者的反应 21 21

ITC中国研究主要发现总结 总体上，中国《公约》相关政策比其他一些国家弱: – 2008年10月修改后的健康警示几乎是无效的 – 无烟法规并未降低公共场所的吸烟状况 – 卷烟消费税的提高并未引起零售价的上升，因此对吸烟行为毫无影响 What would an ideal evaluation model look like? It would be an international evaluation system (because evaluation of the impact of policies within one country is best accomplished by having a CONTROL country (or countries) for comparison). This international system would be a SURVEILLANCE effort in that it would measure basic tobacco use behaviours over time. It would also measure variables directly relevant to each of the FCTC policies. It would measure variables from a strong theoretical perspective and it would measure the same variables across the countries It would have common designs and methods across countries It would take advantage of policies being implemented in a particular country--and set up and measure the relevant variables BEFORE and AFTER the policy implementation in that country. It would then link the measures of policy impact to the policy implementation, and compare the results to those of other countries where that policy had not changed over that same time period. 22

ITC中国研究主要发现总结 但是，中国吸烟者支持更强有力的控烟政策: – 41%的吸烟者支持在烟盒上印刷更多健康信息，只有6%希望健康信息更少 – 大约50%的吸烟者支持工作场所无烟 – 83%的吸烟者以及91%的非吸烟者认为中国政府应加强烟草控制工作 What would an ideal evaluation model look like? It would be an international evaluation system (because evaluation of the impact of policies within one country is best accomplished by having a CONTROL country (or countries) for comparison). This international system would be a SURVEILLANCE effort in that it would measure basic tobacco use behaviours over time. It would also measure variables directly relevant to each of the FCTC policies. It would measure variables from a strong theoretical perspective and it would measure the same variables across the countries It would have common designs and methods across countries It would take advantage of policies being implemented in a particular country--and set up and measure the relevant variables BEFORE and AFTER the policy implementation in that country. It would then link the measures of policy impact to the policy implementation, and compare the results to those of other countries where that policy had not changed over that same time period. 23

政策建议 按《公约》第6条要求: 提高卷烟税收及价格 按《公约》第11条实施准则要求：在烟盒正面及背面的上部使用覆盖50%面积的图形方式健康警示 按《公约》第8条实施准则要求，实施全面无烟法规：需要更强有力的执行和实施 增加公共教育项目以增加公众对吸烟及二手烟危害相关知识的认识 增加医疗卫生系统帮助吸烟者戒烟的能力 建立独立监督检测烟草制品的系统 What would an ideal evaluation model look like? It would be an international evaluation system (because evaluation of the impact of policies within one country is best accomplished by having a CONTROL country (or countries) for comparison). This international system would be a SURVEILLANCE effort in that it would measure basic tobacco use behaviours over time. It would also measure variables directly relevant to each of the FCTC policies. It would measure variables from a strong theoretical perspective and it would measure the same variables across the countries It would have common designs and methods across countries It would take advantage of policies being implemented in a particular country--and set up and measure the relevant variables BEFORE and AFTER the policy implementation in that country. It would then link the measures of policy impact to the policy implementation, and compare the results to those of other countries where that policy had not changed over that same time period. 24

项目核心资助来自美国国立癌症研究所 (P01 CA138389)   ITC项目经费来源 项目核心资助来自美国国立癌症研究所 (P01 CA138389) 项目额外的核心资助来自加拿大卫生研究院 ITC项目研究机构 25 25 25