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2016年3月5日，著名心脑血管专家、中国控制吸烟协会会长胡大一教授与世界卫生组织驻华代表施贺德博士相聚世卫组织驻华代表处，就“挥之不去的二手烟，到底应该怎么管？”话题进行了一个小时的在线答疑。
胡大一教授表示。他相信正义，相信时间 相信历史。绝不相信一个伤害人民健康，让年轻人提前心肌梗死，使人过早致残丢失生命的烟草行业和他们的后台能猖狂长久，都是纸老虎。不控烟，慢病防控无望；不控烟，何谈健康中国，愚公移山，挖山不止。越是对大众健康有益的事，越难做，也越值得为之奋斗，有生之年当上一任中国控烟协会会长，无比幸福，无限荣光。
施贺德：世卫组织驻华代表 北京市控烟志愿者
胡大一：中国控烟协会会长 著名心脑血管专家
想知道他们究竟都聊了些什么？不要着急，精彩内容就在后面！
问题一：二手烟的危害究竟有多大？
胡大一：
? “二手烟致命”并不是耸言听闻有大量的证据，二手烟危害健康，而且控制二手烟，一年就可以看到心肌梗死发病率下降。烟雾里面漂浮着上百种的有害物质，肯定对健康有害，这并不是耸人听闻。
女性在怀孕期间接受二手烟，对孩子有很大影响。现在很多女性计划要二胎，吸烟对母子都有影响，造成低体重儿、早产、新生儿猝死。
如果得过心肌梗死的人吸烟或者吸二手烟，会增加再次梗死和猝死的风险。做过支架、得过心肌梗死的人如果能够彻底戒烟，可以减少未来死亡的风险36%，远远超过任何的药物，包括阿斯匹林等。
施贺德：
二手烟危害甚至超过雾霾如果有三个人同时在餐馆吸烟，PM2。5可能瞬间就会超过600。二手烟会对健康产生极大的危害！但同时它也是很容易就可以避免的。所以，让我们一起努力，来保证大家免受二手烟的危害。
问题二：遭遇二手烟该如何办？
施贺德：
全国无烟立法是关键中国需要一部全国无烟立法：在办公室和公共场所吸烟都应该是违法的。当我们有一部完善的法律，在办公室、向领导劝烟将变得容易许多。领导们应该和大家一样严格遵守法律，而且要带头遵守。
公共场所遭遇二手烟，我们可以好好跟他们说，不要和他们争执。如果是在北京，告诉他们已经出台的控烟条例。我也是这么做的，而且还没遇到对此反应过激的人。实际上，有时积极的谈话能给你带来意想不到的惊喜！
胡大一：
要有法，也要有行动！第一点要进一步完善执法机制，加强执法力度，发动更多志愿者的参与；第二要进一步完善和强化举报电话和举报体制的功能；第三，要发动公众，让更多人敢于站出来，维护不吸烟者的健康权利 。
问题三：电子烟、水烟也有害？
施贺德：
电子烟、水烟同样有危害水烟和卷烟是相似的：它同样可以产生烟雾，所以会对人体产生和卷烟一样的危害。电子烟虽然不产生烟雾，但其中却存在许多对身体有害的化学物质。
胡大一：
电子烟也是一种吸烟行为我们并不提倡用电子烟来替代卷烟，因为电子烟也是一种吸烟行为，我们提倡彻底戒烟。
问题四：控烟该有谁来管？
胡大一：
政府主导立法是关键二手烟的控制最有效的方法是立法、执法。公共场所立法是政府应该主导，力度应该加强。
施贺德：
既是政府责任，也要全民参与保障人民的健康是政府的责任。健康中国必须也是无烟中国。我们需要一部全国无烟立法，同时也需要清晰明确的实施细则和严格的执法。
此外，控烟需要我们每个人的参与！比如，我就是一名北京控烟志愿者，而且我特别喜欢穿着我的蓝色控烟马甲出行。我们鼓励大家都考虑也注册成为一名志愿者！
?问题五：禁烟会影响国家税收吗？
施贺德：
提高烟草税，控烟财税两不误许多控烟效果好的国家都有比中国高得多的烟草税。烟草税提高，政府税收也会随之提高。显然，从长远角度看，如果吸烟率降低了，曾经依赖烟草来盈利的商家会转向销售其他产品或服务，而这些也将为国家税收做贡献。
?问题六：控烟关闭烟厂最有效？
施贺德：
以此为起点，为孩子创造无烟环境！当然，如果没有烟厂，那将不会有烟草制品，也不会有人吸烟。但在如今这个互相连接的时代，很遗憾，做到这点并不容易。但让我们将此作为起点，让我们的孩子和孩子的孩子都能生活在一个无烟的世界里。
?问题七：烟草慈善为何不可以？
胡大一：
烟草慈善是误区现在很多人都有这个误区，觉得烟草企业做慈善是好事，但是实际上烟草企业利用各种手段打着慈善的旗号，来扩大烟草的影响，目的都是营销烟草。所以我们应该通过立法来教育公众，禁止烟草企业赞助，不允许烟草企业通过慈善来变相营销烟草。
施贺德：
所有烟草广告、促销和赞助都该禁烟草行业聪明地利用慈善捐赠提升其品牌价值，让人们觉得他们是良好的企业公民。世卫组织《烟草控制框架公约》已明确规定，为保护人们健康，应该禁止一切形式的烟草广告、促销和赞助。烟草是致命产品，因此，不得以任何形式进行宣传，包括通过慈善活动进行宣传。
?问题八：展望未来三十年，中国控烟能有大进展？
胡大一：
大趋势是好的看到现在的大趋势，正在一步一步向着好的方向走，三十年会有很大变化。
施贺德：
期待无烟中国！我们当然可以！！其他许多国家的经验都表明，无烟立法实施几年后，吸烟率都会明显下降。让我们也让中国老百姓享受到这些！一个健康的中国必然要是一个无烟的中国！
What Do We Do With Secondhand Smoke？Live chat with Dr. Hu Dayi and Dr. Bernhard Schwartl?nder
It's the annual Two Sessions again， but there is something different about Beijing this year. The Beijing Smoke—free Law has brought fresh air to indoor places in Beijing that visiting delegates can enjoy. This is great， but we believe that NPC delegates and the people they represent should be able to enjoy the same freedom from second—hand smoke back home. That’s why WHO is calling for the adoption of a national smoke—free law.
On 5th March， 2016， the famous cardio surgeon and China Association of Tobacco Control （CATC） chairman Dr Hu Dayi together with World Health Organization （WHO） Representative in China Dr Bernhard Schwartl?nder conducted a live chat at the WHO China office to discuss this issue， why it is so important， and what we do with second—hand smoke （SHS）.
Dr Bernhard Schwartl?nderWHO Representative in ChinaDr Hu Dayi
CATC ChairmanFamous Cardio Surgeon
Want to know what they talked about？ Here are some of the questions and answers you may be interested in！
Q1： How harmful is second hand smoke ？Dr Hu — secondhand smoke really kills Much evidence indicates that second—hand smoke is harmful to people’s health. It takes only one year of SHS control to see the decrease in myocardial infarction （heart attacks） incidence. There are more than one hundred hazardous chemicals in cigarette smoke， and there is no question they are bad for health. I am not exaggerating.
When pregnant women are exposed to SHS， their babies will be adversely affected. Many women are now planning to have a second child. Smoke will take a toll on both the pregnant women and their babies and might result in low birth weight， prematurity and sudden infant death.
If people who have previously suffered from myocardial infarction continue smoking， their risks of having another infarction and sudden death are much higher. Yet if people with stents in their body or having myocardial infarction before could completely quit smoking， their possibility of death will be lowered by 36%. Quitting smoking is much more effective than taking any medicine， including aspirin.
Dr Schwartl?nder — secondhand smoke can be more harmful than smogIf 3 people are smoking in a restaurant， the PM2.5 reading may exceed 600. Not only is this terribly unhealthy， it can easily be avoided — so let's make sure we protect everybody from SHS.
Q2： What should we do when exposed to SHS？Dr Schwartl?nder — National Smoke—free Law is the keyWe need a national smoke—free law in China. It should be illegal to smoke in offices and public places everywhere. With a good law in place， it will be much easier to talk about it in your workplace， and to your leader.Leaders should adhere to the same laws as everybody else， in fact they should be role models.
When you see people smoking in the public places， talk to them — don't just yell at them！ Remind them about the smoke—free law （if you are in Beijing）. That is what I do — and I so far have never encountered anyone who reacts aggressively. In fact you may be surprised by some of the positive discussions which can result！
Dr Hu — We need the law， and action as wellWe should first improve the enforcement mechanism， enforce the law in a stronger manner and encourage the participation of more volunteers. We then need to consolidate the function of hotline and complaint system. Third， we should mobilize the public to stand out and protect the right of non—smokers.
Q3： Are electronic cigarettes and water pipes harmful as well？ Dr Schwartl?nder — They are harmfulWater pipes are very similar to cigarettes — as they are still combustible tobacco， so they create the same kind of smoke which is very damaging to health. E—cigarettes do not burn tobacco in the same way as cigarettes do， but they still contain many toxic chemicals which are damaging to health.
Dr Hu — E—cigarette is not recomendedElectronic cigarette is not recommended to replace cigarette. It is also a behavior of smoking. We encourage smokers to completely quit smoking.
Q4： Who is responsible for tobacco control？
Dr Hu — Government should take the leadThe best way to control SHS is through legislation and law enforcement. Government should play a leading role in prohibiting smoke in public places through legislation with stronger enforcement.
Dr Schwartl?nder — Government is responsible， but it also need all of us to be engagedThe government carries responsibility for the health of the people. Healthy China must be a smoke—free China. This is why we need a national smoke—free law， and we need clearly defined responsibility for its enforcement.
All of us are part of implementing tobacco control！ For example， I am a Beijing Tobacco Control Volunteer and love wearing my blue vest. You should think about signing up too！
Q5： Will tobacco control affect national tax revenue？Dr Schwartl?nder — Raising tobacco tax is a win—win for tobacco control and national revenueMany countries with good tobacco control have tobacco taxes at much higher level than in China. When tobacco taxes go up， government revenue goes up too. Obviously， over time if smoking goes down， businesses which rely on money from tobacco today will shift to other goods and services — all of these contribute tax revenue to the Government.
Q6： Why don't we just close all tobacco factories？ Dr Schwartl?nder — Let's make this the beginning of the journeyOf course， if there were no tobacco factories， there would be no cigarettes and no smoking. But in an inter—connected modern world， unfortunately its not that simple. But let's make this the beginning of the journey — so that our children and grandchildren can live in a smoke—free world.
Q7： Why did we ban tobacco philanthropy？ Dr Hu — Tobacco philanthropy is a mythMany people mistakenly believe that tobacco philanthropy is a good deed. Yet tobacco enterprises are taking advantage of charity to advertise and promote tobacco products. Thus through legislation， we need to ban tobacco philanthropy， educate people and stop tobacco enterprises from using philanthropy for tobacco advertising.
Dr Schwartl?nder — All tobacco advertisement， promotion and sponsorship should be bannedThe tobacco industry is very smart at using philanthropic donations to increase their brand value， and to make people think that they are good corporate citizens. International law （the WHO Framework Convention on Tobacco Control） is clear that all tobacco advertising， promotion and sponsorship should be banned to protect the health of people. Tobacco products kill people， so the companies should not be allowed to promote them in any way — including through philanthropy.
Q8： What progress will China make in the next 30 years？ Dr Hu — We are moving forwardBased on the recent trends and developments， we are moving in the right direction， step by step. The next thirty years will see a big change.
Dr Schwartl?nder — Look forward to a smoke—free ChinaWe have seen in many places around the world， that smoke—free laws are the first step towards dramatically reduced smoking rates just a few years later. Let's make it happen for Chinese people！ Healthy China = smoke—free China！
摘引网址：http://q.115.com/t-101075-1234610.html
