推動菸害防制之政策分析與啟發

Analysis and Insights on the Promotion of Tobacco Control Policies

邱尚志(Shang-Jyh Chiou) ； 張詠晴(Yung-Ching Chang) ； 劉育秀(Yu-Hsiu Liu) ； 周芷羽(Zhi-Yu Zhou) ； 何金蓮(Chin-Lien Ho) ； 劉亭余(Ting-Yu Liu) ； 江婉琪(Wan-Chi Chiang) ； 林杏子(Xing-Zi Lin) ； 曾馨儀(Hsin-Yi Tseng) ； 林寬佳(Kuan-Chia Lin)

《健康科技期刊》 8卷1期 (2021/09) Pp. 41-56

https://doi.org/10.6979/TJHS.202109_8(1).0004

摘要

經過多年的努力，多數國家的吸菸率已逐漸下降，然而菸害防制仍是全球公共衛生最重要的議題之一。大抵而言，菸害防制政策中包括有非價格政策與價格措施。直至目前，全世界將近三分之一人口至少受一種非價格菸害防制政策和措施的健康保護。而無論是價格或非價格類政策措施，評估其政策效益，學術研究上屬於一種經驗性問題（Empirical questions），通常會收集三個指標的趨勢，1. 吸菸率（分男、女的15歲以上成年人），2. 每人菸草消耗量，與3. 吸菸初發年齡。經濟合作暨發展組織（Organization for Economic Cooperation and Development，OECD）目前建立了一個吸菸主題的調查資料平台也定期發表於健康速覽（Health at a Glance）的報告中，提供會員國於菸害防制政策上進行調整，本文茲針對世界衛生組織菸草控制框架公約（Framework Convention of Tobacco Control, FCTC）以及OECD各國推動菸害防制之政策進行了綜整並透過三段五級結構進行政策實施生態的檢視與概要分析。而從各國實施相關菸害防制政策後的省思建議，可以發現因單一政策施行的策略影響力有限，應該採用廣泛的政策實施進行多管道控制，同時為因應相關政策會隨年度而效益遞減，因此，定時的監控與檢討是進行政策調整的關鍵手段。藉由回顧主要國家實施菸害政策的成效，提供我國推動菸害防制政策之參考。

關鍵字

經濟合作暨發展組織 ； 世衛菸草控制框架公約 ； 菸害防制政策分析

並列摘要

After several years of effort, the percentage of the population that smoke tobacco has dropped gradually in many countries. However, tobacco control remains one of the most important issues in global public health. Generally speaking, tobacco control policies include non-price and price measures. To date, almost one third of the global population has received health protection from at least one non-price tobacco control policy or measure. Assessments of the effectiveness of either price or non-price measures are done empirically in academic research. Such research is usually done by collecting data related to three indicators, 1. Percentage of the population that smoke tobacco (divided into male and female adults above the age of 15), 2. Tobacco consumption per capita and 3. The age that people start smoking tobacco. The Organization for Economic Cooperation and Development (OECD) built an iLibrary platform that includes information on tobacco, which is periodically presented in the Health at a Glance Report. It serves as a resource for member states to adjust their own tobacco control policies. This article focuses on the World Health Organization's (WHO) Framework Convention on Tobacco Control (FCTC) and OECD member states tobacco control policies and provides a comprehensive collation. This article also inspects and briefly analyzes the policy environments through the three levels and five stages of disease prevention frameworks. From the retrospective advice given by each member state in regards to tobacco control policies, we can see that the implementation of a single policy only has a limited influence. We should therefore implement policies more broadly and control tobacco through multiple channels. Furthermore, we need to tackle the diminishing effectiveness of the policies year after year. Therefore, periodic monitoring and review of policies are crucial means to adjust tobacco control policies. Through the study of the effectiveness of the tobacco control policies enacted by key countries, this research serves as a reference to the promotion of Taiwan's tobacco control policy.

並列關鍵字

Organization for Economic Cooperation and Development (OECD) ； WHO Framework Convention on Tobacco Control (FCTC) ； Analysis on tobacco control policies

參考文獻

蔡 韻 竹、 蔡 憶 文（2015）． 我 國 菸害 防 制 政 策 制 定 的 政 治 分 析[Political Perspective Analysis of Taiwan's Tobacco Control Policy]. 台 灣 公 共 衛 生 雜 誌，34(5)， 447-462。https://doi.org/10.6288/tjph201534103095

Amul, G. G. H., & Pang, T. (2018). Progress in Tobacco Control in Singapore: Lessons and Challenges in the Implementation of the Framework Convention on Tobacco Control. Asia & the Pacific Policy Studies, 5(1), 102-121. https://doi.org/10.1002/app5.222

Bajoga, U., Lewis, S., McNeill, A., & Szatkowski, L. (2011, Jul). Does the introduction of comprehensive smoke-free legislation lead to a decrease in population smoking prevalence? Addiction, 106(7), 1346-1354. https://doi.org/10.1111/j.1360- 0443.2011.03446.x

Bardach, A., Rodríguez, M. B., Ciapponi, A., Augustovski, F., Andrea, A., Soto, N., Virgilio, S., Reynales-Shigematsu, L. M., Roberti, J., & Pichón-Riviere, A. (2020). Smoke-Free Air Interventions in Seven Latin American Countries: Health and Financial Impact to Inform Evidence-Based Policy Implementation. Nicotine & Tobacco Research, 22(12), 2149-2157. https://doi.org/10.1093/ntr/ntaa133

Bosdriesz, J. R., Willemsen, M. C., Stronks, K., & Kunst, A. E. (2015, Apr). Tobacco control policy development in the European Union: do political factors matter? Eur J Public Health, 25(2), 190-194. https://doi.org/10.1093/eurpub/cku197