15.6 吸烟与健康
章节大纲
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Sure Death
::确实死亡This anti-smoking cartoon clearly makes the point that smoking causes death. The cartoon is not using hyperbole, because smoking actually is deadly. It causes about six million deaths each year, and is the single greatest cause of preventable death worldwide. As many as half of all people who smoke tobacco die from it. As a result of smoking’s deadly effects, the life expectancy of long-term smokers is significantly less than that of non-smokers. In fact, long-term smokers can expect their lifespan to be reduced by as much as 18 years, and they are three times more likely than non-smokers to die before the age of 70.
::这幅反吸烟卡通画清楚地表明了吸烟会导致死亡。 卡通画并没有使用高音,因为吸烟实际上是致命的。它每年造成大约600万人死亡,也是全世界可预防死亡的最主要原因之一。 吸烟者中有多达一半死于吸烟。 由于吸烟的致命影响,长期吸烟者的预期寿命大大低于非吸烟者的预期寿命。 事实上,长期吸烟者可以预期其寿命会缩短多达18年,比70岁前非吸烟者死亡的可能性高三倍。 事实上,长期吸烟者可以预期其寿命会缩短多达18年,比70岁前非吸烟者死亡的可能性高三倍。Why Is Smoking Deadly?
::为什么吸烟是致命的?As shown in the figure , tobacco smoking has adverse effects on just about every bodily system and organ. The detrimental health effects of smoking depend on the number of years that a person smokes and how much the person smokes. Contrary to popular belief, all forms of tobacco smoke — including smoke from cigars and tobacco pipes — have similar health risks as those of cigarette smoke. Smokeless tobacco may be less of a danger to the lungs and heart, but it, too, has serious health effects. It significantly increases the risk of cancers of the mouth and throat, among other health problems.
::如图所示,吸烟对每个身体系统和器官都有不利影响,吸烟对健康的有害影响取决于一个人吸烟的年数和吸烟人数,与人们的信念相反,一切形式的烟草烟雾,包括雪茄和烟管烟雾的烟雾,都具有与吸烟类似的健康危险,无烟烟烟对肺部和心脏的危险可能较小,但也对健康产生严重影响,大大增加了口喉癌的风险,以及其他健康问题。Smoking is known to cause many different cancers and chronic diseases.
::据知吸烟造成许多不同的癌症和慢性病。Even non-smokers may not be spared the deadly risks of tobacco smoke. If you spend time around smokers either at home or on the job, then you are at risk of the dangers of secondhand smoke. Secondhand smoke enters the air directly from burning cigarettes (and cigars and pipes), and indirectly from smokers' lungs . This smoke may linger in indoor air for hours, and it increase the risk of a wide range of adverse health effects. N on-smokers who are exposed to secondhand smoke may have as much as a 30 percent increase in their risk of lung cancer and heart disease. The 2014 U.S. Surgeon General’s Report concluded that there is no established risk-free level of exposure to secondhand smoke.
::即使是非吸烟者也可能无法幸免吸烟的致命风险。 如果你在家里或工作中花时间与吸烟者打交道,那么你就会面临二手烟的危险。 二手烟直接从燃烧香烟(以及雪茄和烟管)中进入空气,间接从吸烟者的肺中进入空气。 这种烟雾可能在室内空气中停留了数小时,并增加了各种有害健康影响的风险。 接触二手烟的非吸烟者患肺癌和心脏病的风险可能增加30%。 2014年美国外科总报告得出结论,没有固定的无风险水平接触二手烟。Tobacco contains nicotine, which is a psychoactive drug. Although nicotine in tobacco smoke does not directly cause cancer or most of the other health risks of smoking, it is a highly addictive drug. N icotine is actually even more addictive than cocaine or heroin. The addictive nature of nicotine explains why it is so difficult for smokers to quit the habit, even when they know the health risks and really want to stop smoking. The good news is that if someone does stop smoking, his or her risks of smoking-related diseases and death soon start to fall. B y one year after quitting, the risk of heart disease drops to only half of that of a continuing smoker.
::烟草含有尼古丁,这是一种精神活性药物。虽然烟雾中的尼古丁并不直接导致癌症或其他大部分吸烟的健康风险,但它是一种高度上瘾的药物。尼古丁实际上比可卡因或海洛因更具有上瘾性。尼古丁的上瘾性解释了为什么吸烟者很难戒掉这个习惯,即使他们知道健康风险并真正想戒烟。好消息是,如果有人戒烟,他或她患与吸烟有关的疾病的风险和死亡的风险就会很快开始下降。在戒烟一年后,心脏病的风险下降到仅持续吸烟者的一半。Smoking and Cancer
::吸烟与癌症One of the main health risks of smoking is cancer, particular cancer of the lung. Because of the increased risk of lung cancer with smoking, the risk of dying from lung cancer before age 85 is more than 20 times higher for a male smoker than for a male non-smoker. As the rate of smoking increases, so does the rate of lung cancer deaths, although the effects of smoking on lung cancer deaths can take up to 20 years to manifest themselves, as shown in the graph . Besides lung cancer, several other forms of cancer are also significantly more likely in smokers than non-smokers, including cancers of the kidney, larynx, mouth, lip, tongue, throat, bladder, esophagus, pancreas, and stomach. Unfortunately, many of these cancers have extremely low cure rates.
::吸烟对健康的主要危害之一是癌症,特别是肺癌,由于吸烟导致肺癌风险增加,85岁前男性吸烟者死于肺癌的风险比男性吸烟者高出20倍以上,吸烟率上升,肺癌死亡率也上升,尽管吸烟对肺癌死亡的影响可能要花20年才能显现出来,如图所示。除了肺癌以外,在吸烟者中,其他几种癌症形式也比非吸烟者大得多,包括肾、喉、嘴、嘴、嘴、嘴、喉、喉、膀胱、食道、胰腺和胃等癌症。不幸的是,许多这些癌症的治愈率极低。Cigarette smoking by men in the U.S. began to decline in the 1950s, but it wasn’t until the 1970s — roughly 20 years later — that this was reflected by a concomitant decline in lung cancer deaths in men.
::1950年代美国男性吸烟开始下降, 但直到1970年代, 大约20年后, 男性肺癌死亡率也随之下降,When you consider the composition of tobacco smoke, it’s not surprising that it increases the risk of cancer. Tobacco smoke contains dozens of chemicals proven to be carcinogens, or causes of cancer. Many of these chemicals bind to DNA in a smoker’s cells, and may either kill the cells or cause mutations. If the mutations inhibit programmed cell death, the cells can survive to become cancer cells. Some of the most potent carcinogens in tobacco smoke include benzopyrene, acrolein, and nitrosamines. Other carcinogens in tobacco smoke are radioactive isotopes, including lead-210 and polonium-210.
::考虑到烟草烟雾的构成,增加癌症风险并不奇怪。烟草烟雾含有数十种被证明是致癌物或致癌原因的化学物质。 其中许多化学物质与吸烟者的细胞中的DNA结合,可能杀死细胞,也可能导致突变。 如果突变抑制了计划细胞死亡,细胞可以存活下来成为癌症细胞。 烟草烟雾中最有力的致癌物质包括苯丙烯、丙烯和硝基胺。 烟草烟雾中的其他致癌物质是放射性同位素,包括铅210和210。Respiratory Effects of Smoking
::吸烟的呼吸系统效应Long-term exposure to the compounds found in cigarette smoke — such as carbon monoxide and cyanide — are thought to be responsible for much of the lung damage caused by smoking. These chemicals reduce the elasticity of alveoli, leading to chronic obstructive pulmonary disease (COPD). COPD is a permanent, incurable, and often fatal reduction in the capacity of the lungs, reducing the lungs' ability to fully exhale air. The chronic inflammation that is also present in COPD is exacerbated by the tobacco smoke carcinogen acrolein and its derivatives. COPD is almost completely preventable simply by not smoking and by also avoiding secondhand smoke.
::长期接触烟雾中发现的化合物(如一氧化碳和氰化物)被认为对吸烟造成的肺损伤负有责任,这些化学品减少了肺泡的弹性,导致慢性阻塞性肺病(COPD),肺部不吸烟和避免二手烟几乎完全可以预防。Cardiovascular Effects of Smoking
::吸烟对心血管的影响Inhalation of tobacco smoke causes several immediate responses in the heart and blood vessels. Within one minute of inhalation of smoke, the heart rate begins to rise, increasing by as much as 30 percent during the first ten minutes of smoking. Carbon monoxide in tobacco smoke binds with hemoglobin in red blood cells, thereby reducing the blood’s ability to carry oxygen. Hemoglobin bound to carbon monoxide forms such a stable complex that it may result in a permanent loss of red blood cell function. Several other chemicals in tobacco smoke lead to narrowing and weakening of blood vessels, as well as an increase in substances that contribute to blood clotting. These changes increase blood pressure and the chances of a blood clot forming and blocking a vessel, thereby elevating the risk of heart attack and stroke. A recent study found that smokers are five times more likely than non-smokers to have a heart attack before the age of 40.
::吸入烟草烟雾导致心脏和血管的几处立即反应。在吸入烟雾的一分钟内,心率开始上升,在吸烟的前10分钟内上升了30%。烟草烟雾中的一氧化碳与红细胞中的血红蛋白结合,从而降低了血液携带氧气的能力。与一氧化碳结合的血红蛋白形成一个稳定的复合体,可能导致红细胞功能永久丧失。烟草烟雾中的其他几种化学物质导致血管缩小和衰弱,以及导致血液凝血的物质增加。这些变化增加了血压,并增加了血凝块形成和阻塞容器的可能性,从而增加了心脏病发作和中风的风险。最近的一项研究发现,吸烟者比40岁前的非吸烟者心脏病发作的可能性高出五倍。Smoking has also been shown to have a negative impact on levels of blood lipids. Total cholesterol levels tend to be higher in smokers than non-smokers. Ratios of “good” cholesterol to “bad” cholesterol tend to be lower in smokers than non-smokers.
::吸烟对血脂水平也有负面影响,吸烟者中胆固醇的总含量往往高于非吸烟者,“好”胆固醇与“坏”胆固醇的比率往往低于非吸烟者。Additional Adverse Health Effects of Smoking
::吸烟对健康的额外不利影响A wide diversity of additional adverse health effects are attributable to smoking. Here are just a few of them:
::吸烟对健康造成各种各样的不利影响。-
Smokers are at significantly increased risk of developing chronic kidney disease (in addition to kidney cancer). For example, smoking hastens the progression of kidney damage in people with diabetes.
::吸烟者患慢性肾病(除肾癌外)的风险大大增加,例如,吸烟加速了糖尿病患者肾脏损伤的蔓延。 -
People who smoke — especially the elderly — have a greater risk of influenza and other infectious diseases than non-smokers. Smoking more than 20 cigarettes a day has been found to increase the risk of infectious diseases by as much as four times the risk in non-smokers. These effects occur because of damage to both the respiratory system and the immune system.
::吸烟者——特别是老年人——比非吸烟者更容易感染流感和其他传染病,每天吸烟超过20支香烟,使感染传染病的风险增加高达非吸烟者风险的四倍,这些影响是由于呼吸系统和免疫系统受损造成的。 -
In addition to oral cancer, smoking causes other oral problems, including periodontitis (gum disease). Roughly half of the cases of gum inflammation are attributable to current or former smoking. This inflammation increases the risk of tooth loss, which is also higher in smokers than non-smokers. In addition, smoking stains the teeth and causes halitosis (bad breath).
::除了口腔癌之外,吸烟还引起其他口腔问题,包括宫颈炎(肿瘤疾病),大约一半口香糖炎病例是当前或以前吸烟造成的,这种炎症增加了失去牙齿的风险,吸烟者中这种风险也高于非吸烟者,此外,吸烟会玷污牙齿,并导致口腔硬化(呼吸不良)。 -
Smoking is a key cause of erectile dysfunction (ED), probably because it leads to narrowing of arteries in the penis, as it does elsewhere in the body. The incidence of ED is about 85 percent higher in males who smoke than it is in non-smokers.
::吸烟是勃起功能障碍(ED)的关键原因之一,这可能是因为它导致阴茎动脉缩小,就像身体其他地方一样。 吸烟男性的ED发生率比非吸烟男性高出85%左右。 -
Smoking also has adverse effects on the female reproductive system, potentially causing infertility, in part because it interferes with the body’s ability to produce estrogen. Female smokers are about 60 percent more likely to be infertile than non-smokers. Pregnant women who smoke or are exposed to secondhand smoke have a higher risk of miscarriages and low-birth-weight infants.
::吸烟对女性生殖系统也有不利影响,可能导致不孕症,部分原因是吸烟会干扰身体生产雌激素的能力。 女性吸烟者比非吸烟者更可能不育。 吸烟或接触二手烟的孕妇流产和出生体重不足的婴儿的风险更高。 -
Certain therapeutic drugs, including some antidepressants and anticonvulsants, are less effective in smokers than in non-smokers. This occurs because smoking increases levels of liver enzymes that break down the drugs.
::某些治疗性药物,包括某些抗抑郁剂和抗抽搐剂,在吸烟者中不如在非吸烟者中有效,这是因为吸烟增加了导致毒品分解的肝酶水平。 -
Smoking causes an estimated ten percent of all fire-related deaths worldwide. Smokers are also at a greater risk of dying in motor vehicle crashes and other accidents.
::吸烟造成全世界与火灾有关的死亡估计占所有死亡的10%,吸烟者在机动车辆撞车和其他事故中死亡的风险也更大。 -
Smoking leads to an increased risk of bone fractures, especially of the hip. It also leads to slower wound healing after surgery, and an increased rate of postoperative complications.
::吸烟导致骨折风险增加,特别是臀骨骨骨折风险增加,还导致手术后伤口愈合缓慢,手术后并发症增加。
Feature: Human Biology in the News
::特著:《新闻》中的人类生物学The item in this photo looks like a regular cigarette, but it’s actually an electronic cigarette, or e-cigarette. E-cigarettes are battery-powered devices that change flavored liquids and nicotine into vapor that the user inhales . E-cigarettes are often promoted as being safer than traditional tobacco products, and their use is touted as a good way to quit smoking. They are often not banned in smoke-free areas, where it is illegal to smoke tobacco cigarettes.
::这张照片中的项目看上去像普通香烟,但其实是电子香烟,或者电子香烟。 电子香烟是电池动力装置,可以将口味液体和尼古丁变成用户吸入的蒸气。 电子香烟常常被提倡为比传统烟草产品更安全,而且被称作戒烟的好方法。 在无烟区,人们通常不禁止使用电子香烟,因为吸烟是非法的。A study completed in 2015 by researchers at the Harvard School of Public Health and widely reported in the mass media found that e-cigarettes may, in fact, be very harmful to the user’s health. E-cigarettes contain nicotine and cancer-causing chemicals, such as formaldehyde. According to the study, about three-quarters of flavored e-cigarettes also contain a chemical called diacetyl that causes an incurable and potentially fatal disorder of the lungs, commonly called “popcorn lung” (bronchiolitis obliterans). In this disorder, the bronchioles compress and narrow due to the formation of scar tissue, greatly diminishing the breathing capacity of people with the disorder. Popcorn lung gained its common name in 2004, when it was diagnosed in workers at popcorn factories. The buttery flavoring used in the factories contained diacetyl.
::哈佛公共卫生学院研究人员于2015年完成的、大众媒体广泛报道的一项研究发现,e-cigarette可能事实上对用户的健康非常有害。 e-cigarettes含有尼古丁和癌症致癌化学品,如甲状腺素。 根据这项研究,大约四分之三的口味电子-cigarettes也含有一种名为二乙基的化学品,它导致肺部不可治愈和潜在致命的紊乱,通常被称为“聚虫肺 ” ( 丙醇炎 ) 。 在这种混乱中,支气管压缩器和狭窄的支架子组织形成,极大地降低了患者的呼吸能力。 2004年,流行鼠肺在爆花厂的工人中被诊断出时获得了普通名称。 工厂使用的黄油调味含有二甲基素。Some manufacturers of e-cigarettes and flavorings advertise that their products are now free of diacetyl. However, because e-cigarettes are not currently regulated by the FDA, there is no way of knowing for sure whether the products are actually safe. Equally disturbing is the appeal of flavored e-cigarettes to teens and producers' attempts to specifically market their products to this age group. Flavors such as “cotton candy,” “Katy Perry’s cherry,” and “alien blood” are obviously marketed to youth. Not surprisingly, the use of e-cigarettes is on the rise in middle and high school students, who are more likely to use them than regular cigarettes. Public health officials fear that e-cigarettes will be a gateway for teens to move on to smoking tobacco cigarettes. Some states have recently passed laws prohibiting minors from buying e-cigarettes. As more questions are raised about their potential negative health effects, it is likely that more laws will be passed to regulate e-cigarettes . Watch the news for updates on this issue.
::一些电子香烟制造商和口味广告称其产品现已无二亚西泰尔。 然而,由于目前没有林业发展局监管,因此无法确定这些产品是否真正安全。 同样令人不安的是,口味电子香烟对青少年的吸引力,以及生产商试图专门向这一年龄组推销其产品的吸引力。 诸如“棉花糖果 ” 、 “凯蒂派瑞的樱桃” 、 “异性血液”等“糖果”等花瓶显然被推销给年轻人。 毫不奇怪,中、高中学生使用电子香烟的比例正在上升,他们比普通香烟更有可能使用这些产品。 公共卫生官员担心电子香烟将成为青少年开始吸烟的大门。 一些州最近通过了禁止未成年人购买电子香烟的法律。 随着更多关于他们潜在的负面健康影响的问题被提出,可能有更多的法律被通过来监管e-cigarette。 观看有关这个问题的最新消息。Summary
::摘要-
Smoking is the single greatest cause of preventable death worldwide. It has adverse effects on just about every body system and organ. Tobacco smoke affects not only smokers, but also non-smokers who are exposed to secondhand smoke. The nicotine in tobacco is highly addictive, making it very difficult to quit smoking.
::吸烟是全世界可预防死亡的最主要原因之一。 它对每个身体系统和器官都有不利影响。 烟草烟雾不仅影响吸烟者,而且影响接触二手烟的非吸烟者。 烟草中的尼古丁具有很高的上瘾性,因此很难戒烟。 -
A major health risk of smoking is cancer of the lungs. Smoking also increases the risk of many other types of cancer. Tobacco smoke contains dozens of chemicals known as carcinogens.
::吸烟对健康的主要危害是肺癌,吸烟也增加了其他许多类型癌症的风险,烟草烟雾含有数十种称为致癌的化学品。 -
Smoking is the primary cause of chronic obstructive pulmonary disease (COPD). Chemicals such as carbon monoxide and cyanide in tobacco smoke reduce the elasticity of alveoli so the lungs can no longer fully exhale air.
::吸烟是慢性阻塞性肺病(COPD)的主要原因,烟草烟雾中的一氧化碳和氰化物等化学品会降低 alveoli 的弹性,使肺不再能够完全呼吸空气。 -
Smoking damages the cardiovascular system and increases the risk of high blood pressure, blood clots, heart attack, and stroke. Smoking also has a negative impact on levels of blood lipids.
::吸烟会损害心血管系统,增加高血压、血块、心脏病发作和中风的风险,吸烟也会对血脂水平产生负面影响。 -
A wide diversity of additional adverse health effects are attributable to smoking, such as erectile dysfunction, female infertility, and slow wound healing.
::吸烟对健康造成多种其他不利影响,如勃起功能障碍、女性不孕症和伤口愈合缓慢。
Review
::回顾1. What percentage of people who smoke are likely to die from it?
::1. 吸烟者中有多少人可能死于吸烟?2. Contrast the life expectancy of long-term smokers and non-smokers.
::2. 对比长期吸烟者和非吸烟者的预期寿命。3. What smoking-related factors determine how smoking affects a smoker’s health?
::3. 哪些与吸烟有关的因素决定了吸烟如何影响吸烟者的健康?4. What are the two sources of secondhand cigarette smoke? How does exposure to secondhand smoke affect non-smokers?
::4. 二手烟烟的两种来源是什么?接触二手烟对不吸烟者有何影响?5. Why is it so difficult for smokers to quit the habit? How is their health likely to be affected by quitting?
::5. 为什么吸烟者很难戒烟?他们的健康如何可能因戒烟而受到影响?6. List five types of cancer that are significantly more likely in smokers than non-smokers.
::6. 列出五类癌症,其中吸烟者比不吸烟者更有可能患的癌症。7. Why does smoking cause cancer?
::7. 为什么吸烟导致癌症?8. Explain how smoking causes COPD.
::8. 解释吸烟如何导致人口与疾病控制局。9. Identify some of the adverse effects of smoking on the cardiovascular system.
::9. 查明吸烟对心血管系统的一些不利影响。10. Give three examples of additional adverse health effects that are more likely with smoking.
::10. 举三个例子,说明吸烟对健康造成更多不利影响的可能性更大。11. Do you think e-cigarettes can be addictive? Explain your reasoning.
::11. 你认为e-cigarettes可以上瘾吗?12. People who smoke are more likely to get ___________ than people who do not smoke.
::12. 吸烟者比不吸烟者更有可能吸烟。a. lung cancer
::a. 肺癌b. influenza
::b. 流感c. kidney disease
::c. 肾病d. all of the above
::d. 以上所有情况13. Name three toxic chemicals present in tobacco smoke.
::13. 列出烟草烟雾中存在的三种有毒化学品。14. True or False: Nicotine is more addictive than heroin.
::14. 真实或假:尼古丁比海洛因更具有上瘾性。15. True or False: Smoking has many negative effects on the respiratory and cardiovascular systems, but not on other systems of the body.
::15. 真实或假:吸烟对呼吸系统和心血管系统有许多负面影响,但对身体的其他系统没有负面影响。Explore More
::探索更多Using tongue-in-cheek humor, the physician and public health specialist in this TED talk review how far we have come in regulating tobacco marketing — and how far we still have to go.
::在本次TED演讲中,医生和公共卫生专家运用低语语语幽默,回顾我们在管制烟草销售方面取得了多大进展——以及我们还需要走多远。 -
Smokers are at significantly increased risk of developing chronic kidney disease (in addition to kidney cancer). For example, smoking hastens the progression of kidney damage in people with diabetes.
