北京市控烟政策分析报告(1996-2012).doc
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1、北京市控烟政策分析(1996- 2012) 培 养 单 位 : 申 请 人 : 指 导 教 师 : 二一三年十二月 北京市控烟政策分析(1996-2012) 摘 要 I 关于学位论文使用授权的说明 摘 要 烟草是目前人类健康的最大威胁,吸烟是可有效预防的首位死因,是需要给 予优先处理的公共卫生问题,控烟已成为全人类的共识。2006 年烟草控制框架 公约在我国生效后,政府采取了一系列控烟措施,但效果甚微。因此,选取典 型城市进行研究,系统分析控烟政策,监测吸烟状况,评估政策实施效果,据此 提出全面可行政策建议,具有相当的理论价值和实践意义。 本文通过对北京市 19962012 年控烟政策和实施的
2、系统回顾分析,对全市 和重点行业吸烟状况及控烟效果监测数据进行了定量分析,对政策实施效果进行 了评估,结合文献定性分析、访谈调研和个案分析,形成对北京市控烟政策的综 合评价。结果显示,在全国控烟工作整体疲软的形势下,北京市控烟成效显著。 自 1995 年颁布国内第一部地方控烟法规以来,采取了法制建设、行政管理、健 康教育和社会支持等一系列干预措施,并借无烟奥运将北京控烟工作推向高潮。 北京市 6 次居民吸烟状况调查结果显示,总体吸烟率从 1997 年的 34.50下降到 2011 年的 20.89,被动吸烟率从 1997 年的 54.20%下降到 2008 年的 25.58%。 对北京市控烟政
3、策进行效果评价,十类完全禁烟公共场所大多达到 80以上的完 全禁烟率,基本达到法规设定要求;实施收益大于实施成本,属于合理、有效的 法规条例。对医疗卫生系统、中小学校、出租车行业、餐饮业、旅店业和无烟奥 运控烟效果监测分析显示,各项工作有序开展,成效明显。 对比烟草控制框架公约要求,北京市控烟也存在一系列亟待解决的问题。 控烟策略上,立法未与时俱进,执法力度羸弱,欠长效机制,缺专职人员。监测 结果提示男性吸烟率居高不下、青少年控烟任重道远,戒烟服务疲软、戒烟执行 不力。效果评估提示公共场所卫生间、公共交通工具、餐饮业、宾馆旅店、小型 商店和互联网服务类场所应进一步加强禁烟。 根据分析、监测、评
4、估结果,从公共治理的视角,借鉴国内外控烟成功经验, 扬长抑短,对北京市未来控烟体系的构建和控烟政策提出针对性组合建议。建议 确立市级烟草控制总负责人并充分表达在北京地区全面控烟的意愿和承诺,组建 北京市烟草控制工作委员会,根据国家立法和政策制定北京市烟草控制规划,各 摘 要 II 部门制定并实施部门内烟草控制方案,通过法制建设、行政管理、健康教育和社 会支持策略,在立法、执法、教育、科技、文化、宣传等多领域开展工作。 本文创新点主要有三个方面:一是首次对省级城市的控烟政策进行系统全面 的政策分析,从政策与实施回顾,到吸烟状况描述,到法规实施评价,形成一个 完整的逻辑分析链,避免了以往其他学者只
5、攫取部分问题进行单点研究的局限; 二是对北京市十余年长时段跨度的综合调研跟踪评价,填补了国内长时段控烟政 策跟踪研究的空白,在国际相关研究领域也属创新。对一手调查数据的全角度分 析,对多影响因素的综合评价,通过长时段跨度来消除个别大事件的影响,结果 更真实客观。三是首次将公共治理理论运用在控烟领域,打破国内以政府控烟为 主导的现状,通过对调查数据系统全面的定量分析,结合实证分析结果,从公共 治理的视角,为北京市未来控烟工作给出重构控烟系统和控烟策略的政策建议。 本文研究成果,将为制定北京市控制吸烟条例提供支持,为北京实现 “十二五”规划控烟目标提供帮助,为国内兄弟省市控烟提供参考,为世界发展
6、中国家控烟提供借鉴,为北京建设“世界无烟之都”的构想奠定基础,并最终为 提高北京居民平均期望寿命贡献力量。 关键词:北京市; 烟草控制; 吸烟状况; 政策分析; 控烟体系 Abstract III Abstract Tobacco is currently the greatest threat to human health and tobacco control has become the consensus of all mankind. Smoking, as the first cause of preventable death, is the public health iss
7、ue which needs to be given priority. After the “Framework Convention on Tobacco Control“ took effect in China from 2006, the government adopted a series of tobacco control measures; however, the effect is minimal. As a result, it has great theoretical significance and practical value to select a typ
8、ical city to make researches, analyze tobacco control policies, monitor smoking status, evaluate the effect of policy deployment and hence propose feasible suggestions on policy-making. This article reviews and analyzes the tobacco control policy in Beijing from 1996 to 2012.Supplemented with the li
9、terature qualitative analysis methods as well as interviews, surveys and case studies, we gave a comprehensive assessment of Beijings tobacco control policy based on the quantitative analysis of the monitoring data concerning the smoking status and tobacco control effects in the whole city and some
10、key industries, which show that the Beijing tobacco control effect is remarkable in the situation of sluggish national tobacco control overall. Since the first local tobacco control legislation was issued in 1995, under the auspices of the Beijing Patriotic Health Campaign Committee, Beijing has tak
11、en a series of interventions in the field of legal construction, administration, health, education and social support. Whats more, tobacco control work came to a climax by the historical opportunity of the smoke-free Olympic Games. The six times survey results of Beijing residents smoking status sho
12、wed that the overall smoking rate dropped from 34.50 percent in 1997 to 20.89 percent in 2011 and the passive smoking rate dropped from 54.20 percent in 1997 to 25.58 percent in 2008. Evaluation of the effects of tobacco control policies in Beijing showed that most of the ten categories of completel
13、y non-smoking public places achieved the rate of completely non-smoking more than 80%; the implementation of the policies basically achieved the requirements of regulations. As a reasonable and effective policy, the benefits of implementation outweigh the cost. Monitoring and analysis of tobacco con
14、trol effects on health care systems, elementary and secondary schools, taxi industry, catering, hotel industry and smokeless Olympics showed that all tasks were conducted well and the effect was significant. Abstract IV In contrast with “Frame Convention on Tobacco Control“, a series of tobacco cont
15、rol problems still need to be solved in Beijing, which include the legislation not keeping pace with the times, weak law enforcement, lack of long-term mechanism, lack of full-time staff, and so on. Monitoring results suggest the following aspects: the high rate of male smokers, a long way to go for
16、 youth tobacco control, sluggish smoking cessation services, weak enforcement of smoking cessation. Impact assessment prompted smoking control in public places toilets, public transport, catering, hotels, Inns, small shops and Internet service areas should be further strengthened. Based on the analy
17、sis, monitoring and evaluation of the outcomes of tobacco control and successful tobacco control home and abroad, from the perspective of public governance, we proposed pertinent suggestions on the construction of future tobacco control system in Beijing and its tobacco control policies. We proposed
18、 to establish a municipal chief of tobacco control who should fully express the willingness and commitment of comprehensive tobacco control in the Beijing area, set up the Beijing tobacco control working Committee and formulate Beijing tobacco control programs in accordance with national legislation
19、 and policy. By developing and implementing tobacco control programs within the department, each department should carry out corresponding work in legislation, enforcement, education, technology, culture, publicity and many other areas through the legal system construction, administration, health an
20、d education, social support strategies. The innovative points of the article lie in the following three aspects. Firstly, it made a systematic and complete analysis on the tobacco control policies of an provincial city for the first time, which constituted a complete logic chain from the review of p
21、olicy implementation to the description of smoking status and the evaluation of the implementation of regulations and avoided the limitation of the single point researches on some problems made by other scholars; Secondly, the comprehensive survey and tracking evaluation on the tobacco control polic
22、y implementation in Beijing for more than ten years fill in the gap in the long-term tobacco control policy tracking analysis domestically, which belong to an innovation in relevant research fields abroad. Based on the multi-perspective analysis of the survey data and comprehensive evaluation of dif
23、ferent influence factors, the results were more realistic and objective through the long-period study which eliminates the influence of individual events. Thirdly, public governance theories were introduced into the tobacco control for the Abstract V first time, which broke the status quo of domesti
24、c tobacco control led by the government. From the perspective of public governance, in combination with the empirical analysis results, the article proposed suggestions on the reconstruction of tobacco control system and tobacco control strategies of the future tobacco control work in Beijing throug
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