Ukusetshenziswa kukagwayi kuyaqhubeka nokuba yimbangela ehamba phambili yezifo nokufa okungavinjelwa eCanada. Ngo-2017, ukufa kwabantu abangaphezu kuka-47,000 kwabangelwa ukusetshenziswa kukagwayi eCanada, kanti izindleko zokunakekelwa kwempilo eziqondile ezilinganiselwa ku-$6.1 billion kanye nezindleko eziphelele ezingama-$12.3 billion.1 NgoNovemba 2019, imithethonqubo yokupakisha imikhiqizo kagwayi yaqala ukusebenza njengengxenye yeSu Logwayi laseCanada, elihlose ukufeza umgomo wokusetshenziswa kukagwayi okungaphansi kuka-5% ngo-2035.
Ukupakisha okujwayelekile kuye kwamukelwa yinani elikhulayo lamazwe emhlabeni jikelele. Kusukela ngoJulayi 2020,I-Canadaukupakishwa kukagwayiisisetshenziswe ngokugcwele ezingeni lomkhiqizi kanye nelokuthengisa emazweni ayi-14: i-Australia (2012); iFrance kanye ne-United Kingdom (2017); iNew Zealand, iNorway, kanye ne-Ireland (2018); i-Uruguay, kanye neThailand (2019); iSaudi Arabia, iTurkey, i-Israel, kanye neSlovenia (Januwari 2020); iCanada (Febhuwari 2020); kanye neSingapore (Julayi 2020). NgoJanuwari 2022, iBelgium, iHungary, kanye neNetherlands zizobe sezisebenzise ngokugcwele ukupakisha okucacile.
Lo mbiko ufingqa ubufakazi obuvela ku-International Tobacco Control (ITC) Policy Evaluation Project mayelana nokusebenza kahle kokupakisha okulula eCanada. Kusukela ngo-2002, i-ITC Project yenze ucwaningo lwesikhathi eside emazweni angu-29 ukuhlola umthelela wezinqubomgomo ezibalulekile zokulawula ugwayi ze-World Health Organization Framework Convention on Tobacco Control (WHO FCTC). Lo mbiko wethula okutholakele ngomthelela wokupakisha okulula eCanada ngokusekelwe kudatha eqoqwe kubantu abadala ababhemayo ngaphambi (2018) nangemva (2020) kokwethulwa kokupakisha okululaI-Canadaukupakishwa kukagwayiIdatha evela eCanada nayo yethulwa ngokwesimo kanye nedatha evela kwamanye amazwe e-ITC Project angafika kwangu-25 — okuhlanganisa i-Australia, i-England, i-France, ne-New Zealand, lapho kufakwe khona ukupakisha okulula.
Ukupakisha okulula kunciphisa kakhulu ukukhanga kwephakethe — ama-45% abantu ababhemayo babengathandi ukubukeka kwephakethe labo likagwayi ngemuva kokusebenzisa okulula.I-Canada ukupakishwa kukagwayikwethulwa, uma kuqhathaniswa no-29% ngaphambi komthetho. Unlik Lo mbiko walungiswa yi-ITC Project eNyuvesi yaseWaterloo: uJanet Chung-Hall, uPete Driezen, u-Eunice Ofeibea Indome, uGang Meng, uLorraine Craig, noGeoffrey T. Fong. Siyazisa imibono evela kuCynthia Callard, oDokotela beCanada engenasmoko; uRob Cunningham, iCanadian Cancer Society; noFrancis Thompson, iHealthBridge kuma-draft alo mbiko. Umklamo wezithombe kanye nokuhlelwa kwawo kwanikezwa nguSonya Lyon weSentrik Graphic Solutions Inc. Siyabonga kuBrigitte Meloche ngokuhlinzeka ngezinsizakalo zokuhumusha isiFulentshi; kanye noNadia Martin, i-ITC Project yokubuyekeza nokuhlela ukuhumusha isiFulentshi. Uxhaso lwalo mbiko lwanikezwa yi-Health Canada's Substance Use and Addictions Program (SUAP) Arrangement #2021-HQ-000058. Imibono evezwe lapha ayimeleli ngempela imibono yeHealth Canada.
Ucwaningo lwe-ITC Four Country Smoking and Vaping lusekelwe yizibonelelo ezivela ku-US National Cancer Institute (P01 CA200512), i-Canadian Institutes of Health Research (FDN-148477), kanye ne-National Health and Medical Research Council of Australia (APP 1106451). Usekelo olwengeziwe lunikezwa uGeoffrey T. Fong yi-Senior Investigator Grant evela ku-Ontario Institute for Cancer Research.
Igunya lokulawula ukupakisha okujwayelekile kukagwayi (okwaziwa nangokuthi ukupakisha okujwayelekile) linikezwa ngaphansi koMthetho Wemikhiqizo Kagwayi Nokupholisha Ugwayi (i-TVPA)4, owamukelwe izichibiyelo ngoMeyi 23, 2018 njengohlaka lwezomthetho lokunciphisa umthwalo omkhulu wokufa nezifo ezihlobene nogwayi eCanada.I-Canadaukupakishwa kukagwayiihlose ukunciphisa ukukhanga kwemikhiqizo kagwayi futhi yethulwa ngaphansi kweMithethonqubo Yemikhiqizo Kagwayi ka-2019 (Ukubukeka Okucacile Nokujwayelekile)5 njengenye yezinqubomgomo eziphelele zokusiza ukufinyelela umgomo wokusetshenziswa kukagwayi okungaphansi kuka-5% ngo-2035 ngaphansi kweSu Lokubhema laseCanada.
Imithethonqubo isebenza ekupakisheni yonke imikhiqizo kagwayi, okuhlanganisa nogwayi owenziwe, ukugoqa imikhiqizo yakho (ugwayi okhululekile, amashubhu kanye namaphepha okugoqa ahloselwe ukusetshenziswa nogwayi), ugwayi kanye nogwayi omncane, ugwayi wepayipi, ugwayi ongenantuthu, kanye nemikhiqizo kagwayi efudumele. Imikhiqizo ye-e-cigarettes/vaping ayimboziwe ngaphansi kwale mithethonqubo, ngoba ayihlukaniswa njengemikhiqizo kagwayi ngaphansi kwe-TVPA.
4 Ukupakishwa okujwayelekile kogwayi, ugwayi omncane, imikhiqizo kagwayi okuhloswe ukusetshenziswa namadivayisi, kanye nayo yonke eminye imikhiqizo kagwayi kwaqala ukusebenza ezingeni lomkhiqizi/lomngenisi ngoNovemba 9, 2019, kanye nesikhathi sokushintsha sezinsuku ezingama-90 ukuze abathengisi bakagwayi bahambisane nomthetho ngaphambi komhla ziyi-7 kuNhlolanja 2020. Ukupakishwa okujwayelekile kogwayi kwaqala ukusebenza ezingeni lomkhiqizi/lomngenisi ngoNovemba 9, 2020, kanye nesikhathi sokushintsha sezinsuku eziyi-180 ukuze abathengisi bakagwayi bahambisane nomthetho ngaphambi komhla ziyi-8 kuNhlaba 2021.5, 8
I-Canada ukupakishwa kukagwayiimithethonqubo ibizwe ngokuthi ibanzi kakhulu emhlabeni, ibeka izibonelo eziningi zomhlaba wonke (bheka Ibhokisi 1). Wonke amaphakheji emikhiqizo kagwayi kumele abe nombala onsundu ojwayelekile, angenazo izici ezihlukile nezikhangayo, kanye nokuboniswa kombhalo ovunyelwe endaweni ejwayelekile, ifonti, umbala, kanye nosayizi. Izinti zikagwayi azikwazi ukudlula ubukhulu obubekiwe bobubanzi nobude; zibe nanoma yiluphi uphawu; futhi ukuphela kwesihlungi kumele kube yisicaba futhi kungabi nezimbobo.I-Canada ukupakishwa kukagwayikuzokwenziwa kube ngokwefomethi yesilayidi negobolondo ezingeni lomkhiqizi/lomngenisi kusukela ngoNovemba 9, 2021 (abathengisi banesikhathi kuze kube nguFebhuwari 7, 2022 sokuthobela), ngaleyo ndlela benqabela amaphakethe anokuvulwa kwe-flip top. Isithombe 1 sibonisa ukupakishwa kwesilayidi negobolondo okune-plainI-Canada ukupakishwa kukagwayi lapho kuvezwa khona umlayezo wolwazi lwezempilo ngemuva kwephakheji yangaphakathi lapho iphakethe livulwa. ICanada iyizwe lokuqala emhlabeni ukudinga ukupakishwa kwesilayidi negobolondo FUTHI yayiyizwe lokuqala ukudinga ukuphakelwa kwemiyalezo yezempilo yangaphakathi.
I-Canadaukupakishwa kukagwayiimithethonqubo iyona enamandla kakhulu emhlabeni futhi iyona yokuqala:
• Vimbela ukusetshenziswa kwezincazelo zemibala kuzo zonke izinhlobo zomkhiqizo kanye namagama ahlukile
• Dinga ifomethi yokupakishwa kwesilayidi negobolondo likagwayi
• Kudingeka umbala onsundu okhanyayo ngaphakathi kwephakheji
• Vimbela ugwayi ongaphezu kuka-85mm
• Nqabela ugwayi omncane ongaphansi kuka-7.65mm ububanzi
Izibonelo zomhlaba wonke ezibekwe yimithethonqubo yokupakisha ecacile yaseCanada
ICanada ayizange isebenzise izixwayiso zezempilo ezintsha nezinkulu (ama-PHW) emaphaketheni kagwayi kanye nemithethonqubo yokupakisha ecacile, njengoba kudingeka kwamanye amazwe afaka phakathi i-Australia, i-United Kingdom, iFrance ne-New Zealand. Kodwa-ke,Iphakethe likagwayi laseCanadaizexwayiso (75% zangaphambili nangemuva) zizoba zikhulu kakhulu emhlabeni ngokwendawo yonke lapho kuqala ukusebenza ifomethi yesilayidi negobolondo ngoNovemba 2021. I-Health Canada iphothula izinhlelo zokusebenzisa amasethi amaningana ezexwayiso zezempilo ezintsha zemikhiqizo kagwayi okuzodingeka zijikelezwe ngemva kwesikhathi esithile.9 Isibalo 2 sibonisa isikhathi sokupakisha okusobala eCanada maqondana ne-ITC Four Country Smoking and Vaping Surveys, enikeza idatha yalo mbiko.
Lo mbiko wethula idatha evela ku-ITC Canada Smoking and Vaping Survey ngaphambi nangemva kokusetshenziswa ngokugcwele kokupakisha okusobala ezingeni lokuthengisa ngoFebhuwari 7, 2020. I-ITC Canada Smoking and Vaping Survey, ingxenye yocwaningo olukhulu lwe-ITC Four Country Smoking and Vaping Survey, olwenziwe futhi ngesikhathi esifanayo nocwaningo lwamaqembu e-United States, e-Australia nase-England, luwucwaningo lwamaqembu enziwa phakathi kwabantu abadala ababhemayo kanye nabashushumbisi abaqokwe kumaphaneli ewebhu kazwelonke ezweni ngalinye. Ucwaningo lwe-inthanethi lwemizuzu engama-45 luhlanganisa imibuzo ephathelene nokuhlolwa kokupakisha okusobala, okusetshenziswe yi-ITC Project ukuhlola ukupakisha okusobala e-Australia, eNgilandi, eNew Zealand, naseFrance. Ucwaningo lwe-ITC Canada Smoking and Vaping lwenziwa phakathi kwesampula emele izwe lonke yabantu abadala abangu-4600 ababhemayo abaqede ucwaningo ngo-2018 (ngaphambi kokupakisha okulula), ngo-2020 (ngemuva kokupakisha okulula), noma eminyakeni emibili. Idatha yesikhathi eside evela eCanada iqhathaniswa nedatha evela kwamanye amazwe amabili e-ITC (e-Australia nase-United States) lapho kwenziwa khona ucwaningo olufanayo phakathi nesikhathi esifanayo, futhi oluhlukahluka ngesimo semithetho yabo yokupakisha ugwayi kanye nezidingo zezinguquko kuma-PHW (bheka Ithebula 1). Izici zabaphenduli benhlolovo eCanada, e-Australia, nase-United States zifingqiwe kuThebula 2. Umbiko uphinde wethule ukuqhathaniswa kwemininingwane yezindlela zomphumela womthelela wenqubomgomo ezikhethiwe eCanada nakwamanye amazwe e-ITC afinyelela ku-25.ii
Imininingwane egcwele ngezindlela zokuthatha amasampula kanye nezindlela zokuhlola ezweni ngalinye ivezwe ku-ITC Four Country Smoking and Vaping Survey
imibiko yobuchwepheshe, etholakala ku:https://itcproject.org/methods/
Iphrojekthi ye-ITC ishicilele imibiko ngaphambilini ngomthelela wokupakisha okusobala eNew Zealand18 naseNgilandi19. Amaphepha esayensi e-ITC esikhathi esizayo azokwethula ukuhlaziywa okubanzi komthelela wokupakisha okusobala eCanada nakwamanye amazwe, kanye nokuqhathaniswa komthelela wenqubomgomo kulo lonke isethi lamazwe e-ITC asebenzise okusobala.I-Canadaukupakishwa kukagwayi.Umehluko omncane phakathi kwemiphumela ebikwe eCanada emaphepheni esayensi azayo kanye nemiphumela ebikwe kulo mbhalo ubangelwa umehluko ezindleleni zokulungisa izibalo, kodwa awushintshi iphethini iyonke yemiphumela.ii.
Imiphumela yaseCanada ka-2020 eyethulwe ngezibalo zamazwe ahlukene ingase ihluke kancane emiphumeleni yango-2020 ngezibalo ezinde ezethulwe kulo mbiko ngenxa yokwehluka kwezindlela zokulungisa izibalo zohlobo ngalunye lokuhlaziya.
Ngesikhathi sokuhlolwa kokupakisha ngemva kokusetshenziswa kwempahla eCanada, amaphakethe amaningi alula ezindaweni zokuthengisa ayekwifomethi ye-flip top, kanti ifomethi yesilayidi negobolondo itholakala kuphela ngenani elilinganiselwe lemikhiqizo. Enye yezinhloso ezibalulekile zokupakisha okulula ukunciphisa ukukhanga nokukhanga kwemikhiqizo kagwayi.
Ucwaningo olwenziwe emazweni ahlukene luye lwabonisa njalo ukuthi amaphakethe kagwayi avamile awakhangi kangako ababhemayo kunamaphakethe anophawu.12-16
Ucwaningo lwe-ITC lukhombisile ukuthi kube nokwenyuka okukhulu kwephesenti lababhemayo baseCanada abathole iphakethe labo likagwayi “lingathandeki nhlobo” ngemuva kokuqaliswa kokusetshenziswa I-Canadaukupakishwa kukagwayi.Lokhu kwehla okukhulu kokukhanga kwakuhlukile kwamanye amazwe amabili aqhathaniswayo—i-Australia ne-US—lapho kungekho khona ushintsho emaphesentini abantu ababhemayo abathole iphakethe labo likagwayi “lingathandeki nhlobo”.
Kube nokwanda okukhulu kwephesenti lababhemayo abathi abakuthandi ukubukeka kwephakethe labo likagwayi ngemuva kokusetshenziswa kokupakisha okulula eCanada (kusuka ku-29% ngo-2018 kuya ku-45% ngo-2020). Ukukhanga kwephakethe kwakuphansi kakhulu e-Australia (lapho ukupakisha okulula kwakusetshenziswa khona kuhlanganiswe nama-PHW amakhulu ngo-2012), kanti abangaphezu kwezingxenye ezimbili kwezintathu zababhemayo babike ukuthi abakuthandi ukubukeka kwephakethe labo ngo-2018 (71%) nango-2020 (69%). Ngokuphambene nalokho, iphesenti lababhemayo abathi abakuthandi ukubukeka kwephakethe labo lihlale liphansi e-US (9% ngo-2018 kanye no-12% ngo-2020), lapho izixwayiso zingumbhalo kuphela kanti ukupakisha okulula akukaqaliswa (bheka Umfanekiso 3).
Le miphumela ihambisana nemiphumela yangaphambilini ye-ITC Project ekhombisa ukwanda kwenani labantu ababhemayo abangakuthandi ukubukeka kwephakethe labo ngemva kokufakwa kwephakheji e-Australia (kusuka ku-44% ngo-2012 kuya ku-82% ngo-2013)17, eNew Zealand (kusuka ku-50% ngo-2016-17 kuya ku-75% ngo-2018)18, kanye naseNgilandi (kusuka ku-16% ngo-2016 kuya ku-53% ngo-2018).19
Okutholakele kwamanje kunezela ebufakazini obuvela ezifundweni ezishicilelwe ezibonisa ukwehla okukhulu ekukhangeni kwamaphakethe ngemuva kokusetshenziswa kokupakisha okujwayelekile okunama-PHW amakhulu e-Australia20, 21 kanye nomthelela omuhle weI-Canadaukupakishwa kukagwayiekunciphiseni ukukhanga kwamaphakethe ngaphezu kwalokho, ukwandisa usayizi wama-PHW eNgilandi.22
Olunye ucwaningo lwamuva nje oluhlola umthelela wokupakisha okulula e-United Kingdom naseNorway kusetshenziswa izindlela zokuhlola ze-ITC ezisunguliwe lunikeza ubufakazi obengeziwe bokuthi ukusetshenziswa kokupakisha okulula kanye nama-PHW amasha amakhulu kuthuthukisa ukukhalipha kwesixwayiso kanye nokusebenza kahle okungaphezu kwalokho okungafinyelelwa ngokusebenzisa ukupakisha okulula ngaphandle kokushintsha izixwayiso zezempilo. Ngaphambi kokusetshenziswa kokupakisha okulula, womabili la mazwe ayenezixwayiso zezempilo ezifanayo emaphaketheni kagwayi (isixwayiso sombhalo esingu-43% ngaphambili, i-PHW engu-53% ngemuva).
Ngemva kokusetshenziswa kokupakisha okujwayelekile kanye nama-PHW amasha amakhulu (65% wangaphambili nangemuva) e-United Kingdom, kwaba nokwanda okukhulu kwababhemayo abaqaphela, bafunda, futhi bacabanga ngezixwayiso, bacabanga ngezingozi zempilo zokubhema, ukuziphatha kokugwema, ukuyeka ugwayi, kanye nokuba namathuba amaningi okuyeka ngenxa yezixwayiso.
Ngokuphambene nalokho, kube nokwehla okukhulu ekuqapheleni, ekufundeni, nasekubhekeni ngokucophelela izixwayiso, ekucabangeni ngezingozi zempilo zokubhema, kanye nokuba namathuba amaningi okuyeka ngenxa yezixwayiso phakathi kwababhemayo eNorway, lapho ukupakisha okujwayelekile kwakusetshenziswa ngaphandle kokushintsha izixwayiso zezempilo.23 Iphethini ehlukile yemiphumela ebonwe e-United Kingdom uma iqhathaniswa neNorway ibonisa ukuthiI-Canada ukupakishwa kukagwayikuthuthukisa ukusebenza kahle kwezixwayiso ezinkulu ezintsha zezithombe, kodwa akukwazi ukwandisa umthelela wezixwayiso zombhalo/zezithombe ezindala
Isikhathi sokuthunyelwe: Juni-15-2024