参考文献
禁煙は喫煙関連疾患の予防や改善に役立ち大きな効果をもたらすが、禁煙の継続は容易でなく、喫煙をやめたくてもやめられない喫煙者は多い。
Lopesらが1994年に提唱したモデルを改変したRamstromのタバコ流行モデルを図７に示した81)82)。世界各国におけるタバコ流行は男性の喫煙率の増加（第1期）、男性喫煙率の減少開始と女性（および未成年）の喫煙率の増加（第2期）女性と未成年の喫煙率の減少の開始と喫煙関連疾患死亡の増加（第3期）喫煙関連疾患死亡が減少（第4期）の４つのステージにわけられるが、すでに第4期に達して肺がんなど喫煙関連疾患が減少傾向にある英国やフィンランドと異なり、わが国は女性および未成年の喫煙率の増加がようやく減少に転じ、男女ともに喫煙関連疾患が増加する第3期にある。第3期の喫煙関連疾患の増加はまだ10年以上続くと見られる中、循環器疾患を予防する立場の循環器医師の役割として「喫煙をなくす」ための効果的な働きかけが実施され、非喫煙が当たり前の話となる日の来ることを願ってやまない。
Lopesらが1994年に提唱したモデルを改変したRamstromのタバコ流行モデルを図７に示した81)82)。世界各国におけるタバコ流行は男性の喫煙率の増加（第1期）、男性喫煙率の減少開始と女性（および未成年）の喫煙率の増加（第2期）女性と未成年の喫煙率の減少の開始と喫煙関連疾患死亡の増加（第3期）喫煙関連疾患死亡が減少（第4期）の４つのステージにわけられるが、すでに第4期に達して肺がんなど喫煙関連疾患が減少傾向にある英国やフィンランドと異なり、わが国は女性および未成年の喫煙率の増加がようやく減少に転じ、男女ともに喫煙関連疾患が増加する第3期にある。第3期の喫煙関連疾患の増加はまだ10年以上続くと見られる中、循環器疾患を予防する立場の循環器医師の役割として「喫煙をなくす」ための効果的な働きかけが実施され、非喫煙が当たり前の話となる日の来ることを願ってやまない。
図7：たばことたばこ関連疾患の流行モデル
参考文献
1）厚生労働省 令和元年国民健康・栄養調査結果の概要「第2部 第4章 飲酒・喫煙に関する状況」
https://www.mhlw.go.jp/content/10900000/000687163.pdf
2）Katanoda,K, Marugame T, Saika K, et al: Population Attributable Fraction of Mortality Associated with Tobacco Smoking in Japan: A Pooled Analysis of Three Large-scale Cohort Studies. J Epidemiol. 18:251-264.2008.
3）Peto R, Lopez AD, Boreham J: Mortality from tobacco in developed countries 1950-2000 Oxford Univ Press.1994
4）上島弘嗣：特別報告：1980年循環器疾患基礎調査の追跡研究（NIPPON DATA）日循環協誌 31：231-237，1997
5）村松茂登彦：たばこの燃焼と煙成分の生成. Health Science, 11(1); 21-28, 1995
6）US Department of Health and Human Service. Cigar, 1998
7）Roberts DL: Nature Tobacco flavor. Recent Adv Tobacco Sci, 14; 49-81, 1988
8）Jarvis MJ , Boreham R, Primatesta P, et al: Nicotine yield from machine-smokes cigarettes and nicotine intakes in smokers. Evidence from a representative population survey. J Natl Cancers Res. 93:134-138, 2001
9）平成11，12年度たばこ煙にふくまれる既知の発がん物質等の有害物質の含量の測定に関する報告書。
厚生労働省保健医療局地域保健・健康増進栄養課
10）Perkins KA, Epstein LH, Jennings. JR, et al: The cardiovascular effects of nicotine during stress. Psychopharmacol, 90:373-378, 1986
11）Allison RD, Roth GM: Central and peripheral vascular effects during cigarette smoking. Arch. Envioron.Health, 19:189-198, 1969
12）Iida M, Iida H, Dohi S, et al: Mechanisms underlying cerebrovascular effects of cigarette smoking in rat in vivo. Stroke 29: 1656-1665, 1998
13）Ohkubo C: Some acute cardio-pulmonary effects of mainstream and sidestream cigarette smoke in man. Prev.Med., 11:173-186, 1982
14）飯田稔他：わが国の循環器疾患の発生におよぼすHDLコレステロールの影響. 厚生の指標，28 （10）：3，1981
15）柴田博，須山靖夫，松崎俊久：High Density Lipoproteinコレステロールに関する因子の解析. 日本老年医誌，18：456-462，1981
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17）Wolf PA, et al: Cigarette smoking as a risk factor for stroke. The Framingham Study.JAMA.259:1025-1029,1988
18）The Pooling Project Research Group: Relationship of blood pressure, serum cholesterol, smoking habit, relative weight, and ECG abnormalities to incidence of major coronary events: Final report of the Pooling Project. J Chron Dis 31:201-306, 1978
19) 循環器領域における性差医療に関するガイドライン 班長：鄭 忠和 Circulation J 74, Suppl II, 2010
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28）Kawakami N、Takatsuka N, Shimizu H, et al: Effects of smoking on the incidence of non-insulin-dependent diabetes mellitus：replication and extension in a Japanese cohort of male employees. Am.J Epidemiol, 145:103-109, 1997
29）Savage S, Nagel NJ, Estacio RO, et al: Clinical factors associates with urinary albumin excretion in type II diabetes. Am J Kidney Dis, 126:836-844,1995
30) Craig WY, Palomaki GE, Haddow JE: Cigarette smoking and serum lipid and lipoprotein concentrations: an analysis of published data. Br Med J. 298: 784-8, 1989
31) Nakanishi N, Takatorige T, Suzuki K: Cigarette smoking and the risk of metabolic syndrome in middle-aged Japanese male office workers. Ind Health 43: 295-301, 2005
32) Law MR, Hackshaw AK: A meta-analysis of cigarette smoking, bone mineral density and risk of hip fracture: recognition of a major effect BMJ 315: 841-846, 1997
33）Adena MA, Gallagher HG: Cigarette smoking and the age at menopause. Ann. Hum. Biol. 9; 121-130, 1982
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http://www.ncbi.nlm.nih.gov/pubmed?term=smoking%2C%20Lancet%2C%201998%2C%20Rotterdam Lancet 351:1840-1843. 1998
35) California Environmental Protection Agency Health effects of exposure to environmental tobacco smoke: Final draft for scientific, public, and SRP review. Office of Environmental Health Hazard Assessment. California Environmental Protection Agency,1997
36）Steenland K: Passive smoking and the risk of heart disease. JAMA 267 94-99, 1992
37）Otsuka R, Watanabe H, Hirata K et al: Acute effects of passive smoking on coronary circulation in healthy young adults. JAMA; 286:436-441, 2001
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39) Meyers DG, Neuberger JS, He J: Cardiovascular effect of bans on smoking in public places:a systematic review and meta-analysis. J Am Coll Cardiol. 54:1249-1255, 2009
40)Lightwood JM, Grants SA: Declines in acute myocardial infarction after smoke-free laws and individual risk attributable to secondhand smoke. Circulation. 120:1373-1379, 2009
41) Pell JP, Haw S, Cobbe S,, et al: Smoke-free legislation and hospitalizations for acute coronary syndrome. N Engl J Med. 2008.
42）禁煙ガイドライン（2010年改訂版）
https://www.j-circ.or.jp/cms/wp-content/uploads/2020/02/JCS2010murohara.h.pdf
43)急性冠症候群診療ガイドライン（2018年改訂版）
https://www.j-circ.or.jp/cms/wp-content/uploads/2018/11/JCS2018_kimura.pdf
44）2023年改訂版 冠動脈疾患の一次予防に関する診療ガイドライン
https://www.j-circ.or.jp/cms/wp-content/uploads/2023/03/JCS2023_fujiyoshi.pdf
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48）田中 哲郎： 乳幼児死亡の防止に関する研究 平成9年度厚生省心身障害研究
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76）あなたにもできる禁煙ガイド PASSPORT to STOP SMOKING 第3版 日本循環器学会禁煙推進委員会企画・発行 2008
https://www.j-circ-kinen.jp//textbook/001/index.html
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https://www.j-circ-kinen.jp//textbook/004/index.html
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79）高橋裕子：ポジテイブ禁煙 東京法規出版 東京 2009
80）日本心臓財団:禁煙のすすめ－タバコをやめようかなと思っている方へ 2011
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https://www.mhlw.go.jp/content/10900000/000687163.pdf
2）Katanoda,K, Marugame T, Saika K, et al: Population Attributable Fraction of Mortality Associated with Tobacco Smoking in Japan: A Pooled Analysis of Three Large-scale Cohort Studies. J Epidemiol. 18:251-264.2008.
3）Peto R, Lopez AD, Boreham J: Mortality from tobacco in developed countries 1950-2000 Oxford Univ Press.1994
4）上島弘嗣：特別報告：1980年循環器疾患基礎調査の追跡研究（NIPPON DATA）日循環協誌 31：231-237，1997
5）村松茂登彦：たばこの燃焼と煙成分の生成. Health Science, 11(1); 21-28, 1995
6）US Department of Health and Human Service. Cigar, 1998
7）Roberts DL: Nature Tobacco flavor. Recent Adv Tobacco Sci, 14; 49-81, 1988
8）Jarvis MJ , Boreham R, Primatesta P, et al: Nicotine yield from machine-smokes cigarettes and nicotine intakes in smokers. Evidence from a representative population survey. J Natl Cancers Res. 93:134-138, 2001
9）平成11，12年度たばこ煙にふくまれる既知の発がん物質等の有害物質の含量の測定に関する報告書。
厚生労働省保健医療局地域保健・健康増進栄養課
10）Perkins KA, Epstein LH, Jennings. JR, et al: The cardiovascular effects of nicotine during stress. Psychopharmacol, 90:373-378, 1986
11）Allison RD, Roth GM: Central and peripheral vascular effects during cigarette smoking. Arch. Envioron.Health, 19:189-198, 1969
12）Iida M, Iida H, Dohi S, et al: Mechanisms underlying cerebrovascular effects of cigarette smoking in rat in vivo. Stroke 29: 1656-1665, 1998
13）Ohkubo C: Some acute cardio-pulmonary effects of mainstream and sidestream cigarette smoke in man. Prev.Med., 11:173-186, 1982
14）飯田稔他：わが国の循環器疾患の発生におよぼすHDLコレステロールの影響. 厚生の指標，28 （10）：3，1981
15）柴田博，須山靖夫，松崎俊久：High Density Lipoproteinコレステロールに関する因子の解析. 日本老年医誌，18：456-462，1981
16）Reed DM, Maclean CJ, Hayashi T: Predictors of atherosclerosis in the Honolulu Heart Program. I. Biologic dietary, and lifestyle characteristics. Am J Epidemiol,136: 214-225,1987
17）Wolf PA, et al: Cigarette smoking as a risk factor for stroke. The Framingham Study.JAMA.259:1025-1029,1988
18）The Pooling Project Research Group: Relationship of blood pressure, serum cholesterol, smoking habit, relative weight, and ECG abnormalities to incidence of major coronary events: Final report of the Pooling Project. J Chron Dis 31:201-306, 1978
19) 循環器領域における性差医療に関するガイドライン 班長：鄭 忠和 Circulation J 74, Suppl II, 2010
20) Huxley RR, Woodward M： Cigarette smoking as a risk factor for coronary heart disease in women compared with men: a systematic review and meta-analysis of prospective cohort studies. Lancet 378:1297-1305, 2011
21）Kawachi I, Golditz GA., Stamper MJ, et al: Smoking cessation and decreased risk of stroke in women. JAMA 269; 232-236,1999
22）Smoking and Health US Public Health Service, Report of the Advisory Committee to the Surgeon General of the Public Health Service, DEHW Public Health Service Publ,No.1103,1964
23) 日本呼吸器学会COPDガイドライン作成委員会編 COPD（慢性閉塞性肺疾患）診断と治療のためのガイドライン第3版 メデイカルレビュー社 2009
24) 厚生省免疫・アレルギー研究班： 喘息の危険因子.喘息予防・管理ガイドライン 協和企画通信：23-30, 1998
25）Bense L, Eklund G, Wiman LG: Smoking and the increased risk of contracting spontaneous pneumothorax. Chest, 92:1009-1012, 1987
26）丸岡秀一郎、橋本修：発症・進展要因としてのエラスターゼ・アンチエラスターゼ不均衡。日本臨床、57：1982-1987，1999
27）Kato I, Nomura AMY, Stemmermann GN, et al: A prospective study of gastric and duodenal ulcer and its relation to smoking and diet. Am J Epidemiol. 135: 521-530, 1992
28）Kawakami N、Takatsuka N, Shimizu H, et al: Effects of smoking on the incidence of non-insulin-dependent diabetes mellitus：replication and extension in a Japanese cohort of male employees. Am.J Epidemiol, 145:103-109, 1997
29）Savage S, Nagel NJ, Estacio RO, et al: Clinical factors associates with urinary albumin excretion in type II diabetes. Am J Kidney Dis, 126:836-844,1995
30) Craig WY, Palomaki GE, Haddow JE: Cigarette smoking and serum lipid and lipoprotein concentrations: an analysis of published data. Br Med J. 298: 784-8, 1989
31) Nakanishi N, Takatorige T, Suzuki K: Cigarette smoking and the risk of metabolic syndrome in middle-aged Japanese male office workers. Ind Health 43: 295-301, 2005
32) Law MR, Hackshaw AK: A meta-analysis of cigarette smoking, bone mineral density and risk of hip fracture: recognition of a major effect BMJ 315: 841-846, 1997
33）Adena MA, Gallagher HG: Cigarette smoking and the age at menopause. Ann. Hum. Biol. 9; 121-130, 1982
34) Ott A, Slooter AJ, Hofman A, et al: Smoking and risk of dementia and Alzheimer's disease in a population-based cohort study: the Rotterdam Study.
http://www.ncbi.nlm.nih.gov/pubmed?term=smoking%2C%20Lancet%2C%201998%2C%20Rotterdam Lancet 351:1840-1843. 1998
35) California Environmental Protection Agency Health effects of exposure to environmental tobacco smoke: Final draft for scientific, public, and SRP review. Office of Environmental Health Hazard Assessment. California Environmental Protection Agency,1997
36）Steenland K: Passive smoking and the risk of heart disease. JAMA 267 94-99, 1992
37）Otsuka R, Watanabe H, Hirata K et al: Acute effects of passive smoking on coronary circulation in healthy young adults. JAMA; 286:436-441, 2001
38) U.S. Department of Health and Human Survices. 2006 Surgeon General's Report—The Health Consequences of Involuntary Exposure to Tobacco Smoke. Center for Disease Control and Prevention, Coordinationg Center for Health Promotion.National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Atlanta, GA, 2006
39) Meyers DG, Neuberger JS, He J: Cardiovascular effect of bans on smoking in public places:a systematic review and meta-analysis. J Am Coll Cardiol. 54:1249-1255, 2009
40)Lightwood JM, Grants SA: Declines in acute myocardial infarction after smoke-free laws and individual risk attributable to secondhand smoke. Circulation. 120:1373-1379, 2009
41) Pell JP, Haw S, Cobbe S,, et al: Smoke-free legislation and hospitalizations for acute coronary syndrome. N Engl J Med. 2008.
42）禁煙ガイドライン（2010年改訂版）
https://www.j-circ.or.jp/cms/wp-content/uploads/2020/02/JCS2010murohara.h.pdf
43)急性冠症候群診療ガイドライン（2018年改訂版）
https://www.j-circ.or.jp/cms/wp-content/uploads/2018/11/JCS2018_kimura.pdf
44）2023年改訂版 冠動脈疾患の一次予防に関する診療ガイドライン
https://www.j-circ.or.jp/cms/wp-content/uploads/2023/03/JCS2023_fujiyoshi.pdf
45）Howe G, Westhoff C, Vessey M et al: Effects of age, cigarette smoking and other factors on fertility. Findings in a large prospective study. BMJ. 290; 1697-1700, 1985
46）斎藤麗子: 妊婦と夫の喫煙状況と出生時への影響。日本公衛誌 38：124-131，1991
47）Frazier T M. Davis G H, Goldstein H et al: Cigarette Smoking and Prematurity: a Prospective study. Am.J. Obstet. Gynecol. 81(5): 988-996, 1961
48）田中 哲郎： 乳幼児死亡の防止に関する研究 平成9年度厚生省心身障害研究
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