<International Circulation>: Are these people surveyed at doctor’s visits?

　　《国际循环》：是在医生随访时对受试者进行观察吗？

　　Dr Fong: No. These are general population surveys. In some countries， particularly the high income countries， it is by telephone; so random digit dialed surveys. In countries like China， and Thailand， Malaysia， Bangladesh， India and we are starting in some African countries (Zambia， Nigeria and Kenya) it is known as cluster sampling or hierarchical sampling. It covers different parts of those countries but it is not every single province or region. They are all probability samples so are representative of the area in which the sampling occurs. We have all kinds of protocols and the sampling procedures have a survey that is quite extensive; about 250 or 300 questions of which about 150 have to do with policy. For example， concerning warning labels， we have twelve or fifteen questions on noticing warnings in the last few months， thinking about the health risks of smoking， thinking about secondhand smoke， belief and awareness that smoking causes a list of diseases including cardiovascular diseases， attitudes and beliefs and one’s own perceived risk. We have all of these questions which relate to each of the policy domains – we have twelve to fifteen questions on warning labels; we have about fifteen to twenty about smoke-free. For example， the last time you were in a restaurant， was there any smoking at all? Since we have a random representative sample of smokers and non-smokers and they each report on the last time they were in a restaurant， then by proxy we have a random sample of restaurants in an area weighted by popularity. From this， we can get a fix on what is the prevalence of smoking and what is the percentage of restaurants in Beijing， for instance， that have smoke in them. It is actually around 85% to 95%. And nothing has changed since the smoke-free laws and nothing has changed since the Olympics initiative and so on. We are finding this across the different countries. Our general findings are that in China， the tobacco control policies are in need of strengthening. Taxes went up two years ago but prices haven’t changed and it is only when you have a state-owned tobacco industry that something like that can happen. So it is really not an effective policy for changing behavior if prices don’t change. There are warning labels on the back of every pack but it is in English. In a paper published in Tobacco Control， the main journal in the field， we show that over 90% of smokers don’t know what those words on the pack mean. It is another example of where policy is not working. They are going to increase the font size and so on， but really the ITC Project has been at the forefront of international work showing that graphic warnings work better and Article 11 Guidelines for packaging and labeling recommend very strongly that the parties to the FTCT， including China， should be implementing graphic warnings. In China there are tremendous challenges. I know there are strong forces that are preventing positive action from taking place in this horrific epidemic that is claiming over a million lives every year in China.

　　Fong博士：不是。这是人群调查。在某些国家，尤其是在高收入国家，人群调查是通过打电话完成的，也就是随机数字拨号调查。在中国、泰国、马来西亚、孟加拉国和印度这样的国家，还有一些非洲国家（津巴布韦、尼日利亚和肯尼亚），采用的是整群抽样或层次抽样。调查覆盖了这些国家的不同区域，不是每一个省或每一个地区。所抽取的是几率样本，因此能够代表样本所在的区域。我们有多种多样的方案，抽样的方法相当广泛；大约有250～300个问题，其中约150个问题与政策有关。例如，关于警示标签的问题，我们在过去的几个月中有12～15个问题是关于警示标签的问题，包括认识到吸烟的健康风险、认识二手烟、认识到吸烟会导致心血管疾病等一系列疾病，受访者对自己风险的态度和认识。我们设立了这些与不同政策领域相关的问题。关于无烟有15～20个问题。例如，最后一次你去的餐馆是无烟餐馆吗？由于我们观察的是吸烟者和非吸烟者随机代表的样本，他们可以报告最后一次去餐馆的情况，随后通过代理机构，我们会得到依据人口数所确定的餐馆随机样本。从中我们可以得出吸烟的比例是多少，在某一城市有多高比例的餐馆不是无烟餐馆。实际上这一比例大约是85%～95%。无烟法案和奥林匹克倡议公布后，一切都没有改变。我们在不同的国家都得出了这个同样的结论。我们发现在中国，烟草控制政策需要加强。两年前国家提高了对烟草的税收，但是烟草价格并没有变化，因此只有烟草生产厂家是国有的情况下我们才能实现提升烟草价格的目的。因此，如果烟草价格不提高的话，这确实不是一个改变人群行为的有效政策。在每一个烟盒的背面都印有警示标签，但是标签是英文的。《烟草控制》是控烟领域的一本核心的杂志，在《烟草控制》上所发表的一篇论文中，我们发现超过90%的吸烟者不知道标签的意思是什么。这又是一个政策不起作用的例子。烟草生产厂家应当增加字体的大小和做出其他变化，而ITC项目是走在了全球的最前沿，显示图片警告会起到更好的作用，包装和标签指南的第11条强烈推荐包括中国在内的FTCT成员国应当实施图片警告。在中国我们要面临巨大的挑战。在中国这个烟草流行的国家，我们知道有一些很强有力的力量在阻止积极行为的发生，每年烟草要夺走100万中国人的生命。
 

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