Who's smoking now and why it matters
现在谁在吸烟，为什么它很重要
Adapted from: 改编自：
Suppose you were told that there is something responsible for nearly 1 of every 5 deaths of Americans, and that it is completely avoidable. Would you believe - today - that “something” is cigarette smoking?
假设你被告知，几乎每 5 个美国人中就有 1 人死亡是由某种原因造成的，而且这是完全可以避免的。今天，你会相信 “某事” 是吸烟吗？
If you’re a college graduate, you might not believe it. You don’t smoke. Your friends and colleagues don’t smoke. You never see smoke in your workplace, nor in the restaurants and bars you go to. Like many of the nation’s most educated citizens, you may well regard the problem of smoking as largely answered. Because the educated population is also the most politically engaged, cigarette smoking has almost disappeared from the nation’s health policy agenda.
如果你是大学毕业生，你可能不相信。你不抽烟。你的朋友和同事不抽烟。您永远不会在工作场所看到烟雾，也不会在您去的餐馆和酒吧看到烟雾。像许多美国受教育程度最高的公民一样，您很可能认为吸烟问题在很大程度上得到了解答。由于受过教育的人口也是政治参与度最高的群体，因此吸烟几乎从国家的卫生政策议程中消失了。
The good news and the bad news
好消息和坏消息
No one can disagree with the extraordinary wins against smoking. Since the 1964 Surgeon General’s report on smoking and health, adult smoking has dropped by two-thirds, from 43 percent to 14 percent.
没有人会不同意反对吸烟的非凡胜利。自 1964 年卫生局局长关于吸烟与健康的报告发布以来，成人吸烟率下降了三分之二，从 43% 下降到 14%。
The drop among young people has been even more significant. For example, since smoking peaked among high school seniors 20 years ago, smoking rate in the past 30 days has fallen by nearly 80 percent.
年轻人的下降更为显著。例如，自 20 年前高中生吸烟达到顶峰以来，过去 30 天的吸烟率下降了近 80%。
Driven by tobacco control initiatives, Americans’ decisions to quit smoking and not to start in the first place avoided 8 million early deaths from 1964 to 2012. The Centers for Disease Control and Prevention considers tobacco control one of the 10 greatest public health successes of the 20th century and of the first decade of the 21 st.
在烟草控制举措的推动下，美国人决定戒烟而不是从一开始就开始吸烟，从 1964 年到 2012 年避免了 800 万人过早死亡。疾病控制和预防中心认为烟草控制是 20 世纪和 21 世纪第一个十年的 10 大公共卫生成就之一。
That’s the good news. The bad news is that 1 of every 7 adults still smokes. And smoking kills nearly 500,000 Americans every year. That number exceeds - by a lot - the sum total of all deaths caused by the opioids and other drugs, alcohol, car injuries, murder, suicide, HIV/AIDS and fires.
这是个好消息。坏消息是，每 7 个成年人中就有 1 个仍然吸烟。吸烟每年导致近 500,000 名美国人死亡。这个数字大大超过了阿片类药物和其他药物、酒精、车伤、谋杀、自杀、艾滋病毒/艾滋病和火灾造成的所有死亡总数。
Who smokes now? The role of education
现在谁吸烟？教育的作用
What accounts for the difference between common ideas about smoking and the sad reality? In large part it is notable changes in who is smoking. Increasingly, today’s smokers are those with lower education, lower income and - importantly - a higher rate of mental illness.
是什么解释了关于吸烟的常见观念和悲惨的现实之间的差异？在很大程度上，吸烟者发生了显着变化。今天的吸烟者越来越多地是那些受教育程度较低、收入较低且重要的是，精神疾病发病率较高的人。
Consider this: In 1966, the smoking rate of Americans who hadn’t graduated high school was just 20 percent greater than that of college grads. By 2017, in contrast, the smoking rate of the least educated was nearly four times greater than that of the most educated.
想想看：1966 年，高中未毕业的美国人的吸烟率仅比大学毕业生高 20%。相比之下，到 2017 年，受教育程度最低的人的吸烟率几乎是受教育程度最高的人的四倍。
Smoking has dropped greatly at both ends of the education spectrum but to a much higher degree among college graduates: by half among Americans lacking a high school degree, but by 85 percent among college graduates.
吸烟率在教育光谱的两端都大幅下降，但在大学毕业生中的下降幅度要大得多：在没有高中学历的美国人中下降了一半，但在大学毕业生中下降了 85%。
For college grads, the rate of smoking in 2017 was almost gone. For those without a high school degree, and indeed for high school grads too, fully 1 out of 5 remain smokers. The difference matters. Research links a fifth to a third of a large education-related gap in life span to differences in smoking.
对于大学毕业生来说，2017 年的吸烟率几乎消失了。对于那些没有高中学历的人来说，实际上对于高中毕业生来说，整整五分之一的人仍然是吸烟者。差异很重要。研究将与教育相关的巨大寿命差距的五分之一到三分之一与吸烟差异联系起来。
Money matters 金钱很重要
A similar pattern of smoking holds with respect to income classes, themselves highly linked with educational level. According to the latest data, Americans who live below the federal poverty level were three times more likely to smoke than Americans with incomes at least 400 percent above the federal poverty level. The gap has widened since the early 1990s.
类似的吸烟模式也适用于收入阶层，他们本身就与教育水平高度相关。根据最新数据，生活在联邦贫困线以下的美国人吸烟的可能性是收入至少高于联邦贫困线 400% 的美国人的三倍。自 1990 年代初以来，差距不断扩大。
There is an enormous difference in life spans between the nation’s richest and poorest citizens. Smoking is again a significant factor in this difference.
美国最富有和最贫穷的公民之间的寿命存在巨大差异。吸烟再次成为造成这种差异的一个重要因素。
Mental health does, too 心理健康也是如此
An enormously important factor in smoking today is that the smoking rate of people suffering from serious mental illness is more than double that of the population not so affected ( 28 percent and 13 percent, respectively, in 2014). People with mental health problems or drug use issues make up a quarter of the U.S. population but consume 40 percent of all cigarettes smoked. They have more difficulty stopping smoking.
当今吸烟的一个极其重要的因素是，患有严重精神疾病的人的吸烟率是未受影响人群的两倍多（2014 年分别为 28% 和 13%）。有心理健康问题或药物使用问题的人占美国人口的四分之一，但消费的香烟占所有吸烟量的 40%。他们戒烟更困难。
Rates differ by mental illness condition. In 2007, nearly 60 percent of schizophrenics smoked. That was three times the rate of the general population. Smokers with serious psychological distress (SPD) lose 15 years of life span. Nonsmoking victims of SPD lose five years. Research has thus linked up to two-thirds of the life span reduction of SPD victims who smoke to their use of cigarettes.
费率因精神疾病状况而异。2007 年，近 60% 的精神分裂症患者吸烟。这是普通人口的三倍。患有严重心理困扰 （SPD） 的吸烟者会失去 15 年的寿命。SPD 的非吸烟受害者失去了五年。因此，研究表明，吸烟的 SPD 受害者的寿命缩短有三分之二与他们使用香烟有关。
Marginalized smokers 边缘化吸烟者
As these data show, the main victims of smoking are members of marginalized populations. Despite the enormous continuing importance of smoking in U.S. health, the issue is hidden. Smoking no longer afflicts the nation’s most economically well-off population, and those it does burden lack an effective voice in the nation’s political life.
正如这些数据所显示的那样，吸烟的主要受害者是边缘化人群。尽管吸烟在美国健康中持续具有巨大的重要性，但这个问题是隐藏的。吸烟不再困扰着美国经济最富裕的人群，而吸烟所负担的人群在国家的政治生活中缺乏有效的发言权。
Besides, smokers tend to blame themselves for the behavior.
此外，吸烟者往往会为这种行为责备自己。
In point of fact, smoking is a stubborn addiction, one that the vast majority of smokers picked up in their youth. They were helped in so doing by a greedy tobacco industry that marketed aggressively to young people. Kids have been called “replacement smokers,” the new smokers needed to refill the industry’s customer base as its most loyal customers die from smoking-caused diseases.
事实上，吸烟是一种顽固的成瘾，绝大多数吸烟者在年轻时就染上了这种成瘾。他们这样做得到了一个贪婪的烟草业的帮助，该行业积极地向年轻人推销。孩子们被称为“替代吸烟者”，随着该行业最忠实的客户死于吸烟引起的疾病，这些新吸烟者需要重新填充该行业的客户群。