目錄
譯者序 i
WHO煙草制品管制研究小組第十一次會(huì)議 iii
致謝 xi
縮略語(yǔ) xv
1.引言 1
參考文獻(xiàn) 3
2.促進(jìn)吸入的添加劑（涼味劑、煙堿鹽和調(diào)味劑） 5
摘要 5
2.1 引言 6
2.2 方法 7
2.3 煙堿和其他影響可吸入性的感官刺激物 7
2.4 促進(jìn)吸入的添加劑 8
2.4.1 定義和概念框架 8
2.4.2 證據(jù)審查與整合 10
2.5 具有清涼作用的添加劑 11
2.5.1 薄荷醇 11
2.5.2 合成涼味劑 12
2.6 降低pH值的添加劑 13
2.6.1 電子煙煙液中的有機(jī)酸 14
2.6.2 卷煙中的乙酰丙酸和其他有機(jī)酸 15
2.6.3 糖類(lèi) 15
2.7 可掩蓋苦味的調(diào)味劑 15
2.7.1 甜味添加劑 15
2.7.2 糖類(lèi)和甜味劑 16
2.8 討論 17
2.8.1 主要發(fā)現(xiàn) 17
2.8.2 歐盟和北美對(duì)促進(jìn)吸入的添加劑的監(jiān)管機(jī)制 18
2.9 推薦研究 19
2.10 政策建議 20
參考文獻(xiàn) 22
3.合成煙堿：科學(xué)基礎(chǔ)、全球法律環(huán)境及監(jiān)管考量 31
主要發(fā)現(xiàn) 31
3.1 引言 32
3.1.1 背景 32
3.1.2 合成煙堿產(chǎn)品的種類(lèi) 33
3.1.3 合成煙堿產(chǎn)品的營(yíng)銷(xiāo)和推廣 33
3.2 合成煙堿的科學(xué)基礎(chǔ) 34
3.2.1 方法 34
3.2.2 結(jié)果 35
3.2.3 總結(jié)與討論 40
3.3 法律環(huán)境 41
3.3.1 方法 42
3.3.2 結(jié)果 43
3.3.3 討論 45
3.4 政策建議 46
3.5 結(jié)論 47
參考文獻(xiàn) 47
4.尼古丁袋：特性、用途、危害及監(jiān)管 54
主要發(fā)現(xiàn)、挑戰(zhàn)和監(jiān)管影響 54
4.1 引言 54
4.2 方法 56
4.3 產(chǎn)品特性 57
4.4 市場(chǎng)營(yíng)銷(xiāo) 58
4.5 使用者概況 59
4.6 產(chǎn)品潛在危害評(píng)估 61
4.6.1 吸引力 61
4.6.2 致癮性 61
4.6.3 毒性 62
4.7 人群效應(yīng)及相關(guān)因素 63
4.8 監(jiān)管和監(jiān)管機(jī)制 63
4.8.1 監(jiān)管考慮 66
4.8.2 國(guó)家案例研究：荷蘭 67
4.9 討論 67
4.10 研究空白、優(yōu)先事項(xiàng)和問(wèn)題 69
4.11 關(guān)于產(chǎn)品監(jiān)管和信息傳播的政策建議 69
4.12 結(jié)論 70
參考文獻(xiàn) 71
5.電子煙堿傳輸系統(tǒng)和加熱型煙草制品的暴露、效應(yīng)和易感性的生物標(biāo)志物及其優(yōu)先次序評(píng)估 76
摘要 76
5.1 背景 77
5.2 暴露生物標(biāo)志物 78
5.2.1 煙草和煙堿產(chǎn)品研究中常用暴露生物標(biāo)志物的定義和概述 78
5.2.2 暴露生物標(biāo)志物在ENDS和HTP研究中的應(yīng)用 82
5.3 效應(yīng)生物標(biāo)志物（危害或疾病） 86
5.3.1 煙草和煙堿產(chǎn)品研究中常用效應(yīng)生物標(biāo)志物的定義和概述 86
5.3.2 效應(yīng)生物標(biāo)志物在ENDS和HTP研究中的應(yīng)用 87
5.4 易感性生物標(biāo)志物 93
5.4.1 煙草和煙堿產(chǎn)品研究中易感性生物標(biāo)志物的定義和概述 93
5.4.2 易感性生物標(biāo)志物在ENDS和HTP研究中的應(yīng)用 94
5.5 生物標(biāo)志物測(cè)量的已建立、經(jīng)驗(yàn)證的方法 95
5.6 ENDS和HTP生物標(biāo)志物證據(jù)總結(jié)及其對(duì)公共衛(wèi)生的影響 96
5.6.1 現(xiàn)有數(shù)據(jù)總結(jié)及對(duì)公共衛(wèi)生的影響 96
5.6.2 生物標(biāo)志物的局限性 98
5.6.3 研究空白 99
5.7 煙草控制生物標(biāo)志物可能優(yōu)先次序的建議 99
5.8 解決研究空白和優(yōu)先事項(xiàng)的建議 101
5.9 政策建議 101
參考文獻(xiàn) 102
6.煙草和非治療性煙堿產(chǎn)品的互聯(lián)網(wǎng)營(yíng)銷(xiāo)及相關(guān)監(jiān)管考量 121
摘要 121
6.1 背景 122
6.2 網(wǎng)絡(luò)和社交媒體營(yíng)銷(xiāo)對(duì)煙草和ENDS使用的影響 123
6.2.1 年輕人使用ENDS 123
6.2.2 網(wǎng)絡(luò)和數(shù)字媒體中TAPS示例 123
6.2.3 社交媒體平臺(tái)的煙草廣告政策 126
6.2.4 煙草廣告法的全球現(xiàn)狀 128
6.3 討論 128
6.3.1 跨境廣告 129
6.3.2 其他有害產(chǎn)品的網(wǎng)絡(luò)營(yíng)銷(xiāo)監(jiān)管 129
6.3.3 煙草廣告產(chǎn)品監(jiān)管面臨的挑戰(zhàn) 130
6.3.4 新產(chǎn)品和網(wǎng)絡(luò)營(yíng)銷(xiāo)的相關(guān)挑戰(zhàn) 130
6.4 結(jié)論 131
6.5 研究空白和優(yōu)先事項(xiàng) 131
6.6 政策建議 131
參考文獻(xiàn) 132
7.綜合建議 138
7.1 主要建議 139
7.2 對(duì)公共衛(wèi)生政策的意義 141
7.3 對(duì)WHO規(guī)劃的影響 142
參考文獻(xiàn) 142
Contents
Participants in the eleventh meeting of the WHO Study Group on Tobacco Product Regulation vii
Acknowledgements xiii
Abbreviations and acronyms xvii
1.Introduction 145
References 148
2.Additives that facilitate inhalation, including cooling agents, nicotine salts and flavourings 150
Abstract 150
2.1 Introduction 151
2.2 Methods 152
2.3 Nicotine and other sensory irritants that affect inhalability 153
2.4 Additives that facilitate inhalation 154
2.4.1 Definition and conceptual framework 154
2.4.2 Evidence review and integration 156
2.5 Additives with cooling effects 157
2.5.1 Menthol 157
2.5.2 Synthetic cooling agents 158
2.6 Additives that lower pH 159
2.6.1 Organic acids in e-liquids 160
2.6.2 Laevulinic and other organic acids in cigarettes 162
2.6.3 Sugars 162
2.7 Additives with flavouring properties that may mask bitter taste 162
2.7.1 Flavourings with sweet features 162
2.7.2 Sugars and sweeteners 164
2.8 Discussion 164
2.8.1 Main findings 164
2.8.2 Regulatory mechanisms in the European Union and North America for additives that facilitate inhalation 166
2.9 Recommended research 167
2.10 Policy recommendations 168
References 171
3.Synthetic nicotine: science, global legal landscape and regulatory considerations 179
Preface: key findings 179
3.1 Introduction 180
3.1.1 Background 180
3.1.2 Types of synthetic nicotine products 181
3.1.3 Marketing and promotion of synthetic nicotine products 182
3.2 The science of synthetic nicotine 183
3.2.1 Methods 183
3.2.2 Results 183
3.2.3 Summary and discussion 191
3.3 The legal landscape 192
3.3.1 Methods 193
3.3.2 Results 193
3.3.3 Discussion 196
3.4 Recommendations for consideration by policy-makers 197
3.5 Conclusions 198
References 199
4.Nicotine pouches: characteristics, use, harmfulness and regulation 205
Key findings, challenges and regulatory implications 205
4.1 Introduction 206
4.2 Methods section 208
4.3 Characteristics of the products 209
4.4 Marketing 211
4.5 User profile 212
4.6 Evaluation of potential harmfulness of the products 214
4.6.1 Attractiveness 214
4.6.2 Addictiveness 214
4.6.3 Toxicity 215
4.7 Population effects and related factors 216
4.8 Regulation and regulatory mechanisms 217
4.8.1 Regulatory considerations 220
4.8.2 Country case study: Netherlands (Kingdom of the) 221
4.9 Discussion 222
4.10 Research gaps, priorities and questions 224
4.11 Policy recommendations for product regulation and information dissemination 224
4.12 Conclusions 226
References 226
5.Biomarkers of exposure, effect and susceptibility for assessing electronic nicotine delivery devices and heated tobacco products, and their possible prioritization 231
Abstract 231
5.1 Background 232
5.2 Biomarkers of exposure 234
5.2.1 Definition and overview of biomarkers of exposure commonly used in studies of tobacco and nicotine products 234
5.2.2 Application of biomarkers of exposure in studies of ENDS and HTPs 238
5.3 Biomarkers of biological effects (harm or disease) 243
5.3.1 Definitions and overview of biomarkers of biological effects commonly used in studies of tobacco and nicotine products 243
5.3.2 Application of biomarkers of biological effect in studies of ENDS and HTPs 245
5.4 Biomarkers of susceptibility 252
5.4.1 Definition and overview of biomarkers of susceptibility used in studies of tobacco and nicotine products 252
5.4.2 Application of biomarkers of susceptibility in studies of ENDS and HTPs 253
5.5 Established and validated methods for measuring biomarkers 254
5.6 Summary of evidence on biomarkers for ENDS and HTPs and implications for public health 255
5.6.1 Summary of available data and implications for public health 255
5.6.2 Limitations of biomarkers 258
5.6.3 Research gaps 259
5.7 Recommendations for possible prioritization of biomarkers for tobacco control 260
5.8 Recommendations for addressing research gaps and priorities 261
5.9 Relevant policy recommendations 262
References 263
6.Internet, influencer and social media marketing of tobacco and non-therapeutic nicotine products and associated regulatory considerations 279
Abstract 279
6.1 Background 280
6.2 Impact of online and social media marketing on tobacco and ENDS use 281
6.2.1 ENDS use by young adults 282
6.2.2 Illustrative examples of TAPS in online and digital media 282
6.2.3 Social media platform tobacco advertising policies 287
6.2.4 Global status of tobacco advertising laws 288
6.3 Discussion 289
6.3.1 Cross-border advertising 290
6.3.2 Regulation of online marketing of other harmful products 291
6.3.3 Challenges to regulation of tobacco advertising 291
6.3.4 New products and associated challenges to online marketing 292
6.4 Conclusions 292
6.5 Research gaps and priorities 293
6.6 Policy recommendations 293
References 294
7.Overall recommendations 299
7.1 Main recommendations 301
7.2 Significance for public health policies 303
7.3 Implications for the Organization’s programmes 304
References 305