关键词：吸烟;卫生服务;癌;心肺疾病,肺气肿;健康影响;发病率;人口;预防医学;烟草;治疗项目;烟草戒烟
摘 要：Tobacco is a highly addictive substance with well-documented health risks. Although great progress has been made in reducing and preventing tobacco use in the United States, the rates of cigarette use and dependence remain high in certain subpopulations, including those with substance use disorders. For example, 2011 data show that an estimated 22 percent of U.S. adults are current cigarette smokers, whereas smoking prevalence rates for those in substance abuse treatment exceeded 70 percent between 2005 and 2009. The negative health effects of tobacco use among alcohol- and drug dependent individuals can be substantial. Individuals in substance abuse treatment smoke more heavily than the general population, and consequently are more likely to suffer from tobacco-related morbidity, including cardiopulmonary problems, emphysema, and cancer, than are smokers in the general population. One study of substance abuse treatment clients found that tobacco use caused more deaths than the alcohol or drug use that brought them to treatment; specifically, the rate of death among tobacco users was nearly 1.5 times the rate of death from other addiction-related causes.