英國打造無煙世代法案 突破菸草成癮循環邁向菸草終局

英國國會通過《菸草與電子菸法案》（Tobacco and Vapes Bill），該法案的核心在於建立「無煙世代」（Smokefree Generation, SFG）政策，旨在徹底終結菸草成癮的無限循環。根據最新的模擬研究顯示，這項具備開創性的法律若順利實施，將顯著改善公共衛生並縮減社會健康不平等。

禁售菸草予2009年後出生者 邁向「菸草終局」

「無煙世代」政策的核心概念是採取「出生日期限售」模式，禁止向2009年或之後出生的人員銷售香菸產品。這意味著法律規定的合法購菸年齡將逐年遞增，從而終身禁止該群體購買紙菸。

這項政策的最終目標是實現「菸草終局（Tobacco Endgame）」，即將全國吸菸流行率降低至5%以下。根據諾丁漢大學（University of Nottingham）Nathan Davies博士研究團隊的微觀模擬研究，在中央預估情境下，英格蘭12至30歲族群的吸菸率預計將在2049年降至5%以下，若採取更樂觀的政府預估模型，此目標甚至有望在2037年提前達成。

顯著公共衛生效益與經濟回饋

模擬數據指出，無煙世代政策將帶來巨大的健康紅利。研究預測，到2075年，該政策將為英格蘭民眾增加約 87,899個經折現的品質調整壽命年（QALYs），而在未折現的情況下，增加的健康壽命年數更超過37萬年。

在經濟層面，根據政府的模型估算，至2050年，該法案預計將創造高達 1,110億英鎊的社會價值回饋，這些收益主要來自於勞動生產力的提升以及醫療成本的減輕。

縮減健康不平等：精準投放成關鍵

研究特別強調了政策在「健康公平性」上的潛力。目前英格蘭最貧困地區的吸菸率比最富裕地區高出約60%。模擬結果顯示，無煙世代政策能有效縮減不同社會階層與性別間的「絕對不平等」。

然而，專家也提醒，若要進一步消除「相對不平等」，政府必須採取「比例普遍主義」（Proportionate Universalism）的執行策略，將執法資源、宣導教育與戒煙支持優先投入於最貧困的40%地區，研究證實，透過這種精準投放，吸菸率低於5%的里程碑可望再提早一年達成。

面臨的挑戰：執法與資源投入

儘管法案獲得廣泛的公眾與專家支持，但落實仍面臨挑戰。研究指出，負責執行菸草銷售法律的「貿易標準局」（Trading Standards）在過去十年間面臨約39%的預算削減。為了確保政策成功，未來必須投入充足的資金與培訓，加強零售端的執法，以防止未成年人非法取得菸草。

中文：Google NotebookLM

校正：台灣菸草減害研究院（ Taiwan Institute of Tobacco Harm Reduction）王郁揚

參考資料：

Impact of the UK’s smokefree generation policy on tobacco-related equity in England: a simulation study

https://tobaccocontrol.bmj.com/content/early/2026/01/29/tc-2025-059669

Correspondence to Nathan Davies; nathan.davies@nottingham.ac.uk

Abstract

Background Modelling studies find the smokefree generation (SFG) policy could help achieve the tobacco endgame. The UK is on course to introduce an SFG in 2027 that prohibits tobacco sales to individuals born in or after 2009.

Methods We adapted an individual-level microsimulation model with a synthetic representative English population, and used previously validated smoking initiation, quit and relapse probabilities by age and deprivation quintile. We simulated four scenarios from 2023 to 2075: no intervention, pessimistic SFG, central SFG and optimistic SFG. Proportionate universalism sensitivity analyses assumed effective targeting led to greater effects in more deprived areas and smaller effects in less deprived areas. Equity was assessed using slope and relative indices of inequality.

Results The central SFG scenario forecast smoking prevalence to be reduced to <5% in 12–30 year-olds by 2049, but not until 2055 for males and not until 2059 for those living in the most deprived quintile. Absolute socioeconomic inequalities were reduced but not relative inequalities. Under proportionate universalism, <5% prevalence is achieved a year earlier (2048) and both absolute and relative inequalities by index of multiple deprivation quintile are substantially reduced by 2050. By 2075, 87 899 (85 293–90 791) discounted quality-adjusted life years were gained in the central scenario compared with baseline.

Conclusions The SFG policy has potential to reduce absolute inequalities among its target population and achieve significant gains in quality and length of life. Achieving reductions in relative inequalities will likely require targeted interventions that lead to greater effectiveness in lower socioeconomic areas and for males.

Data availability statement

Data are available in a public, open access repository. All data used in the model are publicly available and their references provided in the manuscript. The model is available in the OSF repository: DOI 10.17605/OSF.IO/ANVQR.

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

https://doi.org/10.1136/tc-2025-059669

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