NGHIEN CLfU - TRAO BOI DEN CHI Tilu VA SUfC KHOE CUA NGUOl DAN QUAN NINH KIEU, THANH PHO CAN THO Truang Vdn Hdu, Thdi DUng Nam vd Nguyen Thanh Binh Vien Nghien ciiu Phdt trien dong bdng
Trang 1NGHIEN CLfU - TRAO BOI
DEN CHI Tilu VA SUfC KHOE CUA NGUOl DAN QUAN NINH KIEU, THANH PHO CAN THO
Truang Vdn Hdu, Thdi DUng Nam vd Nguyen Thanh Binh Vien Nghien ciiu Phdt trien dong bdng song Cdu Long, Dai hoc Cdn Tha
IGlUlTHItU
Hiit thudc la khong chi anh htfdng de'n chi phi trtfc tie'p cua vide mua thud'c ma cdn anh htfdng de'n cac chi phi gian tiep khac nhtf y te cho ban than va cpng ddng, giam nang sua't lao dpng Viet Nam thupc nhdm
15 ntfdc cd so' ngtfdi hiit thudc cao nha't tren the' gidi Theo dieu tra nam 2010 ve tinh hinh stf dung thud^c la d ngtfdi trtfdng thanh tren 15 tudi do Bp Y te, Tong cue Thd'ng ke va WHO phdi hdp thtfc hien, ty le ngtfdi trtfctng thanh hiit thudc la 47,4% d nam gidi va 1,4% d ntt gidi Udc tinh, d ntfdc ta mdi nam cd khoang 40.000 ngtfdi ttf vong vi cac benh lien quan de'n hiit thudc, gap 4 lan so' ca ttf vong vi tai nan giao thdng dtfdng bp, vao nam 2030,
con so' nay se tang len 70.000 ca (Levy D va ctv, 2006) Nghien ctfu "Chi phi y te cho ndm benh lien quan de'n hut thudc Id tai VietNam" dtfpc tie'n hanh nam 2010-2011 bdi Dai hpc Y te' Cong cpng va to' chtfc HeathBridge
Canada cho tha'y; mdi nam Viet Nam chi hdn 22.000 ty ddng cho stf dung thud'c la va 23.139 ty ddng de giai quye't 5 nhdm benh do thudc la mang lai, (ung thtf phdi, dot quy, benh tim thie'u man cue bp, benh phdi tac nghen man tinh, ung thtf dtfdng ho ha'p va tieu hda tren), con so' nay chie'm de'n 0,91% GDP toan qudc Qua do cho tha'y ganh nang ve kinh te', stfc khde va chi phi phai tra de giai quye't hau qua do viec hut thudc la gay nen
la qua to ldn
Nghien ctfu nay dtfdc thtfc hien nham fim hieu hien trang hiit thudc la cung nhtf danh gia anh htfdng cua hiit thudc la de'n chi tieu va stfc khde cua ngtfdi dan tren dia ban thanh phd Can Thd (TP.Can Thd); ttf do de xua't nhttng giai phap nham han che' finh trang hiit thud'c la va tac dpng do viec hut thud'c la gay nen cho nln kinh te' TP.Can Thd ndi rieng, vilng ddng bang sdng Ctfu Long (DBSCL) va ca ntfdc ndi chung
Nghien ctfu dtfdc thtfc hien tai quan Ninh Kieu, TPCT vao thang 8/2014 bang each phdng va'n trtfc tiep
60 ngtfdi dang htit thud'c va 30 ngtfdi khdng hiit thudc de tim hieu hien trang hiit thud'c la va so sinh cac va'n dl lien quan de'n stfc khde, chi tieu gitfa 2 nhdm dang hiit thud'c (DHT) va khdng hut thud'c (KHT) Phtfdng phap thd'ng ke mo ta va so sanh hai mSu dpc lap (t-test) dtfdc stf dung de phan tich sd Udu thu thap dtfdc
3.KETQUAvATH/iOLUAN
3.1 Thdng tin chung v l dap vidn va hd
Thdng tin ve gidi, dan tpc, trinh dp hpc va'n va nghe nghiep cua 90 dap vidn dtfdc trinh bay trong Bang 1 Qua do cho tha'y dd'i vdi nhdm KHT, dap vien la nam gidi chie'm 80% va ntt gidi 20%; dd'i vdi nhdm DHT dii 100% dap vien la nam gidi; tinh trung hinh chung cho ta't ca 90 quan sat trong nghien ctfu nay thi 93,3% dap vien la nam gidi va 6,7% la ntt gidi Ve dan tpc 97,8% la ngtfdi Kinh va 2,2% la ngtfdi Khd-me
Bdng 1: Thong tin ve gidi, ddn toc, trinh do hoc vdn vd nghe nghiep cua ddp vien
Gidi tinh
Dan tdc
Nam Ntt
long
Kinh Khd-me
Tdng
Nhdm khdng hut
o Ty le (%)
24 80,0
6 20,0
30 100,0
29 96,7
1 3,3
30 100,0
Nhdm dang hiit
n
60
0
60
59
1
60
Ty Ie {%)
100,0 0,0
100,0
98,3
1.7
100,0
Tong chung
n
'?4
6
90
88
2
90
Ty Id (%)
93,3
6,7
100,0
97,8
2,2
100,0
Trang 2NGHIEN CLTU-TRAO DOI
Hpc va'n Khong bie't chtt
Ca'pl Ca'p 2 Ca'p 3
mm Cao dang, dai hpc
Sau dai hpc
Tong
Nghe Cong nhan
nghiep Can bp vien chtfc
Budn ban, dich vu Sinh vien
Khac
long
Ghi chii: n la sd quan sdt
Trinh dp hpc va'n cua cac dap vien nhdm KHT tap trung phan ldn d bac cao dang va dai hpc (33,3%) va sau dai hpc (20,0%); trong khi do, nhdm DHT cd trinh dp hpc van tiia'p hdn, chu yen la ca'p 1 (23,3%) va cap
2 (33,3%) Nghe nghiep cua cac dap vien bao gdm cdng nhan 31,1%, budn ban va dich vu 31,1%, vien chtfc 20,0%, sinh vien 6,7% va cac nganh nghe khac chie'm 11,1% (Bang 1)
Tud'i dap vien, tdng thanh vien trong hp va tiiu nhap binh quan dau ngtfdi tren tiiang cua hp dtfdc the Men d Bang 2 Tudi ciia dap vien dao dpng ttf 19 de'n 69 tud'i, trung binh la 42,7 tud'i va khong cd stf khac biet
ve tudi dap vien gitfa nhdm KHT va nhdm DHT qua phep thtf t-test d mtfc y nghla 5% So' tiianh vien trung binh mdi hp d nhdm KHT va DHT lan Itfdt la 4,13 va 3,63 ngtfdi/hp, chi tieu nay cung khdng khac biet gitta hai nhdm hp khao sat (P>0,05) Ttfdng ttf, tiiu nhap binh quan dau ngtfdi gitfa 2 nhdm hp cung khdng khac biet qua thd'ng ke, ddi vdi nhdm KHT thu nhap binh quan dau ngtfdi la 3,81 trieu ddng/ngtfdi/thang va nhdm DHT
la 3,23 trieu ddng/ngtfdi/thang
Bdng 2: Tudi ddp vien, tdng thdnh vien trong ho vd thu nhap binh qudn ddu ngUdi tren thdng cua ho duac phong vd'n
1
4
4
5
10
6
30
2
7 II
10 "
5
6
30
3,3 13,3 13,3 16,7 33,3 20,0
100,0
6,7 23,3 30,3 16,7 20,0
100,0
2
14
20
11
12
1
60
26
11
18
1
4
60
3,3 23,3 33,3 18,3 20,0 1.7
100,0
43,3 18,3 30,0 1,7 6,7
100,0
3
18
24
16
22
7
90
28
18
28
6
10
90
3,3 20,0 26,7 17,8 24,4 7,8
100,0
31,1 20,0 31,1 6,7 11.1
100,0
So sanh giffa hai nhdm
Nhdm Nhdm P-value
khdng hut dang hut
Tudi dap vidn (tudi)
Tong thanh vien (ngtfdi/hp)
TNBQ (trieu/ngtfdi/thang)
40,9 4,13 3,81
43,7 3,63 3,23
0,373 0.113 0,177
Tdng chung Trung Nhd Ldn nha't binh nhat
1 7 3,42 0,9 10,0
Ghi chii: TNBQ = thu nhgp binh qudn
Nhin chung, cac chi tidu cd ban ve thdng tin dap vien va hp khdng khac biet gitta 2 nhdm dang khao sat Day la da'u hieu td't ve tinh khach quan cua vide lay man nghien ctfu, lam tang dp tin cay khi so sanh anh htfdng cua hiit thud'c la de'n cac thdng so' ve chi tieu va stfc khde trong ke't qua nghien ctfu
3.2 Hidn trang hut thud'c la
3.2.1 Tudi bdt ddu hut thudc Id
Kd't qua nghien ctfu cho tha'y tmng binh tudi bat dau hiit thud'c la ciia ngtfdi dan quan Ninh Kieu la 19,9 tud'i; trong do dtfdi 18 tudi chid'm 11,7%, ttf 18 de'n 24 tud'i chie'm 75,0% va tren 28 tud'i chie'm 13,3% (Bang 2) Nhieu nghien ctfu chi ra rang tudi bat dau hiit thud'c cang tre thi nguy cd nghien thud'c cang cao; qua dp tudi nhtf da trinh bay thi tud'i bat dau hut thud'c la d thanh thie'u nien quan Ninh Kieu chie'm ty 16 kha cao, day se la mpt hid'm hpa ldn cho gia dinh va xa hdi ndn can dtfdc quan tam nhieu hdn, nha't la stf khuyen nhii cua gia dinh, tuyen truyen trong nha trtfdng, doan thanh nidn-hdi sinh vidn va tren cac phtfdng tidn thdng tin dai chung nham giiip tudi tre nang cao nhan thtfc ve tac hai cua thud'c va thtfc hidn khau hieu "Hay ndi khdng vdi thud'c la!"
Bdng 2: Tudi bat ddu hut thudc Id eda ngUdi ddn d qudn Ninh Kieu
Tuoi bdt dau hiit Soltfcfng
Dtfdi 18 tudi
Ttf 18 de'n 24 tuoi
Ting
T i l e ( % )
11,7 75,0 13,3
100,0
Trang 3NGHIEN cufu-TRAO DOI
3.2.2 Sddie'u thudc Id hut moi ngdy
60 1
E 40
is
c
Q 20
-*
Dir6M0di4u Ti>11 dln20ai^u Tr«n20(3i^u
s6 thu6c hCit (ai^u/ngi/*i/ngSy)
//m/z 1: Ty le ngUdi hiit thudc Id theo sd luang
thudc hut moi ngdy d qudn Ninh Kieu
Tac hai cua vide hiit thud'c la ttfdng quan vdi sd die'u thud'c la hiit mdi ngay Hinh 1 cho bie't cd 33,3% ngtfdi hiit thud'c la hiit dtfdi 10 die'u/ngay, ttf 11 de'n 20 die'u chie'm 58,3% va tren 20 die'u chie'm 8,3% Ke't qua dieu tra cdn cho tha'y binh quan mdi ngtfdi htit thud'c la d quan Ninh Kieu stf dung 16,7 die'u thudc/ ngay Nghien ctfu tren toan qud'c nam 2010 thi con sd nay la 13,5 die'u/ngtfdi/ngay (GATS, 2010) Nhtf vay Itfdng thud'c la tieu thu binh quan mdi ngtfdi mpt ngay ciia ngtfdi dan d quan Ninh Kieu cao hdn so vdi binh quan ca ntfdc
3.2.3 Nhan hieu thudc hut
Cac nhan hieu thud'c la ngtfdi dan d quan Ninh Kieu stf dung nhieu nha't la Hero (47%) va Jet (40%), ke' de'n la Caraven (con meo) chie'm 10% va cac nhan hieu khac nhtf 555, Basto chie'm 3% (Hinh 2) Hero
va Jet la hai mat hang thud'c la lau chie'm de'n 90% thi trtfdng thudc la lau d Viet Nam (CAST, 2010) Viec stf dting cac mat hang thud'c la lau nay gay that thu ldn cho nha ntfdc Tuy nhien, cac bien phap phong chd'ng thud'c la lau Hero va Jet ttf Campuchia qua Viet Nam v i n chtfa that stf hieu qua Cd the mpt trong nhttng bien phap "gd'c r e " de khdng cdn finh trang thud'c la lau hien nay la tuyen truyen de ngtfdi hiit thud'c la chpn cac san pham san xua't trong ntfdc hay nhap khau hdp phap thay vi thdi quen stf dung Hero
va Jet nhap lau nhtf ke't qua khao sat d quan Ninh Kieu trong nghien ctfu nay
3.2.4 Nai hut thudc Id
Ke't qua fim hie'u ve ndi hiit thudc la cua ngtfdi dan quan Ninh Kieu dtfdc trinh bay d Bang 3 Qua do cho tiia'y ndi hiit thud'c la phd bie'n nha't la d nha (76,7%), ke tie'p la ndi lam viec (70,0%), d cac quan ca phe, quan nhau (61,7%) va ndi cdng cpng (56,7%) Ngtfdi hiit thud'c la cung cho bie't hp hiit liic nghi ngdi (65,0%), liic giao tie'p vdi ban be, khach hang (38,3%), liic lam vide (33,3%) hay luc bi cang thang (23,3%)
Bdng 3: Nai hiit thudc Id cua ngUdi ddn qudn Ninh Kieu
Hinh 2: Ty le cdc nhdn hieu thudc Id duac ngUdi
tieu dUng sd dung d qudn Ninh Kieu
Ndi hiit
Hut liic
Dac diem
Nha Ndi lam viec Ndi cdng cdng Ndi khac (quan ca phd, quan nhSu, v.v) Liic nghi ngdi
Liie giao tie'p vdi ban be, khach hang Liic lam vide
Liie hi cang thang (stress) i^
Tild(%)
76,7 70,0 56,7 61,7 65,0 38,3 33,3
.~~ ^„„„w »„ xviiv^AA.^ v-iii u i i i i i i u v j j g yi.\^ix ju>^ jvuvjv^ i^ua uan m a i l i i g u u i iiuL i i i a w u u a i i u i i u u u g
nhttng ngtfdi xung quanh (hut thud'c la thu dpng) Theo Hidp hdi Ung thtf My, ctf mdi gid d cung phdng vdi ngtfdi hiit thud'c la, nguy cd mac ung thtf phdi cao gap 100 lan so vdi vide sd'ng 20 nam trong tda nha ehtfa
<sS.:; 23,3 ::^^ Ghi chii: cdu hdi co nhieu lua chpn
Viec hut thudc la khdng chi anh htfdng de'n stfc khde cua ban than ngtfdi hiit ma cdn anh htfdng de'n
: vdi mpt song ZU nam trong tda nha ehtfa chat ddc asen Ngtfdi thtfdng xuyen hit phai khdi thud'c la cd nguy cd bi ung thtf phd'i cao hdn 26% so vdi ngtfdi khdng hit phai khdi thude la Hiit thud'c la thu ddng edn la mdt trong cac tae nhan gay nhieu benh ve tim mach, phd'i, lam suy giam chtfe nang hd ha'p va anh htfdng tdi chtfc nang sinh san d ca nam va ntt (CDC Hoa Ky, 2006) Viec hiit thud'c la cua ngtfdi dan quan Ninh Kieu cho dii d nha hay ndi edng sd, ndi cdng cpng, cae quan ea phe, quan nhau ma khdng cd phdng hiit rieng chac chan se anh htfdng ldn dd'n stfc khde ngtfdi than va cdng dong
Do do, tuyen truyen eho ngtfdi dan khdng hiit thud'c d ndi cdng cdng va bd tri cac phdng danh rieng cho ngtfdi htit thude la d nhtfng ndi nay la rat can thie't
Trang 4NGHIEN c a u - T R A O DOI
3.3 Anh htfoTng cua hut thud'c la dd'n chi tidu
chi cho thtfc pham chiem 50,6%, chi giao due 14,5%, cae khoan gas-dien-ntfdc 7,8%, stfc khde 4,4%, tiidng tin Uen lac 3,9%, thud'c la 1,5% va cae chi phi khac 17,4% Trong khi dd, tdng chi phi cua nhdm DHT la 8,2 trieu dong/tiiang/hp; trong dd chi thtfc pha'm 50,2%, giao due 6,6%, gas-dien-ntfdc 6,9%, stfc khde 4,5%, thdng tin Uen lac 3,9%, tiiudc la 6,5% va cac chi phi khae 21,5% (Bang 4) Bao eao dieu tra ve mtfc sd'ng nam 2012 eho bie't ehi phi an ud'ng va hiit trung binh cua ngtfdi dan DBSCL chie'm khoan 52,9% tdng chi tieu (Td'ng cue Thdng
ke, 2013) Nhtf v | y , ke't qua dieu tra d quan Ninh Kieu trong nghien ctfu nay cung ttfdng dtfdng vdi bao eao tren (chi tiitfc pha'm va thudc la d nhdm khdng hiit thudc chie'm 52,1% va nhdm hiit thudc chie'm 56,7% td'ng cac khoan ehi tieu)
Bdng 4: So sdnh chi tieu giita nhom khong hiit thudc vd dang hiit thudc
Ac khoan chi
Nhdm khdng hiit thuoc Gia tri (ngan Ty le (%) dong/hd/thang)
Nhdm dang hiit thudc Gia trj (ngan Ty Id (%) dong/ho/thang)
P-Value
Thtfc pham
Giao due
Gas, dien, ntfdc
Stfc khde
Thdng tin lien lac
Thud'c la
Khac
Td'ng
4.723 1.350
725
409
368
139 1.622 9.355
50,6 14,5 7,8 4,4 3,9 1.5 17,4 100,0
4.093
537
560
368
318
528 1.757 100,0
50,2 6,6 6,9 4,5 3,9 6,5 21,5 8.160
0,277 0,001 0,046 0,759 0,417 0,000 0,720 0,262
0.6
J
1.0 1.0
III
Gas, di$n nirdc TTi6ng tin lifin lac Giclodgc ThLi6cB
Hinh 3: So sdnh chi tieu cho thud'c Id vdi mot so'khodn
chi khde eua nhdm dang hut thude
Qua do cho tha'y chi phi cho viee mua thude la ttfdng dd'i ldn, ddi vdi nhdm DHT la 528 ngan ddng/hp/thang So' tien nay ttfdng dtfdng vdi chi phi eho giao due hay tdng ehi cho cae khoan gas-dien-ntfdc cua hp Neu so vdi chi phi stfc khde hay thdng tin lien lac thi chi cho hut thud'c
la tiiam chi cdn ldn hdn (Hinh 3) Da sd (87%) nhttng ngtfdi htit thud'c la cho rang bd hiit thud'c
se dd gay tdn that ve kinh te' eho gia dinh Nhtf vay, ne'u bd hiit thud'c thi so' tien chi cho thud'c la
cd the stf dung cho cae mue dich khac hieu qua hdn, nha't la trong bd'i eanh kinh te' khd khan, thu nhap bap benh nhtf hien nay
3.4 Anh htfo^ng cua hut thud'c la dd'n stfc khoe
3.4.1 Nhan thde ve benh do thudc Id
Nhan thtfc eua dap vien ve benh do thud'c la gay ndn dtfde trinh bay d Hinh 4 Hau het ngtfdi dan d hai nhdm khao sat deu nhan ra rang htit thud'c la gay nen ung thtf phdi va cae benh lien quan de'n hd ha'p, nhtflig dd'i vdi benh tim mach thi chi 42% dap vien cua nhdm khdng hiit thud'c va 47% eua nhdm dang hiit thud'c nhan thtfc dtfdc thud'c la ed anh htfdng dd'n benh nay Ridng anh htfdng cua thudc la de'n stfc khde sinh
san va bdnh rang mieng thi rat it ngtfdi nhan ra (Hinh 4) Theo cac ehuyen gia y te' thi hiit thude
la la nguyen nhan cua 25 can bdnh, trong do ed nhieu benh nguy hiem nhtf ung thtf phdi, bdnh phdi tac nghen man tinh, nhoi mau cd tim, xd vtfa dpng mach va eae bdnh khae nhtf ung thtf vdm hong, ung thtf da, loang xtfdng, ung thtf thanh quan, phd' quan, due nhan mat, loet da day, liet dtfdng, giam kha nang sinh san v.v do khdi thudc
la cd chtfa hdn 7.000 chat hoa hpe, trong dd ed nicotine la chat gay nghidn va khoang 70 chat la tae nhan gay ung thtf Ngtfdi nghidn thude la cd
1 1 J
E Khong hut thuoc
I Gang hut thuoc
1
Ung thi/ phSi B$nli tio hip Bf nh dm m?ch Si>c khie sinh sin B#nh ring mifng
Hinh 4: Nhdn thde eda ddp vien ve benh do thude Id
tqi qudn Ninh Kieu
TAP CHf KHOA HQC CAN THO 27
Trang 5Benh tim mach \ 2% \
Anh hirang v l
- rang mieng 7%
Hinh 5: Ty le mac benh lien quan den thudc Id ciia nhom dang hut thude d qudn Ninh Kieu
NGHIEN cufu-TRAO DPI
nguy cd ttf vong cao gap 2,5 de'n 10 lan so vdi ngtfdi khdng hiit thud'c la (GATS, 2010) Tuy nhien, trong nghien ctfu nay chi ed 27% ngtfdi hut thude la cho rang hut thud'c la cd anh htfdng nhieu de'n stfc khde ban than Nhtf vay, mac dii ngtfdi dan cd hie'u bie't ve tac hai cua thud'c la gay nen mpt sd bdnh nhtflig stf hie'u bie't nay vSn cdn han che' Do do, viec nang cao nhan thtfc eua edng ddng ve tae hai cua thud'c la can phai dtfde quan tam hdn ntfa
3.4.2 Nhilm benh lien quan den thudc id
Ddi vdi nhtfng ngtfdi DHT, cd 37% cho bie't
khdng bi cac benh Uen quan de'n thud'c la, 54% bi benh
Uen quan de'n hd ha'p, 7% Uen quan de'n rang ntfeng
va 2% Uen quan de'n tim mach (Hinh 5) Chi phi kham
ehtfa cac benh Uen quan de'n thudc la ciing ttfdng dd'i
cao, binh quan 243 ngan ddng/ngtfdi/thang Mae dii d
day cac dap vien khdng de cap de'n benh ung thtf phdi
nhtfng dieu nay chtfa h i n la hp khdng bi, ed the hp hi
cac benh Uen quan de'n hd ha'p nhtfng chtfa phat hien
vi phan ldn ngtfdi dan chi di xet nghiem ung thtf khi
cd trieu chtfng nang Hien tai, Benh vien Lao va Phdi
tai Can Thd dang theo doi va dieu tri 714 benh nhan
hi benh phdi tac nghen man tinh, theo cae ehuyen gia
y te' tai day thi "Khoang 90% benh nhan mac benh
phdi tae nghen man tinh la do thude la, hiit thud'c la
gay hau qua am tham lau dai, khdng bpe lp ngay trtfdc mat nen gidi tre, ngtfdi mdi hut thud'c khdng tha'y dtfdc de' bd thud'c hay tranh hut thude" (Le Anh, 2014)
4.Klftluanvakllfnngli|
Nghien ctfu ve hien trang hiit thud'c la va anh htfdng eua hiit thude la de'n chi tieu va stfc khde eua ngtfdi dan d quan Ninh Kieu, thanh phd Can Thd riit ra dtfde mpt so' ke't luan nhtf sau:
Tudi bat dau hiit thud'c la la 19,9 tudi
- So' die'u thud'c hiit binh quan mdi ngay la 16,7 die'u
Hero va Jet la hai nhan hieu dtfdc ngtfdi tieu dung stf dung vdi ty le rat eao, nhtfng day lai la hai loai thude nhap lau;
Ngtfdi hiit thude la ed the hiit d mpi ndi, mpi liic, nhtfng phd bie'n nha't la cae ndi edng cpng nen anh htfdng khdng chi cho ban than hp ma cdn cho nhtfng ngtfdi xung quanh;
- Chi tieu cho thud'c la ttfdng dd'i ldn, chie'm 6,5% tdng ehi tidu gia dinh eua nhdm DHT, so' tien nay ttfdng dtfdng vdi chi cho gas-dien-ntfdc hay ehi cho giao due cua con em hp;
Nhan thtfc cua ngtfdi dan ve tac hai cua thud'c la cdn han che, phan ldn cho rang hiit thudc la ehi lien quan de'n benh ung thtf phdi va benh hd ha'p;
Dd'i vdi nhdm dang hiit thud'c, 63% dap vien bi nhidm cae bdnh lien quan dd'n thudc la (hd ha'p, rang mieng, tim mach) va phi dieu tri cac benh nay binh quan d mtfc 243 ngan ddng/ngtfdi/thang
De han che' tac hai do thud'c la gay ndn, de tai cd mdt so' kie'n nghi nhtf sau:
Tuyen truyen, nang cao nhan thtfc cho ngtfdi dan, nha't la thanh thid'u nidn ve tae hai eua thud'c la de'n ban than ngtfdi hiit eiing nhtf de'n gia dinh va epng ddng Viee tuyen truyen nay nen ke't hdp bang nhieu hinh thtfc thdng qua phtfdng tien thdng tin dai ehiing, nha trtfdng, doan thanh nien, v.v.;
Tuyen truyen cho ngtfdi hiit thud'c khdng stf dting thud'c la nhap lau nhtf Hero va Jet ma nen diing eac san pham san xua't trong ntfdc hoae san pham dtfde nhap khau theo luat phap Viet Nam de tranh that thoat nguon thu ngan sach;
O cae ndi edng cpng, cdng sd phai bd tri phdng hiit thud'c danh rieng eho ngtfdi mud'n hut thud'c de khdng anh htfdng de'n ngtfdi khae;
- Chinh quyen dia phtfdng phai trien khai va giam sat chac che viec thtfc hien Luat Phdng chd'ng tac hai thud'c la tren dia ban
TAI UEU THAM KHAO
Dai hoc y te cong cong va to chu'c Heath Bridge Canada (2010-2011), "Chi phi y te cho 5 benh lien quan den thudc la tai VietNam"
GATS (2010) Dieu tra toan cau ve hiit thudc la d ngtfdi trtfdng thanh tai Viet Nam Ha Noi, 2010
Levy D, Bales, S, Nguyen TL (2006) The role of public policies in reducing smoking anh deaths caused by smoking in Vietnam: Results from the Vietnam tobacco policy simulation model Social Science & Medicine 62 (2006) 18191830
Le Anh (2014) Hut thudc cang sdm hau qua cang nang ne http://www.baocantho.com.vn
Tong cue Thdng ke (2013) Ke't qua khao sat mu'c sdng dan ctf nam 2012 Nha xuat ban thdng ke Ha Noi