The past, present and future of nicotine addiction | Mitch Zeller

Prevodilac: Ivana Krivokuća Lektor: Kristina Radosavljević

I'm going to tell you a story.

Ispričaću vam priču.

I'm going to tell you a story

Ispričaću vam priču

about how the deadliest consumer product imaginable

o tome kako je nastao najsmrtonosniji proizvod koji se može zamisliti.

came to be.

It's the cigarette.

U pitanju su cigarete.

The cigarette is the only consumer product

Cigareta je jedini tržišni proizvod koji,

that, when used as intended,

kada se koristi kako je predviđeno,

will kill half of all long-term users prematurely, later in life.

prevremeno ubije polovinu dugoročnih korisnika, kasnije u životu.

But this is also a story

Ali ovo je takođe priča

about the work that we're doing at the Food and Drug Administration,

o tome šta mi preduzimamo u Upravi za hranu i lekove,

and specifically, the work that we're doing

i konkretno o tome šta radimo

to create the cigarette of the future,

da bismo stvorili cigaretu budućnosti

that is no longer capable of creating or sustaining addiction.

koja više neće moći da stvori i održava zavisnost.

A lot of people think that the tobacco problem or the smoking problem

Mnogi misle da je problem sa duvanom ili sa pušenjem

has been solved in the United States

rešen u Sjedinjenim Državama

because of the great progress that's been made

zbog velikog napretka koji je ostvaren

over the last 40, 50 years,

tokom proteklih 40-50 godina,

when it comes to both consumption and prevalence.

što se tiče korišćenja i rasprostranjenosti.

And it's true;

To jeste istina;

smoking rates are at historic lows.

stopa pušenja nikada nije bila niža u istoriji.

It's true for both adults and for kids.

To važi i za odrasle i za decu.

And it's true that those who continue to smoke

Takođe je tačno da oni koji nastave sa pušenjem

are smoking far fewer cigarettes per day

puše znatno manje cigareta dnevno

than at any time in history.

nego ikada pre u istoriji.

But what if I told you that tobacco use,

Ali šta ako bih vam rekao da upotreba duvana,

primarily because of firsthand and secondhand exposure

pre svega zbog direktne i pasivne izloženosti

to the smoke in cigarettes,

dimu cigarete,

remains the leading cause of completely preventable disease and death

ostaje vodeći uzrok potpuno sprečivih bolesti i smrti

in this country?

u ovoj zemlji?

Well, that's true.

Pa, to je istina.

And what if I told you that it's actually killing more people

I šta ako bih vam rekao da zapravo ubija više ljudi

than we thought to be the case ever before?

nego što smo ikada ranije mislili?

That's true, too.

To je takođe istinito.

Smoking kills more people each year than alcohol, AIDS, car accidents,

Pušenje svake godine ubije više ljudi od alkohola, side, saobraćajnih nesreća,

illegal drugs, murders and suicides combined.

ilegalnih droga, ubistava i samoubistava zajedno.

Year in and year out.

Iz godine u godinu.

In 2014,

Godine 2014,

Dr. Adams's predecessor released

prethodnik dr Adamsa objavio je izveštaj autoriteta za javno zdravlje,

the 50th anniversary Surgeon General's report

povodom 50. godišnjice, u vezi sa pušenjem i zdravljem.

on smoking and health.

And that report upped the annual death toll from smoking,

A taj izveštaj je izneo veći broj smrtnih slučajeva od pušenja godišnje,

because the list of smoking-related illnesses

jer se povećao spisak bolesti koje su povezane sa pušenjem.

got bigger.

And so it is now conservatively estimated

Tako da se sada sa oprezom procenjuje

that smoking kills 480,000 Americans every year.

da pušenje svake godine ubije 480 000 Amerikanaca.

These are completely preventable deaths.

To su potpuno sprečivi smrtni slučajevi.

How do we wrap our heads around a statistic like this?

Kako da shvatimo ovakve statističke podatke?

So much of what we've heard at this conference

Dobar deo onoga što smo čuli na ovoj konferenciji

is about individual experiences and personal experiences.

tiče se pojedinačnih i ličnih iskustava.

How do we deal with this at a population level,

Kako da se pozabavimo ovim na nivou stanovništva,

when there are 480,000 moms,

kada postoji 480 000 majki,

dads, sisters, brothers, aunts and uncles

očeva, sestara, braće, tetki i teča

dying unnecessary deaths every year from tobacco?

koji svake godine umiru od duvana nepotrebnom smrću?

And then what happens when you think about this trajectory

A šta se dešava kada razmislite o ovoj tendenciji

for the future?

u budućnosti?

And just do the simple math:

Samo primenite prostu matematiku:

from the time of the 50th anniversary Surgeon General's report five years ago,

od 50. godišnjice izveštaja o javnom zdravlju pre pet godina,

when this horrible statistic was raised,

kada su objavljeni ti užasni statistički podaci,

just through mid-century --

tek sredinom veka -

that's more than 17 million avoidable deaths in the United States

to je više od 17 miliona sprečivih smrtnih slučajeva u SAD-u

from tobacco use,

usled korišćenja duvana,

primarily because of cigarettes.

prvenstveno zbog cigareta.

The Surgeon General concluded

Portparol za javno zdravlje je zaključio

da će 5,6 miliona dece koja žive u SAD-u 2014. godine

that 5.6 million children alive in the United States in 2014

will die prematurely later in life because of cigarettes.

kasnije u životu umreti prevremeno zbog cigareta.

Five point six million children.

Pet zarez šest miliona dece.

So this is an enormous public health problem for all of us

Dakle, ovo je ogroman problem javnog zdravlja za sve nas,

but especially for us as regulators

ali naročito za nas regulatore

at the Food and Drug Administration and the Center for Tobacco Products.

u Upravi za hranu i lekove i Centru za duvanske proizvode.

What can we do about it?

Šta možemo da uradimo povodom toga?

What can we do to reverse this trajectory of disease and death?

Šta možemo učiniti da preokrenemo ovu putanju bolesti i smrti?

Well, we have an interesting guide to help unravel issues

Pa, imamo zanimljiv vodič

za pomoć u rešavanju problema kao što su:

like: How did the cigarette as we know it come to be?

kako su nastale cigarete kakvim ih znamo?

What is the true nature of the tobacco and cigarette business?

Koja je prava priroda poslovanja sa duvanom i cigaretama?

How did the industry behave

Kako se ova industrija ponašala na ranije neregulisanom tržištu?

in the historically unregulated marketplace?

And our guide

Naš vodič

is previously secret internal documents from the tobacco industry.

predstavljaju prvobitno tajna unutrašnja dokumenta iz duvanske industrije.

Come with me

Pođite sa mnom

in a tobacco industry document time machine.

u vremensku mašinu dokumenata duvanske industrije.

Nineteen sixty-three

Godina 1963.

was 25 years before the Surgeon General was finally able to conclude

bila je 25 godina pre nego što je portparol za javno zdravlje

konačno zaključio da nikotin i cigarete stvaraju zavisnost.

that the nicotine and cigarettes was addictive.

That did not happen until the Surgeon General's report in 1998.

To se nije dogodilo do izveštaja iz 1998. godine.

Nineteen sixty-three

Godina 1963.

was one year before the first-ever Surgeon General's report in 1964.

bila je godina pre prvog izveštaja portparola za javno zdravlje iz 1964. god.

I remember 1964.

Sećam se 1964. godine.

I don't remember the Surgeon General's report,

Ne sećam se izveštaja o javnom zdravlju, ali sećam se 1964. godine.

but I remember 1964.

I was a kid growing up in Brooklyn, New York.

Bio sam dečak koji je odrastao u Bruklinu u Njujorku.

This was at a time

To je bilo u vreme

when almost one in two adults in the United States smoked.

kada je skoro jedna od dve odrasle osobe u Sjedinjenim Državama pušila.

Both of my parents were heavy smokers at the time.

Oba moja roditelja bili su strastveni pušači u to vreme.

Tobacco use was so incredibly normalized

Upotreba duvana je bila tako neverovatno normalizovana

that -- and this wasn't North Carolina, Virginia or Kentucky,

da smo - a ovo nije bila Severna Karolina, Virdžinija ili Kentaki,

this was Brooklyn --

ovo je bio Bruklin -

we made ashtrays for our parents in arts and crafts class.

pravili pepeljare za roditelje na časovima likovnog.

(Laughter)

(Smeh)

The ashtrays I made were pretty awful, but they were ashtrays.

Pepeljare koje sam pravio su bile grozne, ali bile su pepeljare.

(Laughter)

(Smeh)

So normalized that I remember seeing a bowl of loose cigarettes in the foyer

Toliko je to bilo normalno da se sećam da sam viđao

činije sa otpakovanim cigaretama u hodniku naše kuće i drugih kuća

of our house and other houses

as a welcoming gesture when friends came over for a visit.

kao gest dobrodošlice kada bi prijatelji došli u posetu.

OK, we're back in 1963.

U redu, vraćamo se u 1963. godinu.

The top lawyer for Brown and Williamson,

Glavni advokat koji je radio za Braun i Vilijamson,

which was then the third-largest cigarette company in the United States,

tada treću najveću kompaniju cigareta u Sjedinjenim Državama,

wrote the following:

napisao je sledeće:

"Nicotine is addictive.

„Nikotin stvara zavisnost.

Mi smo, prema tome, u poslu prodaje nikotina - droge koja izaziva zavisnost.“

We are, then, in the business of selling nicotine -- an addictive drug."

It's a remarkable statement,

To je izuzetna izjava,

as much for what it doesn't say as for what it does say.

zbog onoga što ne kaže, kao i zbog onoga što kaže.

Nije rekao da se bave poslom sa cigaretama.

He didn't say they were in the cigarette business.

Nije rekao da se bave poslom sa duvanom.

He didn't say they were in the tobacco business.

Rekao je da su u poslu prodaje nikotina.

He said they were in the business of selling nicotine.

Philip Morris in 1972:

Filip Moris 1972. godine:

"The cigarette isn't a product,

„Cigareta nije proizvod,

it's a package.

to je pakovanje.

The product is nicotine.

Proizvod je nikotin.

The pack is a storage container for a day's supply of nicotine.

Pakla je kutija za skladištenje dnevne doze nikotina.

The cigarette, a dispenser for a dose unit of nicotine."

Cigareta je sredstvo za dostavljanje doze nikotina.“

We'll come back to this dose unit notion later.

Vratićemo se tom pojmu doze kasnije.

And R.J. Reynolds in 1972:

R. Dž. Rejnolds 1972. godine:

"In a sense, the tobacco industry may be thought of as being a specialized,

„Na neki način, duvanska industrija se može smatrati specijalizovanim,

highly ritualized and stylized segment of the pharmaceutical industry.

vrlo ritualizovanim i stilizovanim segmentom farmaceutske industrije.

Tobacco products uniquely contain and deliver nicotine,

Duvanski proizvodi na jedinstven način sadrže i oslobađaju nikotin,

a potent drug with a variety of physiological effects."

snažnu drogu sa raznim fiziološkim efektima.“

At the time, and for many decades, publicly,

U to vreme i decenijama pre je, u javnosti,

the industry completely denied addiction

industrija u potpunosti negirala zavisnost

and completely denied causality.

i sasvim poricala uzročnost.

But they knew the true nature of their business.

Ali znali su pravu prirodu svog posla.

And from time to time,

S vremena na vreme,

there have been health scares made public about cigarettes,

u javnosti bi se javila zabrinutost u vezi sa uticajem cigareta na zdravlje,

going back many decades.

mnogo decenija unazad.

How did the industry respond?

Kako je industrija reagovala?

And how did they respond

I kako su reagovali

in this historically unregulated marketplace?

na ovom prethodno neregulisanom tržištu?

Going back to the 1930s,

Ako se vratimo u 1930-e,

it was with advertising that heavily featured imagery of doctors

odgovor su bile reklame sa vrlo istaknutim slikama doktora

and other health care professionals

i drugih zdravstvenih radnika

sending messages of reassurance.

koje su slale poruke razuveravanja.

This is an ad for Lucky Strikes,

Ovo je reklama za Laki strajk,

the popular cigarette of the time in the '30s:

popularne cigarete u to vreme, '30-ih godina.

[20,679 physicians say "Luckies are less irritating."

[20 679 lekara kaže da „Laki manje iritira“.

Your throat protection against irritation, against cough.]

Zaštita grla od iritacije, protiv kašlja.]

(Laughter)

(Smeh)

We laugh,

Smejemo se,

but this was the kind of advertising

ali to je bilo reklamiranje

that was there to send a health message of reassurance.

radi slanja poruke razuveravanja o posledicama po zdravlje.

Fast-forward to 1950s, '60s and '70s.

Premotajmo film na 1950-e, '60-e i '70-e.

And here, again, in the absence of regulation,

I ovde, opet, u nedostatku propisa,

what we're going to see is modifications to the product

videćemo izmene proizvoda

and product design

i dizajna proizvoda

to respond to the health concerns of the day.

da bi odgovorio na tadašnje brige u vezi sa zdravljem.

This is the Kent Micronite filter.

Ovo je filter Kent majkronajt.

And here, the innovation, if you will, was the filtered cigarette.

A ovde je inovacija, može se reći, bila cigareta sa filterom.

[Full smoking pleasure ...

[Potpuno pušačko zadovoljstvo...

plus proof of the greatest health protection ever.]

plus dokazano najbolja zaštita za zdravlje do sada.]

What the smoker of this product didn't know,

Ono što pušač ovog proizvoda nije znao,

what their doctor didn't know,

ono što njegov doktor nije znao,

what the government didn't know,

ono što vlada nije znala

is that this was a filter that was lined with asbestos --

je da je ovaj filter bio obložen azbestom -

(Gasps)

(Uzdah)

so that when smokers were smoking this filtered cigarette

tako da kada su pušači pušili tu cigaretu sa filterom

and still inhaling the chemicals and smoke

i i dalje udisali hemikalije i dim

that we know are associated with cancer and lung disease

za koje znamo da su povezani sa rakom, bolestima pluća

and heart disease,

i srčanim oboljenjima,

they were also sucking down asbestos fibers.

takođe su usisavali vlakna azbesta.

(Gasps)

(Uzdah)

In the 1960s and the 1970s,

Tokom 1960-ih i 1970-ih,

the so-called innovation was the light cigarette.

takozvana inovacija bila je „lajt“ cigareta.

This is a typical brand of the day called True.

Ovo je tipičan tadašnji brend zvani True.

And this is after the Surgeon General's reports have started coming out.

Ovo je nakon što su počeli da izlaze zvanični izveštaji o javnom zdravlju.

And you see the look of concern on her face.

Vidite njen zabrinuti izraz lica.

[Considering all I'd heard,

[S obzirom na sve što sam čula,

I decided to either quit or smoke True.

rešila sam da ili prestanem da pušim, ili da pušim True.

I smoke True.]

Pušim True.]

(Laughter)

(Smeh)

[The low tar, low nicotine cigarette.]

[Cigarete sa malom količinom katrana i nikotina.]

And then it says, "Think about it."

A onda kaže: „Razmislite o tome.“

And then even below that in the small print

Onda ispod toga sitnim slovima

are tar numbers and nicotine numbers.

stoje brojke vezane za količinu katrana i nikotina.

What was a light cigarette?

Šta su bile lajt cigarete?

How did it work?

Kako je to funkcionisalo?

This is an illustration of the product modification

Ovo je ilustracija izmene proizvoda

known as "filter ventilation."

poznata kao „ventilacija filtera“.

Ovo nije uvećana slika pravog filtera.

That's not a real filter blown up.

That's just a picture

To je samo slika

so that you could see the rows of laser-perforated ventilation holes

da možete da vidite linije laserski izbušenih otvora za ventilaciju

that were put on the filter.

koji su stavljani na filter.

When you look at a real cigarette,

Kada pogledate pravu cigaretu,

it's harder to see.

to je teže videti.

Every patent for this product shows

Svaki patent za ovaj proizvod pokazuje

that the ventilation holes should be 12 millimeters

da ventilacioni otvori treba da budu 12 milimetara

from the lip end of the filter.

od kraja filtera koji ide na usnu.

How did it work?

Kako je to funkcionisalo?

The cigarette got stuck into a machine.

Cigaretu bi zaboli u mašinu.

The machine started puffing away on the cigarette

Mašina bi počela da povlači dim iz cigarete

and recording tar and nicotine levels.

i da beleži nivo katrana i nikotina.

As the machine smoked,

Dok bi mašina pušila,

outside air came through those ventilation holes

spoljni vazduh bi prolazio kroz te ventilacione otvore

and diluted the amount of smoke that was coming through the cigarette.

i razblaživao količinu dima koji je prolazio kroz cigaretu.

So as the machine smoked,

Tako da, dok je mašina pušila,

there really was less tar and nicotine being delivered

zaista je oslobađano manje katrana i nikotina

compared to a regular cigarette.

u poređenju sa običnom cigaretom.

What the tobacco industry knew

Duvanska industrija je ipak znala

was that human beings don't smoke like machines.

da ljudska bića ne puše kao mašine.

How do human beings smoke this?

Kako ljudi to rade?

Where do the fingers go?

Gde idu prsti?

(Murmurs)

(Mrmljanje)

Where do the lips go?

Gde idu usne?

I told you that the patent said

Rekao sam vam da patent nalaže

that the holes are 12 millimeters from the lip end.

da otvori budu 12 milimetara od kraja za usnu.

The smoker didn't even know they were there,

Pušači nisu ni znali da su tu,

but between fingers and lips, the holes get blocked.

ali između prstiju i usana, otvori se blokiraju.

And when the holes get blocked, it's no longer a light cigarette.

A kada se otvori blokiraju, to više nije lajt cigareta.

Turns out that there's actually

Ispostavilo se da zapravo postoji

basically as much nicotine inside a light cigarette

praktično ista količina nikotina u lajt cigaretama

as a regular cigarette.

kao i u običnim.

The difference was what's on the outside.

Razlika je bila samo u onome što je spolja.

But once you block what's on the outside,

Ali kada blokirate to što je spolja,

it's a regular cigarette.

to je obična cigareta.

Congress put FDA in the business of regulating tobacco products

Ovog juna će biti 10 godina otkad je Kongres

Upravi za hranu i lekove poverio regulisanje duvanskih proizvoda.

10 years ago this June.

So you heard the statistics at the beginning

Čuli ste na početku statističke podatke

about the extraordinary contribution to disease and death that cigarettes make.

o neverovatnom doprinosu cigareta bolestima i smrtnom ishodu.

We've also been paying a lot of attention

Takođe smo dosta pažnje posvećivali

to how the cigarette works as a drug-delivery device

tome kako cigarete funkcionišu kao sredstvo snabdevanja drogom

and the remarkable efficiency with which it delivers nicotine.

i izuzetnoj efikasnosti u dostavljanju nikotina.

So let's take a look.

Pogledajmo kako to izgleda.

When the smoker puffs on the cigarette,

Kada pušač povuče dim cigarete,

the nicotine from that puff gets up into the brain

nikotin iz tog dima stiže do mozga

in less than 10 seconds.

za manje od 10 sekundi.

Less than 10 seconds.

Manje od 10 sekundi.

Up in the brain,

Gore u mozgu

there are these things called "nicotinic receptors."

postoji nešto što se zove „nikotinski receptori“.

They're there ...

Oni tamo...

waiting.

čekaju.

They're waiting for, in the words of that Philip Morris document,

Čekaju, prema rečima iz tog dokumenta Filipa Morisa,

the next "dose unit of nicotine."

sledeću „dozu nikotina“.

The smoker that you see outside,

Pušač kojeg viđate napolju,

huddled with other smokers,

na gomili sa drugim pušačima,

in the cold,

na hladnoći,

in the wind,

na vetru,

in the rain,

na kiši,

is experiencing craving

doživljava snažnu želju za pušenjem

and may be experiencing the symptoms of withdrawal.

i može prolaziti kroz apstinencijalne simptome.

Those symptoms of withdrawal are a chemical message

Ti apstinencijalni simptomi su hemijska poruka

that these receptors are sending to the body,

koju ti receptori šalju telu,

saying, "Feed me!"

poručujući: „Nahrani me!“

And a product that can deliver the drug in less than 10 seconds

Za proizvod koji može da dostavi drogu za manje od 10 sekundi

turns out to be an incredibly efficient and incredibly addictive product.

ispostavilo se da je neverovatno efikasan i da neverovatno stvara zavisnost.

We've spoken to so many addiction treatment experts

Razgovarali smo sa toliko stručnjaka za lečenje bolesti zavisnosti

over the years.

proteklih godina.

And the story I hear is the same over and over again:

Priča koju slušam je uvek ista, iznova i iznova:

"Long after I was able to get somebody off of heroin

„Mnogo nakon što uspem da nekog skinem sa heroina,

or cocaine or crack cocaine,

kokaina ili kreka,

I can't get them to quit cigarettes."

i dalje ne mogu da postignem da prestanu da puše cigarete.“

A large part of the explanation is the 10-second thing.

Veliki deo objašnjenja za to jeste ono što sam govorio o 10 sekundi.

FDA has it within its regulatory reach

Uprava za hranu i lekove u cilju regulacije ima na raspolaganju

to use the tools of product regulation

sredstva za regulisanje proizvoda

to render cigarettes as we know them minimally or nonaddictive.

da bi postigla da cigarete kakve znamo

ne stvaraju ili minimalno stvaraju zavisnost.

We're working on this.

Radimo na tome.

And this could have a profound impact at a population level

To bi moglo da ima ogroman uticaj na nivou populacije,

from this one policy.

samo jedan takav propis.

Pre godinu dana smo sproveli dinamično modeliranje na nivou populacije,

We did dynamic population-level modeling a year ago,

and we published the results in "The New England Journal."

i objavili smo rezultate u „Časopisu Nove Engleske“.

And because of the generational effect of this policy,

Zbog generacijskog dejstva ove strategije,

which I'll explain in a minute,

što ću objasniti za minut,

here's what we project out through the end of the century:

evo šta predviđamo do kraja veka:

more than 33 million people

više od 33 miliona ljudi

who would otherwise have gone on to become regular smokers won't,

koji bi inače bili svakodnevni pušači to neće postati,

because the cigarette that they'll be experimenting with

jer cigarete sa kojima će eksperimentisati

can't create or sustain addiction.

neće stvarati i održavati zavisnost.

This would drive the adult smoking rate down to less than one and a half percent.

To bi smanjilo stopu pušenja kod odraslih na manje od jednog i po procenta.

And these two things combined

Te dve svari zajedno

would result in the saving of more than eight million cigarette-related deaths

bi kao rezultat imale sprečavanje

više od osam miliona smrti povezanih sa pušenjem

that would otherwise have occurred

koje bi se inače dogodile

from the generational impact of this.

usled generacijskog uticaja ovoga.

Now, why am I saying "generational"?

Zašto kažem „generacijskog“?

It's about kids.

Radi se o deci.

Ninety percent of adult smokers started smoking when they were kids.

Devedeset posto odraslih pušača počelo je da puši kada su bili deca.

Half of them became regular smokers

Polovina njih postanu stalni pušači

before they were legally old enough to buy a pack of cigarettes.

pre nego što dostignu starost da zakonski mogu da kupe paklu cigareta.

Half of them became regular smokers before they were 18 years old.

Polovina njih postanu pušači pre nego što napune 18 godina.

Experimentation.

Eksperimentisanje.

Regular smoking.

Svakodnevno pušenje.

Addiction.

Zavisnost.

Decades of smoking.

Decenije pušenja.

And then the illness,

I zatim sledi bolest,

and that's why we're talking about a product

i zato govorimo o proizvodu

that will kill half of all long-term users prematurely later in life.

koji će kasnije u životu prevremeno ubiti polovinu dugoročnih korisnika.

The generational impact of this nicotine-reduction policy

Generacijski uticaj ove strategije smanjenja nikotina

is profound.

je ogroman.

Those old industry documents had a word for young people.

U tim starim dokumentima industrije postojao je termin za mlade.

They were described as "the replacement smokers."

Opisivani su kao „zamenski pušači“.

The replacement smokers for addicted adult smokers

Zamenski pušači za odrasle pušače zavisnike

who died or quit.

koji su umrli ili prestali da puše.

Future generations of kids, especially teens,

Buduće generacije dece, a naročito tinejdžeri,

are going to engage in risky behavior.

ulaziće u rizične aktivnosti.

We can't stop that.

To ne možemo da zaustavimo.

But what if the only cigarette that they could get their hands on

Ali šta bi bilo kada jedine cigarete kojih bi mogli da se domognu

could no longer create or sustain addiction?

ne bi više mogle da stvore i održavaju zavisnost?

That's the public health return on investment

To je povraćaj ulaganja javnog zdravlja

at a population level over time.

koji se vremenom ostvaruje na nivou stanovništva.

Haven't said anything about e-cigarettes.

Ništa nisam rekao o elektronskim cigaretama.

But I have to say something about e-cigarettes.

Ali moram da kažem nešto o elektronskim cigaretama.

(Laughter)

(Smeh)

We are dealing with an epidemic of kids' use of e-cigarettes.

Suočavamo se sa epidemijom upotrebe elektronskih cigareta kod dece.

And what troubles us the most,

Ono što nas najviše od svega muči,

in combination with the rising numbers when it comes to prevalence,

u kombinaciji sa povećanjem brojeva kada se radi o rasprostranjenost,

is frequency.

je učestalost.

Not only are more kids using e-cigarettes,

Ne samo da sve više dece koristi elektronske cigarete,

but more kids are using e-cigarettes 20 or more days in the past 30 days

već više dece koristi elektronske cigarete 20 ili više dana u mesecu

than at any time since e-cigarettes came onto the market.

otkad su se elektronske cigarete pojavile na tržištu.

And at FDA, we're doing everything that we can

U Upravi za hranu i lekove činimo sve što možemo

using program and policy,

koristeći program i zakone,

first to get the word out to kids

najpre da bismo doprli do dece

that this is not a harmless product

sa porukom da to nije bezopasan proizvod,

and to make sure that kids aren't initiating and experimenting

i da bismo se postarali da deca ne započinju eksperimentisanje

on any tobacco product,

sa duvanskim proizvodima, bilo da je sagorevanje tu prisutno ili ne.

whether combustion is present or not.

But think about e-cigarettes in a properly regulated marketplace

Ali razmislite o elektronskim cigaretama na pravilno regulisanom tržištu

as something that could be of benefit

kao o nečemu što bi moglo koristiti

to addicted adult cigarette smokers

odraslim pušačima zavisnim od cigareta

who are trying to transition away from cigarettes.

koji pokušavaju da tako ostvare prelaz.

So, I'll leave you with this vision:

Zaključiću ovom vizijom:

imagine a world

zamislite svet

where the only cigarette that future generations of kids

u kome jedine cigarete sa kojima bi buduće generacije dece

could experiment with

mogle da eksperimentišu

could no longer create or sustain addiction

ne bi više mogle da stvaraju niti održavaju zavisnot

because of a single policy.

zbog jednog jedinog propisa.

Imagine a world

Zamislite svet

where health-concerned cigarette smokers,

u kome bi pušači zabrinuti za zdravlje,

especially if a policy goes into effect

naročito ako stupi na snagu propis koji smanjuje nikotina na nivo

that takes the nicotine levels down to minimally or nonaddictive levels,

koji ne stvara ili minimalno stvara zavisnost,

could transition to alternative and less harmful forms

mogli da pređu na alternativne i manje štetne oblike

of nicotine delivery,

snabdevanja nikotinom,

starting with FDA-approved nicotine medications,

počevši od nikotinskih lekova odobrenih od strane Uprave,

like the gum, patch and lozenge.

kao što su žvake, flasteri i pastile.

And finally,

I najzad,

imagine a world and a properly regulated marketplace,

zamislite u svetu valjano regulisano tržište gde,

whether it's e-cigarettes or whatever the technology of the day,

bilo da se radi o elektronskim cigaretama ili koja god da je to nova tehnologija,

it's not the product developers and the marketers

nisu pronalazači proizvoda i prodavci

who decide which products come to market

ti koji odlučuju koji proizvodi stupaju na tržište i šta se tvrdi o njima,

and what claims get made for them,

it's review scientists at FDA,

već su to naučnici Uprave zaduženi za kontrolu,

who look at applications

koji pregledaju prijave i odlučuju,

and decide, using the standard that Congress has entrusted us

koristeći pri tome standarde koja nam je Kongres poverio

to implement and enforce,

da ih sprovodimo i primenjujemo,

whether a particular product should come to market,

o tome da li određeni proizvod treba da se pojavi na tržištu,

because the marketing of that product and the words of our law

da bi marketing tog proizvoda i slova naših zakona

would be appropriate for the protection of the public health.

bili prikladni za zaštitu javnog zdravlja.

These are the kinds of powerful regulatory tools

To su moćna regulatorna sredstva

that are within our reach

koja su nam unutar dometa

to deal with what remains

za borbu sa onim što je još uvek vodeći uzrok

the leading cause of completely preventable disease and death

sasvim sprečivih bolesti i smrtnih slučajeva u zemlji.

in the country.

If we get this right,

Ako ovo uradimo ako treba,

that trajectory, those 5.6 million kids,

ona putanja, onih 5,6 miliona dece,

is breakable.

može se narušiti.

Thank you.

Hvala.

(Applause)

(Aplauz)