1 Department of Community Medicine， University of Hong Kong， 21 Sassoon Road， Pokfulam， Hong Kong， China，2 Department of Health， Student Health Service， 4/F Lam Tin Polyclinic， Kowloon， Hong Kong， China，3 Nuffield Department of Clinical Medicine， University of Oxford， Oxford OX2 6HE Introduction Passive smoking can cause death from lung cancer and coronary heart disease， but there is little evidence for associations with other causes of death in never A recent study showed increased all cause mortality with exposure to secondhand smoke at home but did not examine associations with specific causes of death and dose-response 1 We have published estimates of the mortality attributable to active smoking in Hong Kong2 and now present the related findings on passive smoking at Participants， methods， and results Details of the sample selection and data collection have been 2 Each person who reported a death in 1998 at four death registries was given a questionnaire which asked about the lifestyle 10 years earlier of the decedent and of a living person about the same age who was well known to the Passive smoking was identified in the interview with the question， "Ten years ago， in about 1988， excluding the decedent/control， how many persons who lived with the decedent/control smoked" Decedents or controls who lived with one or more smokers were classed as Cause of death was obtained from the death We selected never smoking decedents and controls aged 60 years or over because there were few younger To avoid selection bias， we included only cases and controls who had a living spouse at the time of We used logistic regression to derive odds ratios adjusted for age and education， and for sex when men and women were What is known on this topic There is strong evidence that passive smoking is causally associated with death from lung cancer， coronary heart disease， and all causes， and also with acute stroke What this study adds The dose-response relation between passive smoking and mortality from stroke and chronic obstructive pulmonary disease， as well as from lung cancer， ischaemic heart disease， and all causes of death， strengthens the causal link We identified 4838 never smoking cases (55% male) and 763 never smoking controls (55% male) All controls were used in the analysis for each specific cause of We found significant dose dependent associations between passive smoking and mortality from lung cancer， chronic obstructive pulmonary disease， stroke， ischaemic heart disease， and from all cancers， all respiratory and circulatory diseases， and all causes (table) The association between mortality and passive smoking did not differ between males and Deaths due to injury or poisoning were not associated with passive Number of subjects who were or were not exposed to secondhand smoke at home and odds ratios (adjusted for age and education， and for sex when men and women were combined) for mortality in people aged 60 or over， Hong K Values are odds ratio (95% confidence interval) unless indicated otherwise Comment Dose dependent associations between passive smoking and causes of death are consistent with previous findings for lung cancer and coronary heart disease and extend the evidence on Previous studies have shown associations between passive smoking and first acute strokes，3 4 and we have now shown a dose-response relation with mortality from Previous studies focused on ischaemic strokes but Chinese populations have a greater incidence of haemorrhagic stroke than do white populations，5 implying that many of the strokes in our study may have been non- Passive smoking probably affects all stroke subtypes， as does active Our finding of a 34% increase in all cause mortality is consistent with but higher than that (15%) in the New Zealand 1 Exposure to secondhand smoke at home is higher in Hong Kong than in New Zealand due to crowded living Before the 1990s， awareness of the danger of passive smoking was lower and smokers smoked freely at We focused on passive smoking at home because the proxy reporter could most reliably supply these data， and we adjusted for education， which was also reliably recorded2 and is a good proxy for social class in Hong K As data on cases and controls were derived from the same proxy， reporting bias should be 2 If our results are not due to residual confounding， they provide further evidence that the dose-response associations between passive smoking and stroke and all cause mortality are likely to be See Editorial by Kawachi This article was posted on on 27 January 2005: We thank W L Cheung for help with analysis; the Immigration Department of the Government of the Hong Kong Special Administrative Region for data and assistance; and， in particular， the relatives who provided Contributors: THL， SYH， AJH， KHM， and RP designed and carried out the study on which this analysis was based; SMcG， MS， LMH， and GNT planned and carried out this analysis; and all authors contributed to writing the SMcG and THL are Funding: Hong Kong Health Services Research Committee (#631012) and Hong Kong Council on Smoking and H Competing interests: THL is vice chairman and AJH a former chairman of the Hong Kong Council on Smoking and H Ethical approval: Ethics Committee of the Faculty of Medicine， University of Hong K References Hill SE， Blakely TA， Kawachi I， Woodward A Mortality among never smokers living with smokers: two cohort studies， 1981-4 and 1996- BMJ 2004;328: 988- Lam TH， Ho SY， Hedley AJ， Mak KH， Peto R Mortality and smoking in Hong Kong: case-control study of all adult deaths in BMJ 2001;323: 361- Bonita R， Duncan J， Truelson T， Jackson RT， Beaglehole R Passive smoking as well as active smoking increases the risk of acute Tobacco Control 1999;8: 156- Iribarren C， Darbinian J， Klatsky AL， Friedman GD Cohort study of exposure to environmental tobacco smoke and risk of first ischemic stroke and transient ischemic Neuroepidemiology 2004;23: 38- Kay R， Woo J， Kreel L， Wong HY， Teoh R， Nicholls MG Stroke subtypes among Chinese living in Hong Kong: the Shatin stroke Neurology 1992;42: 985-
means of mum`s loveTime is running out for my While we are sitting at lunch she casually mentions she and her husband are thinking of starting a "We're taking a survey，"she says， half- "Do you think I should have a baby?" "It will change your life，" I say， carefully keeping my tone "I know，"she says， "no more sleeping in on weekends， no more spontaneous " But that's not what I mean at I look at my friend， trying to decide what to tell I want her to know what she will never learn in childbirth I want to tell her that the physical wounds of child bearing will heal， but becoming a mother will leave her with an emotional wound so raw that she will be vulnerable I consider warning her that she will never again read a newspaper without thinking: "What if that had been MY child?" That every plane crash， every house fire will haunt That when she sees pictures of starving children， she will wonder if anything could be worse than watching your child I look at her carefully manicured nails and stylish suit and think that no matter how sophisticated she is， becoming a mother will reduce her to the primitive level of a bear protecting her I feel I should warn her that no matter how many years she has invested in her career， she will be professionally derailed by She might arrange for child care， but one day she will be going into an important business meeting， and she will think her baby's sweet She will have to use every ounce of discipline to keep from running home， just to make sure her child is all I want my friend to know that every decision will no longer be That a five-year-old boy's desire to go to the men's room rather than the women's at a restaurant will become a major The issues of independence and gender identity will be weighed against the prospect that a child molester may be lurking in the However decisive she may be at the office， she will second-guess herself constantly as a Looking at my attractive friend， I want to assure her that eventually she will shed the added weight of pregnancy， but she will never feel the same about That her own life， now so important， will be of less value to her once she has a She would give it up in a moment to save her offspring， but will also begin to hope for more years—not to accomplish her own dreams—but to watch her children accomplish I want to describe to my friend the exhilaration of seeing your child learn to hit a I want to capture for her the belly laugh of a baby who is touching the soft fur of a dog for the first I want her to taste the joy that is so real it My friend's look makes me realize that tears have formed in my "You'll never regret it，" I say Then， squeezing my friend's hand， I offer a prayer for her and me and all of the mere mortal women who stumble their way into this holiest of 时光任苒，朋友已经老大不小了。我们坐在一起吃饭的时候，她漫不经心地提到她和她的丈夫正考虑要小孩。“我们正在做一项调查，”她半开玩笑地说。“你觉得我应该要个小孩吗？”“他将改变你的生活。”我小心翼翼地说道，尽量使语气保持客观。“这我知道。”她答道，“周末睡不成懒觉，再也不能随心所欲休假了……”但我说的绝非这些。我注视着朋友，试图整理一下自己的思绪。我想让她知道她永远不可能在分娩课上学到的东西。我想让她知道：分娩的有形伤疤可以愈合，但是做母亲的情感伤痕却永远如新，她会因此变得十分脆弱。我想告诫她：做了母亲后，每当她看报纸时就会情不自禁地联想：“如果那件事情发生在我的孩子身上将会怎样啊！”每一次飞机失事、每一场住宅火灾都会让她提心吊胆。看到那些忍饥挨饿的孩子们的照片时，她会思索：世界上还有什么比眼睁睁地看着自己的孩子饿死更惨的事情呢？我打量着她精修细剪的指甲和时尚前卫的衣服，心里想到：不管她打扮多么考究，做了母亲后，她会变得像护崽的母熊那样原始而不修边幅。我觉得自己应该提醒她，不管她在工作上投入了多少年，一旦做了母亲，工作就会脱离常规。她自然可以安排他人照顾孩子，但说不定哪天她要去参加一个非常重要的商务会议，却忍不住想起宝宝身上散发的甜甜乳香。她不得不拼命克制自己，才不致于为了看看孩子是否安然无羔而中途回家。我想告诉朋友，有了孩子后，她将再也不能按照惯例做出决定。在餐馆，5岁的儿子想进男厕而不愿进女厕将成为摆在她眼前的一大难题：她将在两个选择之间权衡一番：尊重孩子的独立和性别意识，还是让他进男厕所冒险被潜在的儿童性骚扰者侵害？任凭她在办公室多么果断，作为母亲，她仍经常事后后悔自己当时的决定。注视着我的这位漂亮的朋友，我想让她明确地知道，她最终会恢复到怀孕前的体重，但是她对自己的感觉已然不同。她现在视为如此重要的生命将随着孩子的诞生而变得不那么宝贵。为了救自己的孩子，她时刻愿意献出自己的生命。但她也开始希望多活一些年头，不是为了实现自己的梦想，而是为了看着孩子们美梦成真。我想向朋友形容自己看到孩子学会击球时的喜悦之情。我想让她留意宝宝第一次触摸狗的绒毛时的捧腹大笑。我想让她品尝快乐，尽管这快乐真实得令人心痛。朋友的表情让我意识到自己已经是热泪盈眶。“你永远不会后悔，”我最后说。然后紧紧地握住朋友的手，为她、为自己、也为每一位艰难跋涉、准备响应母亲职业神圣的召唤的平凡女性献上自己的祈祷A Box Full Of Kisses Once upon a time， a man punished his 5-year-old daughter for using up the family's only roll of expensive gold wrapping Money was tight， and he became even more upset when on Christmas Eve， he saw that the child had pasted the gold paper so as to decorate a shoebox to put under the Christmas Nevertheless， the next morning the little girl， filled with excitement， brought the gift box to her father and said， "This is for you， Daddy!" As he opened the box， the father was embarrassed by his earlier But when he opened it， he found it was empty and again his anger "Don't you know， young lady，” he said harshly， “when you give someone a present there's supposed to be something inside the package!" The little girl looked up at him with tears rolling from her eyes and said: "Daddy， it's not I blew kisses into it until it was all " The father was He fell on his knees and put his arms around his precious little He begged her to forgive him for his unnecessary An accident took the life of the child only a short time It is told that the father kept that little gold box by his bed for all the years of his Whenever he was discouraged or faced difficult problems he would open the box， take out an imaginary kiss， and remember the love of this beautiful child who had put it In a very real sense， each of us as human beings have been given an invisible golden box filled with unconditional love and kisses from our children， family， friends and G There is no more precious possession anyone could 从前，一位父亲惩罚了自己5岁的女儿，因为她用光了家里仅有的一卷昂贵的金色包装纸。家中余钱无多，在圣诞前夜来临时，父亲变得更加心烦意乱，他看到了圣诞树下的一个鞋盒，女儿原来把金纸贴在了这个鞋盒上做装饰。然而，圣诞日的早上，小女孩满是兴奋得把这个圣诞礼盒呈到了父亲面前，说到：“爸爸，这个送给你！”当父亲打开礼盒时，他为自己先前的过度反应而局促不安着。但是当他打开盒子后，发现里面是空的，他的怒火再次爆发了。“你不知道吗，小丫头，”他严厉地说，“当你送人礼物时，盒子里面应该是有东西的！”小女孩抬头看着气头上的父亲，泪水在她的眼眶中打圈：“爸爸，它不是空的。这里面装满了我的吻。”男人顿时被击垮了。他跪下双膝，双手环抱着自己珍爱的小女孩，祈求她的原谅。之后不久，一场事故夺走了小女孩的生命。据说，父亲便将那个小金盒子放在床头，一直陪伴着他的余生。无论何时他感到气馁或者遇到难办的事情，他就会打开礼盒，取出一个假想的吻，记起漂亮女儿给予了自己特殊的爱。从一个非常真实的意义上说，我们每个人都被赠与过一个无形的金色礼盒，那里面装满了来自子女，家人，朋友及上帝无条件的爱与吻。人们所能拥有的最珍贵的礼物莫过于此了。Love and Time Once upon a time， there was an island where all the feelings lived: Happiness， Sadness， Knowledge， and all of the others， including L One day it was announced to the feelings that the island would sink， so all constructed boats and Except for LLove was the only one who Love wanted to hold out until the last possible When the island had almost sunk， Love decided to ask for Richness was passing by Love in a grand Love said，"Richness， can you take me with you?"Richness answered， "No， I can' There is a lot of gold and silver in my There is no place here for "Love decided to ask Vanity who was also passing by in a beautiful "Vanity， please help me!""I can't help you， L You are all wet and might damage my boat，" Vanity Sadness was close by so Love asked， "Sadness， let me go with ""Oh Love， I am so sad that I need to be by myself!"Happiness passed by Love， too， but she was so happy that she did not even hear when Love called Suddenly， there was a voice， "Come， Love， I will take " It was an So blessed and overjoyed， Love even forgot to ask the elder where they were When they arrived at dry land， the elder went her own Realizing how much was owed the elder， Love asked Knowledge， another elder， "Who Helped me?""It was Time，" Knowledge "Time?" asked L "But why did Time help me?"Knowledge smiled with deep wisdom and answered， "Because only Time is capable of understanding how valuable Love "从前有一个岛，所有的情感都住在那里：幸福、悲伤、知识和所有其它的，爱也不例外。一天，所有的情感听说小岛即将沉没，因此建造小船，纷纷离开，除了爱。爱是唯一留下来的，因为它希望能坚持到最后一刻。小岛即将沉没了，爱决定请求帮助。富有驾着一艘大船从爱身边经过，爱说，“富有，你能带上我么？”富有回答说：“不行，我的船上载满金银财宝，没有你的地方。”虚荣坐在漂亮的小船中从爱身边驶过，爱问：“虚荣，你能帮助我么？”虚荣说：“不行，你全身湿透，会弄脏我的船。”悲伤的船靠近了，爱问：“悲伤，请带我走吧。”“哦 爱，我太难过了，想一个人呆着。”幸福经过爱的身边，它太开心了，根本没听见爱在呼唤。突然，一个声音喊道：“来，爱，我带你走。” 声音来自“年老”。爱太高兴了，甚至忘了问他们即将去何方。当他们来到岸上，年老自己离开了。爱突然意识到“年老”给了它多大的帮助。于是，爱问另一位老者--知识：“谁帮助了我？”知识说：“是时间。”“时间？”爱问：“但是时间为什么帮助我？”知识睿智地微笑道：“因为只有时间了解爱的价值。”The paradox of our time in history is that we have taller buildings， but shorter tempers; wider freeways， but narrower viewpoints; we spend more， but have less; we buy more but enjoy 我们这个时代在历史上的说法就是我们拥有更高的建筑，但是有更暴的脾气；我们拥有更宽阔的高速公路，却有更狭隘的观点；我们花费得更多，拥有得却更少；我们购买得更多却享受得更少。 We have bigger houses and smaller families; more conveniences， but less time; we have more degrees， but less sense; more knowledge， but less judgment; more experts， but more problems; more medicine， but less 我们的房子越来越大，家庭却越来越小；便利越来越多，时间却越来越少；学位越来越多，感觉却越来越少；知识越来越多，观点却越来越少；专家越来越多，问题也越来越多；药物越来越多，健康却越来越少。 We drink too much， spend too recklessly， laugh too little， drive too fast， get too angry too quickly， stay up too late， get up too tired， read too little， watch TV too much， and pray too 我们喝得太多，花钱大手大脚，笑得太少，开车太快，易怒，熬夜，赖床，书读得越来越少，电视看得越来越多，却很少向上帝祈祷。 We talk too much， love too seldom， and hate too We’ve learned how to make a living， but not a life; we’ve added years to life， not life to 我们常常夸夸其谈，却很少付出爱心，且常常心中充满了仇恨。我们学会了如何谋生，而不知如何生活。我们延长了生命的期限，而不是生活的期限。 We’ve been all the way to the moon and back， but have trouble crossing the street to meet the new We’ve conquered outer space， but not inner space; we’ve done larger things， but not better 我们登上了月球，并成功返回，却不能穿过街道去拜访新邻居。我们已经征服了太空，却征服不了自己的内心；我们的事业越做越大，但质量却没有提高。 We’ve cleaned up the air， but polluted the soul; we’ve split the atom， but not our We write more， but learn less; we plan more， but accomplish 我们清洁了空气，却污染了灵魂；我们分离了原子，却无法驱除我们的偏见；我们写得更多，学到的却更少；我们的计划更多，完成的却更少。 We’ve learned to rush， but not to wait; we have higher incomes， but， lower 我们学会了奔跑，却忘记了如何等待；我们的收入越来越高，道德水平却越来越低。 We build more computers to hold more information to produce more copies than ever， but have less communication; we’ve become long on quantity， but short on 我们制造了更多的计算机来存储更多的信息，制造了最多的副本，却减少了交流；我们开始渴望数量，但忽视了质量。 These are the days of two incomes， but more divorce; of fancier houses， but more broken 这个时代有双收入，但也有了更高的离婚率；有更华丽的房屋，却有更多破碎的家庭。 These are the days of quick trips， disposable diapers， throw away morality， one night stands， overweight bodies， and pills that do everything from cheer， to quiet， to Where are we ? 这个时代有了快速旅游，免洗尿布，却抛弃了道德、一夜情、超重的身体，以及可以从快乐中走向静止和自杀的药物。我们将走向何方……？ If we die tomorrow， the company that we are working for could easily replace us in a matter of But the family we left behind will feel the loss for the rest of their 如果我们明天就死掉，我们为之工作的公司可能会在一天内很轻易地找人代替我们的位置。但是当我们离开家人后，他们的余生将会在失落中度过。 And come to think of it， we pour ourselves more into work than to our family an unwise investment 考虑一下吧，我们将自己的时间更多地投入到工作中，而放弃与家人在一起的时光，实在并非明智之举。 So what is the morale of the story?那么这则故事的主旨是什么呢?Don’t work too and you know what’s the full word of family? 不要工作得太辛苦，你知道家的全称吗？ FAMILY = (F)ATHER (A)ND (M)OTHER， (I) (L)OVE (Y)OU
