2. Π‘ΠΊΡΠΈΠ½ΠΈΠ½Π³ ΠΏΡΠΈΠΌΠ΅Π½ΡΠ΅ΡΡΡ ΡΠΎΠ»ΡΠΊΠΎ ΠΎΡΠ½ΠΎΡΠΈΡΠ΅Π»ΡΠ½ΠΎ Π½Π΅ΠΊΠΎΡΠΎΡΡΡ ΡΠΈΠΏΠΎΠ² ΡΠ°ΠΊΠ°, ΡΠ°ΠΊ ΠΊΠ°ΠΊ ΠΏΡΠΈΠΌΠ΅Π½ΡΠ΅ΠΌΡΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΠΉ ΠΌΠ΅ΡΠΎΠ΄ Π΄ΠΎΠ»ΠΆΠ΅Π½ Π±ΡΡΡ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΡΠΌ Π² Π²ΡΡΠ²Π»Π΅Π½ΠΈΠΈ Π±ΠΎΠ»Π΅Π·Π½ΠΈ Π½Π° ΡΠ°Π½Π½Π΅ΠΉ ΡΡΠ°Π΄ΠΈΠΈ, Π±Π΅Π·ΠΎΠΏΠ°ΡΠ½ΡΠΌ ΠΈ ΡΠΊΠΎΠ½ΠΎΠΌΠΈΡΠ΅ΡΠΊΠΈ ΠΏΡΠΈΠ΅ΠΌΠ»Π΅ΠΌΡΠΌ.
3. ΠΠ΅ΠΊΠΎΡΠΎΡΡΠ΅ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΡΠ΅ΡΡΡ ΡΠΏΠΎΡΠΎΠ±Π½Ρ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΠΎ Π²ΡΡΠ²Π»ΡΡΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠ΅ Π½Π° ΡΠ°Π½Π½Π΅ΠΌ ΡΡΠ°ΠΏΠ΅ ΡΠ°Π·Π²ΠΈΡΠΈΡ, Π½ΠΎ ΡΠ²Π»ΡΡΡΡΡ ΡΠ»ΠΈΡΠΊΠΎΠΌ Π΄ΠΎΡΠΎΠ³ΠΈΠΌΠΈ, ΡΡΠΎΠ±Ρ Π±ΡΡΡ Π²ΠΊΠ»ΡΡΠ΅Π½Π½ΡΠΌΠΈ Π² Π³ΠΎΡΡΠ΄Π°ΡΡΡΠ²Π΅Π½Π½ΡΡ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΡ. ΠΠ½ΡΠΎΡΠΌΠ°ΡΠΈΡ ΠΎ ΠΏΠΎΠ»ΡΠ·Π΅ ΠΈ ΠΏΡΠΈΠ΅ΠΌΠ»Π΅ΠΌΠΎΡΡΠΈ ΡΠΎΠ³ΠΎ ΠΈΠ»ΠΈ ΠΈΠ½ΠΎΠ³ΠΎ ΠΌΠ΅ΡΠΎΠ΄Π° Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΏΠΎΠ·Π²ΠΎΠ»ΡΠ΅Ρ Π»ΡΠ±ΠΎΠΌΡ ΡΠ΅Π»ΠΎΠ²Π΅ΠΊΡ ΠΏΡΠΎΠ²Π΅ΡΡΠΈ ΠΈΠ½Π΄ΠΈΠ²ΠΈΠ΄ΡΠ°Π»ΡΠ½ΡΠΉ ΡΠΊΡΠΈΠ½ΠΈΠ½Π³, ΠΈΡΠΏΠΎΠ»ΡΠ·ΡΡ ΡΠ°ΡΡΠ½ΡΠΉ ΠΌΠ΅Π΄ΠΈΡΠΈΠ½ΡΠΊΠΈΠΉ ΡΠ΅ΠΊΡΠΎΡ.
4. ΠΠ°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΡΠΈΡΠΎΠΊΠΎ ΠΈΡΠΏΠΎΠ»ΡΠ·ΡΠ΅ΠΌΡΠ΅ ΠΏΡΠΎΠ³ΡΠ°ΠΌΠΌΡ ΡΠΊΡΠΈΠ½ΠΈΠ½Π³Π° Π²ΠΊΠ»ΡΡΠ°ΡΡ ΠΌΠ°ΠΌΠΌΠΎΠ³ΡΠ°ΡΠΈΡ Π΄Π»Ρ ΡΠ°ΠΊΠ° Π³ΡΡΠ΄ΠΈ; ΡΠΈΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ (ΠΌΠ°Π·ΠΎΠΊ) ΠΈ ΡΠ΅ΡΡΠΈΡΠΎΠ²Π°Π½ΠΈΠ΅ Π½Π° Π½Π°Π»ΠΈΡΠΈΠ΅ ΠΏΠ°ΠΏΠΈΠ»Π»ΠΎΠΌΠ°Π²ΠΈΡΡΡΠ° ΡΠ΅Π»ΠΎΠ²Π΅ΠΊΠ° Π΄Π»Ρ Π²ΡΡΠ²Π»Π΅Π½ΠΈΡ ΡΠ°ΠΊΠ° ΡΠ΅ΠΉΠΊΠΈ ΠΌΠ°ΡΠΊΠΈ; Π²Π·ΡΡΠΈΠ΅ ΠΊΠ°Π»Π° Π½Π° ΠΏΡΠΈΡΡΡΡΡΠ²ΠΈΠ΅ ΡΠΊΡΡΡΠΎΠΉ ΠΊΡΠΎΠ²ΠΈ, ΡΠΈΠ³ΠΌΠΎΠΈΠ΄ΠΎΡΠΊΠΎΠΏΠΈΡ ΠΈΠ»ΠΈ ΠΊΠΎΠ»ΠΎΠ½ΠΎΡΠΊΠΎΠΏΠΈΡ Π΄Π»Ρ Π²ΡΡΠ²Π»Π΅Π½ΠΈΡ ΠΈΠ»ΠΈ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ (ΡΠ΄Π°Π»Π΅Π½ΠΈΠ΅ ΠΏΠΎΠ»ΠΈΠΏΠΎΠ²) ΡΠ°ΠΊΠ° ΠΊΠΈΡΠ΅ΡΠ½ΠΈΠΊΠ°.
5. ΠΠ°ΠΆΠ½ΠΎ ΠΏΡΠΎΠΈΠ·Π²ΠΎΠ΄ΠΈΡΡ ΡΠ°ΠΌΠΎΠΎΠ±ΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π³ΡΡΠ΄ΠΈ ΠΊΠ°ΠΆΠ΄ΡΠΉ ΠΌΠ΅ΡΡΡ, ΡΡΠΎ ΠΏΠΎΠ·Π²ΠΎΠ»ΠΈΡ ΠΌΠ°ΠΊΡΠΈΠΌΠ°Π»ΡΠ½ΠΎ ΡΠ°Π½ΠΎ ΠΎΠ±Π½Π°ΡΡΠΆΠΈΡΡ Π½Π΅ΠΊΠΎΡΠΎΡΡΠ΅ ΠΏΠ°ΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΎΠ±ΡΠ°Π·ΠΎΠ²Π°Π½ΠΈΡ.
6. Π‘ΠΈΠΌΠΏΡΠΎΠΌΡ, ΡΠΊΠ°Π·ΡΠ²Π°ΡΡΠΈΠ΅ Π½Π° ΠΏΡΠΎΠ±Π»Π΅ΠΌΡ Π² ΠΆΠ΅Π»ΡΠ΄ΠΊΠ΅, Π΄ΠΎΠ»ΠΆΠ½Ρ ΡΠΏΠΎΠ΄Π²ΠΈΠ³Π½ΡΡΡ Π²Π°ΡΠ΅Π³ΠΎ Π²ΡΠ°ΡΠ° Π½Π° Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΡ Π½Π°Π»ΠΈΡΠΈΡ ΠΈΠ½ΡΠ΅ΠΊΡΠΈΠΈ Helicobacter pylori. Π ΡΠ»ΡΡΠ°Π΅ ΠΎΠ±Π½Π°ΡΡΠΆΠ΅Π½ΠΈΡ Π±Π°ΠΊΡΠ΅ΡΠΈΠΈ ΡΠ»Π΅Π΄ΡΠ΅Ρ ΠΏΡΠΎΠ²Π΅ΡΡΠΈ Π΅Π΅ ΡΡΠ°Π΄ΠΈΠΊΠ°ΡΠΈΡ Π΄Π»Ρ Π»Π΅ΡΠ΅Π½ΠΈΡ ΡΠ·Π²Π΅Π½Π½ΠΎΠΉ Π±ΠΎΠ»Π΅Π·Π½ΠΈ, ΡΠ½ΠΈΠΆΠ΅Π½ΠΈΡ ΡΠΈΠΌΠΏΡΠΎΠΌΠΎΠ² ΠΈ, Π²ΠΎΠ·ΠΌΠΎΠΆΠ½ΠΎ, ΠΏΡΠ΅Π΄ΠΎΡΠ²ΡΠ°ΡΠ΅Π½ΠΈΡ ΡΠ°Π·Π²ΠΈΡΠΈΡ ΡΠ°ΠΊΠ° ΠΆΠ΅Π»ΡΠ΄ΠΊΠ°.
7. ΠΡΡΠ΅Π½ΠΈΠ΅ ΡΠ²Π»ΡΠ΅ΡΡΡ ΠΏΡΠΈΡΠΈΠ½ΠΎΠΉ 90β % Π²ΡΠ΅Ρ ΡΠ»ΡΡΠ°Π΅Π² ΡΠ°ΠΊΠ° Π»Π΅Π³ΠΊΠΈΡ , ΡΠ²Π»ΡΡΡΠ΅Π³ΠΎΡΡ ΠΎΠ΄Π½ΠΈΠΌ ΠΈΠ· ΡΠ°ΠΌΡΡ Π°Π³ΡΠ΅ΡΡΠΈΠ²Π½ΡΡ Π²ΠΈΠ΄ΠΎΠ² Π·Π»ΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΠΎΠ³ΠΎ ΠΏΡΠΎΡΠ΅ΡΡΠ°. ΠΡΠ΅ΠΊΡΠ°ΡΠ΅Π½ΠΈΠ΅ ΠΊΡΡΠ΅Π½ΠΈΡ ΡΠ²Π»ΡΠ΅ΡΡΡ ΡΠ°ΠΌΡΠΌ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΡΠΌ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠΌ ΠΏΡΠΎΡΠΈΠ»Π°ΠΊΡΠΈΠΊΠΈ ΡΡΠΎΠ³ΠΎ ΡΠ°ΠΊΠ°. ΠΠ±ΡΡΠ½ΡΠΉ ΡΠ΅Π½ΡΠ³Π΅Π½ Π³ΡΡΠ΄Π½ΠΎΠΉ ΠΊΠ»Π΅ΡΠΊΠΈ ΠΌΠΎΠΆΠ΅Ρ Π±ΡΡΡ ΠΏΡΠΎΡΡΡΠΌ ΠΈ ΡΡΡΠ΅ΠΊΡΠΈΠ²Π½ΡΠΌ ΡΠΏΠΎΡΠΎΠ±ΠΎΠΌ ΡΠ°Π½Π½Π΅ΠΉ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΡΠ°ΠΊΠ° Π»Π΅Π³ΠΊΠΈΡ .
Π‘ΠΏΠΈΡΠΎΠΊ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ (Π³Π»Π°Π²Π° 12)
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ΠΡΠΈΠΌΠ΅ΡΠ°Π½ΠΈΡ
1
ΠΡΡΠΎΡΠ½ΠΈΠΊ: Jonathan M. Samet, Prakash C. Gupta, Cecily S. Ray. Tobacco smoking and smokeless tobacco use. World Cancer Report 2014, pp. 88β89.
2
ΠΠ°Π»ΡΠ²Π°Π΄ΠΎΡ β ΠΎΡ ΡΡ. Calvados β ΡΠ±Π»ΠΎΡΠ½ΡΠΉ ΠΈΠ»ΠΈ Π³ΡΡΡΠ΅Π²ΡΠΉ Π±ΡΠ΅Π½Π΄ΠΈ, ΠΏΠΎΠ»ΡΡΠ°Π΅ΠΌΡΠΉ ΠΏΡΡΠ΅ΠΌ ΠΏΠ΅ΡΠ΅Π³ΠΎΠ½ΠΊΠΈ ΡΠΈΠ΄ΡΠ°, ΠΊΡΠ΅ΠΏΠΎΡΡΡ ΠΎΠΊΠΎΠ»ΠΎ 40Β°.