2019年上海市黄浦区青少年烟草流行状况及影响因素分析

目的了解上海市黄浦区青少年烟草流行情况,分析影响青少年吸烟的危险因素,为制定控烟政策、策略和措施提供依据。方法采用多阶段分层整群抽样的方法,在上海市黄浦区的中学生中随机抽取579人进行问卷调查,问卷内容包括人口学特征、现在吸烟情况、二手烟暴露和烟草广告暴露等。结果调查对象中28人(4.8%)现在吸烟,417人(72.0%)暴露于二手烟,427人(73.7%)暴露于烟草广告,好朋友吸烟是影响调查对象是否吸烟的主要因素。结论黄浦区青少年现在吸烟率处于较低水平,但二手烟和烟草广告暴露率较高,倡导不在家中吸烟和禁止一切形式的烟草广告,对保护青少年免受烟草危害具有重要意义。     

西藏自治区初中生吸烟现状及影响因素分析

目的了解西藏自治区初中学生吸烟现状及其影响因素,为后期制定干预措施提供依据。方法采用多阶段抽样方法,使用全球统一标准的青少年烟草调查核心问卷,对西藏自治区11所初中学校的3652名学生进行调查。结果现在烟草使用率为19.0%,尝试吸烟率为31.0%。多因素分析表明,男学生(OR=11.423)、年级越高(二年级OR=1.580,三年级OR=2.815)、母亲吸烟(OR=8.240)和父母均吸烟(OR=1.565)、朋友吸烟(全部吸烟OR=16.544)、家庭二手烟暴露(OR=2.711)、公共场所室内二手烟暴露(OR=1.377)、公共场所室外二手烟暴露(OR=2.249)、学校看到过有人吸烟(OR=1.833)、看到过控烟信息(OR=1.606)、得到免费烟草制品(OR=3.617)、电视电影或视频上看到使用烟草制品(OR=1.252)、吸烟会让人社交轻松(OR=2.070)为现在吸烟的危险因素;肯定开始吸烟后很难戒掉(OR=0.744)、认为二手烟暴露会有害健康(OR=0.513)则是现在吸烟的保护因素(P均0.05)。结论初中学生控烟工作重点在于减少二手烟暴露、媒体烟草广告及烟草相关促销,深入强化传播烟草危害相关知识。     

辽宁省城市初中生二手烟暴露及对二手烟危害和控烟认知情况调查

目的了解辽宁省城市初中在校学生二手烟暴露现状及其影响因素,学生对二手烟危害和控烟等认知情况,为开展青少年控烟健康教育获取基础性数据,为制定或修订青少年控烟立法或条例提供依据。方法于2013年,采用分层多阶段整群抽样方法,在沈阳市、鞍山市、丹东市、锦州市、营口市和盘锦市共抽取2 913名初中在校学生,对其进行问卷调查。调查内容主要包含基本情况、二手烟暴露、吸二手烟态度、控烟知识来源、学校有烟及控烟等。用SPSS 13.0软件进行统计分析,计数资料的组间比较用χ~2检验,多因素分析采用logistic回归分析。结果在过去7 d内,71.9%的城市初中在校学生遭受二手烟暴露,暴露场所和比例由高至低依次为室外公共场所(57.0%),室内公共场所(53.0%),家庭(41.5%)和交通工具(24.9%);44.1%的学生回答看到有人在学校的建筑物内或者室外吸烟,7.4%的学生几乎每天在学校(室内或室外)看到过教师吸烟;城市初中在校学生二手烟暴露受父母是否吸烟(OR=2.614,95%CI:2.092~3.267)、好朋友是否吸烟(OR=2.106,95%CI:1.527~2.906)、在学校是否学习过烟草危害(OR=1.479,95%CI:1.185~1.846)等因素影响。76.5%的学生认为二手烟对其他人的健康会产生危害,赞同室内、室外禁烟的比例分别为60.9%和61.1%;63.1%的学生在过去的30 d内在电视、广播、互联网、户外广告牌、海报、报纸、杂志或电影上听到或看到过控烟的信息,21.2%的学生在体育赛事、集会、音乐会或社区活动、社交聚会等场合看到或听到过控烟信息,35.7%的初中生看到过卷烟包装上的健康警语并对其有正面影响,在课堂上接受过烟草使用危害教育的仅占30.5%。结论辽宁省城市青少年二手烟暴露情况严峻,应尽快出台控制吸烟的相关条例,保护青少年免受于二手烟危害;加大城市青少年二手烟危害的宣传力度和无烟学校创建力度,实现学校、家庭和青少年自身三方共同抵制烟草。     

开封市某城区学生二手烟暴露及影响因素分析

了解开封市某城区学生烟草流行行为状况和相关影响因素,为制定学生控烟策略提供依据.方法 采用分层整群抽样的方法,对开封市某城区9所学校27个班级共计1 546名学生的二手烟暴露情况进行问卷调查.结果 开封市某城区学生尝试吸烟率为11.06%,现吸烟率为8.15%;二手烟暴露率为56.21%,其中男、女生二手烟暴露率分别为63.04%和49.22%,差异有统计学意义(x2=19.995,P<0.05).多因素非条件Logistic回归分析结果显示,父母吸烟(OR=12.425)、教师吸烟(OR=2.429)、朋友吸烟(OR=2.017)、年龄>14岁(OR=1.873)等增加了学生二手烟暴露的危险性;学校开设控烟健康教育课降低了学生二手烟暴露的危险性(P值均<0.01).结论 开封市某城区学生吸烟和二手烟暴露率较高.父母、老师、朋友等吸烟是二手烟暴露的主要因素,学校健康教育可以减少学生二手烟暴露的危险性.     

浙江省城市中学生二手烟暴露及影响因素分析

了解浙江省城市中学生二手烟暴露现状及其影响因素,为制定青少年学生控烟策略提供依据.方法 采用分层整群抽样方法,对浙江省11个市的22所学校共计3 799名中学生的二手烟暴露情况进行问卷调查.结果 浙江省城市中学生的二手烟暴露率为59.44%,其中男、女生分别为60.59%和56.96%,初、高中生分别为56.89%和60.50%;中学生在家庭、学校遭受二手烟暴露率分别为44.85%和32.28%.中学生周边人群中的吸烟者比例高(父亲为61.54%,教师为34.17%).Logistic回归分析发现,男生二手烟暴露的危险性为女生的1.18倍;中学生吸烟者二手烟暴露的危险性为非吸烟者的1.96倍;中学生周边人群吸烟都使其二手烟暴露的危险性增加,父母吸烟是非吸烟者的8.56倍、教师吸烟是非吸烟者的2.43倍、同伴吸烟是非吸烟者的1.69倍、其他家人吸烟是非吸烟者的1.19倍;学校教过“拒绝吸烟的技巧”可以减少中学生二手烟暴露的危险性(OR=0.75).结论 浙江省城市中学生二手烟暴露情况严重.控制和减少中学生周边人群吸烟,学校开设控烟健康教育课程,能有效控制中学生烟草暴露.     

2019年海口市青少年烟草暴露及其影响因素分析北大核心

目的了解2019年海口市青少年烟草暴露现状,为开展青少年吸烟干预以及制订控烟策略、措施提供依据。方法采用多阶段分层整群随机抽样方法,使用全球青少年烟草调查(GYTS)核心问卷,对海南省海口市4个监测区中抽取的初中、高中及职高在校学生进行调查。使用SPSS 20.0软件对数据进行分析,采用χ2检验进行多个率的比较,通过多因素Logistic回归进行影响因素分析。结果共抽中3343名学生,应答率97.91%。研究对象的平均年龄为(14.60±1.78)岁,其中男生1637人(50.02%),女生1636人(49.98%)。海口市青少年尝试吸烟率为14.54%,现在吸烟率为4.01%,经常吸烟率为0.91%。在家庭内部、公共场所室内、公共场所室外及学校4种环境中存在二手烟暴露的人各类吸烟行为发生风险均存在不同程度增加现象。海口市有83.72%青少年处于二手烟暴露下。存在二手烟暴露史、对接触二手烟持感觉良好或不确定态度的青少年各类吸烟行为发生风险显著增加(P<0.05)。结论海口市青少年烟草流行情况有所改善,尝试吸烟率和现在吸烟率明显下降。二手烟暴露情况严峻,是影响青少年发生各类吸烟行为的危险因素。     

北京市2013-2015年小学生二手烟暴露现况

了解北京市小学生2013-2015年二手烟的暴露状况及室外公共场所、室内公共场所和家庭环境中二手烟的暴露及其影响因素,为减少小学生二手烟暴露提供参考.方法 采用以学校为初级抽样单位、以班级为最小抽样单位的二阶段分层随机整群抽样方法,于2013年和2015年使用“北京市学校人群烟草监测调查问卷”对学生进行匿名自填式问卷调查,调查内容包括烟草使用、二手烟暴露、烟草制品获得与价格、控烟宣传、烟草广告和促销、对烟草的认知和态度等内容.结果 2015年有72.64%的调查对象报告在过去7d内暴露于二手烟,比2013年暴露率(80.02%)有所下降,但仍处于较高水平.室内公共场所的暴露比例最高(55.87%),其次是室外公共场所(52.95%)、家里(42.09%).多元Logis-tic回归分析显示,父母吸烟(OR=2.46)、朋友中有人吸烟(OR=3.98~23.92)、见过教师吸烟(OR=1.47~2.20)的学生更容易发生二手烟暴露.结论 2015年北京市小学生二手烟暴露率有所下降,但高于全国平均水平,暴露状况依然严峻.建议强化相关法律法规建设,积极探索学校控烟适宜技术,为孩子的健康成长营造良好环境.     

无烟政策的评价方法探讨

正世界卫生组织烟草控制框架公约明确指出,由于二手烟的暴露没有安全水平,完全禁止在室内公共场所、工作场所和交通工具中吸烟是保护吸烟者免受二手烟危害的重要措施。自愿的政策是无效的,必须通过无烟法律和政策来实现。在WHO制定的MPOWER控烟策略中,保护人们不接触烟草烟雾是重要的控烟策略。无烟法律是全球广泛采用的控烟措施。与MPOWER的其他策略有所差别的是,该策略主要影响的是非吸烟     

广东省初中生吸烟现况及影响因素分析北大核心

目的了解广东省初中学生吸烟现状及其影响因素,为后期制定干预措施提供依据。方法采用多阶段抽样方法,使用全球统一标准的青少年烟草调查核心问卷,对广东省48所初中学校的7 354名学生进行调查。结果初中学生现在吸烟率为4.89%。在家、室内场所、室外公共场所、学校暴露于二手烟的比例分别为39.10%,50.15%,51.97%,48.17%。多因素分析表明,初中生吸烟的危险因素有男生、在家里暴露于二手烟、看到有人在学校室内或室外场所吸烟、曾有烟草公司工作人员提供免费烟草、拥有烟草品牌标志物品认为吸烟在聚会庆祝及社交场合更轻松;保护因素有肯定地认为开始吸烟后很难戒掉、肯定地认为其他人吸烟的烟雾对自己有害(P值均<0.05)。结论初中学生控烟工作重点在于减少二手烟暴露、媒体烟草广告,并普及吸烟的成瘾性、二手烟危害方面的知识。     

2019年河北省中学生烟草使用及二手烟暴露状况调查

目的了解河北省青少年烟草使用现状,为开展针对性的控烟工作提供参考依据。方法于2019-04/10采用分层多阶段整群概率抽样方法在河北省15个城乡监测点抽取14 020名在校中学生进行烟草流行现状问卷调查,采用SPSS22.0软件分析中学生吸烟率、二手烟暴露率等情况,多个率的比较采用χ2检验,检验水准α=0.05。结果河北省13 839名初高中学生中,尝试吸烟者2 740人,尝试吸烟率为19.3%,现在吸烟者954人,现在吸烟率为6.7%,男生均明显高于女生,差异有统计学意义(P0.05);在954名现在吸烟者中,尝试戒烟者631人(71.7%),接受过专业人员提供戒烟建议者仅60人(5.9%);在过去7 d,在家里暴露于二手烟的青少年8 656人(37.5%),在校园里暴露于二手烟的青少年7 216人(51.0%),在室内封闭公共场所暴露于二手烟的青少年7 399人(51.9%),在室外公共场所暴露于二手烟的青少年7 360人(50.8%);对吸烟危害认知及态度调查中,76.0%的学生肯定地认为别人吸烟产生的烟雾会对自己产生危害,84.2%的学生认为在社交聚会场合吸烟使人更不舒服;多因素Logistic回归分析结果显示,男性、二手烟暴露天数较长、可支配生活费充足、父母吸烟、朋友吸烟、看到教师吸烟、未接触过媒体控烟信息是影响青少年吸烟率的主要因素。结论河北省青少年烟草流行现状仍十分严峻,青少年吸烟的影响因素众多,需从个人、家庭、学校、社会多层面开展控烟干预,降低青少年吸烟的可能性。     

Determinants of exposure to second-hand tobacco smoke (SHS) among current non-smoking in-school adolescents (aged 11-18 years) in South Africa: results from the 2008 GYTS study

The aim of this study was to estimate the prevalence and identify correlates of second-hand tobacco smoke (SHS) among 6,412 current non-smoking school-going adolescents (aged 11 to 18 years) in South Africa. A cross-sectional study was carried out in 2008 in South Africa within the framework of the Global Youth Tobacco Survey. Overall, 25.7% of students were exposed to SHS at home, 34.2% outside of the home and 18.3% were exposed to SHS at home and outside of the home. Parental and close friends smoking status, allowing someone to smoke around you and perception that passive smoking was harmful were significant determinants of adolescent's exposure to both SHS at home and outside of the home. Identified factors can inform the implementation of public health interventions in order to reduce passive smoking among adolescents.     

Linking Global Youth Tobacco Survey 2003 and 2006 data to tobacco control policy in India

Background: India made 2 important policy statements regarding tobacco control in the past decade. First, the India Tobacco Control Act (ITCA) was signed into law in 2003 with the goal to reduce tobacco consumption and protect citizens from exposure to secondhand smoke (SHS). Second, in 2005, India ratified the World Health Organization Framework Convention on Tobacco Control (WHO FCTC). During this same period, India conducted the Global Youth Tobacco Survey (GYTS) in 2003 and 2006 in an effort to track tobacco use among adolescents. Methods: The GYTS is a school‐based survey of students aged 13‐15 years. Representative national estimates for India in 2003 and 2006 were used in this study. Results: In 2006, 3.8% of students currently smoked cigarettes and 11.9% currently used other tobacco products. These rates were not significantly different than those observed in 2003. Over the same period, exposure to SHS at home and in public places significantly decreased, whereas exposure to pro‐tobacco ads on billboards and the ability to purchase cigarettes in a store did not change significantly. Conclusions: The ITCA and the WHO FCTC have had mixed impacts on the tobacco control effort for adolescents in India. The positive impacts have been the reduction in exposure to SHS, both at home and in public places. The negative impacts are seen with the lack of change in pro‐tobacco advertising and ability to purchase cigarettes in stores. The Government of India needs to consider new and stronger provisions of the ITCA and include strong enforcement measures.     

Tobacco Exposure,Weight Status,and Elevated Blood Pressure in Adolescents

The pathogenesis of hypertension begins in youth. An estimated 4 % of US adolescents have diagnosed hypertension and 17 % have elevated blood pressures, predisposing them to hypertension and cardiovascular disease (CVD) later in life. There is limited research on the clustering of CVD risk factors such as tobacco exposure and weight status that may be associated with high blood pressure in adolescents. The aim of this exploratory study was to determine the relationships between total smoke exposure (TSE; cigarette smoking and secondhand smoke), waist circumference, and blood pressure in a sample of rural adolescents, ages 15–18. A convenience sample of 148 adolescents ages 15–18 was recruited from two rural high schools (88 female and 60 male, all Caucasian). Adolescents were assessed for tobacco exposure (self-report, salivary cotinine), weight status (body mass index, waist circumference), and blood pressure. Self-report measures of tobacco exposure included the Uptake Continuum and Peer and Family Smoking measure. Age, gender, waist circumference and salivary cotinine contributed to 35 % of the variance in systolic blood pressure and 18 % in diastolic blood pressure. One-fourth (25 %) of adolescent males and 11 % of adolescent females had elevated systolic blood pressures. Approximately one-fifth of the sample (22 %) had elevated salivary cotinine levels indicative of tobacco use and secondhand smoke exposure. TSE and waist circumference were predictors of elevated blood pressure in adolescents. Public health measures need to address clusters of risk factors including blood pressure, tobacco exposure, and weight status among adolescents in order to reduce CVD.     

Personal and Social Correlates of Tobacco Use Among Adolescents With Diabetes

Personal and social correlates of adolescent tobacco use have been widely studied but not among adolescents with diabetes. Perceived health, psychosomatic complaints, decision-making autonomy, self-esteem, and friends' smoking exposure were analyzed in relation to cigarette experimentation, current smoking, and quitting history in adolescents with and without diabetes. Study-defined rates of experimentation (56%), current smoking (22%), and positive quit attempt history (65% of current smokers) did not vary by health status. Perceived health was poorest and complaints were greatest for adolescents with diabetes who experimented with smoking; exposure to friends who smoke was also greatest among adolescent experimental and current smokers with diabetes. Additional research on the design and implementation of diabetes-specific tobacco control programs is warranted.     

广州市城区中学生二手烟暴露及其影响因素分析

了解广州市城区中学生二手烟暴露现状及其影响因素,为制定有效的校园控烟策略提供科学依据.方法 采用多阶段分层整群抽样方法,在广州市越秀区抽取7所学校的3 575名非吸烟中学生进行二手烟暴露情况问卷调查.结果 中学生二手烟暴露率为59.7%,其中公共场所、家里、学校二手烟暴露率分别为49.5%,34.5%,10.7%.多因素Logistic回归分析显示,家里二手烟暴露的影响因素有父亲吸烟、好朋友吸烟、同学吸烟和家里控烟情况;学校二手烟暴露的影响因素有性别、同学吸烟、教师吸烟和好朋友吸烟;公共场所二手烟暴露的影响因素有性别、每月零花钱、父亲吸烟、好朋友吸烟、同学吸烟(P值均<0.05).结论 公共场所和家里是广州市城区中学生二手烟暴露的重点场所,周围人群吸烟是二手烟暴露的危险因素,家里完全禁烟是有效降低二手烟暴露的关键措施.     

Measuring Exposure to Pro- and Anti-tobacco Marketing Among Adolescents: Intercorrelations Among Measures and Associations With Smoking Status

Exposure to tobacco - related marketing has been implicated as one of the risk factors for tobacco use among adolescents. However, tobacco - related marketing exposure has been measured in different ways in different studies, including per ceived pervasiveness, receptivity, recognition, recall, and affect. It is not known whether these measures represent one or more underlying constructs and how these underlying constructs are associated with adolescent smoking status. This study analyzed data from 5, 870 eighth - grade students in California, collected in 1996- 1997 as part of the Independent Evaluation of the California Tobacco Control , Prevention, and Education Program . An exploratory factor analysis of multiple measures of tobacco - related marketing exposure revealed four distinct factors: per ceived pervasiveness of protobacco marketing, perceived pervasiveness of anti tobacco marketing, recognition of specific antitobacco advertisements, and receptivity to protobacco marketing. Receptivity to protobacco marketing showed the strongest association with smoking status; higher levels of receptivity were associated with higher levels of smoking. Two measures of exposure to antitobacco marketing (perceived pervasiveness of antitobacco marketing and recognition of spe cific antitobacco ads) were highest among established smokers and lowest among susceptible nonsmokers. The same pattern was evident for perceived pervasiveness of protobacco marketing. Results suggest that exposure to tobacco - related market ing is a multidimensional construct, and each dimension may have a unique contribution to the process of smoking initiation. Because adolescents are exposed to numerous pro - and antitobacco messages, it is important to develop antitobacco media campaigns that can successfully counter protobacco marketing efforts. Potential strategies include targeting the susceptible nonsmokers who are at high risk for smoking and developing messages to decrease receptivity.     

Secondhand tobacco smoke exposure and associated factors among college students on campus and in the home: a preliminary study

To explore the prevalence of secondhand tobacco smoke (SHS) exposure of college students at two locations, i.e., on campus and in the home, and to identify factors associated with SHS exposure at each location, a preliminary cross-sectional study was conducted on 1754 nonsmoking students from two universities in Korea. In total, 83.1% were exposed to SHS at least once a week on campus or at home; the average SHS exposure was 3.4 times per week. Specifically, 79.7% and 23.5% were exposed to SHS on campus and in the home, respectively. On campus, SHS exposure was significantly more prevalent in freshmen and sophomore students. In the home, SHS exposure was significantly more prevalent among females, those with smokers in their families, and those who rated their health as poor. SHS exposure was common among nonsmoking college students, with more than two-thirds exposed on campus. The prevalence of SHS exposure was greater on campus than in the home; the factors associated with SHS exposure were location-specific.     

湖北省青少年烟草使用现况及其影响因素分析

了解湖北省青少年烟草使用现况及其影响因素,为制定烟草控制策略提供科学依据.方法 采用多阶段分层整群随机抽样法,抽取湖北省36所初中共5 438名青少年进行自填问卷调查.结果 湖北省青少年现在烟草使用率为5.66%,男生(8.31%)高于女生(2.48%),农村(6.27%)高于城市(4.84%),年级越高、可支配零用钱越多,现在烟草使用率越高(x2值分别为104.282,21.746,48.768,22.926,P值均<0.01);89.40%的青少年在14岁之前第一次尝试吸卷烟;现在吸烟的青少年中,71.71%想戒烟,91.79%没有接受过专业人员的帮助或建议.Logistic回归分析显示,性别、年龄、每周可支配零花钱数、父母吸烟、朋友吸烟、对戒烟困难性与二手烟危害的认知是青少年现在烟草使用行为的影响因素(P值均<0.01);父母都不吸烟、朋友中没人吸烟、认为戒烟容易、认为二手烟有危害是青少年吸烟行为的保护因素(OR值分别为1.763,10.521,2.047,2.243).结论 湖北省青少年烟草使用现象较为普遍,小学生、初中生是控烟健康教育的重点人群,学校是开展控烟教育的较好场所.     

北京市2019年中学生二手烟暴露现况

  目的  了解北京市青少年二手烟暴露现状及其影响因素,为制定烟草控制措施提供数据支持。  方法  采用二阶段分层整群随机抽样方法,确定北京市16个区48所初中、34所普通高中和14所职业高中共370个班级的10 532名在校生为调查对象,使用中国疾病预防控制中心控烟办公室制定的全国青少年烟草流行监测调查问卷进行信息采集。  结果  2019年北京市中学生在过去7 d内4类场所二手烟暴露率为71.5%(95%CI=70.2%~72.7%),其中室外公共场所的二手烟暴露率最高(60.3%),其次是室内公共场所(48.9%)、家(34.1%),公共交通工具最低(19.1%)。过去30 d内看到有人在学校的建筑物内或室外吸烟的比例为31.6%。多因素Logistic回归分析结果显示,父母中有人吸烟(OR=2.62)、好友中有人吸烟(OR=2.13)、在课堂上学习过烟草危害(OR=0.74)和高一到高三年级(OR=0.68~0.73)与4类场所二手烟暴露率有相关关系(P值均 < 0.05)。  结论  北京市中学生二手烟暴露维持在较高水平。应加强学校烟草危害和控烟宣传,倡导无烟家庭创建,切实保护中学生尤其初中生免受二手烟危害。     

Disparities in secondhand smoke exposure--United States, 1988-1994 and 1999-2004

No level of exposure to secondhand smoke (SHS) is safe. Breathing SHS can cause heart disease and lung cancer in nonsmoking adults and increases the risk for sudden infant death syndrome, acute respiratory infections, middle-ear disease, and exacerbation of asthma in children. In the United States, exposure to SHS declined approximately 70% from the late 1980s through 2002, most likely reflecting widespread implementation of laws and policies prohibiting smoking in indoor workplaces and public places during this period. Although the major sources of SHS exposure for nonsmoking adults are the home and workplace, the primary source of SHS exposure for children is the home; therefore, eliminating smoking in workplaces and public places is less likely to reduce children's exposure to SHS. This report examines changes in the prevalence of self-reported SHS exposure at home and changes in any exposure, as measured by serum cotinine (a biologic indicator of SHS exposure), in nonsmoking children, adolescents, and adults. The analysis was conducted using data from the 1988-1994 and 1999-2004 National Health and Nutrition Examination Surveys (NHANES). The results indicated that self-reported SHS exposure at home and SHS exposure as measured by serum cotinine declined significantly (i.e., by 51.2% and 44.7%, respectively) in the U.S. population from 1988-1994 to 1999-2004; however, the decline was smaller for persons aged 4-11 years and 12-19 years. These results underscore the need to continue surveillance of SHS exposure and to focus on strategies to reduce children's SHS exposure.