大学生安全饮酒健康教育效果评价

报道显示,青少年饮酒率逐年增加,饮酒年龄亦出现低年龄化的趋势[1-3].青少年饮酒不但严重损害其身心健康,而且已成为严重的社会问题.有调查发现,2010年青海省医学生整体饮酒率及男、女生饮酒率分别是93.3%,96.7%和92.6%,其中不乏有学生存在危险饮酒行为[4].为有效预防危险饮酒行为对大学生的影响,笔者进行了相关研究,现将结果报道如下.     

青少年饮酒流行现况及危害

近年来,随着生活方式的变化,酒精的消费量呈逐年上升趋势.酒在人类日常生活中扮演了一个重要角色,饮酒是一种社会认可的行为,充当了社会活动的“媒介”.但饮酒和酒精相关问题也是世界各国极为关注的公共卫生问题之一,特别是青少年饮酒已成为全球公共卫生和政策关注的一个重点[1-3].近年来的调查发现,很多青少年存在酒精滥用问题,开始饮酒的年龄主要集中在13 ~ 18岁,随年龄的增大,饮酒率呈上升趋势[4].与成年人相比,青少年正处于生长发育和青春期生理变化阶段,对酒精更敏感,也更容易导致生理和心理发育上更大的潜在危害[5].了解青少年饮酒的流行现况,对预防和解决青少年饮酒相关问题具有重要的指导意义.     

美国高中学生酒精使用模式和饮酒驾驶的危险性

饮酒驾驶的摩托车碰撞有关，特别是１５－２４岁年龄段青少年，减少其饮酒驾驶已成为一个美国公共卫生优先考虑的问题。作动用１９９１年美国青少年危险行为调查资料评估饮酒率，饮酒作乐，酒精掺和其他药物，开始使用酒精的年龄和驾驶之间的危险性。作提出了减青少年饮酒驾驶的社会措施和策略。     

父母饮酒与儿童青少年饮酒的关联分析

目的 探讨父母饮酒与儿童青少年饮酒的关系,为儿童青少年饮酒的防控政策制定提供科学依据。方法 采用方便整群抽样的方法,选取济南市城区8~17岁儿童青少年,通过调查问卷获取儿童青少年及其父母饮酒的相关信息,共获得有效样本量2 785人。采用多因素logistic回归模型分析父母饮酒与儿童青少年饮酒的关系。结果 儿童青少年饮酒者占11.2%（311名）,父亲饮酒者占58.6%（1 633名）,母亲饮酒者占7.3%（204名）。与父亲从不饮酒者相比,父亲现在饮酒（OR=1.36,95% CI：1.03~1.80）和重度饮酒（OR=2.09,95% CI：1.44~3.05）与儿童青少年饮酒存在关联。与母亲从不饮酒者相比,母亲现在饮酒也与儿童青少年饮酒存在关联（OR=2.72,95% CI：1.89~3.91）。与父母均不饮酒者相比,父母仅一方饮酒（OR=1.58,95% CI：1.20~2.09）和父母双方均饮酒（OR=4.12,95% CI：2.73~6.20）与儿童青少年饮酒存在关联。按照性别、年龄组分层分析,男生组及13~17岁组的结果与总体结果类似,但是仅父亲重度饮酒或父母双方均饮酒与女生、8~12岁儿童饮酒存在关联。结论 父母饮酒可能是儿童青少年饮酒的重要影响因素。今后儿童青少年饮酒的防控政策制定应该考虑父母饮酒因素。     

南京市大中学生吸烟饮酒现状

目的了解南京市青少年吸烟及饮酒现状,为进一步开展青少年戒烟限酒教育提供科学依据。方法采用问卷对南京市部分大中学生进行现状调查。结果南京市青少年吸烟和饮酒率分别为25.55%和48.20%。初中生、高中生、大学生的吸烟及饮酒率依次递增,且不同学段学生的吸烟率、饮酒率差异均有统计学意义。男性吸烟率及饮酒率分别为35.06%和58.99%,女性吸烟率及饮酒率分别为15.09%和36.21%,男、女性吸烟率及饮酒率差异均有统计学意义。青少年首次吸烟、饮酒呈低龄化趋势。大学生吸烟频率较初中生和高中生高。高中生吸烟量超过20支/d的比例高于大学生和初中生。大学生的醉酒频率比中学生高。结论南京市青少年吸烟率及饮酒率增高不容忽视,应大力开展烟酒危害的宣传教育,以减少其对青少年健康的危害。     

青少年饮酒行为及其影响因素的Logistic分析

[目的]了解成都地区青少年中饮酒行为的流行情况,并分析其影响因素,为日后的健康教育干预提供依据. [方法]采取分层整群抽样方法,对成都市的9所初中、9所高中以及3所职业高中随机抽取42个班的学生进行自填式问卷调查.[结果]在被调查的学生中,总饮酒率为37.2%.男生饮酒率为55.4%,女生饮酒率为30.9%.调查显示青少年学生饮酒后带来的愉快感受和交往便利可能是促使青少年饮酒的影响因素.青少年饮酒与个人因素,家庭环境及学校、社会影响有密切关系.学校的教育质量较高、学习成绩较好以及亲戚朋友的劝告是学生饮酒的保护因素,而周围经常有喝醉酒的同龄人以及饮酒后带来的各种愉快感受成为饮酒的危险因素. [结论]在青少年中,尤其在男生中饮酒的问题不容忽视,在青少年中全面开展相关的健康教育,倡导健康的生活方式以及宣传饮酒危害的工作任重而道远.     

天津市在校青少年饮酒行为调查分析

目的了解天津市青少年饮酒行为的流行情况,为开展有针对性的干预措施提供依据。方法于2011-2012年,应用中国城市青少年健康相关行为调查问卷,采用自填匿名问卷集体调查方法,对天津市36所中学和6所大学的10800名学生进行调查。结果学生曾饮酒率为59.0%,现在饮酒率为25.0%。大专男生及大学女生曾饮酒报告率最高,男生、女生曾饮酒率分别为63.7%和55.0%,差异有统计学意义（χ2=83.169,P=0.01）。饮酒学生中,首次饮酒年龄≤13岁的比例为53.1%,重点中学学生比例高于普通中学,隔代家庭与重组家庭中的学生比例最高。过去30 d内,大专学生经常饮酒（≥6d）的比例最高（30.4%）,普通初中生频繁饮酒（≥20 d）、重度饮酒的比例最高。在过去12个月中,重组家庭学生醉酒比例最高。结论天津青少年的曾饮酒率、现在饮酒率水平较高。饮酒受家庭因素的影响。应尽早采取措施对青少年进行宣传教育,控制饮酒行为。     

南京市大学生饮酒与过量饮酒现状及影响因素分析

饮酒与过量饮酒是青少年大学生的健康危险行为之一,酒精易使脑细胞破坏,导致智力减退,学习成绩下降,且伴生许多致伤害行为,如暴力、车祸、危险性行为等,也与成年后形成的酒精依赖密切相关[1-3].目前,青少年饮酒及过量饮酒在许多国家已成为严重的社会问题.美国每年约有1400名18 ~24岁的大学生因过量饮酒而死亡,有超过7万件性骚扰、强奸案与大学生饮酒有关[4].饮酒与过量饮酒现象在我国青少年人群中也迅速蔓延,2005年15 ~ 29岁人均酒消费量比1972年增加5倍[5].该文通过了解南京市大学生饮酒及过量饮酒行为的流行现状及其影响因素,尤其是易于观察到的社会人口学因素,为在大学生中开展针对相应人群的饮酒行为干预提供依据.     

高中生饮酒行为的相关因素分析

青少年饮酒问题正日益引起社会的关注。相关研究显示，影响青少年饮酒行为的主要因素有以下几类：父母饮酒行为及其对子女饮酒的态度、朋友饮酒行为及其对同伴饮酒的态度、学习成绩以及性别和经济状况。尽管这些研究在饮酒行为影响因素方面进行了探讨，但大多局限于讨论单一因素或少数几个因素的影响，对于各因素在预测饮酒行为中的相对重要性很少涉及。另一方面，美国和欧洲的许多研究表明文化变迁对人们的饮酒行为有着重要影响。我国自改革开放以来，文化变迁非常显著，     

广州市中学生重度饮酒影响因素分析

了解广州市中学生重度饮酒行为的影响因素,为青少年过量饮酒行为干预提供依据.方法 2013年5-6月,采用多阶段分层随机整群抽样方法抽取广州市4个区初一、初二、高一和高二学生5 922名,采用自填问卷进行饮酒行为调查.结果 7.51%的男生和3.27%的女生有重度饮酒行为,性别间差异有统计学意义(x2=55.882,P<0.01).采用广义混合线性模型,在调整学校聚集性、学生性别、年龄、学校类别、社会经济地位指标后,父、母亲饮酒频率≥2次/月,同伴中50%及以上饮酒、同伴中小部分及以上有重度饮酒行为的青少年较有可能重度饮酒;在控制其他父母/同伴饮酒行为的影响后,同伴饮酒及同伴重度饮酒仍然是青少年重度饮酒行为的预测因子(P值均<0.05).结论 父、母饮酒及同伴饮酒与青少年重度饮酒均有关联,其中以同伴饮酒相关性较高.应针对学生饮酒特点,在学校开展拒绝饮酒的专题健康教育.     

Research on alcohol and adolescent brain development: opportunities and future directions

In the past 15 years, both human and animal studies have advanced our understanding of the effects of adolescent alcohol exposure on behavioral and neural development, particularly in the areas of the ontogeny of initial sensitivity and tolerance to alcohol, the consequences of adolescent alcohol exposure on subsequent drinking patterns, as well as cognitive and neural function. Despite these advances, there are still substantial gaps in our understanding of whether heavy adolescent drinking interferes with normal brain development at the cellular and molecular level, and if so, how these changes may translate into patterns of brain connectivity that result in the emergence of alcohol use disorders. This article discusses our current knowledge of the cellular and molecular brain changes that stem from heavy alcohol exposure, including binge patterns, during adolescence. Progress has been made in linking the behavioral effects of adolescent drinking to underlying cellular and molecular mechanisms. However, it is suggested that future research on the etiology and consequences of adolescent drinking use an integrative approach to this problem by combining multiple levels, including genetic, cellular and molecular, systems (neuroimaging), and behavioral, with an emphasis on integrating the different levels of analysis.     

The influence of alcohol outlet density and advertising on youth drinking in urban Tanzania

Despite the detrimental effects of alcohol on adolescent health, high rates of alcohol use are reported among Tanzanian youth. We conducted systematic community mapping and participatory group activities with 177 adolescents in Dar es Salaam to explore how alcohol outlet density and advertising may contribute to adolescent drinking in urban Tanzania. Findings revealed a high density of alcohol-selling outlets and outdoor advertisements. The abundance of alcohol-related cues, including their close proximity to places where youth congregate, may facilitate and increase adolescent alcohol use in Tanzania. Participants recommended several changes to the alcohol environment to reduce adolescent drinking. Structural interventions that reduce adolescents' access and exposure to alcohol are needed in Tanzania.     

广州市越秀区1139名青少年健康相关行为调查

目的了解广州市青少年的主要健康相关行为,为青少年健康教育工作及制定干预措施提供依据。方法采取整群随机分层抽样法,抽取广州市越秀区2所初中、3所高中和1所大学校共1 139名学生,对饮食、运动与吸烟饮酒情况进行问卷调查。结果广州市青少年健康危险行为主要有缺乏体育锻炼、喝酒、吸烟。初中生喝饮料、吃西式快餐、喝牛奶、吃早餐比例分别为26.7%、9.8%、54.9%、81.6%,高中生分别为18.0%、4.9%、41.2%、91.3%,均高于大学生(8.0%、3.4%、18.8%、64.2%);男生(7.1%)吃西式快餐比例高于女生(4.6%),而男生(75.0%)吃早餐比例低于女生(85.9%)。随着年龄的增大,1周内青少年每天活动至少1 h的天数相对减少;男生每周活动时间比女生长。结论缺乏体育锻炼、吸烟和喝酒普遍存在于广州市青少年当中,有必要采取干预措施,广泛开展各种健康促进活动。     

Adolescent drinking,social identity,and parenting for safety: Perspectives from Australian adolescents and parents

We explored young people and parents' views on adolescent drinking and safety in the locations where drinking may occur. Focus groups with adolescents and parents showed that many believed adolescent drinking and drunkenness is normative. Younger adolescents had more negative views of adolescent drinkers than their older peers. Adolescent drinking occurred in private settings and parents made decisions about allowing their adolescent children to attend social events based on the level of safety attributed to the location. If adolescent drinking was likely then home was the preferred location as it provided scope for risk minimisation. Positive portrayals of non-drinking adolescents and information to assist parents' decision-making are needed.     

Alcohol use and social interactions among adolescents in Sweden: Do peer effects exist within and/or between the majority population and immigrants?

Are adolescents who attend schools with a high level of alcohol use and binge drinking more likely to use alcohol and binge drink themselves? This paper analyzes peer effects in adolescent drinking based on a survey of 13,070 adolescents conducted in Sweden in 2005. The empirical analysis uses a multi-level logistic model to account for non-observable heterogeneity between the schools and the results show that attending a school with a high level of alcohol use and frequent binge drinking is a strong predictor of alcohol use and binge drinking for the individual. Hardly any significant interaction effects are detected, implying that peer influence is similar across different adolescent sub-groups. Looking at adolescents with different ethnic backgrounds, it is found that the drinking-pattern of the Swedish majority population has a significant effect on drinking by Swedish individuals and immigrants from Nordic and European countries, but no effect on drinking by immigrants from non-European countries.     

The Association between Scholastic Measures,Alcohol Outcome Expectancies and Alcohol Use: A Cross-sectional Study in Northern Ireland

Alcohol use among adolescents is associated with both short-term (truancy, illness, trouble with police) and long-term (dependence, unemployment) negative consequences. Moreover, because of its developmental nature, adolescent drinking behaviour is difficult to accurately assess. Individual-level scholastic variables and alcohol outcome expectancies have been found to be associated with drinking behaviours. This study used a cross-sectional design to investigate: the relationship between alcohol use and individual-level scholastic variables, namely academic motivation and academic self-efficacy; and the relationship between alcohol use and alcohol outcome expectancies, while controlling for a wide range of other variables. Participants were post-primary (high) school pupils in the greater Belfast area of Northern Ireland. They completed a range of questionnaires including measures assessing academic self-efficacy, academic motivation, alcohol outcome expectancies, and a composite measure of alcohol use. Results showed that, controlling for the hierarchical nature of the data, socio-demographic variables and other possible confounders, lower reported scores on the individual-level scholastic measures, higher reported scores on positive alcohol outcome expectancies, and lower reported scores on negative alcohol outcome expectancies remained significantly associated with more problematic drinking. Results are discussed in the context of contemporaneous school-related research.     

Lymphocyte measures in treatment-naïve 13-15-year old adolescents with alcohol use disorders

Many adolescents have chronic exposure to hazardous levels of alcohol. This is likely to be a significant predictor of health outcomes, including those related to immunity. We assessed substance use and biochemical immunological parameters in heavy drinking adolescents (meeting DSM-IV criteria for alcohol dependence) and light/nondrinking control adolescents in Cape Town. Lifetime alcohol dose, measured in standard units of alcohol, was orders of magnitude higher in alcohol-dependent (AD) participants than controls. All adolescent AD had a “weekends-only” style of alcohol consumption. The AD group was chosen to represent relatively “pure” AD, with minimal other drug use and no psychiatric diagnoses. With these narrow parameters in place, we found that AD adolescents were lymphopenic compared with controls, with significantly lower mean numbers of absolute circulating CD3+, CD4+, and CD8+ T-lymphocytes. On conclusion, we found that adolescent AD individuals with excessive alcohol intake, in a weekend binge-drinking style but without comorbid drug or psychiatric disorders, may be at increased risk of lymphopenia. This alcohol misuse may increase infectious disease susceptibility (including TB and HIV) by reducing immune system capabilities. Complex interactions of alcohol with other documented high-risk activities may further compound health risks.     

Reducing Youth Exposure to Alcohol Ads: Targeting Public Transit

Underage drinking is a major public health problem. Youth drink more heavily than adults and are more vulnerable to the adverse effects of alcohol. Previous research has demonstrated the connection between alcohol advertising and underage drinking. Restricting outdoor advertising in general and transit ads in particular, represents an important opportunity to reduce youth exposure. To address this problem, the Marin Institute, an alcohol industry watchdog group in Northern California, conducted a survey of alcohol ads on San Francisco bus shelters. The survey received sufficient media attention to lead the billboard company, CBS Outdoor, into taking down the ads. Marin Institute also surveyed the 25 largest transit agencies; results showed that 75 percent of responding agencies currently have policies that ban alcohol advertising. However, as the experience in San Francisco demonstrated, having a policy on paper does not necessarily mean it is being followed. Communities must be diligent in holding accountable government officials, the alcohol industry, and the media companies through which advertising occurs.     

江西抚州市青少年饮酒现状及其与心理行为问题的关联

目的了解目前中学生饮酒现状及其与心理行为问题的关联。方法整群随机抽取江西省抚州市2所普通中学初一到高三4 947名学生进行问卷调查,采用修订的青少年危险行为问卷(YRBSS)评定饮酒行为,采用青少年自评量表(YSR)评定心理行为问题。结果半数以上(53.9%)中学生曾经饮酒,48.7%在12岁或更小年龄初次尝试饮酒,24.9%的学生在调查前30 d内至少有1 d喝过酒,9.3%的被调查者在调查前的30 d喝醉过。各饮酒行为均是男生高于女生,高中生高于初中生。饮酒的中学生YSR得分高于不饮酒的被调查者。饮酒行为对男、女生的影响以及初、高中生的影响有所不同。结论中学生饮酒行为较为普遍,饮酒的青少年学生各种心理行为问题的发生显著增高。     

Predictors of alcohol use prior to pregnancy recognition among township women in Cape Town, South Africa

South Africa has the highest prevalence of Fetal Alcohol Spectrum Disorders (FASDs) in the world. The purpose of this study was to identify high risk factors associated with drinking alcohol prior to pregnancy recognition in 24 neighborhoods in the Cape Flats outside Cape Town, South Africa. An interviewer assessed risk among 619 pregnant Black/African women between the ages of 18 and 41 years. Logistic regression analyses explored factors associated with drinking alcohol post conception but prior to pregnancy recognition. Forced multiple logistic regression analysis revealed that drinking prior to pregnancy recognition was associated with being younger, single, having better living conditions, smoking, having a longer gestation prior to pregnancy recognition, having a greater number of sexual partners, and a higher incidence of intimate partner violence. Depressive symptoms tended to be higher among alcohol users. These risk factors were consistent with other research on the characteristics of South African women having children with a diagnosis of Fetal Alcohol Spectrum Disorders and/or of non pregnant women at high risk for an alcohol-exposed pregnancy. These findings highlight the need for women of child-bearing age to be routinely screened for alcohol use and its associated risk factors. Intervention efforts could be integrated into health initiatives already present in South Africa including the prevention and treatment of HIV/AIDS, tuberculosis, and malnutrition. Preconception care is particularly important since pregnancy recognition often occurs several weeks to months following conception and could be implemented by South African community health workers. These endeavors should facilitate national goals of healthier pregnancies and the elimination of FASDs in South Africa.