青春期性发育对青少年吸烟行为的影响

目的 研究青春期性发育早晚对青少年吸烟行为的影响。方法 2000年11月对随机整群抽取的1453名上海市高中学生进行横断面问卷调查，获取青少年吸烟，男孩首次遗精年龄，女孩月经初潮年龄及可能影响青少年吸烟的社会心理因素等信息。结果 男生的尝试吸烟率在性发育较晚组中最高（28．6％），其次为发育较早（21．3％）和中等组（21．7％）；现在吸烟率在性发育较早组最高（16．4％），然后依次为发育较晚（7．1％）和中等组（4．8％）；女生的曾经吸烟率在性发育早，中，晚各组中依次为24．2％，12．0％，6．3％。在控制影响青少年吸烟的一系列社会心理因素后，性发育较早是导致男生现在吸烟的独立危险因素（OR＝3.68,95%,CI:1.23-10.99)，也是女生吸烟的危险因素（OR＝2.23,95%,CI:0.89-5.60)；而性发育较晚可能导致男生尝试吸烟（OR＝1．48，95％CI：0．72－3．06），对女性却可能有一定的保护作用（OR＝0.64,95%CI:0.22-1.86)。结论 学校，家庭和社会应该关心，引导性发育时间偏离正常的男女青少年，加强吸烟危害健康教育。     

Parental smoking and sociodemographic factors related to smoking among German medical students

Smoking among medical students has been found to vary strongly between European countries. Few studies have addressed factors associated with smoking among medical students within countries. In this study, we assessed the association of parental smoking and sociodemographic factors with smoking habits of medical students at the University of Ulm, Germany, Students who entered the 1st, 3rd and 5th year of medical school in fall 1992 were asked to complete a self-administered questionnaire. Questionnaires were returned by 696 (85.2%) of 817 eligible students. Overall, 23.7% of students were current smokers, and 11.9% were former smokers. Smoking habits were related to maternal smoking: Odds ratios for the association of maternal smoking with ever or current smoking of students were 2.11 (95% CI: 1.48–3.03) and 2.01 (95% CI: 1.35–3.01), respectively, after adjustment for potential confounders in multiple logistic regression. In contrast, no asso-ciation was found between paternal smoking and students' smoking status. Male students were more likely to smoke than female students, and living in a large city during secondary school was also associated with ever smoking. No association was found between students' smoking habits and educational achievement of their mothers and fathers. These results suggest a key role of maternal smoking for smoking among medical students in this society.     

A survey of cigarette smoking among middle school students in 1988

A survey of the prevalence of smoking in middle school students aged 13-21 years in Harbin city, China, was undertaken in the Spring of 1988. A random sample of 4712 students was selected using proportional stratified clustering. A self-administered confidential questionnaire relating to smoking habits and certain family and school factors was administered. The results showed that 1.29% of the students (2.21% boys and 0.38% girls) smoked regularly, 5.62% (10.52% boys and 0.76% girls) were light smokers and 13.77% (24.29% boys and 2.92% girls) smoked only occasionally. Smoking habits were related to the type of school and to age, there being a higher proportion of smoking in senior grade students. Students were significantly more likely to smoke if they were male and if their siblings smoked. Prevalence of regular smoking was not related to parental occupation or family income. It is suggested that anti-smoking education in the school curriculum should be directed towards students in middle school.     

Factors associated with smoking progression among Spanish adolescents

Smoking onset takes place in the early years of adolescence, and can be seen as a progression through stages of preparation, trying, experimentation, regular smoking and nicotine dependence or addiction. The objective of this study is to identify 1-year predictors of smoking consolidation among occasional smokers (experimenters) and of cessation among all smokers. A questionnaire developed to monitor trends in smoking and other health-related behaviors was administered in the spring of 1992 and again 1 year later (1993). The survey was carried out in six large, private schools in Barcelona and Raimat, in the Lleida province, in Catalonia (Spain). In total, 1460 schoolchildren aged 12-19 responded to both the baseline and follow-up questionnaires; 1236 questionnaires (84.7%) were matched through a personal code and were used for the longitudinal study. At the baseline survey 28% of the schoolchildren were regular smokers and 17.1 % were occasional smokers, with no differences by gender. At the follow-up survey, progression from occasional to regular smoking was observed in 42% of the girls and 22.7% of the boys. Other predictors of consolidation included drinking alcohol (OR = 3.1; 95% CI = 1.1-10.1) and reporting the intention to smoke in the future (OR = 2.5; 95% CI = 1.3-4.9). Among all the smokers at the baseline, predictors of cessation were smoking occasionally (versus regularly) (OR = 4.9; 95% CI = 2.8-8.6), negative attitudes regarding smoking (OR = 3.3; 95% CI = 1.9-5.4), reporting no intention to smoke in the future (OR = 2.2; 95% CI = 1.3-3.8), gender (OR for boys = 2.1; 95% CI = 1.2-3.6), receiving weekly pocket less than 1000 ptas (OR = 1.7; 95% CI = 1.1-5.3) and age (OR for being 15 and younger = 1.6; 95% CI = 1.1-4.9). We conclude that consolidation of smoking is twice as likely among girls than among boys. Intention to smoke seems to be a good predictor of future behavior, while attitudes may predict cessation, but not consolidation. Available pocket money seems to be a strong risk factor for smoking at this age.     

Smoking habits, exposure to environmental tobacco smoke, and respiratory symptoms in schoolchildren aged 14-15 years in Terrassa (Barcelona)

OBJECTIVES: Assessment of the prevalence of smoking habits, environmental tobacco exposure, and asthma-related symptoms in a cross-sectional study in schoolchildren aged 14-15 years in Terrassa (Barcelona). METHODS: A sample of 793 students from 21 schools answered a self-administered questionnaire including information on smoking habits, environmental tobacco exposure and asthma-related symptoms. RESULTS: The prevalence of smoking daily was 16.3% (CI 13. 7-18.9); no difference between sexes were observed, while the proportion of occasional smokers was higher among girls. Age, maternal habit, friend's smoking habit and having older siblings were independently associated to the schoolchildren's smoking habits. Overall, 13% reported a positive history of wheezing and 20.3% of nocturnal cough during the previous year. Smoking daily and passive smoking were positively associated with the prevalence of asthma-related symptoms, but not with previous diagnosis of asthma. CONCLUSIONS: The prevalence of smoking among adolescents seems to have levelled off. There is some trend toward a higher prevalence among girls than among boys. The presence of smoking in the social environment is a strong predictor of the smoking habits among schoolchildren. Both active smoking and environmental exposure to tobacco smoke are associated to increased asthma-related symptoms.     

A randomized intervention of smoking for adolescents in urban Wuhan, China

BACKGROUND: Tobacco use is a significant public health problem in China. Culturally specific smoking prevention programs are needed for Chinese adolescents. This study evaluated a school-based smoking prevention curriculum with a social normative approach developed in the United States for adolescents in urban Wuhan, China. METHODS: As a randomized trial, the intervention was implemented in 1998 with 7th grade students in seven schools with seven matched control schools. Multilevel logistic regression models were used to compare ever and recent (past-month) smoking behaviors for the control and program conditions. RESULTS: At the 1-year follow-up, smoking had increased more rapidly in the control schools than in the program schools. The odds of baseline nonsmokers initiating smoking did not differ between the program and control groups (OR=1.08 with 95% CI=0.71, 1.64). The program prevented progression to recent smoking among boys who were baseline ever smokers. Among boys who were recent smokers at baseline, the prevention program significantly reduced risk of remaining recent smokers at follow-up (OR=0.45 with 95% CI=0.23, 0.88). CONCLUSIONS: This social normative smoking prevention curriculum did not demonstrate a significant primary prevention effect but showed potential for secondary prevention. Culturally specific smoking prevention programs are needed for Chinese adolescents.     

Quit attempts among African American teenage smokers seeking treatment: gender differences

BACKGROUND: African Americans experience disproportionate smoking-related mortality. Because established smoking during youth predisposes to adult smoking and serious health consequences, characterizing ethnic differences in adolescent smokers' self-quit attempts may inform ethnic-specific approaches to youth smoking cessation. METHODS: African American and European American teenage smokers applying to a teenage smoking cessation study (2000-2003) provided smoking-related data, including characteristics of previous cessation attempts and prior use of nicotine replacement therapy (NRT). Tobacco dependence was assessed using the Fagerstrom Test of Nicotine Dependence (FTND). RESULTS: Of 980 (15.5 +/- 1.3 years, 41.8% African American, 59.9% female) participants, African Americans boys were significantly less likely than European American boys to report a prior quit attempt (OR = 0.35, 95% CI 0.17-0.73, P = 0.0049) or to have used NRT (OR = 0.60, 95% CI 0.36-0.998, P = 0.049) after adjusting for years smoked and FTND score. African American girls were more likely to report a prior request for cessation treatment than European American girls after adjusting for FTND and years smoked (OR = 2.19, 95% CI 1.37-3.48, P = 0.001). CONCLUSIONS: While increasing education and outreach to African American boys and enhancing access to formal cessation programs for African American girls who smoke may be beneficial, our findings warrant extension to non-treatment-seeking teenage smokers.     

吸烟与帕金森病关系的病例对照研究

目的　探讨吸烟与帕金森病 (PD)的关系。方法　采用以人群为基础的病例对照研究 ,调查在北京地区 55岁以上PD患病率调查中确诊及 2 0 0 2年 8月至 2 0 0 3年 1月在北京协和医院帕金森研究中心诊治的病例共 1 1 4例 ;以及性别、民族及居住地与其匹配的对照 2 0 5名。结果　吸烟与PD呈显著负相关联。以非吸烟者为对照 ,曾经吸烟者、现在吸烟者和过去吸烟者患PD的危险性低于对照 ,OR值分别为 0 .49(95 %CI:0 .30～ 0 .79)、0 .44(95 %CI :0 .2 3～ 0 .86)和 0 .54(95 %CI:0 .30～0 .96)。此外 ,对吸烟者分别按吸烟年限≥ 2 0年和 <2 0年、戒烟年限≥ 2 0年和 <2 0年以及吸烟量分层和logistic回归分析 ,其负相关联依然存在并具有剂量反应关系的趋势 (P <0 .0 5)。结论　吸烟与PD存在负相关联 ,今后应着重开展有关生物学依据的研究     

Individual and family household smoking habits as risk factors for wheezing among adolescents

BACKGROUND: The study aimed to evaluate the household smoking habits as risk factors for wheezing in adolescents. METHODS: During a 2-month period, the study was performed by applying the standardized ISAAC phase 1 questionnaire to 3474 adolescents attending a random sample of secondary public schools located at the southeast of Mexico City. Adolescents were grouped as "cases" if they had at least one episode of wheezing in the year prior to the study, or as "controls" if they did not. Positive individual and family (father, mother or other persons living in the home) smoking habits at home were evaluated as potential risk factors. RESULTS: More than 98% of respondents in the two groups reported that the father smoked in the house. More mothers who smoked were reported among cases than controls (OR 2.42; 95% CI 1.60-3.68). More adolescents in the group of cases had history of ever having rhinitis, rash or wheezing. Fifty-four percent of adolescents in the group of cases had ever smoked versus 38.8% of controls (OR 1.89; 95% CI 1.33-2.67). Sex-adjusted logistic regression analysis identified a "protective" role for wheezing when the number of smokers at home was < or =2 (OR 0.44; 95% CI 0.27-0.71). CONCLUSION: Individual, maternal and other family members' indoor smoking habits may increase the risk of wheezing among adolescents.     

Factors associated with smoking and the intention to smoke in secondary school pupils: results of the ESFA project in Barcelona, Spain

Objective: To describe the factors asssociated with smoking and intention to smoke among a representative sample of first-grade pupils of secondary education (12-13 years old) in Barcelona.Subjects and methods: 37 secondary schools were randomly selected to evaluate the impact of a European-wide smoking prevention program (European Smoking prevention Frame Approach, ESFA project). In these schools, 1041 pupils of first grade of secondary education responded to a questionnaire designed at the University of Maastricht to study life-style attitudes and behaviours, mainly smoking.Results: 9.8% of boys and 12.6% of girls declared to smoke either regulary or ocasionally. Among the no-smokers, 61.4% of the boys and 73.3% of the girls reported to have the intention to smoke in the future. Among the boys, factors associated with smoking included social norms (odds ratio [OR] = 2.5; 95% confidence interval [CI]: 1.2-5.2), smoking by siblings (OR = 2.4; 95% CI, 1.1-5.2), attitudes against smoking (OR = 0.3; 95% CI, 0.1-0.6), practicing some sports in the leisure time (OR = 0.3; 95% CI, 0.1-0.7) and having more available pocket money (OR = 3.2; 95% CI, 1.5-6.8). Intention to smoke was only related to attitudes (OR = 0.3; 95% CI, 0.2-0.5). Among girls, smoking was associated to perceived pressure to smoke (OR = 2.5; 95% CI, 1.2-5.0), consumption by friends (OR = 6.0; 95% CI, 2.4-15.4) and attitudes against smoking (OR = 0.2; 95% CI, 0.1-0.4), while intention was only associated to attitudes (OR = 0.4; 95% CI, 0.2-0.6) and hanging out in the street in the leisure time (OR = 2.2; 95% CI, 0.3-3.5).Conclusions: The results stress the need to deal simultaneoulsy with the different factors associated to smoking initiation and attitude shaping, including cognitive factors, environmental factors, and patterns of leisure time utilization.     

Cognitive factors associated with smoking initiation in adolescents

OBJECTIVE: To study the association between cognitive factors of the behavioral change model "Attitude Self Efficacy" (ASE) at different phases of smoking initiation among adolescents. METHODS: We carried out a cross-sectional survey among students in the second grade of Compulsory Secondary Education (13-14 years old) from Cornellà de Llobregat (Barcelona, Spain) in 2000 to obtain information on cognitive factors and smoking. Logistic regression analysis was used to investigate the variables associated with smoking (odds ratio [OR] of experimenters vs. non-smokers and of smokers vs. experimenters). RESULTS: The prevalence of daily smoking was 22.9% (95% CI, 16.5%-29.3%) among boys and 36.2% (95% CI, 29.7%-42.6%) among girls. Factors associated with experimenting (vs. non-smoking) were: attitudes to smoking (disagreement with smoke-free areas [OR = 3.46; 95% CI, 1.65-7.24], agreement with smoking promotion [OR = 3.42; 95% CI, 1.42-8.28]), and subjective norms (perceiving friends as smokers [OR = 2.50; 95% CI, 1.17-5.35]). The variables associated with regular smoking (vs experimenting) belong to: self-efficacy and attitudes to smoking. CONCLUSIONS: Focussing on subjective norms and smoking attitudes with programs targetted younger ages seems appropriate, since these factors are more closely associated with the experimenting phase. Encouraging skills to refuse cigarettes offered by friends is appropriate at a more advanced age, since this determinant is associated with the change from experimenting to regular smoking.     

The joint influence of parental modeling and positive parental concern on cigarette smoking in middle and high school students

Abstract: The purpose of the study was to examine the interaction between parental smoking status and parental attitudes, as measured by positive parental concern, on the risk of adolescent cigarette smoking. Parental smoking and parental concern about smoking were measured in a cross-sectional study of 37,244 students, a random sample of Maryland middle and high school students, who were current or never smokers. Parental concern was classified into 3 levels: strict, moderate, and minimal. The likelihood of youths being current smokers was positively associated with both parental smoking (both versus neither parent smokes: odds ratio [OR] 3.4, 95% confidence interval [CI] 3.1-3.7) and parental concern about smoking (minimal versus strict concern: OR 2.3, 95% CI 2.1-2.4). Youths with parents who did not smoke and with strict concern had the lowest likelihood of smoking. In comparison to this group, after adjustment for other social influences the likelihood of being a current smoker was more than 5 times greater among boys (OR 5.8, 95% CI 4.5-7.4) and girls (OR 5.2, 95% CI 4.1-6.5) whose parents both smoked and were minimally concerned about smoking. Current smoking in youths was independently associated with both parental smoking and less parental concern. When these 2 factors were jointly considered, the prevalence of current smoking in youths increased both with exposure to parental modeling and reduced parental concern about smoking. The results indicate that minimal parental concern about smoking worsens the risk due to parental modeling. Parental modeling and parental attitudes act synergistically to exacerbate the likelihood of smoking. (J Sch Health. 2006;76(8):402-407)     

Determinants of Smoking Behaviour Among Secondary School Students in Bangladesh

Despite established country’s tobacco control law, cigarette smoking by the young people and the magnitude of nicotine dependence among the students is alarming in Bangladesh. This study was aimed to determine the prevalence of smoking and factors influencing it among the secondary school students. A two-stage cluster sampling was used for selection of schools with probability proportional to enrollment size followed by stratified random sampling of government and private schools. The 70-item questionnaire included ‘core GYTS’ (Global Youth Tobacco Survey) and other additional questions were used to collect relevant information. Analysis showed that the prevalence of smoking was 12.3% among boys and 4.5% among girls, respectively. The mean age at initiation of smoking was 10.8 years with standard deviation of 2.7 years. Logistic regression analysis revealed that boys are 2.282 times likely to smoked than girls and it was 1.786 times higher among the students aged 16 years and above than their younger counterparts. Smoking by teachers appeared to be the strong predictor for students smoking behaviour (OR 2.206, 95% CI: 1.576, 3.088) followed by peer influence (OR 1.988, 95% CI: 1.178, 3.356). Effective smoking prevention program should to be taken to reduce smoking behaviour. The school curricula had less impact in preventing smoking except teacher’s smoking behaviour.     

Smoking among urban Malaysian school children

A questionnaire on smoking habits was administered to 4106 Form IV school children in Kuala Lumpur. The period of survey was from 9 to 20 April 1984. 2099 boys and 2007 girls were studied and their mean age was 16.1 years. 32.8% of the students had been initiated to smoking and the mean age of initiation was 13.3 years. The prevalence of smoking was found to be 9.8% and the mean duration of smoking was 2.5 years. Most of the smokers and occasional smokers were boys. About 42% of the smokers wished to stop smoking and only 1% of the non-smokers intended to smoke in the future. The study recommended that health education programmes should be started earlier in school.     

Family influences on future smoking habits among junior high school students in Japan

OBJECTIVE: To examine the effects of health-related behavior and family smoking habits on the future smoking habits of junior high school students in two Japanese cities with different life expectancies. METHODS: A cross-sectional study was conducted in January 2005 of all second-grade students in a junior high school in city A located in Aomori prefecture (399 students) and city B located in Nagano prefecture (447 students). Life expectancies in city B were 4.2 years longer in men and 2.9 years longer in women than in city A. Data on feelings about future smoking habits, dislike of tobacco smoke, family smoking habits and health-related behavior were collected. RESULTS: The proportion of boys who went on to become smokers was higher in city A (18.7%) than in city B (10.3%). The proportions of smoking mothers and other smoking family members were also higher in city A, while the proportion of students who disliked tobacco smoke was lower. For girls in both cities, there was a significant positive association between future smoking and maternal smoking. CONCLUSION: The findings suggest that maternal smoking habits are especially strongly correlated with future smoking in girls. The family smoking environment and health-related behavior should therefore be considered in measures to prevent smoking by students.     

Smoking by French general practitioners: behaviour, attitudes and practice

INTRODUCTION: This paper examines smoking prevalence, sociodemographic factors and the medical practice of French general practitioners. METHOD: Data from the 1998 cross-sectional national survey of 2,073 GPs. The questionnaire was administered by telephone. A response rate of 67% was attained. Instrumentation included questions about medical practice, sociodemographic characteristics, and health behaviour. Bivariate and multiple logistic regression (MLR) analyses were conducted. RESULTS: Almost one-third (32.1%) of physicians were current smokers. A significantly higher proportion of male (33.9%) were smokers compared to women (25.4%, p<0.001) and men were more likely to be former smokers (49.1% versus 31.7%). Two-thirds of physicians reported recommending nicotine replacement therapy to their patients. MLR shown that former smokers were more likely (OR = 1.51, 95% CI, 1.24-1.83) to indicate that their help in getting patients to quit was not effective compared to smokers. Also, physicians who were 'dissatisfied' with the profession were more likely (OR = 0.75, 95% CI, 0.60-0.92) to report their help as not effective than those who were 'satisfied'. CONCLUSION: These data support the need for greater professional participation in reducing smoking among general practitioners in France and greater education concerning the vital role of physicians in promoting cessation among the general population. KEY POINTS: This study examines smoking habits among French GP's, intervention practices, and opinions about their ability to help patients quit smoking. This study found a smoking prevalence rate of 32.1%, 33.9% of male physicians were smokers and 25.4% of women. This study found a smoking prevalence rate of 32.1%, 33.9% of male physicians were smokers and 25.4% of women.     

Tobacco use among Australin secondary students in 1996

OBJECTIVES: To estimate smoking prevalence among Australian secondary students in 1996 and to examine trends in smoking prevalence since 1984. METHOD: A randomly selected representative sample of 434 secondary schools from across Australia participated in the study. At each school 80 randomly selected students completed a pencil-and-paper questionnaire anonymously. Data from 29,850 students aged between 12 and 17 years are reported. RESULTS: Current smoking (smoking in the week before the survey) was 8% in boys and 7% in girls aged 12, and rose to a peak prevalence among 17 year olds of 28% for boys and 34% for girls. The mean number of cigarettes smoked per week among current smokers rose from 11 for boys and six for girls aged 12 to 37 for boys and 34 for girls aged 17. Comparisons across survey years showed that while fewer 12 to 15 year olds were current smokers in 1996 than in 1984, the proportion in 1996 was greater than that in 1987 or 1990. Among 16 and 17 year olds, the proportion of current smokers in 1996 was greater than that seen in 1987 or 1990. An aggregate measure of tobacco involvement suggested that involvement with tobacco had remained stable since 1993 among 12 to 15 year olds. CONCLUSION: The decline in adolescent smoking seen in the late 1980s has stopped. IMPLICATIONS: Extrapolating from this survey, we estimate that more than 276,000 12-17 year old students were current smokers in 1996. If they all continue to smoke, 138,000 would die prematurely.     

Comparison of smoking prevalence in school students sampled from the United States of America and the Union of Soviet Socialist Republics

To assess the smoking prevalence among adolescents in the USA and the USSR, students in Moscow and Minneapolis were surveyed by common protocol and identically trained staff. Smoking habits were measured by a self-report questionnaire and an expired air sample of carbon monoxide (CO). Significant gender differences were found between the two national groups. Among girls in the USA, there was a significantly higher rate of weekly smoking as compared to girls in the USSR. Among boys in the USSR as compared to those in the USA, there was a significantly higher rate of ever smokers and daily smokers, but also of ex-smokers. These gender differences may reflect cultural differences in smoking patterns between the two countries. Cigarette smoking is clearly a public health problem in both countries with its onset in adolescence.     

Do favorite movie stars influence adolescent smoking initiation?

OBJECTIVES: We sought to determine whether adolescents whose favorite movie stars smoke on-screen are at increased risk of tobacco use. METHODS: During interviews, adolescent never smokers taking part in the California Tobacco Survey nominated their favorite stars. We reviewed popular films released during 1994 through 1996 to determine whether stars smoked on-screen in at least 2 films. RESULTS: One third of never smokers nominated a star who smoked on-screen, which independently predicted later smoking risk (odds ratio [OR] = 1.36; 95% confidence interval [CI] = 1.02, 1.82). The effect was strong among girls (OR = 1.86; 95% CI = 1.26, 2.73). Among boys, there was no independent effect after control for receptivity to tobacco industry promotions. CONCLUSIONS: Public health efforts to reduce adolescent smoking must confront smoking in films as a tobacco marketing strategy.     

Smoking habits in school-children with 2 years follow-up

The proportion of smokers among Swedish school-children between 12 and 15 years of age and their short- and long-term attitudes and reactions towards smoking during an antismoking campaign was studied. Of a total of 413 pupils interviewed, 13.3% of the boys and 9.5% of the girls were smokers. Among the 15-year-old pupils 21% were smokers, whereas none of the 12-13-year-old pupils smoked at all. Everyday smoking was twice as common in boys as in girls but on follow-up there was no difference. Our study confirms a trend of diminishing smoking habits in boys but not among girls. Antitobacco campaigns may have a long-term positive effect in supporting changed attitudes towards smoking.