2005年北京市儿童青少年烟草流行现状调查分析

目的了解北京市儿童青少年烟草流行现状及其影响因素，为制定北京市青少年控烟策略提供依据。方法采用多层整群抽样的方法，选取126所大中小学学生进行问卷调查。结果共调查北京市小学生、中学生和大学生17952人，其中男生8873人，女生9079人；小学生5688人，中学生8755人，大学生3509人；农村生源2232人，县镇生源6595人，城市生源9125人。北京市6—14岁学生吸烟率为1．12％，15—24岁学生吸烟率为11．73％；男性吸烟率高于女性，并均于17岁达到高峰；中专与职业高中学生吸烟率最高；学生开始尝试吸烟的高峰年龄为小学高年级及初中阶段；影响学生吸烟的因素主要分为自身、家庭与社会环境三个部分。结论北京市儿童青少年吸烟率达到很高水平，尝试吸烟年龄提前，因此制定有效的干预措施和策略是当务之急。     

中国儿童青少年高血压患病率及影响因素META分析

目的 通过META分析了解我国儿童高血压患病情况。方法 检索CNKI、Wanfang、CBM、VIP和PubMed数据库中有关中国儿童青少年高血压患病率及影响因素相关文献,利用Stata 11.0软件合并患病率,并对影响因素进行分析。结果 共39篇文献纳入本研究,总样本量796512人,男405479人,女391033人。中国儿童高血压合并患病率为9.1%(95%CI: 7.4%~10.7%)。影响儿童高血压发生的主要因素为肥胖（OR=5.78,95%CI: 3.69~9.05)、居住地（OR=1.18,95%CI: 1.06~1.31)、年龄（OR=1.71,95%CI: 1.28~2.27)。结论 我国儿童青少年高血压患病率较高,肥胖、居住地、年龄是儿童高血压的主要影响因素。     

Individual and social environment influences on smoking in children and adolescents

OBJECTIVES: A precise knowledge of the risk factors for childhood and adolescent smoking is crucial for the development of appropriate preventive measures. This study investigated current smoking prevalence and the social and regional correlates for smoking among minors (children and adolescents aged 12-17 years) in Germany. METHODS: Bivariate data analysis was performed on the basis of a representative national cross-sectional study performed in 2004, and multivariable logistic regression models were calculated separately for boys and girls. All correlates identified as significant in the bivariate model were used in the multivariable analysis. STUDY DESIGN: The database used in this research was from the study 'Drug Affinity of Young People in the Federal Republic of Germany 2004', with approximately 1298 children and adolescents aged 12-17 years. RESULTS: Twelve percent of male and 9% of female adolescents in Germany reported that they are habitual smokers, and 12% of male and 13% of female adolescents reported that they are occasional smokers. Multivariable data analysis shows that living in a large city is protective for adolescents in terms of local disparities. The educational level of the respondents also correlates significantly with smoking behaviour. The percentage of adolescent smokers is lowest among those with a high level of education. The presence of smokers in the household is associated with a significantly higher prevalence of smoking among adolescents compared with those growing up in a non-smoking household. CONCLUSION: Smoking is a major public health problem among German children and adolescents. Control measures must tackle the structural and social pressures that shape smoking behaviour during childhood.     

Decrease in the prevalence of smoking among Japanese adolescents and its possible causes: periodic nationwide cross-sectional surveys

Objectives  To assess trends in smoking prevalence among Japanese adolescents and to analyze possible causal factors for the decrease in smoking prevalence observed in a 2004 survey. Methods  Nationwide cross-sectional surveys were conducted in 1996, 2000 and 2004. Survey schools, both junior and senior high schools, considered to be representative of the whole of Japan were sampled randomly. Enrolled students were asked to complete a self-reporting anonymous questionnaire on smoking behavior. The questionnaires were collected from 115,814 students in 1996, 106,297 in 2000, and 102,451 in 2004. School principals were asked about the policy of their respective school on smoking restrictions. Results  Cigarette smoking prevalence (lifetime, current, and daily smoking) in 2004, based on the completed questionaires, had decreased relative to previous years in both sexes and in all school grades. The most important trends were: a decrease in smoking prevalence among the fathers and older brothers of the students; an increase in the proportion of students who did not have friends; a decrease in the proportion of current smokers who usually bought cigarettes in stores decreased in 2004, in particular for the oldest boys. An association was found between a lower smoking rate at a school and a smoke-free school policy. Conclusions  Japan has experienced a decrease in the prevalence of smoking among adolescents. A decrease in smoking prevalence among the fathers and older brothers, limitations to minors’ access to tobacco, an increase in the proportion of students without friends, and a school policy restricting smoking may have contributed to this decreasing trend.     

Treating asthma with a self-management model of illness behaviour in an Australian community pharmacy setting

Asthma affects a considerable proportion of the population worldwide and presents a significant health problem in Australia. Given its chronic nature, effective asthma self-management approaches are important. However, despite research and interventions targeting its treatment, the management of asthma remains problematic. This study aimed to develop, from a theoretical basis, an asthma self-management model and implement it in an Australian community pharmacy setting in metropolitan Sydney, using a controlled, parallel-groups repeated-measures design. Trained pharmacists delivered a structured, step-wise, patient-focused asthma self-management program to adult participants over a 9-month period focusing on identification of asthma problems, goal setting and strategy development. Data on process- clinical- and psychosocial-outcome measures were gathered. Results showed that participants set an average of four new goals and six repeated goals over the course of the intervention. Most common goal-related themes included asthma triggers, asthma control and medications. An average of nine strategies per participant was developed to achieve the set goals. Common strategies involved visiting a medical practitioner for review of medications, improving adherence to medications and using medications before exercise. Clinical and psychosocial outcomes indicated significant improvements over time in asthma symptom control, asthma-related self-efficacy and quality of life, and negative affect. These results suggest that an asthma self-management model of illness behaviour has the potential to provide patients with a range of process skills for self-management, and deliver improvements in clinical and psychosocial indicators of asthma control. The results also indicate the capacity for the effective delivery of such an intervention by pharmacists in Australian community pharmacy settings.     

运城市疾病预防控制人员吸烟状况调查分析

目的了解疾病预防控制人员这一特殊人群吸烟状况。方法以运城市13个县市疾病预防控制工作人员为研究对象，采用统一问卷进行调查。结果运城市疾病预防控制工作人员总吸烟率为40．88％，男性吸烟率为58．56％，女性无吸烟者；平均开始吸烟年龄为23．26岁；吸烟率随着文化程度的提高而降低（P〈0．01）；受控烟教育而戒烟者占戒烟人数的53．33％；吸烟者中有72．82％的人认为吸烟有害健康，4．62％的人认为无害或不知道；吸烟者患慢性支气管炎、支气管哮喘、高血压、肺气肿的危险性大于不吸烟者。结论疾病预防控制人员这一特殊人群吸烟率很高，值得关注。     

中国儿童青少年代谢综合征患病率Meta分析

目的 通过Meta分析了解我国儿童青少年MS的流行现状, 为早期防治提供科学依据。 方法 检索2004-2014年在中国期刊全文数据库(CNKI)、万方数据资源系统(Wanfangdata)、维普数据库(VIP)及PubMed中收录的有关中国地区儿童青少年MS患病率研究的文献。根据加强观察性流行病学研究报告规范(STROBE)声明中横断面研究评价标准进行文献质量评价, 采用Stata 12.0软件进行数据合并估算患病率, 并对性别、体重状态等因素进行亚组分析, 采用漏斗图及Egger检验发表偏倚, 通过排除其中任意一篇文献对合并效应值的影响进行敏感性分析。 结果 共纳入19篇文献(5篇英文、14篇中文)。依据国际糖尿病联盟(IDF)标准、美国国家胆固醇教育计划成人治疗专家组Ⅲ修订(NCEPⅢ)标准、中国儿童青少年代谢综合征定义和防治建议(CHN2012)标准, 我国儿童青少年MS患病率分别为1.8%、2.6%及2.0%。按IDF标准, 男、女童MS患病率分别为2.9%、1.8%, 正常、超重、肥胖儿童中MS患病率分别为0.2%、4.7%、17.3%。NCEPⅢ标准、CHN2012标准结果均呈现男生MS患病率高于女生、肥胖组MS患病率> 超重组> 正常组。 结论 儿童青少年MS呈流行趋势, 应用不同诊断标准对MS检出率影响较大。肥胖是MS的重要危险因素, 因此应遏制肥胖, 对儿童超重、肥胖尽早识别干预, 以减少儿童MS的发生。     

Tobacco use among Native Hawaiian middle school students: its prevalence, correlates and implications

Objectives. This study sought to explore whether Native Hawaiian primary ethnic identity is associated with cigarette use among Native Hawaiian middle school students. This study also explored whether social influence, psychosocial and cultural factors are associated with cigarette use in this sample.

Design. The data are from a cross-sectional survey of 1,695 Native Hawaiian middle school students at 22 public and private schools on five islands in Hawaii. A subset of these students from Native Hawaiian serving schools (N = 136) completed additional measures of Hawaiian cultural variables.

Results. Based on univariate analyses, students whose primary ethnic identification was Hawaiian were more likely to have tried smoking (p < 0.001) and to be current smokers (p < 0.05) as compared to those classified as part Hawaiian. However, these findings were no longer significant in multivariate analyses. Social influence variables (i.e. peer and parental smoking) were most influential in explaining both prior and current smoking. Attendance at public school was also an important factor in explaining previous (OR = 2.43; 95% CI = 1.74, 3.38) and current (OR = 7.20; 95% CI = 4.58, 11.32) smoking behavior. Finally, cultural variables such as valuing Hawaiian folklore, customs, activities and lifestyle were largely unassociated with smoking behavior among Native Hawaiian middle school youth.

Conclusions. Additional research is needed to understand what aspects of ethnic identity are associated with smoking behavior among Native Hawaiian youth. The strong influence of peer and parental smoking suggests the need for interventions that support the creation of social environments that discourage tobacco use.     

Prevalence of overweight and associated factors in southern Brazilian adolescents

OBJECTIVE: The aim of this study was to determine the prevalence of overweight in adolescents in a southern Brazilian city, and ascertain gender differences and association with socio-economic and demographic conditions, family factors and individual behaviours. METHODS: Cross-sectional population-based study with random cluster sampling of households, including 722 adolescents (10-19 years), from a city in southern Brazil. Body mass index (BMI) was calculated based on the National Center for Health and Statistics reference curve, defining overweight as BMI 85th percentile. RESULTS: Prevalence of overweight was 17% in girls and 19% in boys. In multivariate Poisson regression, chronic illness in parent(s) and household of up to four people were associated with overweight in boys, whereas low fibre intake, more hours spent watching television and regular exercise were associated with overweight in girls. CONCLUSION: The prevalence of overweight in Brazilian adolescents is high, with gender differences in associated factors. Health workers in schools and public health services should be aware of these differences in order to improve preventive and therapeutic strategies in this age group.     

Lower levels of occupation, income and education are strongly associated with a longer smoking duration: multivariate results from the 2001 Australian National Drug Strategy Survey

OBJECTIVE: Our aim was to investigate the association of socio-economic status (SES) with duration of smoking among ever smokers. STUDY DESIGN: We used a subsample of ever smokers (n = 9973) aged 18+ years from the 2001 National Drug Strategy Household Survey (conducted by the Australian Institute of Health and Welfare), which involved a multistage area sample and mainly self-administered questionnaires. METHODS: The outcome was smoking duration from onset to cessation. We used survival analysis to predict smoking duration. RESULTS: Results showed that smoking duration from onset to cessation was 14% longer for blue-collar workers than for professionals. Respondents who earned under 300 US dollars/week smoked for 38% longer than those earning 800 US dollars+/week. Individuals with less than 10 years of education smoked for 13% longer than those with 12+ years of education. CONCLUSIONS: Smokers from lower social strata smoke for much longer durations. This finding and the fact that smoking increases the likelihood of financial stress suggest that lower SES smokers who experience financial stress are more likely to suffer a longer period of compromised living standards than their counterparts in the higher strata. The financial and health burdens of smoking coupled with social inequalities in smoking behaviour suggest that smoking may exacerbate social class differences in health and standards of living. Thus, targeting smoking among disadvantaged groups would not only represent a public health policy but also a social policy to reduce social inequalities.     

上海市青少年控烟态度状况及相关因素分析

目的了解上海市青少年控烟态度状况及相关因素。方法采用分层随机抽样方法在上海市19个区县抽取辖区内初中、高中、中等职业学校各1所，每所学校随机抽取164名学生进行控烟态度问卷调查，共调查9347人。结果收回有效问卷9239份，有效率为98．8％。学生吸烟率为19．5％，现在吸烟率为2．5％，尝试吸烟率为17．0％。学生普遍不支持“年轻女性吸烟”（88．2％）和“父母可以吸烟”（80．6％）；对”教育学生停止吸烟是教师的责任”（83．0％）和“教师做不吸烟的榜样”（82．5％）普遍认同；支持“在香烟盒上印警语”（80．4％）、“公共场所禁烟”（81．0％）和“禁止向未成年人出售烟草制品”（84．0％）的比例较高。职校学生控烟正确态度持有率低于初中和高中学生，女生正确态度持有率高于男生；吸烟学生正确态度持有率明显低于尝试吸烟和不吸烟的学生。结论上海市青少年对于吸烟行为的态度仍存在不少误区，应开展有针对性的、多元化的健康教育工作，健康教育的重点人群是男生、职校学生和吸烟学生。     

The ecological relationship of tobacco smoking to the prevalence of symptoms of asthma and other atopic diseases in children: the International Study of Asthma and Allergies in Childhood (ISAAC)

This study examined the relationship between parental smoking and asthma and other atopic diseases at the ecological level. The prevalence of atopic symptoms in 6–7- and 13–14-year old children was assessed in 91 centres (from 38 countries) and 155 centres (from 56 countries) respectively in the International Study of Asthma and Allergy in Childhood (ISAAC). These symptoms were related to prevalence of tobacco smoking for each country by gender as reported by the World Health Organisation. There was a significant negative association between the prevalence of smoking by men and the prevalence of symptoms of asthma and rhinitis, but not eczema in the 13–14-year age group. There was a significant positive relationship between prevalence of smoking by women and prevalence of wheeze in the last 12 months, but not for any other symptoms in the 13–14-year age group. In the 6–7-year age group, there was a significant negative correlation between prevalence of smoking by men and the prevalence of wheeze causing sleep disturbance and a close to significant negative association at the 5% level with the prevalence of wheeze in the last 12 months and rhinitis. Thus, for the countries that are included in this analysis, countries that have high adult male smoking rates have a lower risk of asthma and rhinitis symptoms in children. It should be stressed that this analysis does not involve information on individual exposures and therefore does not contradict the well-established association of active and passive smoking in individuals with the occurrence of asthma symptoms in the same individuals. Rather, it indicates that this well-established individual-level association does not account for the international differences in asthma prevalence, and that other risk factors for asthma must be responsible for the observed international patterns.     

Similar asthma prevalence estimates obtained from preadolescent and parent survey responses

OBJECTIVE: We compared agreement between child and parent responses to questions assessing prevalence of asthma and other severe respiratory symptoms. STUDY DESIGN AND SETTING: Fifth-grade children enrolled in public schools and their parents separately completed a health survey, which included respiratory symptom questions from the International Study of Asthma and Allergies in Childhood (ISAAC). Agreement on respiratory symptom questions was assessed with Cohen's Kappa coefficient. Asthma prevalence estimates based on responses to several questions were also compared using child and parent data. The analysis was based on a study sample size of 230 matched parent and child questionnaires. RESULTS: High levels of agreement (Kappa: 0.76 and 0.79) between child and parent responses were observed for current and lifetime asthma, and similar asthma prevalence estimates were obtained from child and parent response data. Five of the questions on potentially severe respiratory symptoms had low to fair levels of agreement (Kappa: -0.01 to 0.38), resulting in statistically significantly different prevalence estimates in three of the five symptoms. CONCLUSIONS: Separate parent and child responses to a series of respiratory symptom and asthma questions yielded similar estimates for asthma prevalence but different estimates for the prevalence of several severe respiratory symptoms.     

武汉市中学生初次吸烟行为与生活事件的关系初探

目的 分析武汉市中学生初次吸烟行为与日常生活事件的关系以及压力对青少年初次吸烟的影响。方法 采用分层整群随机抽样法,对武汉市城区和郊区22所学校的6994名在校初中生进行问卷调查,选择报告过去一年内开始吸烟和从未吸过烟的学生共5536人作为本次分析对象。结果 武汉市中学生在调查的前一年内开始吸整支烟的吸烟率为8.2％,男生高于女生,初二学生高于初一学生,初三学生略有下降。控制性别、年龄、城乡和年级的影响,多因素logistic回归分析结果显示,武汉市青少年初次吸烟行为与家庭、学校的负性生活事件呈正性相关(P<0.05),而与学校方面的正性生活事件呈负性相关(P<0.05)。结论 青少年学生初次吸烟行为与应激性生活事件有密切的联系,特别是学校和家庭方面的生活事件。     

The epidemiology of panic attacks and panic disorder. Results of three community surveys

The authors report findings pertaining to panic disorder from the first three sites of the National Institute of Mental Health Epidemiologic Catchment Area Program. Probability samples of about 3,000 persons aged 18 years or older were interviewed in the New Haven, Connecticut area, eastern Baltimore City, Maryland, and the greater St. Louis, Missouri area in 1980-1982. Information on panic attacks and panic disorder was obtained using the Diagnostic Interview Schedule. The prevalence rate of panic attacks in the prior six months was found to be about 3% at each of the sites, while the prevalence of panic disorder varied from 0.6 to 1.0%. Age at onset was found to peak at 15-19 years. Simple panic attacks, severe and recurrent panic attacks, and panic disorder were found to be characterized by similar symptom profiles and age at onset distributions, and to have similar distributions by demographic factors.     

Changes in dietary habits and prevalence of cardiovascular risk factors among school students in Macao,China

ObjectiveGiven the increasing burden of childhood obesity, it is important to examine the changes in dietary habits and prevalence of cardiovascular risk factors among Macao students.MethodsA cross-sectional study was conducted among primary and secondary school students in Macao, China in 2014–2015 with addition to data collected from 2008 to 2009 for comparison. The dietary behaviours, prevalence of obesity and dyslipidaemia were compared by study period.SubjectsIn 2014–2015, dietary assessment was conducted among 3635 students, physical assessment was conducted among 1427 school students. In 2008–2009, dietary assessment was conducted among 4271 students, physical assessment was conducted among 1700 school students.ResultsWhen compared with students in 2008, higher percentage of students from present study period consumed dairy products, crispy food and chocolate, while fewer students had fruits, vegetables and fried food at least once every day. Despite lower prevalence of elevated total cholesterol and low-density-lipoprotein cholesterol, the rate of general obesity, low high-density-lipoprotein cholesterol and hyperglycaemia has increased significantly in 2014–2015. Students aged 12–14 consumed less fruits and vegetables and suffered from higher rate of general and abdominal obesity, as well as low high-density-lipoprotein cholesterol and elevated serum triglycerides in 2014–15.ConclusionsThe students’ diet had both favourable and unfavourable changes. The rate of obesity and dyslipidaemia rises, while the situation for students aged 12–14 is more concerning.     

Smoking prevalence and the changing risk profiles in the UK ethnic and migrant minority populations: implications for stop smoking services

Objectives

Smoking is the leading risk factor for disability-adjusted life-years, yet evidence with which to establish the smoking rates of people with different ethnic backgrounds and how they are changing in relation to recent migration is lacking. The objective is to provide current information on the changing risk profiles of the UK population.

Study design

Observational study using cross-sectional surveys.

Methods

Data from the Integrated Household Survey (pooled for the years 2009/10–2011/12), obtained under Special Licence, and the GP Patient Survey (2012) have been used to establish smoking prevalence in a wider range of ethnic groups in England and Wales, including the ‘mixed’ groups and amongst East European migrants, and how such prevalence differs across socio-economic classes.

Results

Smoking prevalence is substantially higher amongst migrants from East European countries (that for males exceeding 50% from three such countries and for females over 33% from four countries) and from Turkey and Greece, compared with most other non-UK born groups, and amongst ethnic groups is elevated in the ‘mixed’ groups. Rates are highest in the Gypsy or Irish Traveller group, 49% (of 162) and 46% (of 155) for males and females respectively. Across ethnic groups, rates are almost always higher in the UK born than non-UK born population with the notable exception of the ‘White Other’ group, with Prevalence Ratios (PRs) indicating a larger migrant-non-migrant differential amongst females (e.g. Indians 2.95 (2.33–3.73); Black Caribbeans 3.28 (2.73–3.94). Age-adjusted rates show the persistence of these differentials in females across age groups, though young males (18–29) in seven minority ethnic groups show lower rates in the UK-born groups. The ‘White’ and ‘Chinese’ groups show a strong socio-economic gradient in smoking which is absent in the South Asian groups and diminished in the ‘mixed’ and black groups.

Conclusions

Given the evidence that smoking behaviour is significantly different in some of the new groups, notably East European migrants, stop smoking services are failing to optimize the acceptability and, consequently, favourable outcomes for these programmes. These services need to be adapted to the particular patterns of smoking behaviour and language skills within different communities of descent.     

Population attributable risk for adverse pregnancy outcomes related to smoking in adolescents and adults

BACKGROUND: Little is known about how population-attributable risks (PAR) for adverse birth outcomes due to smoking differ in adolescent and adult pregnancies. METHODS: An analysis of community and hospital-based cross-sectional studies in Liverpool was undertaken to estimate the PAR values of low birthweight (LBW), preterm birth, and small for gestational age (SGA) births resulting from pregnancy smoking covering the period between 1983 and 2003. Maternal smoking status and pregnancy outcomes were available for a sample of 12631 women. RESULTS: The prevalence of maternal pregnancy smoking was 40% in the community sample and 33% in adults and 40% among adolescent pregnancies in the hospital sample. The PAR values (95% CI) associated with LBW, preterm birth and SGA outcomes due to maternal pregnancy smoking in the community sample were 27% (25-30), 13% (11-15) and 25% (23-27), respectively. The PAR values in adults in the hospital sample were 29% (27-31) for LBW, 16% (14-19) for preterm birth and 28% (26-31) for SGA. The corresponding PAR values in adolescents were 39% (34-43), 12% (7-18) and 31% (23-40). The LBW risk attributed to pregnancy smoking in adolescents was significantly higher than for adults (P=0.05). CONCLUSION: About one-third of LBW, one-quarter of SGA and one-sixth of preterm births could be attributed to maternal smoking during pregnancy. The magnitude of the problem was greater among adolescent pregnancies, among whom a sub-group of mothers with very high risk for adverse birth outcomes due to pregnancy smoking was identified.