江西省居民吸烟行为及烟草消费情况分析

目的 了解江西省居民吸烟行为,分析烟草消费隋况及烟草价格上涨对吸烟行为潜在影响。方法 采用三阶段随机整群抽样方法,在江西省11个设区市中选择上饶市和宜春市作为调查现场,利用KISH码在32个街道/镇820户家庭中选择15岁及以上居民进行问卷调查。结果最终人组的805名居民中,现在吸烟者218人,吸烟率为27.08%(男性吸烟率为46.62%,女性吸烟率为3.05%)。218名吸烟居民中,烟龄最短1年,最长50年,烟龄中位数为20年。96.33%的吸烟居民通过“自己购买”获得卷烟,54.59%吸烟居民吸5～9元一包的卷烟,20.64%吸l～4元一包的卷烟,18.8l%吸10～15元一包的卷烟,仅13名吸烟居民平常吸15～30元一包的卷烟。吸烟居民平均每月最少花费20元,最多花费800元,平均花费192元,占个人月收入的13%。根据218名吸烟居民关于卷烟价格上涨对其吸烟行为影响的回答绘制曲线图,可了解卷烟价格上涨对吸烟者吸烟行为的潜在影响情况。结论 江西省吸烟居民的烟草经济负担较重,烟草价格上涨将促使吸烟者改变吸烟行为。应考虑中国烟草价格低、价格跨度大等现实问题,合理提高烟草销售价格,改变吸烟人群的吸烟行为,进而逐渐降低人群吸烟率。     

我国2015年卷烟消费税上调对卷烟零售价格的影响

目的 评估2015年卷烟消费税上调对卷烟零售价的影响。方法 利用2013-2015年10城市开展的烟草价格监测数据,计算卷烟的名义价格和实际价格,描述价格变化趋势。结果 2013-2015年3次均监测到352种卷烟,其中2013、2014年卷烟名义价格未发生显著变化,2015年卷烟消费税上调后,较2014年有286种卷烟价格上涨,10种常见卷烟名义价格相对于2013年涨幅为0.6%～7.4%,但实际价格与2013年相比涨跌不一。结论 2015年卷烟消费税上调可传导至卷烟零售价,但考虑到通货膨胀和购买力等因素,实际价格上涨有限,其对控烟的意义还需进一步评估。     

中国初中学生烟草广告和促销暴露现况调查

目的 了解中国初中在校学生烟草广告和促销暴露的现状。方法 采用多阶段分层整群随机抽样的方法, 在全国31个省(自治区、直辖市)初中在校学生中选取调查样本(n=155 117)。采用学生自填问卷方式收集数据, 内容主要包括烟草使用、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。对数据加权后, 采用SAS 9.3软件进行数据分析。结果 在过去的30 d内, 48.5%的初中生见过烟草广告或促销。其中通过电视的比例最高(21.3%), 其次为户外广告牌(20.1%)、烟草零售点(17.5%)和互联网(15.6%)。此外, 4.6%的学生报告自己有印着烟草产品品牌的物品;2.0%的学生得到过烟草公司工作人员提供的免费烟草产品;25.2%的吸烟学生最近一次购买卷烟是按“支”购买的;69.7%的学生报告在电视/录像/电影中看到吸烟镜头。从未使用过烟草产品的学生中, 暴露于烟草广告和促销者认为吸烟更有吸引力、好朋友给烟可能会或肯定会吸、未来12个月可能会或肯定会吸烟、吸烟令人感到更舒服、自己可能会喜欢吸烟的比例均高于非暴露组(P<0.000 1)。结论 中国初中学生暴露于烟草广告和促销的现状相当严重, 暴露使学生更容易对烟草使用持正向态度。现有法律法规已不能充分有效保护青少年, 建议尽快修订《广告法》, 全面禁止烟草广告、促销和赞助。     

中国1996-2015年食管癌经济负担研究的系统综述

目的 探讨中国1996-2015年食管癌经济负担研究开展情况。方法 采用经济负担、费用等作为关键词,全面检索PubMed、中国知网和万方数据库1996-2015年间发表的文献,对纳入文献行信息摘录和统计分析。采用美国卫生保健质量和研究机构推荐包含11条目的横断面研究质量评价标准,由双人独立对纳入的研究进行评价。以中国医疗保健消费价格指数对费用数据进行统一贴现,采用平均增长速度计算年均增长率。结果 最终纳入23篇文献（个体研究21篇和群体研究2篇）,其中12篇发表于近5年。21篇个体研究中,有17篇为个体患者病案摘录,纳入文献质量一般,数据多为单一直接医疗费用,分析指标以例均、次均和日均费用等多见。1996-2012年中国食管癌患者例均费用中位数为7 463～37 647元（年均增长率为7.68%）,1996-2013年次均费用中位数为6 851～57 554元（年均增长率为11.89%）,1996-2010年日均费用中位数为225～1 319元（年均增长率为12.53%）。直接医疗次均费用存在地区差异,以北京、山西和湖北较高。无论个体还是群体研究,对直接非医疗费用和间接费用造成的经济负担报道均较少。结论 中国食管癌经济负担评价数据仍有限且结果可比性一般,尤其是人群层面和间接负担的研究较少。直接医疗费用呈上升趋势,且地区差异较大。     

中国初中学生烟草使用及其影响因素研究

目的 了解中国初中学生烟草使用的情况,探讨烟草使用行为的主要影响因素。方法 采用多阶段分层整群随机抽样的方法,在31个省（自治区、直辖市）初中在校学生中选取调查样本。采用学生自填问卷的方式收集数据,调查烟草使用、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。对数据加权后,采用SAS 9.3软件复杂调查数据分析程序进行数据分析。结果 共调查155 117名初中学生,烟草使用率为6.9%,男生（11.2%）高于女生（2.2%）,农村（7.8%）高于城市（4.8%）,西部地区（10.3%）高于中部地区（6.4%）且两者均高于东部地区（4.5%）,差异均有统计学意义。看到控烟媒体宣传、在课堂上学习过烟草导致具体健康危害知识是烟草使用的保护因素;父母吸烟（尤其是母亲吸烟）、教师吸烟、好朋友吸烟、每周零花钱>20元、看到烟草广告或促销、二手烟暴露、对烟草成瘾的错误认知以及对吸烟行为的正向态度是烟草使用的危险因素。结论 中国初中男生吸烟率高于全球平均水平,值得关注。采取宣传教育、提高烟草价格、全面禁止烟草广告和促销、公共场所禁止吸烟等一系列综合干预措施,对降低青少年吸烟率有意义。     

控烟政策背景下北京市卷烟价格、可负担性及价格对卷烟需求的影响

目的 本研究旨在分析控烟政策背景下北京市2004—2017年卷烟价格、烟草可负担性及卷烟需求价格弹性系数,为控烟政策发展提供参考。方法 从《北京烟草年鉴》获取北京市卷烟销量、北京市卷烟单箱销售额数据,从《北京市统计年鉴》获取人口、收入、卷烟价格指数、居民消费价格指数。采用卷烟零售价格指数调整卷烟价格,描述各年份卷烟价格变化,使用购买100包卷烟所需的花费占收入的比重计算烟草可负担性。使用对数线性回归模型估算卷烟价格需求弹性系数。结果 北京市卷烟名义价格和实际价格在2004—2017年间基本保持上涨,购买100包卷烟的花费占收入的比重整体呈下降趋势,烟草可负担性在近年来在提高。卷烟价格弹性系数为- 0.42,表明价格每上涨10%,卷烟销量下降4.2%（t = - 17.015, P＜0.001）。结论 北京市落实烟税改革状况较好,尽管卷烟价格上升,卷烟可负担性近年来却在提高。提高烟税需要达到一定比例,才可以降低卷烟可负担性,实现控制烟草消费的目的。非价格措施如公共场所全面禁烟也应得到推广。     

2007-2015年四次横断面调查中陕西省居民吸烟变化情况分析

目的 分析2007-2015年陕西省成年人烟草流行现状及趋势变化。方法 利用2007、2010、2013和2015年全国慢性病及其危险因素监测数据,计算4次调查的吸烟率、吸烟量、戒烟率及二手烟暴露率,用趋势χ²检验计算其变化趋势,以抽样权重及2010年第六次人口普查数据计算加权率,以敏感性分析加以验证。结果 2007年陕西省成年人吸烟率为38.26%,2013年降至30.95%,但2015年上升到34.11%（趋势性χ²检验：Z=2.46,P=0.014）;2007-2015年,陕西省吸烟者吸烟量从16.90支/d,上升到17.76支/d;成年人戒烟率从11.02%上升到16.95%（趋势性χ²检验：Z=-4.18,P<0.01）;二手烟暴露率从2010年48.10%上升到2015年的63.88%（趋势性χ²检验：Z=-10.60,P<0.01）。敏感性分析趋势不变。结论 2007-2015年,陕西省成年人吸烟率和吸烟量保持在比较高的水平且变化不大,虽然吸烟人群的戒烟率逐渐提高,但非吸烟人群中二手烟暴露率迅速增加。     

中国9省(区)2000-2009年糖尿病与非糖尿病居民医疗费用比较研究

目的 比较分析中国糖尿病患者和非糖尿病居民年医疗费用及其变化趋势,评估糖尿病个人和家庭额外医疗费用及经济负担。方法 利用“中国健康与营养调查(CHNS)”数据,采用特征分数配比法根据特征变量,对糖尿病患者和非糖尿病居民匹配出的679对研究对象进行数据分析。结果 2000-2009年糖尿病患者与非糖尿病居民年人均医疗费用的差值从3361．93元增长至6608．48元;两组研究对象的费用比值约为4倍、个人经济负担和家庭经济负担的比值约为4～5倍。结论 与非糖尿病居民相比,中国糖尿病患者年人均医疗费用明显较高,绝对费用增长 幅度显著,个人经济负担和家庭经济负担较重。     

苏州市居民吸烟行为及卷烟零售价格上涨对其吸烟行为的影响

目的了解苏州市居民吸烟行为,分析烟草消费情况及烟草价格上涨对吸烟行为潜在影响。方法采用四阶段随机抽样方法,在苏州市6个城区30个街道/镇3 000户家庭选择2 972名18岁及以上居民进行问卷调查。结果 2 972名调查对象中,现在吸烟率为32.8%,其中55岁以上居民吸烟率最高(41.0%),居民年龄越大、平均月收入越高,其吸烟率也越高。过去一年中,吸烟者尝试戒烟率为28.9%,28.3%居民得到过医生或卫生保健人员的戒烟的建议,25.5%的吸烟者表示看到烟包上健康警示语会考虑戒烟。95%的吸烟者通过"自己购买"获得卷烟,33.5%吸烟者吸10~15元/包的卷烟,吸烟者购买卷烟每月最多花费1 855元,平均花费355元。卷烟价格提高较低的倍数即可促使大多数吸烟者减少吸烟量或更换便宜的卷烟牌子,而吸烟者戒烟行为的改变需要更大倍数的卷烟价格提高。结论苏州市居民吸烟率较高,烟草花费负担严重,应加大控烟力度,强化宣传和教育。同时应考虑中国烟草价格低、价格跨度大等现实问题,合理提高烟草销售价格,改变吸烟人群的吸烟行为,进而逐渐降低人群吸烟率。     

金昌队列人群胃癌疾病负担研究

目的 分析金昌队列人群中胃癌造成的疾病负担及其变化趋势。方法 应用历史队列研究方法收集金昌队列人群2001－2013年胃癌全死因资料及2001－2010年胃癌住院患者资料,应用死亡率、潜在减寿年(PYLL)、潜在工作损失年(WPYLL)、住院费用等指标评价胃癌造成的疾病负担,运用Spearman秩相关分析、平均增长速度描述疾病负担的变化趋势。结果 2001－2013年间金昌队列人群中因胃癌死亡213人、年均粗死亡率为38.30/10万,未呈现显著变化趋势。男性胃癌死亡196人、粗死亡率为56.17/10万,女性胃癌死亡17人、粗死亡率为8.21/10万,男性粗死亡率为女性的6.84倍。胃癌死亡者以50~79岁年龄段为主(176人,构成比为82.62%),<50岁年龄组胃癌死亡率呈增长趋势、年均增长速度为0.77%。因胃癌而造成的人均PYLL(APYLL)以8.43%的平均速度随年份呈下降趋势,人均WPYLL(AWPYLL)以10.46%的平均速度随年份呈下降趋势。2001－2010年该队列人群胃癌住院患者例均费用为8 102.23元,日均费用为463.45元,无明显变化趋势。结论 金昌队列人群胃癌疾病负担严重,男性尤为突出,有年轻化表现;胃癌所致PYLL及 WPYLL十余年来无明显变化趋势、而APYLL及 AWPYLL随年份呈下降趋势;住院患者直接经济负担平稳无变化。     

Cigarette consumption in rural China: survey results from 3 provinces

OBJECTIVES: This study assessed cigarette consumption and its main determinants in rural China. METHODS: A logistic regression model was used to analyze status of smoking, daily amount of smoking, and expense of cigarettes in rural China. RESULTS: Approximately 57.1% of the males and 3.1% of the females were current smokers. The daily amount of smoking among smokers was 15.23 cigarettes, and their annual expenses were 227 yuan. CONCLUSIONS: People in rural China consume fewer cigarettes and are less likely to smoke than those in urban areas. Education and occupation are 2 major factors that determine the likelihood of smoking in rural China.     

中国12个地区乙型肝炎相关疾病住院患者经济负担调查

目的 中国缺少全国性乙型肝炎（乙肝）相关疾病经济负担研究,本病的社会经济危害未能阐明,乙肝防治经济学评价缺乏关键参数;本研究旨在获得我国不同地区乙肝相关疾病患者住院期间及年均直接、间接和无形费用。方法 选取中国12个地区的传染病专科医院和综合性医院,采用时间阶段连续病例整群抽样法,对住院治疗的乙肝相关疾病患者进行调查。直接费用包括直接医疗和直接非医疗费用;间接费用采用人力资本法,分地区按城镇和农村人口计算患者和陪护人误工费;无形费用采用支付意愿法。多元线性逐步回归分析直接和间接费用的影响因素。结果 全国12个地区共调查医院27所,有效调查样本4 718例,总应答率为77.7%。按住院期间计算,平均住院29.2（27~34）d,例均费用16 832.80元,药费（10 365.10元）占比（61.2%）最高;直接和间接费用分别为18 336.10元和4 759.60元,二者之比3.85：1,直接和间接费用高低与乙肝严重程度相一致。直接医疗费用为17 434.70元,高于直接非医疗费用（901.40元）;直接医疗费用中,住院费高于门诊费和自购药费;直接非医疗费用中,旅费最高。间接费用中,患者误工费（3 832.50元）高于陪护人误工费（927.20元）。直接和间接费用合计高低依次为肝移植、重型乙肝、原发性肝癌和失代偿期肝硬化,而急性乙肝、代偿期肝硬化和慢性乙肝（CHB）较低。直接和间接费用共同影响因素为医院级别高、乙肝相关疾病严重、城市户籍、使用抗病毒治疗、住院天数多、家庭收入高。按1年计算,年均门诊和住院3.74次和1.51次,年均直接、间接和无形费用分别为30 135.30元、6 253.80元和44 729.90元,合计总费用为81 119.00元;直接、间接和无形费用的构成比分别为37.3%、7.7%和55.0%。年均直接费用中,住院直接费用（26 074.20元）高于年均门诊费（4 061.10元）,年均直接医疗费用（28 402.80元）远高于年均直接非医疗费用（1 732.50元）。年均间接费用中,门诊和住院间接费用分别为763.60元和5 490.10元。年均无形费用以肝癌最高,肝硬化和CHB次之,重型乙肝和肝移植均较低,急性乙肝最低。结论 乙肝相关疾病给中国带来了沉重经济负担,患者更多的依赖医疗服务,非医疗服务费用较少;采取有效治疗策略,遏制乙肝相关疾病的恶化,将会收到显著的经济效益;乙肝相关疾病对人群心理健康的影响,可用无形费用给出经济学表述。     

Effect of a large increase in cigarette tax on cigarette consumption: an empirical analysis of cross-sectional survey data

OBJECTIVES: This study used cigarette price elasticity estimates to assess the possible effects on cigarette consumption of a large increase in cigarette tax. It also investigated different responses to the cigarette tax increase among smokers from different socio-economic backgrounds and with different smoking characteristics. STUDY DESIGN: Cross-sectional study on 483 valid questionnaires completed during a telephone survey of current smokers aged 15 years and above from all 23 major cities and counties in Taiwan. METHODS: This study analysed the willingness of current smokers to quit smoking or reduce cigarette consumption when faced with a tax increase of NT$22 per pack, which would raise the price of cigarettes by 44%. The Tobit regression model and the maximum likelihood method were used to estimate cigarette demand elasticity. RESULTS: Estimation results yielded a cigarette price elasticity of -0.29 in connection with a 44% increase in the price of cigarettes. This suggests that smokers will have relatively little response to such an event. The most significant response to the price increase was found among women, low-income smokers, moderately addicted smokers, and smokers who regularly purchase low-price cigarettes. A 44% increase in the price of cigarettes would reduce the average annual per capita cigarette consumption in Taiwan by 14.86 packs; a reduction of 12.87%. The tax increase would also boost the Government's cigarette tax revenue by approximately NT$41.4 billion, and increase cigarette merchants' income by approximately NT$27.4 billion. CONCLUSIONS: Since current cigarette prices are low in Taiwan and smokers are relatively insensitive to cigarette price hikes, a large increase in cigarette tax would reduce cigarette consumption effectively, and would also increase the Government's cigarette tax revenue and cigarette merchants' income. Clearly, such a tax would create a win-win outcome for the Government, cigarette merchants and smokers, and it is therefore recommended.     

Per-pack price reductions available from different cigarette purchasing strategies: United States, 2009–2010

ObjectiveFollowing cigarette excise tax increases, smokers may use cigarette price minimization strategies to continue their usual cigarette consumption rather than reducing consumption or quitting. This reduces the public health benefits of the tax increase. This paper estimates the price reductions for a wide-range of strategies, compensating for overlapping strategies.MethodWe performed regression analysis on the 2009–2010 National Adult Tobacco Survey (N = 13,394) to explore price reductions that smokers in the United States obtained from purchasing cigarettes. We examined five cigarette price minimization strategies: 1) purchasing discount brand cigarettes, 2) using price promotions, 3) purchasing cartons, 4) purchasing on Indian reservations, and 5) purchasing online. Price reductions from these strategies were estimated jointly to compensate for overlapping strategies.ResultsEach strategy provided price reductions between 26 and 99 cents per pack. Combined price reductions were possible. Additionally, price promotions were used with regular brands to obtain larger price reductions than when price promotions were used with generic brands.ConclusionSmokers can realize large price reductions from price minimization strategies, and there are many strategies available. Policymakers and public health officials should be aware of the extent that these strategies can reduce cigarette prices.     

The effect of cigarette price on smoking behavior in Korea]

OBJECTIVES: To determine the impact of cigarette prices on the decision to initiate and quit smoking by taking into account the interdependence of smoking and other behavioral risk factors. METHODS: The study population consisted of 3,000 male Koreans aged > or =20. A survey by telephone interview was undertaken to collect information on cigarette price, smoking and other behavioral risk factors. A two-part model was used to examine separately the effect of price on the decision to be a smoker, and on the amount of cigarettes smoked. RESULTS: The overall price elasticity of cigarettes was estimated at -0.66, with a price elasticity of -0.02 for smoking participation and -0.64 for the amount of cigarettes consumed by smokers. The inclusion of other behavioral risk factors reduced the estimated price elasticity for smoking participation substantially, but had no effect on the conditional price elasticity for the quantity of cigarettes smoked. CONCLUSIONS: From the public health and financial perspectives, an increase in cigarette price would significantly reduce smoking prevalence as well as cigarette consumption by smokers in Korea.     

The association between cigarette rod length,slim design,and blood cadmium levels among U.S. smokers: NHANES 1999–2010

BackgroundPrevious research has shown that long or slim cigarette design can mitigate perception of harmfulness. Cadmium (Cd) is a toxicant in cigarettes and is associated with adverse outcomes. We assessed the relationship between cigarette rod length/circumference and blood Cd levels among U.S. smokers using data from the 1999–2010 National Health and Nutrition Examination Survey.MethodsThe analyses were performed on 4486 current cigarette smokers aged ≥ 20 years old. Cigarette rod length included regular (68–72 mm), king (79–88 mm), long (94–101 mm), and ultra-long (110–121 mm) cigarettes currently smoked. Overall and gender stratified multivariate linear regression analyses were performed, adjusting for other influential covariates.ResultsGender stratified analysis indicated that female smokers of long and ultra-long cigarette had 20% and 27% higher mean Cd levels compared to smokers of regular sized cigarettes respectively, despite the fact that all the ultra-long cigarettes were slim cigarettes. Furthermore, among females, slim cigarette users did not reduce blood cadmium levels compared to non-slim users.ConclusionsFemale smokers of long or ultra-long cigarettes had higher mean blood Cd levels compared to smokers of regular cigarettes independent of slim design. Further research into this association is warranted.     

Interactions between cigarette and alcohol consumption in rural China

The objective of this paper is to analyze interdependencies between cigarette and alcohol consumption in rural China, using panel data for 10 years (1994–2003) for rural areas of 26 Chinese provinces. There have been many studies in which cigarette and alcohol consumption have been considered separately but few to date for China on interactions between the consumption of these two products. Taxes are often recommended as a tool to reduce alcohol and cigarette consumption. If cigarettes and alcohol are complements, taxing one will reduce the consumption of both and thus achieve a double public health dividend. However, if they are substitutes, taxing one will induce consumers to increase consumption of the other, offsetting the public health benefits of the tax. Our results indicate that the demands for both cigarettes and alcohol are very sensitive to the price of alcohol, but not to the price of cigarettes or to income. This suggests that taxes on alcohol can have a double dividend. On the other hand, an increase in cigarette taxes may not be effective in curbing cigarette or alcohol consumption in rural China.     

2015年中国15个省份城乡成年男性吸烟与睡眠时间关联性分析

目的:分析中国15个省份城乡成年男性居民吸烟状况与睡眠时间之间的关系。方法:数据来源于2015年“中国居民营养状况变迁的队列研究”资料。选取有完整吸烟状况和睡眠时间的18~64岁成年男性共计4 419人,其中城市1 713人（38.8%）,农村2 706人（61.2%）。依据调查对象是否吸烟以及吸烟者每日吸烟数量将研究...