云南省城市大中小学学生二手烟暴露的影响因素分析

[目的]了解云南省城市大中小学学生二手烟暴露情况,了解学校开展控烟方面的健康教育对学生二手烟暴露行为的影响,为开展学校控烟工作提供依据。[方法]对云南省的昆明、曲靖和楚雄3个城市采用多阶段分层随机抽样,抽取8所学校的800名大、中、小学生,对学生的二手烟暴露及影响学生二手烟暴露行为的因素进行调查。[结果]①云南省城市大、中、小学学生的家里二手烟暴露率为53.32%;家外二手烟暴露率为53.93%;家里和家外二手烟暴露率为70.59%。中学生在家里遭受二手烟的危害最严重,大学生家外遭受二手烟危害更严重。②影响学生家里二手烟暴露的回归分析显示,不知道父母是否吸烟(OR=0.529;P=0.639)、大部分好友吸烟(OR=3.658;P=0.000)、不征求他人意见吸烟(OR=1.763;P=0.034)的小学生(OR=2.449;P=0.000)在家里遭受二手烟暴露的风险性显著高于其他学生。③影响学生家外二手烟暴露的回归分析显示,朋友大部分吸烟(OR=4.306;P=0.000)、自己吸烟(OR=1.433;P=0.49)、不征求他人意见吸烟(OR=1.570;P=0.090)的曲靖学生(OR=1.753;P=0.005)家外遭受二手烟暴露危害的风险显著高于其他学生。[结论]云南省城市大中小学学生家里和家外二手烟暴露情况较严重,需要政府、社会、学校、社区和家庭共同行动起来,才能避免学生受二手烟的危害。     

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.     

学校与家庭控烟对中学生家庭二手烟暴露的联合作用

观察学校与家庭控烟对中学生的联合作用,探讨其对降低中学生家庭二手烟暴露的有效性,以期为中学生控烟工作提供新思路.方法 采用分层整群随机抽样的方法,在北京市东城区抽取4所中学的所有初一和高一学生共2 125名开展问卷调查.调查内容包括中学生个人基本信息,中学生家庭、学校和周围社会控烟环境情况及中学生控烟相关知识、态度和行为等.结果 北京市东城区中学生的家庭二手烟暴露率为33.41%.在校园内见过“明确禁烟标识”的学生中,家里有限制吸烟规定的暴露率(4.92%)低于家里没有规定的学生(58.94%) (x2=452.57,P<0.01).Logistic回归分析结果显示,父母至少一方吸烟与学生家庭二手烟暴露呈正相关(OR=22.88,P<0.05);有家庭限制吸烟规定分别与见过校园内禁烟标识(OR=0.08)、在学校接受过控烟宣教(OR=0.08)对中学生的家庭二手烟暴露存在联合作用.结论 学校与家庭的联合控烟措施能有效降低中学生家庭二手烟暴露率,较二者单独控烟作用更优.     

北京市2010年中学生烟草使用流行现状分析

目的 了解2010年北京市中学生烟草使用相关行为和二手烟暴露现状以及对烟草的认知和态度,为积极开展学校控烟工作提供参考.方法 采用分层整群抽样的方法,于2010年4-5月对北京市共计33所学校中11242名学生进行匿名自填式问卷调查,共回收有效问卷11208份.结果 中学生尝试吸烟率为24.70％,现在吸烟率为9.11％,吸烟率为5.06％;不吸烟中学生的二手烟暴露率为38.47％.男生、住宿生的烟草使用率均显著高于女生和非住宿生;郊区、非重点校、职业中学的烟草使用率分别高于城区、重点校和普通中学,差异均有统计学意义(P值均＜0.01).现在吸烟率和吸烟率较2008年均略有下降,二手烟暴露率有了明显下降.结论 中学生尝试吸烟率居高不下,对于烟草危害及有关态度的认识有待于进一步提高.建议继续加强对中学生开展健康教育,引导和教育中学生坚决“拒吸第一支烟”.     

云南省初中生吸烟行为及其影响因素研究

目的通过对云南省初中生吸烟现状及影响因素进行研究,为实施控烟干预,降低初中生吸烟率提供参考依据。方法采用多阶段分层整群随机抽样的方法,在云南省初中在校学生中选取调查样本。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。采用SPSS 16.0软件对数据进行统计分析。初中生吸烟行为的影响因素分析用Logistic回归模型。结果云南省初中生吸烟率为13.7%,其中男生为23.0%,女生为4.8%。影响云南省初中生吸烟行为的因素包括性别(OR=0.231)、好朋友吸烟行为(OR=8.591)、父母吸烟行为(OR=1.331)、课堂烟草危害宣讲(OR=1.368)、烟草广告(OR=1.378)、教师吸烟行为(OR=1.482)、在公共场所暴露于二手烟(OR=2.002)等。结论云南省初中生吸烟率在全国处于较高水平。影响初中生吸烟的因素包括家庭、学校、社会等,其中好朋友吸烟是影响青少年吸烟的一个重要因素。     

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。     

广东省城市学生吸烟与被动吸烟现状及吸烟危害认知调查

目的了解城市青少年吸烟与被动吸烟状况及吸烟相关认知状况，了解学校控烟措施开展情况，为进一步开展针对性的控烟工作提供依据。方法采用分层整群抽样的方法，在广州市、江门市抽取大学、中学、小学各1所，各调查100名学生，在增城市抽取中学、小学各1所，各调查100名学生，采用中国疾病预防控制中心控烟办公室统一设计的《学生被动吸烟调查问卷》对学生吸烟、被动吸烟情况、吸烟相关知识等进行调查。结果共调查学生800人，其中男生474人，女生326人。学生现在吸烟率为6．3％，男生为8．4％，女生为3．1％，大、中、小学生分别为8．0％、7．3％、4．0％。学生在家里和家外遭受被动吸烟的比例分别为32．4％和36．1％。学生中父母、朋友、老师吸烟，学生自身尝试吸烟率较高。学生对吸烟与被动吸烟损害健康的知晓率分别为95．9％和91．1％。小学生控烟相关教育开展较好，大学校园内控烟宣传栏和组织控烟为主题的活动较少。结论青少年吸烟和被动吸烟情况较为严重，要通过大力开展学校控烟健康教育工作，提供控烟与戒烟相关服务与资讯，来预防青少年吸烟和减少二手烟的危害。     

平湖市儿童家庭二手烟暴露现况

了解平湖市部分小学、幼儿园儿童家庭二手烟暴露情况,为进一步开展控烟健康教育提供参考依据.方法 整群抽取平湖市辖区内7个镇/街道13所小学、幼儿园大班的儿童(或其家长)2 416名,采用自编问卷进行调查.结果 儿童家长中男性吸烟率为51.81%,父亲的吸烟率低于爷爷/外公的吸烟率,城市家长吸烟率低于农村家长吸烟率,差异均有统计学意义(P值均<0.01);53.26%的学生在家庭中受二手烟污染;城乡之间、父辈与祖辈之间吸烟者使儿童受二手烟危害的差异均无统计学意义(P值均>0.01).结论 防止儿童受二手烟污染要依靠家庭健康促进手段,使吸烟者树立自身和家庭的健康后果信念才能获得成效.     

云南省教师吸烟行为及控烟知识态度

了解云南省大中小学教师吸烟状况、对烟草的知识和态度以及控烟教学活动开展情况,为指导开展无烟校园干预工作提供参考依据.方法 通过三阶段随机抽样方法,在昆明、普洱和楚雄抽取27所大中小学的811名教师,进行面对面的问卷调查.结果 云南大中小学教师的吸烟率、现在吸烟率和戒烟率分别为22.56%,16.76%和25.68%.男教师的吸烟率、现在吸烟率和戒烟率为52.8%,39.52%和25.13%,女教师的吸烟率、现在吸烟率和戒烟率为0.85%,0.43%和50.00%.在控烟教学活动中,大中小学教师在告知学生吸烟危害健康、教学生拒烟技巧、获预防吸烟的资料和接受预防学生吸烟的培训差异均有统计学意义(P值均<0.01).男女教师在教拒烟技巧和获预防吸烟资料方面差异有统计学意义(P值均<0.05).大中小学教师对尼古丁是引起多种癌症的化学物质、教师应是不吸烟的榜样、应在学校范围内禁烟和教师应指导学生拒烟或戒烟的知晓率/态度持有率差异有统计学意义(P值均<0.05).吸烟者和非吸烟者对低焦油低尼古丁的烟危害很小、尼古丁是引起癌症的化学物质、被动吸烟对健康的危害很小、吸烟成瘾是一种慢性疾病、教师应是不吸烟的榜样、应在学校范围内禁烟的知晓率差异有统计学意义(P值均<0.05).结论 云南省教师存在不同程度的校园吸烟现象,且对烟草相关知识的掌握仍有不足.应普及教师控烟知识和技能的培训.     

西藏青少年2019年吸烟行为现状及相关因素分析

  目的  了解西藏青少年烟草使用现状及影响因素, 为开展有针对性的控烟干预提供技术依据。  方法  于2019年8—10月, 采用与人口数量规模成比例的整群抽样方法抽取西藏4 983名学生进行问卷调查, 采用χ2检验和非条件Logistic回归分析探讨西藏青少年现在吸烟率的相关因素。  结果  2019年西藏青少年现在吸烟率为11.3%(563/4 983), 尝试吸烟率为21.8%(1 086/4 983), 二手烟暴露率为62.4%(3 111/4 983)。82.9%的吸烟者表示想要戒烟, 79.9%的吸烟者在过去12个月内有过尝试戒烟行为, 仅有11.7%的吸烟者表示受到过专业人员的戒烟帮助或建议。Logistic回归分析结果显示, 城市(OR=2.38)、三年级(OR=1.51)、学校类型为普通高中(OR=2.90)或职业高中(OR=3.53)、男生(OR=16.93)、每周零花钱≥50元(OR=1.93)、暴露于二手烟(OR=16.12)、认为二手烟可能会(OR=1.40)或可能不会(OR=4.89)产生危害、暴露于烟草广告(OR=1.83)、朋友吸烟(OR=7.47)、几乎每天能看到教师吸烟(OR=1.79)与青少年现在吸烟行为均呈正相关; 认为吸烟行为能减少吸引力(OR=0.54)与青少年现在吸烟行为呈负相关(P值均 < 0.05)。  结论  2019年西藏青少年吸烟及尝试吸烟行为较普遍, 二手烟暴露问题较严重, 职业高中学生是开展控烟干预的重点人群, 学校为控烟干预的重点场所。     

Household smoking bans and adolescents' perceived prevalence of smoking and social acceptability of smoking

OBJECTIVES: Household smoking bans might decrease the visibility of cigarette smoking and communicate nonsmoking social norms and parental attitudes to youths, which may serve as mediators to reduce smoking initiation. Whether they have these effects even if parents smoke or do not otherwise communicate strong disapproval of smoking to their children is not clear. We tested these hypotheses in multi-level analyses. METHODS: A telephone survey of a random sample of 3831 Massachusetts adolescents (12-17 years) assessed respondents' perceptions of smoking prevalence and attitudes about the social acceptability of smoking in their community. The association of these outcomes with the presence of a smoking ban in the youths' home was tested in multivariate analyses that adjusted for town-level clustering and individual and environmental characteristics. RESULTS: A household smoking ban was reported by 71% of all youths and 49% of youths who lived with smokers. In multivariate models, youths who had a household smoking ban were more likely to perceive a lower adult smoking prevalence (OR 2.1; 95% CI 1.7-2.5; P < 0.001), greater adult disapproval of adult smoking (OR 2.0; 1.5-2.6; P < 0.001) and of teen smoking (OR 1.5; 95% CI 1.2-1.9; P = 0.001). CONCLUSIONS: Among adolescents, a household smoking ban was associated with a lower perceived prevalence of adult smoking in their communities and more negative attitudes about the social acceptability of smoking, two factors that affect the likelihood of smoking initiation. Household smoking bans had these effects even in the presence of two parental factors known to encourage adolescent smoking initiation (parental smoking and lack of perceived parental disapproval of youth tobacco use). This provides an additional rationale for promoting household smoking bans to parents.     

Household smoking restrictions and adolescent smoking

PURPOSE: To examine the association between household smoking restrictions and adolescent smoking, controlling for parental smoking, peer smoking, and tobacco marketing. DESIGN: Cross-sectional analysis of 1999 data from the Growing Up Today Study, a longitudinal cohort of adolescents. SETTING: Self-report questionnaire. SUBJECTS: 10,593 adolescents aged 12 to 18 years. MEASURES: The dependent variable was established smoking (smoking > or = 100 cigarettes). Variables of interest were household smoking restrictions, parental smoking, peer smoking, and tobacco promotional item (TPI) possession. RESULTS: Four percent of participants reported that their households permitted smoking. Parental smoking, peer smoking, and TPI possession were significantly associated with established smoking In logistic regression models adjusted for age, gender, peer smoking, and TPI possession, adolescent smoking was inversely related to the presence of a restrictive household policy (odds ratio [OR] = 0.67, 95% confidence interval [CI] = 0.48-0.93); however, when parental smoking was added to this model, the association was attenuated (OR = 0.94, CI = 0.65-1.35). When only one parent in the household smoked, smoking restrictions were more common when this parent was the father. CONCLUSIONS: Although household smoking restrictions offer health benefits, they do not appear to be associated with adolescent smoking after accounting for other factors. Prior studies did not include parental smoking, peer smoking, and marketing influences. This analytic difference may explain apparent contradictions in the literature.     

Meanings of smoking and adolescent smoking across ethnicities.

PURPOSE: To develop insight into population-specific meanings of smoking in our highly multicultural middle schools in order to provide effective and appropriate tools for smoking prevention efforts. METHODS: We used focus group interviews to develop the Meanings of Smoking Index (MSI), a nine-item scale that uses a "mark all that apply" strategy to assess what smoking means to children who have tried smoking as well as to those who are susceptible to smoking. In 24 public and parochial middle schools in the greater Los Angeles area, 2336 7th graders (1483 Latino, 565 Asian/ Pacific Islander and 288 white, 55.2% of the sample was female) completed the MSI as part of a school-based trial of culturally-targeted smoking prevention strategies. Items were rank ordered according to salience (rate of endorsement) and relevance (strength of relationship with lifetime smoking) across the entire sample and separately for Hispanic/Latino, Asian/Asian-American and white respondents. Spearman correlation coefficient was used to compare results between ethnicities. RESULTS: The most frequently endorsed meanings were similar across ethnicities. Magnitude of associations between smoking behaviors and meanings were dissimilar across ethnicities. The meaning with the strongest relationship to lifetime smoking for whites and Latinos was "it helps me study" (OR 3.4 and 2.6 respectively), and for Asians was "don't want to make another smoke alone" (OR 5.4). CONCLUSIONS: We have shown previously that interventions on meanings of eating behaviors changed dietary behaviors in adolescents. The present findings suggest that meanings are powerful determinants of adolescent smoking in culturally diverse populations and could offer powerful intervention tools to prevent adolescent smoking.     

Predicting adult smoking: the influence of smoking during adolescence and smoking among friends and family

The aim of the study was to predict smoking from early adolescenceto adulthood by using longitudinal data. The data was gatheredin connection with the North Karelia Youth Project. The projectwas started in 1978 with students in the seventh grade of juniorhigh school (aged 13 years) and finished in 1980 when the studentsreached the ninth grade. The follow-up study included four additionalsurveys over 15 years, the last being in 1993–94. Theresults show that two-thirds of the smokers in the ninth gradeof junior high school (aged 15 years) were still smoking atthe age of 28. About half of the smokers at the age of 28 weresmokers in the ninth grade and the other half had started afterthat. Previous smoking status and smoking by friends were themost important predictors of smoking. The continuity of smokingand non-smoking from adolescence to adulthood supports the importanceof prevention programs in junior high school. On the other hand,about half of the smoking adults had started smoking after that.This indicates that the prevention programs should continueafter junior high school.     

The impact of school smoking policies and student perceptions of enforcement on school smoking prevalence and location of smoking

The purpose of this study was to comprehensively assess the impact of school tobacco policy intention, implementation and students' perceptions of policy enforcement on smoking rates and location of tobacco use during the school day. Data were obtained from all students in Grades 10-11 (n = 22,318) in 81 randomly selected schools from five Canadian provinces. Policy intention was assessed by coding written school tobacco policies. School administrators most familiar with the tobacco policy completed a survey to assess policy implementation. Results revealed policy intention and implementation subscales did not significantly predict school smoking prevalence but resulted in moderate prediction of tobacco use on school property (R(2) = 0.21-0.27). Students' perceptions of policy enforcement significantly predicted school smoking prevalence (R(2) = 0.36) and location of tobacco use (R(2) = 0.23-0.63). The research findings emphasize: (i) the need to consider both written policy intention and actual policy implementation and (ii) the existence of a policy is not effective in controlling tobacco use unless the policy is implemented and is perceived to be strongly enforced.     

Association of smoking status, cumulative smoking, duration of smoking cessation, age of starting smoking, and depression in Korean adults

ABSTRACT: BACKGROUND: Many previous studies did not sufficiently control for several confounding factors that may affect the association between smoking and depression, such as socioeconomic status. We investigated the association between depression and smoking status, smoking exposure, duration of smoking cessation, and age of starting smoking while controlling for socioeconomic factors. METHODS: This study was based on a community health survey performed in Jeollanam-do, South Korea, between September and November 2009. In total, 20,084 subjects (9,128 males and 10,966 females) were included in the analysis. Information on smoking characteristics, such as smoking status, pack-years of smoking, and age of starting smoking, was collected using a standardized questionnaire. Depression was defined using the Korean CES-D score. RESULTS: The odds ratios (ORs) of depression were 1.35 (0.92-1.98) for former smokers and 1.77 (1.27-2.48) for current-smokers among males, and 2.67 (1.38-5.16) for former smokers and 3.72 (2.11-6.54) for current-smokers among females, after adjusting for other confounding factors. Compared to light smoking, heavy smoking was significantly associated with depression in males [OR = 3.97, 95% confidence interval (CI) = 1.42-11.14], but not in females (OR = 1.24, 95% CI = 0.73-2.09). No significant associations between depression and age of starting smoking and duration of smoking cessation were observed among former smokers. CONCLUSIONS: Our data demonstrate that smoking is strongly associated with depression, particularly among females. These findings suggest that depression prevention may need to be combined with smoking prevention and that different strategies may be needed for males and females.     

Attitudes towards smoking policies and tobacco control measures in relation to smoking status and smoking behaviour

BACKGROUND: To examine support for various smoking policies and tobacco control measures among lifetime smokers in a country with weak anti-smoking legislation and an underdeveloped anti-smoking climate. METHODS: Current (n = 624) and former smokers (n = 131) from a general population survey filled in the 30-item Smoking Policy Index (SPI). Structural equation modelling was used to confirm the SPI factorial structure and to test whether smoking status and smoking behaviour variables were related to the six dimensions of the SPI. RESULTS: The dimension with the highest support was penalties for sales to minors. Sanctions against smokers had the lowest support. Current smokers compared with former smokers showed lower support on the taxes/fees, public education, and environmental restrictions dimensions while controlling for gender, age, and social status. Within current smokers, unfavourable smoking behaviours were associated with lower support. CONCLUSION: Even in a country with poor tobacco control conditions, lifetime smokers including smokers with highly unfavourable smoking behaviours strongly support smoking policies and tobacco control measures concerning penalties and advertising/promotion. These measures should be used to promote anti-smoking legislation, and strict law enforcement of these measures is expected to be accepted by all smokers. For measures that are not supported by all lifetime smokers, interventions may be useful to increase acceptability. A limitation of the present study is the absence of never-smokers as a comparison group.     

College campus smoking policies and programs and students' smoking behaviors

Background  

Although tobacco use in the United States has declined over the past 20 years, cigarette use among college students remains high. Additional research is thus needed to determine how university tobacco control policies and preventive education programs affect college students' smoking behaviors.