中国慢性病前瞻性研究:10个项目地区成年人群吸烟行为特征差异分析

目的 描述中国慢性病前瞻性研究(CKB)10个项目地区成年人群吸烟行为特征的地区差异。方法 剔除CKB基线调查时自报患有冠心病、卒中、肿瘤和慢性阻塞性肺病的个体,分析10个项目地区452 829名30～79岁调查对象吸烟行为的地区差异。 结果 男性当前吸烟率(64.2%)明显高于女性(2.1%)。哈尔滨(10.5%)和四川(8.5%)项目地区的女性当前吸烟率明显高于其他地区;湖南和四川项目地区男性当前吸烟率(68.8%和67.2%)及每日吸烟量(20.9支和21.5支)均较高;海口当前吸烟率虽然最低(49.9%),但每日吸烟量最高(21.9支);甘肃当前吸烟率最高(71.4%),但每日吸烟量较低(14.9支)。男性当前吸烟者以过滤嘴香烟的使用率最高(88.3%);手卷烟/旱烟主要见于四川(38.8%)和甘肃(37.8%),而烟斗/水烟主要见于河南(14.6%)项目地区。 结论 CKB的10个项目地区人群无论在吸烟率还是吸烟者使用烟草品种、吸烟量、吸入深度等特征上均存在明显的地区差异。     

Tobacco smoking among Portuguese high-school students.

The aim of this study was to evaluate the prevalence, behavioural patterns, and determinants of smoking among a large sample of high-school students from Porto, the second largest city in Portugal, information on sociodemographic characteristics and personal history of tobacco, alcohol, coffee, and illicit drug use was obtained from 2974 students, aged 12-19 years (48.7% female, 51.3% male), using an anonymous self-administered questionnaire. Crude and adjusted odds ratios (OR) were calculated by logistic regression analysis to estimate the association between smoking and the characteristics evaluated. Overall, 35.8% students had never smoked, 39.4% had tried it ("experimental" smokers) but were not smokers, 3.3% were former smokers, 6.6% occasional smokers, and 14.9% regular smokers. The mean age for starting smoking was 13.4 +/- 2.1 years for males and 13.4 +/- 1.6 years for females. The prevalence of current smoking was higher among males than females, but the difference was not significant. Male students were significantly more likely to smoke more cigarettes per day than were females. The prevalence of smoking was significantly associated with the following variables: being aged > 12 years; having parents who had attended school for < 4 years; having a mother (OR = 1.88), siblings (OR = 1.96) or friends (OR = 1.75) who smoked; low academic performance (OR = 1.74 for one or two failures and OR = 2.27 for more than two failures at school); and consumption of coffee (OR = 2.90), alcohol (OR = 3.53), or illicit drugs (OR = 6.69). The prevalence of smoking among adolescents increased with age. There is therefore a need for school-based tobacco prevention programmes which also deal with family influences on smoking.     

徐州市2008年15岁及以上常住居民吸烟与被动吸烟现状调查

目的 了解徐州市不同人群吸烟现状,为开展控烟工作提供依据.方法 于2008年6-12月采用多阶段分层随机抽样方法 ,选择具有代表性的样本,对15岁及以上常住居民,采用统一调查问卷进行调查.结果共调查44 686人,其中城市10 295人(23.04%),农村34 391人(76.96%);男性21 524人(48.17%),女性23 162人(51.83%).15岁及以上人群吸烟率、现在吸烟率、常吸烟率、重型吸烟率、平均每日吸烟量、戒烟成功率、复吸率及被动吸烟率分别为22.45%、21.40%、15.49%、9.49%、15.09支、4.68%、5.91%和14.12%.城乡居民的吸烟率、现在吸烟率、常吸烟率差异无统计学意义(P>0.05);戒烟成功率、被动吸烟率城市高于农村(P<0.05);复吸率、重型吸烟率、平均每日吸烟量农村高于城市(P<0.05).男性吸烟率、现在吸烟率、常吸烟率、重型吸烟率、复吸率、平均每日吸烟量比例均高于女性(P<0.05).戒烟成功率、被动吸烟率女性高于男性(P<0.05).该人群吸烟者中主要吸有过滤嘴香烟(85.17%).不同文化程度、职业、经济收入的人群吸烟率比较,经X~2检验,差异均有统计学意义(P<0.05).结论 徐州市居民中吸烟率仍然很高,应采取有针对性的措施,有效地控制烟草的流行.     

Cross-sectional study on the relationship between body mass index and smoking, and longitudinal changes in body mass index in relation to change in smoking status: the Tromso Study

AIMS: To evaluate the effects of smoking and other lifestyle factors on body mass index (BMI), and changes in BMI in relation to changes in smoking status. METHODS: A cross-sectional study was performed on 10,920 males (3937 smokers) and 12,090 females (4343 smokers) who participated in the fourth Troms? Study (performed in 1994-95). A longitudinal study was performed on 2364 males (732 smokers in 1994-95) and 2738 females (942 smokers in 1994-95) who participated in both the fourth and the fifth Troms? studies (performed in 2001). RESULTS: In the cross-sectional study, current smokers of both genders had a lower BMI (25.0+/-3.4 vs. 25.5+/-3.2 kg/m(2) in males, and 23.9+/-3.9 vs. 25.3+/-4.6 kg/m( 2) in females, p<0.01), a lower degree of physical activity, and a higher consumption of coffee and alcohol than never-smokers. We found a U-shaped relationship between number of cigarettes smoked per day and BMI, with the lowest BMI in those smoking 6- 10 cigarettes per day. Heavy smokers and never-smokers had similar BMI. In the longitudinal study, continuing smokers had a smaller increase in BMI than those who gave up smoking. In those who gave up smoking, there was a significant, positive relationship between number of cigarettes smoked in 1994-95 and increase in BMI. CONCLUSIONS: There is a U-shaped relationship between number of cigarettes smoked per day and BMI. Smoking cessation is associated with an increase in weight as compared to those who continue smoking.     

Predictors of the onset of tobacco consumption among secondary school students of Barcelona and Lleida

BACKGROUND: Knowing the factors predisposing the smoking onset of smoking at school age may help to improve the preventive strategies and make the starting age later. This study is set out to describe the natural history of smoking throughout the teen-age years and the main factors which may predict teenagers developing the smoking habit. METHODS: This is a longitudinal study of a survey type, using the school room as the sampling unit at six schools in Barcelona and Lleida. A total of 1,460 students within the 12-19 age range took part. Two surveys were conducted, an initial survey in the spring of 1992 and a follow-up survey one year later. A total of 1,236 questionnaires (84.3%) were paired by means of a personal code used for the longitudinal study. RESULTS: A total of 25% of the students were regular smokers at the start of the study, 17.1% smoking occasionally or having experimented with smoking, there being no differences between sexes for both of these categories. Among those who were non-smokers at the starting survey, 12.7% stated that they smoked occasionally and 6.2% regularly one year later. The females started smoking at an earlier age, the differences as compared to males being statistically significant at 14 years of age. The predictors of the smoking onset include favorable attitudes toward cigarettes (OR = 3.1; CI5% (1.6-5.6), drinking alcoholic beverages (OR = 2.2; CI95% (1.4-3.3), being younger than age 15 (OR = 2.0; CI95% (1.2-3.4), having friends who smoke (OR = 1.9, CI95% (1.2-3.0) and the stated intention of smoking in the future (OR = 1.6; CI95% (1.0-2.5). CONCLUSIONS: The students showing a higher degree of tolerance toward cigarette smoking, entailing favorable attitudes or friends who smoke or who intend to smoke in the future at the start of the study are at a much higher risk of Smoking onset than their classmates who are not of these characteristics. The cigarette smoking prevention programs must focus special attention on the teenagers most highly vulnerable to these factors.     

Cigarette smoking and breast cancer.

An epidemiological case-control study was conducted in New York State, with 1617 primary breast cancer patients and an equal number of controls, to examine the relationship between cigarette smoking and breast cancer. Results showed no overall association between ever smokers versus never smokers and breast cancer risk (odds ratio [OR] = 1.03, 95% confidence interval [CI]: 0.90-1.19), nor was there any dose response trend observed with increased levels of smoking. In addition, no association was found with risk and age started smoking, age stopped smoking, amount smoked or total years smoked. Controlling for previously identified risk factors for breast cancer in the analysis did not significantly alter these relationships. Previous studies have found a difference in menopausal age among smokers compared to nonsmokers. The mean menopausal age was only slightly lower in smokers than in never smokers for both cases and controls. Breast cancer risk was observed to be close to unity for premenopausal women (OR = 0.97, 95% CI: 0.74-1.34) and postmenopausal women (OR = 1.06, 95% CI: 0.91-1.26). A recent study suggested breast cancer risk was more strongly related to starting smoking at a young age among women who smoked at least 25 or more cigarettes per day in the most recent year of smoking. This hypothesis was not supported by these data.     

Cigarette Smoking and Colorectal Cancer: A Study of 1,584 Cases and 2,879 Controls

Background. Although colorectal cancer is not one of the major tobacco-related cancers, a possible association with tobacco has been suggested following the observation of a relationship between cigarette smoking and colorectal adenomas. The issue of a long latency of tobacco on colorectal carcinogenesis has also been suggested, since elevated relative risks were observed in long-term smokers. Methods. The association between colorectal cancer and cigarette smoking has been investigated using data from a case-control study conducted in northern Italy between 1985 and 1991 on 955 cases of colon and 629 cases of rectal cancer and 2,879 controls in hospital for acute, nonneoplastic, nondigestive tract, non-tobacco-related diseases. Odds ratios (OR), and the corresponding 95% confidence intervals, of colorectal cancer according to various measures of tobacco smoking were derived from multivariate models, including terms for sex, age, total calorie intake and selected dietary variables, alcohol consumption, and family history of colorectal cancer. Results. No association between smoking and colorectal cancer was observed. Compared with people who had never smoked, the overall multivariate OR for colorectal cancer was 0.9 in ex-smokers and 0.7 in current smokers. No relationship was found with number of cigarettes smoked (OR = 0.7 for both <15 and 15-24, and 0.8 for ≥ 25 cigarettes per day), age at starting (OR = 0.7 for <20, 0.8 for 20-29, and 0.9 for ≥ 30 years), duration (OR = 0.8 for <10, 0.7 for 10-19, 0.8 for 20-29, and 0.7 for ≥ 30 years), and time since starting (OR = 0.7, for <30, 0.8 for ≥ 30 years) and since stopping (OR = 1.1 for <10, 0.7 for ≥ 10 years). There was no evidence of a trend in risk with increasing lifelong pack years (OR for ≥ 40 PACK-YEARS = 0.8 for colon and rectum), pack-years before age 30 (OR = 0.7 for ≥ 20 pack-years), or pack-years after age 30 (OR = 0.8 for ≥ 30 pack-years). The results were similar for males and females. Conclusions. The findings of this study indicate that smoking was not a strong risk factor for colorectal cancer, even after a long induction period.     

Tobacco Price Increase and Smoking Cessation in Japan,a Developed Country With Affordable Tobacco: A National Population-Based Observational Study

Background

Longitudinal assessment of the impact of tobacco price on smoking cessation is scarce. Our objective was to investigate the effect of a price increase in October 2010 on cessation rates according to gender, age, socioeconomic status, and level of tobacco dependence in Japan.

Methods

We used longitudinal data linkage of two nationally representative studies and followed 2702 smokers for assessment of their cessation status. The odds ratios (ORs) for cessation were calculated using logistic regression. To estimate the impact of the 2010 tobacco price increase on cessation, data from 2007 were used as a reference category.

Results

Overall cessation rates significantly increased from 2007 to 2010, from 3.7% to 10.7% for men and from 9.9% to 16.3% for women. Cessation rates were 9.3% for men who smoked 1–10 cigarettes per day, 2.7% for men who smoked 11–20 cigarettes per day, and 2.0% for men who smoked more than 20 cigarettes per day in 2007. These rates increased to 15.5%, 10.0%, and 8.0%, respectively, in 2010. The impact was stronger among subjects who smoked more than 11 cigarettes per day than those who smoked 1–10 cigarettes per day in both sexes: ORs for 2010 were 4.04 for those smoking 11–20 cigarettes per day, 4.26 for those smoking more than 20 cigarettes per day, and 1.80 for those smoking 1–10 cigarettes per day in the main model in men. There were no obvious differences in the relationship between tobacco price increase and smoking cessation across age and household expenditure groups.

Conclusions

The tobacco price increase in Japan had a significant impact on smoking cessation in both sexes, especially among heavy smokers, with no clear difference in effect by socio-demographic status.Key words: tobacco price increase, smoking cessation, Japan, linkage study     

Cigarette smoking and age at natural menopause.

In a cohort of 656 naturally postmenopausal women who were interviewed at age 60 to 69 years, and was had reached their menopause between the ages of 35 and 59 years, the mean age at menopause declined with increasing number of cigarettes smoked, from 49.4 years of age among women who had never smoked to 47.6 years of age among women who smoked at least 15 cigarettes per day (p less than 0.02). The relationship was not attributable to the onset of menopause inducing women to take up smoking.     

Evidence for compensation in smokers of low yield cigarettes

To determine the relation of smoking low yield cigarettes (tar yield less than 15.0 mg and nicotine yield less than 1.0 mg per cigarette) to the number of cigarettes smoked per day, we analysed information provided on self-administered questionnaires by 7706 current, regular cigarette smokers. The mean age at starting to smoke and the mean number of years of smoking were not consistently different in smokers of low yield compared with smokers of high yield cigarettes. In contrast, at all ages in both men and women, smokers of low yield cigarettes smoked significantly more cigarettes per day than smokers of high yield cigarettes. The differences in the number of cigarettes smoked per day between smokers of low and high yield cigarettes were small--about 3 cigarettes per day in men and about 1 1/2 cigarettes per day in women. However, these small differences might translate to the smoking of as many as one billion more packs of cigarettes per year in the United States alone. The potential beneficial effect of the smoking of cigarettes whose yield per cigarette is lower must be weighed against a possible adverse effect of the smoking of more cigarettes if the relation between smoking low yield cigarettes and smoking more cigarettes is causal.     

Social, personality and environmental determinants of smoking in young Finnish men

The study was based on 471 males, aged 19 to 20 years, who started their compulsory military service in three military bases in Southwest, Southeast and Northern Finland in February 1982. Of these subjects 48% smoked regularly and had smoked in the past three weeks. The correlation between the reported number of cigarettes smoked a day and serum thiocyanate was 0.60. Seventy-four per cent of the subjects whose best friend smoked, were current smokers compared with 24% of the others. Proportion of smokers was higher in urban areas than in rural areas. Among the 14 explanatory variables in the multivariate logistic analysis, family members' and friends' smoking, the place of residence, strenuousness of leisure-time physical activities, number of friends, rebelliousness, intelligence test score, and general pessimism were most strongly associated with the likelihood of being a current smoker. The model explained 87% of the smoking variance.     

Association of thromboangiitis obliterans with cigarette and bidi smoking in Bangladesh: a case-control study

BACKGROUND: In addition to cigarettes, bidi, made of unprocessed and low-grade tobacco, is being smoked widely in Bangladesh and in other south Asian countries. The cause-and-effect relationship is established between thromboangiitis obliterans (TAO) and smoking. However, type of smoking material(s) most strongly related to TAO is not yet determined. METHODS: We conducted a hospital-based case-control study in Rajshahi, Bangladesh, to examine the relationship of type of smoking materials (cigarette versus bidi) with TAO on 103 pairs of cases and controls matched by age and sex during the period 1995 to 1996. The inclusion criteria for cases were newly diagnosed TAO and current smoker, while those for controls were current smokers admitted to the hospital due to non-cardiovascular diseases. RESULTS: Among the cases 35.0% and 65.0% were cigarette and bidi smokers, while among the controls 69.9% and 30.1%, respectively. Using logistic regression approach, considering cigarette smoking approximately 10 per day as reference, bidi smoking >20 per day (odds ratio [OR] = 34.76, 95% CI: 6.11-197.67) and 11-20 per day (OR = 7.12, 95% CI: 2.35-21.63) had greater risk of TAO after adjusting confounding factors. Respective OR for bidi smoking approximately 10 per day, cigarette smoking 11-20 per day and cigarette smoking >20 per day, were 2.18 (95% CI: 0.64-7.51), 3.81 (95% CI: 1.37-10.57) and 6.88 (95% CI: 1.87-25.30). CONCLUSION: Within the limits inherent to case-control study, our findings suggest that bidi smoking may well play a more important role in causing TAO than cigarettes. It leads to the speculation that unprocessed and low-grade tobacco used for producing bidi might play a more potent role to initiate TAO than cigarettes.     

Epidemiological survey on smoking habit among young students in Sardinia. A cross sectional study

The study reports the prevalence of cigarette smoking among 11401 high school Sardinian students. The prevalence of smokers (40.2%) significantly differs between gender (41.1% males and 38.4% females). Males have an early initiation of smoking with an evident addictive effect by age. 54.3% are daily smokers and 21.4% smoke 15 or more cigarettes per day. More than 50% smoke to look grown-up and to be accepted by the group. Besides age (OR=1.10; 95%CI: 1.06-1.15), other factors are associated with smoke: low education level of father (OR=1.08; 95%CI: 1.02-1.15), no maternal support (OR = 1.73; 95%CI: 1.17-2.54), to have at least one smoker cohabitant (OR=1.66; 95%CI: 1.54-1.80) and alcohol drinking (OR=3.46; 95%CI: 3.04-3.93). The smokers' knowledge on smoke topics significantly differ from non smokers. Our results suggest the need of community preventive interventions, diversified for specific target populations, to modify the students' behaviours so that they respect their own health and that of their fellow citizens.     

The capability to resist smoking relapse

BACKGROUND: Remaining in the maintenance stage and preventing a relapse of smoking is the main problem in the smoking cessation process. The objectives of this study were to compare characteristics of successful quitters with those who relapsed, to examine characteristics of the maintenance stage, and reasons for not resuming smoking. METHODS: Prospective face-to-face interviews with 1094 subjects registered with a family practice. Those who had relapsed or stopped smoking permanently comprised the study group. RESULTS: Of all subjects studied, 10.1% stated that they had stopped smoking and 10.8%, that they had relapsed. Quitters were older than relapsers, less educated, smoked significantly more cigarettes per day, and made fewer attempts to quit smoking. No significant difference was found between quitters and relapsers in marital status, country of origin, age of starting to smoke, duration of smoking, and method used to stop smoking. Age and the number of cigarettes smoked per day were associated with the maintenance stage, which was longer when smoking > or = 25 cigarettes/day. No significant association was found between the maintenance stage and marital status, country of origin, education, age of starting to smoke, and duration of smoking. Eighty-three (74.8%) of the quitters stated that the reasons for remaining in the maintenance stage were having the capability to overcome smoking and a strong resistance to temptation for relapse, 16 (14.4%) noted that they had no interest in cigarettes, 8 (7.2%) reported that cigarettes had a bad taste and deterred them from smoking, 4 (3.6%) stated that they were afraid of illness. The main factors associated with remaining in the maintenance stage were the quitters' age, heavy smoking before smoking cessation, and quitters' strong character and ability to overcome relapse and temptations to re-start smoking.     

Smoking,Sociodemographic Determinants,and Stress in the Alabama Black Belt

Purpose: In the Alabama Black Belt, poverty is high, and the educational level is low. Studies have found increased tobacco use among individuals exposed to high levels of stress. Few studies have been conducted in this region to measure smoking status, its sociodemographic determinants, and how smoking status relates to stressful environmental conditions. Methods: A cross‐sectional questionnaire survey of 1,387 individuals. Findings: Approximately 25% of the respondents currently smoked cigarettes. Females were less likely to smoke compared to males (OR, 0.29; 95% CI, 0.23‐0.38). Blacks were less likely to smoke cigarettes compared to whites (OR, 0.64; 95% CI, 0.43‐0.95). Compared to individuals who were employed, participants who were unemployed or retired had increased odds of smoking (OR, 1.68; 95% CI, 1.15‐2.20). The odds of being a current smoker were increased in the presence of moderate level stress (OR, 2.06; 95% CI, 1.38‐3.07) or when there was a high level of stress (OR, 2.21; 95% CI, 1.47‐3.31). Smoking was associated with increased odds of having a moderate level (OR, 2.06; 95% CI, 1.38‐3.08) and a high level of stress (OR, 2.21; 95% CI, 1.47‐3.32). Females who reported moderate to high levels of stress had increased odds of being smokers compared to males. Interaction between gender and stress showed deviation from additivity. Conclusion: Our findings suggest a high rate of cigarette use in the area. Increased stress levels appear to predispose females more than males to cigarette smoking. The implications of this association may guide interventions targeted at reducing smoking and its complications.     

The sociodemographic pattern of tobacco cessation in the 1980s: results from a panel study of living condition surveys in Sweden.

STUDY OBJECTIVES: To analyse the factors that determined whether or not people were successful in quitting tobacco during the 1980s in Sweden. DESIGN: A logistic regression model was used for the analyses and included: education, marital status, socioeconomic group, social network, physical activities, cigarette consumption, and years spent smoking as independent variables. Men and women were analysed separately for smoking. A specific univariate analysis was also performed for men who used snuff. SETTING: Sweden. PARTICIPANTS: A panel of 5104 randomised people aged 16-84 years was interviewed in 1980-81 and followed up in 1988-89 in the survey of living conditions undertaken by Statistics Sweden. The participation rate was 86%. The panel included 1546 men and women who were daily smokers. There were 418 daily users of snuff among the men, and 129 men both smoked and used snuff. MAIN RESULTS: Together 26% of women and 23% of men had quit smoking. Five percent in both groups were new smokers. Among men, 26% had quit using snuff and 5% had begun smoking. New snuff users among men were 5%. In the multivariate analysis, unmarried men kept smoking at significantly higher rates (OR 2.1; 95% CI 1.2,3.6), as did those men who smoked 11-20 cigarettes/day (OR 2.2; 95% CI 1.5, 3.4), or more than 20 cigarettes/day (OR 2.8; 95% CI 1.4,5.7). Among women, smoking 11-20 cigarettes/day was also a significant factor (OR 3.3; 95% CI 2.1,5.0). Men and women aged 25-44 were significantly more likely to continue smoking (OR = 2.1; 95% CI 1.1,3.7, and 2.2; 95% CI 1.2,4.4) as were those who had smoked for 20 years or more (OR 4.7; 95% CI 2.0,10.8 and OR 2.5; 95% CI 1.1,5.5, respectively). For women, low education (up to grade 9) was also a significant factor (OR = 2.5; 95% CI 1.2,5.1). Among men who had quit using snuff we did not find any values of significance. CONCLUSIONS: One in four smokers had quit during the 1980s and a few started smoking (5%). Some men quit smoking and started using snuff instead. For both sexes, the daily consumption of cigarettes, years spent smoking, and age were the most important determinants of successful quitting. In men, being married/ cohabiting was an important factor as was higher education in women.     

Smoking cessation program: baseline carbon monoxide and serum thiocyanate levels as predictors of outcome

One hundred and sixty-two smokers who participated in an aggressive smoking cessation program underwent analysis of expired air carbon monoxide (CO) and serum thiocyanate (SCN) at entry and one year later. Persons who failed to quit smoking had higher baseline CO and SCN and smoked more cigarettes per day than did those who succeeded in quitting. The use of CO, SCN, number of cigarettes smoked, age, and blood pressure at baseline permitted accurate classification of over 70 per cent of the subjects into groups which would succeed and fail in their effort to quit smoking. Persons who failed to quit reduced the reported number of cigaretts smoked per day by one-third, but there was no corresponding reduction in CO and SCN, suggesting that self-reporting of a reduction in the number of cigarettes smoked may not lead to a corresponding decline in exposure.     

Children's health in families with cigarette smokers.

Recent studies have indicated higher rates of certain respiratory conditions among children who live in households with adults who smoke cigarettes. This paper analyzes data from the 1970 National Health Interview Survey. Children in families with no smokers had an average of 1.1 fewer restricted-activity days and 0.8 fewer bed-disability days per year than did children in families with two smokers. Children in families with one smoker were in between. Acute respiratory illness accounted for the difference in disability days among children in families with different smoking characteristics. Family smoking was also measured by the combined number of cigarettes smoked by adults; children in families which smoked 45 or more cigarettes a day had 1.9 more restricted activity days and 0.9 more bed-disability days due to acute respiratory conditions than did children in families who did not smoke cigarettes. The age of the child, the number of adults in the family, the education of the family head, and the family income were all controlled and did not eliminate the relationship between children's health and family smoking.     

吸烟及烟碱型乙酰胆碱受体亚单位α5基因rs17486278位点多态性对肺癌的交互作用

目的 探讨在中国男性人群中吸烟、烟碱型乙酰胆碱受体亚单位α5(CHRNA5)基因多态性与肺癌的关联及其交互作用.方法 采用成组病例对照研究设计,收集男性原发性肺癌病例204例,正常健康对照者821例.采用结构式问卷调查社会人口学特征、吸烟行为及健康状况等,采集静脉血检测CHRNA5 SNP位点rs17486278的多态性.应用多因素logistic回归模型分析吸烟、CHRNA5的基因多态性与肺癌的关系及其交互作用.结果 控制潜在混杂因素后,每天吸烟量＞15支者发生肺癌的风险高于不吸烟者(OR=3.49,95％CI:2.29～ 5.32),未发现CHRNA5上的rs17486278多态性与肺癌有统计学关联.进一步交互作用分析显示,每天吸烟量1～15支并携带rs17486278纯合变异基因型(CC)者对肺癌的发生存在正交互作用(OR=16.13,95％CI:1.27～205.33).根据rs17486278多态性和吸烟行为进行分层分析,与不吸烟并携带rs17486278野生基因型(AA)者相比,每天吸烟量1～15支并携带纯合变异基因型(CC)者、每天吸烟量＞15支并携带野生基因型(AA)者和每天吸烟量＞15支并携带杂合变异基因型(AC)者发生肺癌风险增高,OR直分别为8.14(95％CI:1.17 ～ 56.56)、3.84(95％CI:1.30～ 11.40)和5.32(95％CI:1.78 ～ 15.93).结论 在中国男性人群中CHRNA5的基因多态性与吸烟行为对肺癌的发生存在正交互作用.     

Stages of change and other factors in 'light' cigarette smokers

BACKGROUND: It has become well known that 'light' cigarettes are deceiving in fostering the attitude that they are 'safer' or less health damaging than regular cigarettes. The goal of this study is to analyse the smoking of 'light' cigarettes according to the progress over the stages of change to stop or reduce smoking. METHODS: A sample representing the general population of a northern German region aged 18 to 64 was drawn (T1, N=4075). 1520 smokers of 'light' and regular cigarettes were identified by a face-to-face interview and reassessed longitudinally by questionnaire 30 months later (T2, n=913). RESULTS: At baseline smokers of 'light' cigarettes, in particular males, were more likely to be contemplators or preparators in terms of smoking cessation. Those who smoked 'light' cigarettes were more likely to have made a quit attempt, were more likely to be female, at younger age, never married, higher educated and less nicotine dependent compared to smokers of regular cigarettes. The follow-up data shows that males who smoked 'light' before or changed to 'light' cigarettes were more likely to contemplate or to prepare quitting, had more often tried a quit attempt and stopped smoking more often. CONCLUSION: The results suggest that 'light' cigarettes especially by males are used for reasons of reducing or quitting smoking. It is concluded that as such they deceive the smoker and potentially hinder the process of reducing or quitting.