Tobacco outlet density,neighbourhood stressors and smoking prevalence in Toronto,Canada

A growing body of research has shown that neighbourhood-level factors, such as the density of retail outlets selling tobacco and neighbourhood socioeconomic disadvantage affect smoking prevalence, with high levels of outlet density and neighbourhood disadvantage related to higher smoking prevalence.However, few studies have considered the role of other neighbourhood processes like stressors including perceived neighbourhood disorder in these effects. The present study examined the effects of tobacco outlet density, neighbourhood income and perceived neighbourhood disorder on smoking prevalence among a representative sample of 2,412 adult neighbourhood residents in a large urban centre in Canada. Tobacco outlet density and perceived neighbourhood disorder were significantly associated with smoking in an unadjusted multilevel model, but only perceived neighbourhood disorder remained significant in a model adjusting for other confounders. Findings suggest the need for community-based interventions to address the relationship between neighbourhood disorder and smoking, as well as more research on the combined role of tobacco availability and neighbourhood stressors, beyond neighbourhood socioeconomic disadvantage, on smoking behaviour.     

Association between density and proximity of tobacco retail outlets with smoking: A systematic review of youth studies

BackgroundReducing the retail availability of tobacco has been proposed as a component of tobacco endgame, yet it is not known whether retail availability has a direct impact on smoking behaviours. A narrative review and a meta-analysis have been undertaken to examine the density and proximity of tobacco retail outlets, but were limited in scope, exposure and outcome variables. The aim of this current study was to undertake a systematic review of the international literature on the density and proximity of tobacco retail outlets to homes, schools and communities and their association with smoking behaviours among youth.MethodsWe reviewed and critically appraised the evidence documenting the association between density or proximity of tobacco retail outlets and smoking behaviours among school-age youth (18 and under), between 1 January 1990 and 21 October 2019. We reviewed original quantitative research that examined the associations of tobacco retail outlet density and proximity with individual smoking status or population-level smoking prevalence; initiation of smoking; frequency of tobacco use; sales to minors; purchasing by minors; susceptibility to smoking among non-smokers; perceived prevalence of smoking, and quitting behaviours.FindingsThirty-five peer-reviewed papers met the inclusion criteria. This review provided evidence of a relationship between density of tobacco retail outlets and smoking behaviours, particularly for the density near youths’ home. A study using activity spaces also found a significant positive association between exposure to tobacco retail outlets and daily tobacco use. The review did not provide evidence of an association between the proximity of tobacco retail outlets to homes or schools and smoking behaviours among youth.ConclusionsThe existing evidence supports a positive association between tobacco retail outlet density and smoking behaviours among youth, particularly for the density near youths’ home. This review provides evidence for the development and implementation of policies to reduce the density of tobacco retail outlets to reduce smoking prevalence among youth.     

The effect of tobacco outlet density and proximity on smoking cessation

Objectives. We examined the influence of tobacco outlet density and residential proximity to tobacco outlets on continuous smoking abstinence 6 months after a quit attempt.Methods. We used continuation ratio logit models to examine the relationships of tobacco outlet density and tobacco outlet proximity with biochemically verified continuous abstinence across weeks 1, 2, 4, and 26 after quitting among 414 adult smokers from Houston, Texas (33% non-Latino White, 34% non-Latino Black, and 33% Latino). Analyses controlled for age, race/ethnicity, partner status, education, gender, employment status, prequit smoking rate, and the number of years smoked.Results. Residential proximity to tobacco outlets, but not tobacco outlet density, provided unique information in the prediction of long-term, continuous abstinence from smoking during a specific quit attempt. Participants residing less than 250 meters (P = .01) or less than 500 meters (P = .04) from the closest tobacco outlet were less likely to be abstinent than were those living 250 meters or farther or 500 meters or farther, respectively, from outlets.Conclusions. Because residential proximity to tobacco outlets influences smoking cessation, zoning restrictions to limit tobacco sales in residential areas may complement existing efforts to reduce tobacco use.Although the prevalence of smoking has decreased substantially over the past few decades, smoking remains the leading cause of preventable death and disability among adults in the United States.¹ A key public health strategy to reduce the deleterious health effects of tobacco use is to decrease the prevalence of smoking by increasing smoking cessation rates.² Previous public health and policy approaches to affect smoking prevalence have included restrictions on tobacco advertising, counter-advertising campaigns, bans on smoking in public places, increases in federal and state cigarette excise taxes, and increases in the availability of treatment programs. The effectiveness of these approaches in increasing smoking cessation rates has been supported by the literature.^3–5 However, additional tobacco control strategies are needed to achieve national public health goals.²One potential area of expansion for tobacco control policies is the regulation of tobacco retail outlets. Regulation strategies are designed to facilitate behavior change by altering structural aspects of the community context in which problematic behavior occurs.⁶ An analogous area in which regulation strategies have been applied is alcohol beverage retail outlets. In this case, regulation strategies have included the implementation of zoning restrictions to reduce the density of alcohol outlets and the proximity of alcohol outlets to residential areas. It was hypothesized that such regulations would affect problematic alcohol use at a community level by decreasing residents’ access to alcohol, reducing exposure to on-site product marketing, and changing social norms about alcohol use.⁷ Ultimately, research supported the success of these policies in reducing problematic alcohol use and alcohol-related injury, crimes, and violence.^7–9 In contrast to the alcohol arena, little attention has been paid thus far to the potential utility of tobacco outlet regulation strategies as a supplement to existing tobacco control policies.The Family Smoking Prevention and Tobacco Control Act, signed into law in June 2009, greatly expands the federal government''s ability to enact new public health policies related to tobacco sales in the United States. If one considers the success of alcohol outlet regulation strategies on curbing alcohol use, an increased understanding of the effects of tobacco retail outlets on smoking behaviors may provide direction to emerging tobacco control policies. Thus far, studies largely support associations between tobacco retail outlets and smoking behaviors. For example, the density of tobacco retail outlets around schools has been linked to adolescent smoking initiation¹⁰ and purchasing habits.¹¹ Similarly, the density of tobacco outlets around the home, as well as the proximity of tobacco outlets to the home, has been associated with the number of cigarettes consumed per day among adult smokers.¹² In another study, greater smoker sensitivity to point-of-sale advertising at tobacco outlets predicted a reduced likelihood of having quit smoking 18 months later.¹³ However, no previous studies have directly examined the effects of tobacco outlet density and proximity on smoking cessation during a specific quit attempt.The purpose of our study was to examine the effect of tobacco retail outlet density and proximity on smoking cessation among a racially/ethnically diverse group of smokers undergoing a specific quit attempt. We had two hypotheses. The first was that greater density of tobacco outlets around participants’ homes would be associated with lower odds of cessation. The second was that close residential proximity to a tobacco retail outlet would be associated with lower odds of cessation. All analyses controlled for participant demographics and tobacco-related variables. To our knowledge, this is the first study to examine the effects of tobacco retail outlets on a smoking quit attempt using a prospective, longitudinal design and biochemically verified smoking abstinence.     

Retail tobacco outlet density and youth cigarette smoking: a propensity-modeling approach

OBJECTIVES: We examined whether retail tobacco outlet density was related to youth cigarette smoking after control for a diverse range of neighborhood characteristics. METHODS: Data were gathered from 2116 respondents (aged 11 to 23 years) residing in 178 census tracts in Chicago, Ill. Propensity score stratification methods for continuous exposures were used to adjust for potentially confounding neighborhood characteristics, thus strengthening causal inferences. RESULTS: Retail tobacco outlets were disproportionately located in neighborhoods characterized by social and economic disadvantage. In a model that excluded neighborhood confounders, a marginally significant effect was found. Youths in areas at the highest 75th percentile in retail tobacco outlet density were 13% more likely (odds ratio [OR]=1.13; 95% confidence interval [CI]=0.99, 1.28) to have smoked in the past month compared with those living at the lowest 25th percentile. However, the relation became stronger and significant (OR=0.21; 95% CI=1.04, 1.41) after introduction of tract-level confounders and was statistically significant in the propensity score-adjusted model (OR = 1.20; 95% CI = 1.001, 1.44). Results did not differ significantly between minors and those legally permitted to smoke. CONCLUSIONS: Reductions in retail tobacco outlet density may reduce rates of youth smoking.     

How place matters for smoking cessation: Barriers to smoking cessation among low-income Black women

African Americans start smoking later in life, yet they are less likely to quit smoking than other racial/ethnic groups. Drawing upon 40 in-depth interviews with former and current Black women smokers in the South Side of Chicago, this study examines external barriers to successful smoking cessation among socioeconomically disadvantaged Black women smokers. Beyond individual factors (e.g., stressors), this study finds interpersonal and structural factors that influence Black women's cessation efforts, including the high prevalence and normality of smoking and access to cheaper, loose cigarettes in their communities. Findings highlight the importance of considering local contexts for future tobacco research and policies.     

社区戒烟干预理论概述

通过对近几十年国内外以社区为基础开展戒烟干预研究的文献进行分析汇总,介绍根据不同理论框架开发的戒烟措施在社区应用的效果。针对中国严峻的烟草流行形势和现有戒烟服务的不足,探讨其在降低中国人群吸烟率中的应用前景,以期为国内开展社区戒烟干预研究的理论框架和实践应用提供参考。     

Characteristics of daily and occasional smoking among youths

OBJECTIVES: The purpose of this study was to develop a more detailed understanding of the characteristics of occasional smokers, and how the characteristics of occasional smokers differ from those of daily smokers. This information can then be used in youth smoking programmes to better address these differences in a manner that would target appropriate youth with appropriate cessation methods. METHODS: A questionnaire was administered to 976 university students, aged between 18 and 25 years, in Ankara, Turkey. The topics covered included age, sex and tobacco use characteristics. Daily and occasional smokers were defined according to traditional definitions of smoking. RESULTS: Among the 976 students surveyed, 482 (49.4%) reported being active smokers. Among these smokers, 199 (41.3%) were classified as occasional smokers and 283 (58.7%) were daily smokers using the traditional definitions of smoking. Many of the active smokers had relatives or friends who also smoked, specifically, 46.5% had a father who smokes, 13.3% had a mother who smokes, 26.8% had an older brother or sister who smokes, and 69.7% had two or more close friends who smoke. Although more than 51.3% of smokers planned on quitting smoking, only 26.1% had previously tried to quit smoking but 64.7% believed they could successfully quit. Daily smokers reported that they made fewer attempts to quit smoking than occasional smokers. More often than occasional smokers, daily smokers reported that they smoke because they like the image, they are addicted, smoking relieves stress and/or their friends smoke. Occasional smokers reported that they smoke less at home or at the university than in other places, and smoke more often with friends than when alone or with family members. This pattern is encouraged by the family structure in Turkish society, where smoking by adolescents at home in the presence of family members is frowned upon. CONCLUSIONS: This study demonstrates substantial differences between occasional and daily smokers. If effective future smoking prevention and cessation programmes that target youth are going to be developed, data like those gathered in this study are critical. Basic information regarding cigarette consumption patterns, while important, is insufficient to understand behaviour and key factors that trigger smoking among the youth population.     

'A real man smells of tobacco smoke'--Chinese youth's interpretation of smoking imagery in film

Previous studies have associated youth's exposure to filmic images of smoking with real-life smoking acquisition; initial research in low- and middle-income countries confirms this relationship. The present study in Yunnan, southwest China sought answers to the following questions: How do young people in China make sense of smoking imagery they have seen in film? How are these perceptions shaped by the cultural and social context of images? How do these understandings relate to real-life tobacco use? A study with focus groups and grounded theory was conducted in 2010 and 2011 (Sept–Jan) with middle-school students ages 12 and 13 (n = 68, focus groups = 12, schools = 6). Films and media literacy were important means through which knowledge about smoking was constructed and communicated. Film representations of smoking concurred with Chinese social behaviour (Confucian social networks, face-making, and the notion of society as a harmonious social unit), and were interpreted as congruent with real-life smoking. This pattern, in turn, was intertwined with perceived gender identities of smokers, gender-specific social behaviour, and willingness of girls to explore issues of gender equity. These findings lend new insights into interaction between smoking imagery in film and Chinese youth's smoking beliefs. Tobacco control programs in China should consider young people's interpretations of smoking and the ways they are nested in cultural and social milieu.     

广东省城市居民吸烟与被动吸烟现状及控烟态度调查

目的了解城市居民吸烟状况与被动吸烟状况,了解居民对吸烟与被动吸烟危害的认知与态度状况,为开展针对性的控烟工作提供依据。方法采用随机偶遇抽样方法,在广州市、江门市、增城市医院、商场、车站等候室、政府对外办公大楼4类公共场所抽取18岁及以上人群进行面对面问卷调查,问卷采用中国控烟办公室统一设计的《成人被动吸烟调查问卷》。结果共调查城市居民599人,其中吸烟者190人,吸烟率为31．7％;男性吸烟率为56．6％,女性为3．2％;30-岁组吸烟率为最高,为42．6％;不同文化程度调查对象吸烟率的差异无统计学意义（P〉0．05）。392名不吸烟者中,162人处于被动吸烟状况,被动吸烟率为41．3％,男性被动吸烟率为37．6％,女性为43．1％。调查对象中,家里、室内娱乐场所和室内工作场所全部禁烟的比例分别为32．2％、12．3％和40．9％。非吸烟者对吸烟危害知识的知晓率高于吸烟者,支持公共场所禁烟的比例也高于吸烟者。结论广东省城市居民吸烟和被动吸烟状况严重,居民对公共场所禁烟的支持程度较高,吸烟者对吸烟危害认识不足,应加强吸烟危害健康教育,推动各类公共场所禁烟立法。     

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。     

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。     

天津市青少年被动吸烟现状及干预策略研究

目的了解天津市青少年被动吸烟的现状和他们对烟草相关知识的认知、态度及其对行为的影响，探讨学校、家长以及学生自身在控制青少年吸烟中的作用。方法采用定量调查的方法，对天津市市区、近郊、远郊各一个区（县）共800名学生进行问卷调查。结果男、女学生的吸烟率分别为28．6％和9．7％，其中大学生的吸烟率为41．2％，男、女分别为63．64％和22．64％。90％以上的学生知晓不论是主动吸烟还是被动吸烟都会有害健康，51．9％的学生还存有“吸烟会减轻体重”的错误认识。调查中还发现，71．5％的家长都与子女谈论过吸烟危害，相比之下小学生所占比例最高77％。结论提高学生抵御烟草诱惑的能力，充分发挥家长和学校在学生控烟工作中的作用，加快学生有对烟草危害的认识向戒烟行为形成的转变。     

The impact of regional economic reliance on the tobacco industry on current smoking in China

The purpose of this study was to conduct a preliminary assessment of province of residence and other contextual factors on the likelihood of being a current smoker in China. A cross-sectional, multistage sampling process was used to recruit participants, and their smoking status and sociodemographic characteristics were obtained through face-to-face interviews. The contextual variables were retrieved from a national database. Multilevel logistic regression analysis was performed to assess the impact of provincial economic reliance on the tobacco industry, as well as individual-level characteristics, on the likelihood of being a current smoker. Participants totaled 20,601 from 27 cities located in 26 of the 31 municipalities/provinces in China. Overall smoking prevalence was 31.3% (95% CI: 19.3–33.2%), with rates being highest in Yinchuan City in Ningxia Province (49.8%) and lowest in Shanghai (21.6%). The multilevel analysis showed an excess likelihood of being a current smoker for individuals living in provinces with the highest rate of cigarette production relative to those with the smallest (p<0.001). Findings underscore the importance of restricting cigarette production and regulating the marketing of tobacco products in China.     

Statewide evaluation of a tobacco cessation curriculum for pharmacy students

BACKGROUND: Previous studies suggest that healthcare professionals are inadequately trained to treat tobacco use and dependence. Because even brief interventions from clinicians improve patient quit rates, widespread implementation of effective tobacco cessation training programs for health professional students is needed. METHODS: Pharmacy students received 7-8 h of comprehensive tobacco cessation training. Participants completed pre- and post-program surveys assessing perceived overall abilities for cessation counseling, skills for key facets of cessation counseling (Ask, Advise, Assess, Assist, Arrange), and self-efficacy for counseling. RESULTS: A total of 493 students (82.3%) completed linkable pre- and post-training evaluations. Self-reported abilities, measured on a five-point scale, increased significantly from 1.89 +/- 0.89 to 3.53 +/- 0.72 (P < 0.001). Twenty-two percent of students rated their overall counseling abilities as good, very good, or excellent before the training versus 94% of students after the training. Eighty-seven percent of students indicated the training will increase the number of patients that they counsel; 97% believed it will increase the quality of their cessation counseling. CONCLUSIONS: Comprehensive training significantly improved pharmacy students' perceived confidence and ability to provide tobacco cessation counseling. The curriculum is applicable to other health professional training programs and currently is being used to train pharmacy, medical, nursing, and dental students.     

河北省1021名教师吸烟与控烟状况调查

目的了解河北省教师吸烟与控烟状况。方法抽取河北省3个城市26所大中小学校的一线教师进行面对面问卷调查。结果共调查22—62岁教师1021名,女性无吸烟者,男性吸烟率为25．7％;吸烟者平均每天吸烟12．4支,香烟价格在20元及以下占98．5％;吸烟者在上班时间和在学生面前吸烟的比例分别为86．8％和47．1％,吸烟的主要室内场所是办公室和卫生间;吸烟者有44．1％曾经戒过烟,45．6％有近期戒烟打算。75．8％的教师对学生讲过吸烟的危害,开展过其他控烟相关教学活动的教师比例不到40％;60．5％的教师所在学校实行全部禁烟,17．6％实行部分禁烟,执行禁烟规定好的学校占有禁烟规定学校的56．3％。结论河北省校园内存在不同程度的教师吸烟现象,应加大对学校特别是大、中学校控烟干预和监督力度。     

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。     

Use of the transtheoretical model to predict stages of smoking cessation in Korean adolescents

BACKGROUND: Smoking is popular among Korean male high school adolescents, with the prevalence of 20.7% differing markedly with the type of school, being 16.3% and 27.6% in academic and vocational technical high schools, respectively. The purpose of this study was to identify significant variables that predict stages of smoking cessation among Korean high school students using the transtheoretical model (TTM), in order to provide an empirical basis for developing smoking cessation programs. METHODS: Cross-sectional data were collected in April and May 2004 from 300 male students at 3 vocational technical high schools in Korean metropolitan areas. The survey variables comprised decisional balance, self-efficacy, stages and processes of change, nicotine dependence, and use of smoking cessation aids. RESULTS: Current and former smokers comprised 26.3% and 22.7% of the cohort, respectively, of which 71.4% had experienced smoking cessation at least once and 55.1% utilized smoking cessation aids to help stop smoking. Nicotine-free tobacco and nicotine gum were the most common smoking cessation aids. Decisional balance, use of behavioral processes, and higher self-efficacy were significant in explaining stages of smoking cessation after controlling for nicotine dependence. CONCLUSIONS: The study results suggest that smoking cessation programs developed based on the TTM may help adolescents to progress through stages, with it being important to include information regarding the use of smoking cessation aids.     

山东省部分地区农村男性吸烟者既往戒烟次数的影响因素分析

目的 探讨山东省农村男性吸烟者既往戒烟次数的影响因素。方法 2010年8月在济南市平阴县、临沂市莒南县、济宁市梁山县各抽取3个自然村,对其中≥15岁居民逐户进行面对面问卷调查,获得其一般人口学资料、烟草暴露情况、吸烟的态度和危害认知情况;采用Hurdle计数模型探讨既往戒烟次数的影响因素。结果 1 798名男性现在吸烟者中,既往从未戒过烟者1 267人（70.47%）,至少戒过一次者531人（29.53%）。Hurdle模型logistic回归部分表明,婚姻、教育和吸烟危害认知是影响是否戒烟的主要因素,已婚者相对于未婚者尝试过戒烟的可能性更大（β=0.705,P=0.002）,教育程度（β=0.214,P=0.026）和吸烟危害认知程度（β=0.237,P=0.009）越高尝试过戒烟的可能性越大;零截尾Poisson回归分析表明,开始吸烟年龄和吸烟危害认知是戒烟次数的影响因素,开始吸烟年龄越小（β=-0.167,P=0.035）、吸烟危害认知程度越高（β= 0.146,P=0.020）其戒烟次数越多。结论 山东省农村男性吸烟者中尝试戒烟的比例较低;影响是否戒烟与戒烟次数的因素不完全相同。应根据吸烟者过去是否有过戒烟经历及戒烟次数,采取针对性的干预措施。     

Educational inequalities in exposure to tobacco promotion at the point of sale among adolescents in four Dutch cities

This study aimed to assess educational differences in adolescents’ exposure to tobacco outlets. Data were collected among 312 13-17-year-old non-smoking secondary school students in four Dutch cities. In a smartphone app, exposure (≤10 m from outlet) was measured using GPS and participants reported their educational track (pre-vocational vs. pre-university). Associations were estimated in negative binomial regression models. Mean exposure to tobacco outlet was 16.6 times in 14 days. Pre-vocational education was associated with higher exposure compared to pre-university education (IRR:1.46, 95%CI:1.08–1.98), especially around school (IRR:2.61,95%CI:1.50–4.55). These differences may contribute to socioeconomic inequalities in smoking.     

天津市城区居民吸烟现状及20年间吸烟行为模式的改变

目的 了解天津市城区居民吸烟行为现况及20年来城市居民吸烟行为变化情况。方法 利用中国慢性病及其危险因素监测（2015）调查数据,采用多阶段分层随机抽样方法,对天津市7个监测点进行问卷调查。并提取其中>20岁城区居民与1996年、2010年危险因素调查相应人群结果进行比较。结果 2015年天津市城区>20岁居民男性现吸烟率为41.1%,女性为4.5%。男性开始吸烟年龄为（19.2±4.7）岁,女性为（24.8±10.9）岁,有低龄化的趋势。与1996年和2010年相比,2015年城市居民现在吸烟率呈下降趋势,成功戒烟率呈上升趋势,差异均有统计学意义。结论 自1996年以来,天津市城区居民吸烟水平呈下降趋势,但仍处于较高水平,尤其是女性;开始吸烟年龄呈低龄化趋势,应加强对青少年的无烟教育。