中国成年人行为生活方式与主要慢性病的关联——来自中国慢性病前瞻性研究的证据

中国人群的主要疾病负担来自心血管疾病、糖尿病、恶性肿瘤与呼吸系统疾病等慢性病。西方人群研究证据显示,吸烟、过量饮酒、体力活动不足、不健康的膳食习惯、肥胖等行为生活方式是主要慢性病的独立危险因素。由于行为生活方式和疾病谱的差异,西方人群证据不一定适用于中国人群。在中国人群中确定行为生活方式与主要慢性病的关联方式和效应大小,有助于明确综合生活方式干预对我国慢性病负担的收益大小,及指导相关指南的制订。近年来,包括中国慢性病前瞻性研究在内的以中国人群为研究对象的一系列前瞻性队列研究证据明确了几种不健康的行为生活方式对我国主要慢性病的影响,特别是补充了我国人群一些特定生活方式(如职业性体力活动)、当前营养膳食结构背景下的一些饮食习惯(如吃水果、鸡蛋、辣食和饮茶等)以及特有的健康问题(如出血性脑卒中、消化系统恶性肿瘤、慢性阻塞性肺疾病等)的人群病因学证据。本文旨在综述中国慢性病前瞻性研究项目近年来获得的相关研究证据。     

8116例健康体检人群体质指数与相关疾病分析

目的：探讨8116例健康体检人群不同体质指数与相关疾病的流行情况。方法：选取2011-2012年我院体检的健康人群8116例,分析体质指数正常、超重、肥胖与血压、血脂、血糖及相关慢性病患病率的关系。结果：超重、肥胖人群的血压、血脂、血糖值高于体质指数正常人群;超重、肥胖人群患高血压、糖尿病、高脂血症、脂肪肝、心脑血管疾病等慢性病的比例高于体质指数正常人群。结论：体质指数与慢性病关系密切,对超重、肥胖人群体质指数的管理,合理控制体重,改变不良生活方式,控制慢性病发生,是三级预防的关键。     

慢性病防治策略与研究领域的新视角

心血管疾病、肿瘤、慢性呼吸系统疾病和糖尿病等慢性病已经成为威胁我国人群健康的主要原因[1,2].来自全球广泛人群、众多领域的证据证实,多数的重要慢性病的发生是由吸烟、不健康饮食、少体力活动等危险因素导致[3].     

农村社区的慢性病健康教育

慢性病已经对全世界人群的生活和健康带来了巨大的影响。根据对 1998年全球疾病负担的估计 ,4 3%归结为慢性病所致 ,而中国已经达到了 6 0 %。慢性病是中国人群的主要死因 ,慢性病的死亡占总死亡的 82 .4 % 〔1〕。因此 ,疾病的预防与控制工作应向慢性病防治做战略重点转移。1　农村慢性病防治必须以健康教育为重要手段1.1　慢性病是生活行为方式病　慢性病又称“富裕病”,主要包括心脑血管病、慢性呼吸道疾病和肿瘤等 ,其发病的主要危险因素是不健康的生活方式 ,主要包括吸烟、酗酒、静坐生活方式、高脂、高盐饮食、超重和肥胖等。预防慢性…     

中国农村地区高血压和糖尿病管理和控制模式的探索——基于中国农村卫生发展项目的实践分析

卫十一项目的 8个项目省、40个项目县,以社区诊断和健康档案的建立为切入点,以高血压、糖尿病等主要慢性病为抓手,针对健康人群、高危人群和患者等三类人群的需求,采取健康教育与促进、健康管理和疾病管理等措施,探索建立农村慢性病管理新模式。项目地区慢性病监测数据分析发现,登记和管理的高血压和糖尿病患者显著增加,其管理率从2009年的60.8%和32.2%分别上升到2013年的92.2%和88.8%;全国第五次卫生服务调查结果显示,项目地区调查人口自报高血压和糖尿病的控制率(63.8%,50.2%)显著高于全国农村地区平均水平(54.9%,38.3%)。结果提示,以培训、健康教育、健康管理和疾病管理为核心的农村慢性病管理模式有效改善了农村慢性病服务能力,项目地区所实施的慢性病综合干预措施切实可行,有借鉴和推广价值。     

慢性病健康管理规范（T/CHAA 007-2019)

正1范围本标准规定了主要慢性非传染性疾病(慢性病)健康管理的术语和定义、流程、组成部分、信息系统及服务人群信息汇总、分析与利用。本标准适用于医疗卫生服务机构、健康体检机构、健康管理相关企业等对个体开展心脑血管疾病、糖尿病、癌症、慢性呼吸系统疾病等主要慢性病的健康管理服务。2术语和定义下列术语和定义适用于本文件。2.1慢性病健康管理(health management for chronic     

慢性病的干预原则与健康传播

慢性病的干预原则与健康传播张安玉慢性非传染性疾病——心脑血管病、恶性肿瘤、慢性肺疾患、糖尿病、慢性肝肾疾病等是行为和生活方式疾病，主要通过改变人们的行为和生活方式预防和控制慢性病。１慢性病的干预原则１．１采取以社区为基础，全人群为对象的干预慢性病的流...     

关于社区卫生诊断助力慢性病健康管理工作的思考与建议

目的:本文基于2020年四川天府新区开展的社区卫生诊断结果,分析确定辖区慢性病健康管理重点关注人群,助力创建慢性病综合防控示范区和健康管理工作的开展。方法:通过在四川天府新区九个街道随机抽取的样本小区和样本人群进行问卷调查,实际调查人数为15526人,其中18岁以上居民数为13729人,将数据从线上系统导出为Excel后使用SPSS22.0统计分析软件,根据资料的性质选择适合的统计指标对所获数据进行统计分析。结果:辖区高血压、糖尿病、心脑血管疾病、慢性阻塞性肺疾病、肿瘤等5类重点慢性病对健康影响较大,其患病率分别为18.8%、7.4%、2.4%、1.7%、0.9%。结论:通过社区卫生诊断结果明确辖区慢性病健康管理重点关注人群;开展健康教育与促进行动助力推进慢性病健康管理端口前移;以创建慢性病综合防控示范区为目标开展医防融合慢性病健康管理工作;探索互联网+信息技术等多维智慧服务的运用,将为新时期慢性病健康管理工作的开展提供新思路与新视角。     

社区人群慢性病疾病谱调查

目的调查分析社区不同年龄人群慢性病发病情况,绘制慢性疾病谱,为社区人群疾病防治及生活干预提供科学依据。方法走访调查社区259户共892人,分五个年龄区段统计不同年龄人群慢性病发病情况,绘制疾病谱。结果①45岁以上人群慢性病发病率明显增高;②危害社区人群健康的主要慢性病依次为高血压病、冠状动脉粥样硬化性心脏病、慢性支气管炎、肺气肿、肺心病、脑血管疾病和糖尿病。结论培养社区人群健康的生活方式,对社区人群多发病特别高血压病尽早进行防治和生活干预,对预防心脑血管疾病,减少老年人病死率、致残率,提高生活质量非常必要。     

上城区居民主要慢性病患病情况调查

随着社会经济的发展,生活方式的改变,人口老龄化进程的加快,人群的疾病构成发生着深刻的变化,慢性非传染性疾病（慢性病）在现阶段已经成为威胁人民健康的主要公共卫生问题。为了解慢性病在人群中的现患情况,2012年5月在杭州市上城区进行了一次人群调查,以了解人群慢性病的患病率和分布特征,明确慢性病防治工作的重点,为今后的慢性病干预提供依据。     

中国六城市烟草广告及促销手段相关因素分析

目的 了解中国城市烟草广告、促销现状以及相关因素.方法 在北京、上海、沈阳、长沙、广州和银川6个城市,采用累计概率比例抽样和简单随机抽样方法,对4815名18岁以上的吸烟者进行问卷调查.结果 烟草广告覆盖吸烟人群最广的2种途径分别为广告牌(35.6%)、电视(34.4%).商家最爱使用的促销手段是赠送礼品(23.1%),其次为赠送香烟(13.9%).长沙市的吸烟者通过广告牌(X2=562.474,P<0.001)以及电视(X2=265.570,P<0.001)途径获取烟草广告的比例较高.长沙市吸烟者中可看到烟草相关新闻的比例较高(X2=58.314,P<0.001).多因素logistic同归分析结果显示,生活所在城市及学历情况与"使想吸烟事物"的关注度有关.结论 中国城市烟草制品广告及促销活动较为普遍,各地控烟法律法规执行效果不一,尽快完善并统一相关立法势在必行.     

长沙与国内五城市吸烟者吸烟特征的比较

目的探讨长沙成年吸烟者不同吸烟行为、戒烟行为、控烟政策支持的特征。为长沙市进一步开展控烟工作提供科学依据。方法根据国际烟草政策研究评估调查（ITC项目）要求，分别在长沙、北京、上海、沈阳、广州和银川6个城市使用多阶段抽样法，各抽取800名成年吸烟者，采用人户录音的方式进行面对面问卷调查。结果与结论与其他5个项目城市相比，长沙市吸烟者吸烟行为特征主要为：1．长沙市吸烟者每日吸烟量为21．47支／d、成瘾性HIS为2．80、吸本地烟的比例为95．07％；2．吸烟者戒烟5次以上的比例占10．5％、戒烟意愿不强、戒烟信心不足；3．控烟政策支持力度不够。     

Effectiveness of a Television Advertisement Campaign on Giving Cigarettes in a Chinese Population

Background

Anti-tobacco television advertisement campaigns may convey messages on smoking-related health consequences and create norms against giving cigarettes.

Methods

Altogether, 156 and 112 slots of a television advertisement “Giving cigarettes is giving harm” were aired on Suzhou and Yizheng, respectively, over one month in 2010. Participants were recruited from 15 locations in Suzhou and 8 locations in Yizheng using a street intercept method. Overall 2306 residents aged 18–45 years completed questionnaires, including 1142 before the campaign and 1164 after, with respective response rates of 79.1% and 79.7%. Chi square tests were used to compare the difference between categorical variables.

Results

After the campaign, 36.0% of subjects recalled that they had seen the advertisement. Residents of Suzhou had a higher recall rate than those of Yizheng (47.6% vs. 20.6%, P < 0.001). The rate of not giving cigarettes dropped from 32.1% before the campaign to 28.5% after (P = 0.05). In the post-campaign evaluation, participants who reported seeing the advertisement were more likely not to give cigarettes in the future than those who reported not seeing the advertisement (38.7% vs. 27.5%, P < 0.001).

Conclusions

Our study showed that an anti-tobacco television advertisements helped change societal norms and improve health behavior. Continuous and adequate funding of anti-tobacco media campaigns targeted at different levels of the general population is needed, in conjunction with a comprehensive tobacco control effort.Key words: anti-tobacco television campaign, giving cigarettes, tobacco control     

河南省初中学生烟草广告和促销暴露现状研究

目的 了解河南省青少年烟草广告和促销暴露现状,为控制青少年烟草使用提供科学有效的依据。 方法 采取多阶段分层整群抽样的方法,在河南省抽取16个调查点,48所初中,共7 789名在校学生进行问卷调查。 结果 47.00%的调查对象在过去30天内有过烟草广告和促销暴露,不同性别、年级、父母和朋友吸烟情况、每周零花钱数量的学生,有不同的烟草广告和促销暴露率;电视是学生获取烟草广告和促销的最主要途径(20.10%),其他途径依次是户外广告牌(18.87%)、烟草零售点(16.91%)、互联网(15.71%)、报纸杂志(12.53%)等。 结论 河南省初中学生烟草广告和促销的暴露情况非常严重,应严格按照新《广告法》的要求,全面禁止烟草广告和促销,保护青少年免受烟草危害。     

合肥市区烟草广告发布现状调查与分析

目的　了解合肥市区户外烟草广告和传播媒体烟草广告的发布情况 ,为加强对烟草广告的管理与限制提供依据。方法　现场沿街巡查广告牌、查阅报纸、随机收听收看广播电视节目。结果　合肥市区的 7条主要交通干道中 ,有 6条干道设置有巨幅户外烟草广告 ;影响较大的省、市级 14家传播媒体中 ,有 11家报纸、电视台和广播电台刊播烟草广告或“软广告” ;部分烟草广告的内容违反了有关规定的要求。结论　控烟工作及创建无烟草广告城市活动应从事实上的部门行为逐步走向政府行为 ,在控烟的同时必须严控烟草广告 ;各有关部门要切实履行相关职责 ,并有所作为 ;国家立法机关应加快控烟综合立法建设 ,进一步限制并逐步全面禁止烟草广告及各种烟草促销活动     

Modified tobacco use and lifestyle change in risk-reducing beliefs about smoking

BACKGROUND: This study examined beliefs about potential risk-reduction strategies for tobacco users among a large group of young adults. Strategies examined included switching to low-yield cigarettes, replacing cigarettes with cigars, switching from cigarettes to smokeless tobacco, adopting a healthy diet, and engaging in regular exercise. METHODS: One-year longitudinal survey of 36,012 young adults (mean 20.1 years) entering the U.S. Air Force from October 1999 to September 2000. RESULTS: Smokers generally rated the strategies as providing more risk-reduction potential than never smokers or ex-smokers, although the group differences were small. Diet, exercise, and switching to low-yield cigarettes were rated as providing the most health benefits, regardless of smoking status. Smokers who had either changed their diet or exercise to lower their risks from smoking had significantly lower perceived personal risk of developing a tobacco-related disease than other smokers. Smokers who believed that switching to smokeless tobacco would lower the health risks associated with smoking were more likely, while smokers reporting switching to low-yield cigarettes were significant less likely, to quit during a 1-year follow-up period. CONCLUSIONS: Beliefs about the risk-reduction benefits of both changes in tobacco use and health behaviors may impact tobacco use attitudes and practices.     

Concurrent use of tobacco products by California adolescents

BACKGROUND: To describe patterns and correlates of tobacco product use other than cigarettes in adolescents 12-17 years of age. METHODS: Adolescent respondents (N = 6090) to the 1999 California Tobacco Survey provided estimates of ever and current use (in last 30 days) of smokeless tobacco, cigars, and bidis, which were examined by cigarette smoking experience, demographics, and known predictors of cigarette use. RESULTS: Only 3% of adolescents who never smoked cigarettes experimented with other tobacco products. Among ever smokers who were not current smokers, the rate was 35%. Nearly 60% of current cigarette experimenters had tried another tobacco product, but almost 90% of current established smokers had experimented with one. Over 40% of current established smokers used another tobacco product in the last 30 days. Factors predictive of cigarette smoking were also highly associated with other tobacco use. In ever cigarette smokers, having peers who used other tobacco products was most highly associated with other tobacco use. Problem or risky behaviors, beliefs that cigarettes are safe or beneficial, and receptivity to tobacco promotions were also independently associated with other tobacco product use. CONCLUSIONS: Adolescent smokers who use other tobacco products may be prone to risky behavior and such use may hasten the development of nicotine tolerance.     

Tobacco smoke inhalation pattern, tobacco type, and bladder cancer in Spain

The association between tobacco smoking and bladder cancer was investigated in a multicenter case-control study conducted in five provinces of Spain between 1983 and 1986. A matched analysis was carried out in males, based on 430 histologically confirmed cases, 405 hospital controls, and 386 population controls, matched by age and place of residence. An increased risk was found for smokers as compared with nonsmokers (odds ratio (OR) = 3.79, 95% confidence intervals (CI) 2.41-5.97), and this increase was significantly associated with the intensity of smoking. Smokers of filter-tipped cigarettes had a reduced risk as compared with smokers of non-filter-tipped cigarettes (OR = 0.57, 95% CI 0.32-1.02). A diminution of risk was also observed for smokers of low-tar and low-nicotine ("light") cigarettes. Depth of inhalation was strongly associated with illness. No difference was shown in the logistic regression model between smokers of black tobacco and smokers of blond tobacco after controlling for depth of inhalation. Although the number of persons who smoked blond tobacco exclusively was small, the results suggest that it is important to consider inhalation patterns when studying risk variations between smokers of black tobacco and smokers of blond tobacco. The age at which a person started to smoke did not appear to affect risk. An analysis of the decrease in risk associated with years since quitting smoking suggested that different components of cigarette smoke may play a role at different stages of the carcinogenic process.     

江苏省青少年烟草广告暴露情况与吸烟易感性分析

了解江苏省2013年青少年烟草广告暴露情况及其与吸烟易感性的关系,为更有效地禁止青少年过早养成吸烟习惯提供基础数据.方法 2013年9-11月,采用多阶段分层整群随机抽样方法在江苏省14个监测点抽取5 697名初中在校学生进行自填问卷调查,对烟草广告暴露情况进行加权分析估计率及其95%CI,非吸烟学生易感性与烟草广告之间的关系采用多因素非条件Logistic回归分析.结果 过去30 d内,青少年烟草广告暴露率为46.7%(95% CI=44.0% ~49.3%),男生(48.5%)大于女生(44.4%)(x2=9.63,P=0.04).烟草广告渠道暴露前3位的分别为电视(19.3%)、户外广告牌(19.1%)和烟草零售店(17.4%).在非吸烟青少年中,暴露于烟草广告者烟草易感性(10.4%)高于未暴露者(4.9%)(x2=54.6,P<0.01).暴露的烟草广告媒介越多,吸烟易感性就越高,暴露于4种以上广告渠道者未来烟草易感的OR值为3.67(95%CI=2.65~5.09).结论 青少年广泛暴露于烟草广告中,烟草广告暴露会增加不吸烟青少年的吸烟易感性.     

Tobacco use among women in Dharan, eastern Nepal

The study was undertaken to assess the prevalence and patterns of tobacco use and also assess the factors affecting tobacco use among the female population of Dharan. A cross-sectional survey of a representative sample of 2,340 female participants aged 15 years and above was conducted in Dharan municipality in 2001. Cluster sampling with probability proportionate to size technique was used. Of the 2,340 subjects, 12.9% were cigarette smokers and 14.1% were smokeless tobacco users. The smoking habit had a significant relationship with the habit of tobacco chewing. About 50% of the smokers had been continuously smoking for more than 20 years. Smokers aged 50 years and above were more likely to smoke more than 10 cigarettes per day than those at the reproductive age (15-49 years). Health problems among females did not have any significant relationship with tobacco-chewing, but smokers were nearly twice as likely to suffer from any health problem than non-smokers. Gastrointestinal problems were the most common complaint among the tobacco users. An effective awareness programme is required to discourage the use of tobacco and encourage women to take regular health check-ups.