家庭环境中控烟干预措施实施效果评价

目的 探讨家庭创建无烟环境的有效措施。 方法 于2014年在天津市选取两个社区进行干预。采用多阶段整群抽样的方法,抽取住户,以户为单位,联合社区居委会、学校及社区卫生服务保健机构对其进行干预,主要形式包括大众媒体宣传、发放宣传材料、主题巡展、控烟讲座、烟草危害知识竞赛、微博转发、无烟家庭申报等宣传活动,干预前后调查该户全部15岁以上家庭成员的烟草使用情况及上一周内所有家庭成员及来访客人在家庭中吸烟情况。 结果 共调查976人,总吸烟率为21.3%。其中男性468人,女性508人,男性吸烟率为41.0%,女性为3.1%,干预后调查人群吸烟率较干预前下降了0.4%,但变化差异无统计学意义(P=0.87)。干预后“不想戒烟”的比例由干预前的74.3%下降至58.3%,差异有统计学意义(P=0.000)。干预后家庭成员或客人在家中吸烟、用香烟招待客人、把香烟作为礼物送给别人的比例较干预前有所下降,下降比例分别为19.6%、32.5%和63.0%,差异有统计学意义(P=0.000)。对吸烟及二手烟对健康危害的认知均得到较大程度的提升。无烟环境布置情况均有较大改善,摆放香烟及烟灰缸的现象由62.1%和58.1%分别下降至37.9%和41.9%,有烟蒂(34.7% vs. 65.3%)及烟味(35.4% vs. 64.6%)的比例也有较大幅度下降。 结论 在社区居委会、学校及社区卫生服务保健机构的共同配合下,通过在家庭中实施简单易行的控烟干预方式即可以取得良好的控烟效果。

Evaluation on the effect of tobacco control interventions in families

Objective To explore effective measures for creating a smoke-free environment at home. Methods A multi-stage cluster sampling method was used to sample households from two communities in Tianjin in 2014. With joint efforts of the communities’ neighborhood committees, schools and community healthcare service institutions, interventions including mass media publicity, booklets, theme exhibitions, tobacco control lectures, tabacco harm knowledge contest, micro-blog forwarding, smoke-free family declaration and other propaganda activities were conducted. Tobacco use among the family members aged over 15 years and indoor smoking of all familiy members and visitors in the last week were surveyed before and after the interventions. Results A total of 976 residents , including 468 males and 508 females, were investigated, with the total smoking rate of 21.3%. The smoking rates of males and females were 41.0% and 3.1% respectively. After the interventions, the total smoking rate decreased by 0.4%, but without a statistically significant difference (P=0.87). The proportion of residents having no desire to quit smoking decreased from 74.3% to 58.3%, with a statistically significant difference (P=0.000). The proportion of family members’ and guests’ smoking behavior at home, of residents using cigarettes to treat guests and of residents sending cigarettes as gifts to others declined by 19.6%, 32.5% and 63.0% respectively, with statistically significant differences (P=0.000). The awareness rates of health hazard of smoking and secondhand smoke were both increased significantly. The setting of smoke-free environment in the family was greatly improved, and the proportions of residents placing cigarettes and ashtray at home were decreased from 62.1% and 58.1% to 37.9% and 41.9% respectively. The proportions of households having butt (34.7% vs. 65.3%) and a smell of smoke (35.4% vs. 64.6%) were both significantly decreased. Conclusions With the cooperation of communities’ neighborhood committees, schools and community healthcare services institutions, implementing simple tobacco control interventions in families can obtain a good effect on tobacco control.