文化程度对男性吸烟行为的群体效应和个体效应:中国心血管病流行病学多中心协作研究

目的探讨文化程度在中国男性吸烟行为发生过程中的群体效应及个体效应。方法通过标准化问卷对我国不同地区15个人群,共计7415名35～59岁男性调查其文化程度和吸烟行为状况。将研究人群分为两类:Ⅰ类人群大专以上学历平均占25.8%,Ⅱ类人群大专以上学历占2.0%。分析文化程度在人群内和两类人群间对吸烟行为的影响。结果(1)在Ⅰ类人群中,曾吸烟率、现吸烟率、深吸烟率、因病戒烟者所占比例和吸烟量分别为66.2%、56.4%、34.4%、47.8%、17.2支/d,均显著低于Ⅱ类人群的75.8%、64.4%、40.3%、58.4%、20.4支/d。(2)同Ⅰ类人群大专以上学历组相比,Ι类男性高中学历组吸烟危险为1.8(95%CI:1.5～2.1),初中及以下学历组为2.0(95%CI:1.7～2.5);Ⅱ类男性大专以上学历组吸烟危险为1.4(95%CI:0.9～2.1),高中学历组为1.7(95%CI:1.4～2.1),初中及以下学历组为2.4(95%CI:2.1～2.8)。结论个体文化程度和群体文化水平共同影响吸烟行为发生。发展教育对控烟工作具有积极意义,提高群体受教育水平和通过健康促进创造群体抗烟环境应是今后控烟工作的重要手段。

Inter-population and inter-individual effect of education attainment on men's behavior of smoking: China multi-center study of cardiovascular epidemiology

OBJECTIVE: To study the inter-population and inter-individual effect of education attainment on men's behavior of smoking in China. METHOD: A cross-sectional study of 7,415 men, aged 35-59 years, from 15 population samples was carried out in 1998. Information on education attainment and smoking was collected by standardized questionnaires. The population samples were divided into 2 groups according to the proportion of men with college or above education attainment: group I had an average 25.8% of men with college or above education attainment, and group II had an average 2.0% of men with college or above education attainment. RESULTS: (1) In group I, the percent of ever smokers, current smokers, deeper smoker, and ever smokers with cessation due to disease and the average number of cigarettes per day for the smokers were significantly lower than in group II (66.2%, 56.4%, 34.4%, 47.8%, 17.2 cigarettes/day vs 75.8%, 64.4%, 40.3%, 58.4%, 20.4 cigarettes/day, respectively). (2) The percent of current smokers and the number of cigarettes decreased with increased education attainment in both groups. Taking the men with college or above education attainment in group I as reference, the odd ratio of smoking for those with high school education in group I was 1.8 (95% CI: 1.5-2.1), for those with middle school or lower education in group I was 2.0(95% CI: 1.7-2.5), for those with college or above education in group II was 1.4(95% CI: 0.9-2.1), for those with high school education in group II was 1.7(95% CI: 1.4-2.1), and for those with middle school or lower education in group II was 2.4 (95% CI: 2.1-2.8). CONCLUSION: Smoking behavior was affected by both individual education attainment and population education level. Smoking cessation measures should be focused on the development of better anti-smoking environment, such as education development, health promotion, etc.