基于结构方程模型的江苏省青少年吸烟行为的影响因素分析

目的 探究江苏省青少年吸烟行为的现况与影响因素，结合结构方程模型(structural equation model, SEM)，为控烟干预提供依据。 方法 运用多阶段整群抽样(probability proportionate to size sampling, PPS)方法，向青少年发放调查问卷，分析方法采用结构方程模型。 结果 本次研究累计调查青少年6 104人，江苏省初中生青少年吸烟率为2.65%。logistic回归分析模型分析显示，男性(OR=1.623)、好友中有人吸烟(OR=7.827)、好友给烟可能会使用(OR=7.219)、喜欢吸烟(OR=3.120)、认为自己未来会吸烟(OR=2.854)、老师吸烟(OR=2.068)、室内二手烟暴露(OR=2.196)、认为戒烟很难(OR=2.010)、二手烟危害认知欠缺(OR=1.738)是青少年吸烟的危险因素, 差异均有统计学意义(均有P < 0.05)。在SEM中，烟草易感性对吸烟行为体现为直接作用，效果为0.270，吸烟环境对吸烟行为的间接作用为0.236，烟草可及性对吸烟行为的总作用为0.719，其中直接作用为0.580，间接作用为0.139，模型适配度良好。 结论 青少年吸烟行为的主要影响因素包括烟草易感性、烟草可及性与吸烟环境，将个体与环境等多方面有机结合进行干预可有效降低青少年吸烟率。

Analysis on the factors influencing adolescents smoking behavior in Jiangsu Province using a structural equation model

Objective To identify the factors influencing adolescent smoking behavior in Jiangsu Province by a Structural Equation Model (SEM) model, providing a reference for tobacco control initiatives.. Methods Probability Proportionate to Size Sampling (PPS) was used to distribute questionnaires to adolescents, and the SEM model was conducted for data analysis. Results A total of 6 104 students were surveyed, revealing a 2.65% smoking rate among junior high school students in Jiangsu Province. Logistic analysis showed that the risk factors for student smoking as males (OR=1.623), having friends who smoke (OR=7.827), use cigarettes given by friends (OR=7.219), enjoying smoking (OR=3.120), potential predisposition to smoking (OR=2.854), having teachers who smoke (OR=2.068), exposure to indoor secondhand smoke (OR=2.196), the belief that quitting smoking is difficult (OR=2.010), and a lack of awareness about the harms of secondhand smoke (OR=1.738) (all P<0.05). The results of the SEM demonstrated a direct effect of tobacco susceptibility on smoking behavior (0.270), an indirect effect of smoking environment (0.236). And a total effect of tobacco access (0.719), with a direct effect of 0.580 and an indirect effect of 0.139. The model exhibited a good fit. Conclusions Tobacco susceptibility, access to tobacco, and the smoking environment are the primary factors influencing adolescent smoking behavior. Interventions addressing both individual and environmental aspects can effectively reduce youth smoking rates.