中国医学生吸烟现状及相关因素研究
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摘要
目的本研究旨在了解中国医学本科生的吸烟现状,并分析医学本科生吸烟的影响因素。方法本研究以问卷形式调查中国不同地区13个医科院校和20所综合院校医学本科生,内容主要涉及人口学信息、社会经济水平、过去4周生活事件、吸烟饮酒情况、抑郁及焦虑状态等。应用χ2检验和多因素logistic回归分析医学生吸烟的影响因素。结果共有7 643名医学本科生纳入分析,平均年龄(20. 7±1. 6)岁。吸烟者272人,占3. 6%。男生吸烟率8. 4%,女生吸烟率0. 7%。多因素logistic回归分析发现,年龄较大(23～28组与15～19组比较:调整OR,0. 463; 95%CI,0. 258～0. 830)、母亲受教育程度高(本科及以上与小学及以下相比:0. 729; 0. 491～1. 082)是医学生吸烟的保护因素。而男性(10. 405; 7. 247～14. 939)、饮酒(8. 280; 5. 184～13. 225)、高三复读(1. 665; 1. 256～2. 208)、因学业竞争压力而困扰(非常明显者与完全没有比较:2. 078; 1. 241～3. 480)、抑郁(1. 686; 1. 216～2. 338)和焦虑(1. 818; 1. 290～2. 563)是医学生吸烟的危险因素。结论我国医学生吸烟占一定比例,尤其男医学生中更多见,家庭、学校和社会应该予以更多关注,采取一定措施进行预防及干预,改善其吸烟情况,降低吸烟可能对广大医学生造成的不良影响。
Objective To understand the smoking situation and its influencing factors among undergraduate medical students in China. Methods A multicenter cross-sectional study was conducted in undergraduate medical students from 13 medical universities and 20 comprehensive universities,and information on demographics,social economics,life events in the past four weeks,status of smoking and drinking,and status of depression and anxiety were collected. Chi-square test and multivariate logistic regression analyses were done to identify potential correlates for the prevalence of smoking. Results A total of 7,643 undergraduate medical students( mean age: 20. 7 ± 1. 6 years) were enrolled. The prevalence of smoking was 3. 6%( 272) in all participants,8. 4% for male students and 0. 7% for female students. Older age( adjusted OR,0. 463; 95% CI: 0. 258 ～ 0. 830 for comparisons between 23-28 and 15-19 age groups) and mother's high educational level( OR,0. 729; 95% CI: 0. 491 ～1. 082,college or above versus primary school or below) were associated with lower prevalence of smoking. Male sex( OR,10. 405; 95% CI: 7. 247 ～ 14. 939),alcohol consumption( OR,8. 280; 95% CI: 5. 184 ～ 13. 225),retaking college entrance examination( OR,1. 665; 95% CI: 1. 256-2. 208),peer competition in the past four weeks( OR,2. 078; 95% CI: 1. 241 ～3. 480),screen-detected depression( BDI score≥14; OR,1. 686; 95% CI: 1. 216 ～ 2. 338) and anxiety( SAS score≥50; OR,1. 818; 95% CI,1. 290 ～ 2. 563) were associated with higher prevalence. Conclusion A certain proportion of medical students smoke in China,and the prevalence is particularly high among male students. Schools,families and society should pay attention to the situation,and take measures to prevent smoking to protect them from possible harmful effects of smoking.
Objective To understand the smoking situation and its influencing factors among undergraduate medical students in China. Methods A multicenter cross-sectional study was conducted in undergraduate medical students from 13 medical universities and 20 comprehensive universities,and information on demographics,social economics,life events in the past four weeks,status of smoking and drinking,and status of depression and anxiety were collected. Chi-square test and multivariate logistic regression analyses were done to identify potential correlates for the prevalence of smoking. Results A total of 7,643 undergraduate medical students( mean age: 20. 7 ± 1. 6 years) were enrolled. The prevalence of smoking was 3. 6%( 272) in all participants,8. 4% for male students and 0. 7% for female students. Older age( adjusted OR,0. 463; 95% CI: 0. 258 ～ 0. 830 for comparisons between 23-28 and 15-19 age groups) and mother's high educational level( OR,0. 729; 95% CI: 0. 491 ～1. 082,college or above versus primary school or below) were associated with lower prevalence of smoking. Male sex( OR,10. 405; 95% CI: 7. 247 ～ 14. 939),alcohol consumption( OR,8. 280; 95% CI: 5. 184 ～ 13. 225),retaking college entrance examination( OR,1. 665; 95% CI: 1. 256-2. 208),peer competition in the past four weeks( OR,2. 078; 95% CI: 1. 241 ～3. 480),screen-detected depression( BDI score≥14; OR,1. 686; 95% CI: 1. 216 ～ 2. 338) and anxiety( SAS score≥50; OR,1. 818; 95% CI,1. 290 ～ 2. 563) were associated with higher prevalence. Conclusion A certain proportion of medical students smoke in China,and the prevalence is particularly high among male students. Schools,families and society should pay attention to the situation,and take measures to prevent smoking to protect them from possible harmful effects of smoking.
引文
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[10]朱梓嫣,郑频频.上海市大学生烟草使用现状及影响因素分析[J].上海交通大学学报(医学版),2017,37(2):155-160.
[11] Chkhaidze I,Maglakelidze N,Maglakelidze T,et al. Prevalence of and factors influencing smoking among medical and non-medical students in Tbilisi,Georgia[J]. Jornal Brasileiro de Pneumologia,2013,39(5):579-584.
[12]牛璐,罗丹,周雅思,等.家庭社会经济地位对医学生吸烟行为影响[J].中国公共卫生,2013,29(12):1761-1765.
[13]梁淑华,黄勇,郝元涛.广州地区医学研究生与本科生吸烟状况调查[J].广东医学,2012,33(16):2476-2478.
[14] Dania MG,Ozoh OB,Bandele EO. Smoking habits,awareness of risks,and attitude towards tobacco control policies among medical students in Lagos,Nigeria[J]. Annals of African Medicine,2015,14(1):1-7.
[15]贾鹏宇.某医科大学学生吸烟现状及其影响因素[J].中国校医,2012,26(3):173-174.
[16]郭明,喻芳,黄佳,等.南昌市医学院校学生吸烟现状及影响因素分析[J].当代医学,2014,20(28):160-161.
[17]卢朝霞,高翔春,王晓萃,等.山东省医学院校学生烟草流行现状及其影响因素分析[J].中国预防医学杂志,2012,13(1):66-69.
[18] Al-Naggar RA. Bobryshev YV. Shisha smoking and associated factors among medical students in Malaysia[J]. Asian Pacific Journal of Cancer Prevention,2012,13(11):5627-5632.
[19]喻芳,郭明,钞雪林,等.南昌市某医学院校学生吸烟现状及影响因素分析[J].重庆医学,2014,43(19):2461-2463.
[2]杨功焕. 2010全球成人烟草调查中国报告[M].北京:中国三峡出版社,2011.
[3] Saulle R,Bontempi C,Baldo V,et al. GHPSS multicenter Italian survey:smoking prevalence,knowledge and attitudes,and tobacco cessation training among third-year medical students[J]. Tumori,2013,99(1):17-22.
[4] Brimkulov N,Vinnikov D,Dzhilkiadarova Z. Tobacco use among Kyrgyzstan medical students:an 11-year follow-up crosssectional study[J]. BMC Public Health,2017,17:625.
[5] Tamaki T,Kaneita Y,Ohida T,et al. Prevalence of and factors associated with smoking among Japanese medical students[J].Journal of Epidemiology,2010,20(4):339-345.
[6]黄杏,陈冬峨,王增珍,等.武汉大学医学院学生吸烟行为及其相关因素分析[J].中国学校卫生,2007,28(8):687-688.
[7] Bian J,Du M,Liu Z,et al. Prevalence of and factors associated with daily smoking among Inner Mongolia medical students in China:a cross-sectional questionnaire survey[J]. Substance Abuse Treatment Prevention&Policy,2012,7:20.
[8] Zhang H. Cigarette smoking among Chinese medical staff[J].Lancet,2015,385(9978):1621.
[9]张梅,王丽敏,李镒冲,等. 2010年中国成年人吸烟与戒烟行为现状调查[J].中华预防医学杂志,2012,46(5):404-408.
[10]朱梓嫣,郑频频.上海市大学生烟草使用现状及影响因素分析[J].上海交通大学学报(医学版),2017,37(2):155-160.
[11] Chkhaidze I,Maglakelidze N,Maglakelidze T,et al. Prevalence of and factors influencing smoking among medical and non-medical students in Tbilisi,Georgia[J]. Jornal Brasileiro de Pneumologia,2013,39(5):579-584.
[12]牛璐,罗丹,周雅思,等.家庭社会经济地位对医学生吸烟行为影响[J].中国公共卫生,2013,29(12):1761-1765.
[13]梁淑华,黄勇,郝元涛.广州地区医学研究生与本科生吸烟状况调查[J].广东医学,2012,33(16):2476-2478.
[14] Dania MG,Ozoh OB,Bandele EO. Smoking habits,awareness of risks,and attitude towards tobacco control policies among medical students in Lagos,Nigeria[J]. Annals of African Medicine,2015,14(1):1-7.
[15]贾鹏宇.某医科大学学生吸烟现状及其影响因素[J].中国校医,2012,26(3):173-174.
[16]郭明,喻芳,黄佳,等.南昌市医学院校学生吸烟现状及影响因素分析[J].当代医学,2014,20(28):160-161.
[17]卢朝霞,高翔春,王晓萃,等.山东省医学院校学生烟草流行现状及其影响因素分析[J].中国预防医学杂志,2012,13(1):66-69.
[18] Al-Naggar RA. Bobryshev YV. Shisha smoking and associated factors among medical students in Malaysia[J]. Asian Pacific Journal of Cancer Prevention,2012,13(11):5627-5632.
[19]喻芳,郭明,钞雪林,等.南昌市某医学院校学生吸烟现状及影响因素分析[J].重庆医学,2014,43(19):2461-2463.