2016年北京市15岁及以上人群二手烟暴露水平及相关知识和态度调查
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摘要
目的了解北京市15岁及以上居民二手烟暴露水平、对二手烟危害认知和场所禁烟的支持现状,以及对控烟条例的知晓情况,为政府制定控烟措施提供数据支持。方法于2016年5—7月采用多阶段整群概率抽样法,在北京市16个区抽取10 000个家庭户,采用入户调查方式进行电子数据采集,获得9 372份个人有效问卷。采用SPSS 20.0软件对数据进行复杂加权后,数据分析采用复杂调查数据分析程序计算率,并进行χ2检验。结果 2016年北京市≥15岁居民在酒吧或夜总会二手烟暴露比例最高(80.3%,95%CI:70.7%～87.3%),其次是排队等候(38.9%,95%CI:33.9%～44.1%)和餐馆(32.5%,95%CI:28.0%～37.3%);室内工作场所二手烟暴露比例为20.0%(95%CI:17.4%～23.0%),吸烟者(34.0%,95%CI:29.6%～38.5%)高于非吸烟者(15.7%,95%CI:12.9%～18.9%),差异有统计学意义(P<0.01);家庭二手烟暴露率为37.6%(95%CI:32.8%～42.7%),吸烟者(76.3%,95%CI:73.5%～79.1%)高于非吸烟者(26.5%,95%CI:22.3%～31.2%),农村(60.8%,95%CI:51.5%～69.3%)高于城市(31.6%,95%CI:27.2%～36.4%),差异有统计学意义(P<0.01)。调查对象知晓二手烟同时导致成人肺癌、儿童肺部疾病和成人心脏病的比例为69.2%(95%CI:65.9%～72.3%),现在吸烟者为60.7%(95%CI:56.2%～65.1%),低于非吸烟者(71.7%,95%CI:68.3%～74.8%),差异有统计学意义(P<0.01)。支持中小学校(室内外)、医疗机构、大学、工作场所、出租车、餐馆室内全面禁烟的比例均大于94%,支持酒吧或夜总会全面禁烟的比例最低(74.3%)。知晓《北京市控制吸烟条例》规定中小学校(室内外)、大学、医疗机构、餐馆、出租车禁止吸烟的比例均大于80%,知晓酒吧或夜总会、排队等候禁止吸烟的比例略低,分别为61.6%和66.8%。结论北京市居民二手烟暴露水平尚需进一步改善,应以酒吧或夜总会、餐馆、排队等候和家庭为重点场所,以农村地区和吸烟者为重点人群,加强执法,强化《北京市控制吸烟条例》和二手烟危害知识的深度普及。
Objective To understand the level of second-hand smoke(SHS) exposure,recognition of SHS hazards,the support status of smoking ban and the awareness of tobacco control regulations among residents(≥15 years old) of Beijing,and to provide the data support for taking tobacco control measures. Methods The multi-stage cluster probability sampling method was used to select 10 000 households from 16 districts in Beijing from May to July of 2016. The electronic data were collected through household survey. A total of 9 372 valid questionnaires were obtained. After the data were complex weighted,the complex survey data analysis program was used to analyze the data by the χ2 test. Results In residents(≥ 15 years old) of Beijing in 2016,the SHS exposure proportion in bars or night clubs was the highest(80.3%,95%CI:70.7%-87.3%),the SHS exposure proportions in lines(38.9%,95%CI:33.9%-44.1%) and restaurants(32.5%,95% CI:28.0%-37.3%) were the second. The SHS exposure proportion in work place was 20.0%(95%CI:17.4%-23.0%), the SHS exposure proportion(34.0%,95%CI:29.6%-38.5%) in smokers was significantly higher than that(15.7%,95%CI:12.9%-18.9%) in non-smokers. The SHS exposure rate at home was37.6%(95%CI:32.8%-42.7%),the SHS exposure rate(76.3%,95%CI:73.5%-79.1%) in smokers was significantly higher than that(26.5%,95%CI:22.3%-31.2%) in non-smokers,P<0.01. The SHS exposure proportion(60.8%,95%CI:51.5%-69.3%) in rural residents was significantly higher than that(31.6%,95%CI:27.2%-36.4%) in urban residents,P<0.01. The awareness rate of diseases(adult lung cancer,child lung disease and adult heart disease) related to second-hand smoke in the subjects was69.2%(95%CI:65.9%-72.3%). The awareness rate(60.7%,95%CI:56.2%-65.1%) of smokers was significantly lower than that(71.7%,95%CI:68.3%-74.8%) of non-smokers,P<0.01. The proportion of supporting the smoking ban in primary and secondary schools(indoor and outdoor),medical institutions,universities,workplaces,taxis and restaurants(indoor) was more than 94%,the proportion(74.3%) of supporting the smoking ban in bars or nightclubs was the lowest. The awareness proportion of Beijing smoking control ordinance in primary and secondary schools(indoor and outdoor),universities,hospitals,restaurants and taxis was more than 80%. The awareness proportions(61.6% and 66.8%) of Beijing smoking control ordinance in bars or night clubs and lines were lower. Conclusion The level of SHS exposure in Beijing residents should be improved,the bars or nightclubs,restaurants,lines and households were the key places,the rural residents and smokers were the key population,the law enforcement and Beijing smoking control ordinance should be strengthened,the knowledge of SHS hazard should be disseminated.
Objective To understand the level of second-hand smoke(SHS) exposure,recognition of SHS hazards,the support status of smoking ban and the awareness of tobacco control regulations among residents(≥15 years old) of Beijing,and to provide the data support for taking tobacco control measures. Methods The multi-stage cluster probability sampling method was used to select 10 000 households from 16 districts in Beijing from May to July of 2016. The electronic data were collected through household survey. A total of 9 372 valid questionnaires were obtained. After the data were complex weighted,the complex survey data analysis program was used to analyze the data by the χ2 test. Results In residents(≥ 15 years old) of Beijing in 2016,the SHS exposure proportion in bars or night clubs was the highest(80.3%,95%CI:70.7%-87.3%),the SHS exposure proportions in lines(38.9%,95%CI:33.9%-44.1%) and restaurants(32.5%,95% CI:28.0%-37.3%) were the second. The SHS exposure proportion in work place was 20.0%(95%CI:17.4%-23.0%), the SHS exposure proportion(34.0%,95%CI:29.6%-38.5%) in smokers was significantly higher than that(15.7%,95%CI:12.9%-18.9%) in non-smokers. The SHS exposure rate at home was37.6%(95%CI:32.8%-42.7%),the SHS exposure rate(76.3%,95%CI:73.5%-79.1%) in smokers was significantly higher than that(26.5%,95%CI:22.3%-31.2%) in non-smokers,P<0.01. The SHS exposure proportion(60.8%,95%CI:51.5%-69.3%) in rural residents was significantly higher than that(31.6%,95%CI:27.2%-36.4%) in urban residents,P<0.01. The awareness rate of diseases(adult lung cancer,child lung disease and adult heart disease) related to second-hand smoke in the subjects was69.2%(95%CI:65.9%-72.3%). The awareness rate(60.7%,95%CI:56.2%-65.1%) of smokers was significantly lower than that(71.7%,95%CI:68.3%-74.8%) of non-smokers,P<0.01. The proportion of supporting the smoking ban in primary and secondary schools(indoor and outdoor),medical institutions,universities,workplaces,taxis and restaurants(indoor) was more than 94%,the proportion(74.3%) of supporting the smoking ban in bars or nightclubs was the lowest. The awareness proportion of Beijing smoking control ordinance in primary and secondary schools(indoor and outdoor),universities,hospitals,restaurants and taxis was more than 80%. The awareness proportions(61.6% and 66.8%) of Beijing smoking control ordinance in bars or night clubs and lines were lower. Conclusion The level of SHS exposure in Beijing residents should be improved,the bars or nightclubs,restaurants,lines and households were the key places,the rural residents and smokers were the key population,the law enforcement and Beijing smoking control ordinance should be strengthened,the knowledge of SHS hazard should be disseminated.
引文
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[2]黄洁夫.烟草危害与烟草控制[M].北京:新华出版社,2012:21-40.
[3]北京市人民代表大会常务委员会.北京市控制吸烟条例[EB/OL].(2014-11-28)[2019-04-13].http://www.beijing.gov.cn/zhengce/wenjian/192/33/50/438650/77440/index.html.
[4]刘秀荣.北京市人群烟草调查报告-成人烟草调查报告[M].北京:中国人口出版社,2018:4,21-33.
[5]南奕,熙子,杨焱,等.2015年中国成人烟草调查:15岁及以上成年人群二手烟暴露及其对公共场所禁烟政策支持现状[J].中华流行病学杂志,2016,37(6):810-815.
[6]冯国泽,姜垣,Zhao LH,等.中国城市地区成年人二手烟暴露水平及相关知识和态度调查[J].中华流行病学杂志,2014,35(9):998-1001.
[7]梁晓峰.中国成人烟草调查报告[M].北京:人民卫生出版社,2016:5,8-19.
[8]北京市卫生局.北京市公共场所禁止吸烟的规定[EB/OL].(1996-05-15)[2019-04-13].http://www.bjchfp.gov.cn/zwgk/fgwj/flfg/201612/t20161221_203224.htm.
[9]北京市人民政府.北京市公共场所禁止吸烟范围若干规定[EB/OL].(2008-03-31)[2019-04-13].http://www.gov.cn/gzdt/2008-04/10/content_941252.htm.
[10]北京市人民政府.北京市2016年度卫生与人群健康状况报告[M].北京:人民卫生出版社,2017:109-113.
[11]李玉青,石建辉,曹远,等.控烟条例实施1年对北京市15岁及以上人群二手烟暴露情况的影响[J].中华流行病学杂志,2019,40(3):327-330.
[12] ITC Project.Smoke-free Policies:ITC Cross-Country Comparison Report[EB/OL].[2019-04-13].https://www.itcproject.org/files/ITC_CrossCountry-Smoke-free_Final-web.pdf.
[13]许兆瑞,庄程,章春宇,等.长春市城区居民吸烟及二手烟暴露状况调查[J].中国公共卫生,2015,31(9):1132-1135.
[14]世界卫生组织.防止二手烟暴露:政策建议[M].日内瓦:世界卫生组织,2007:4-11.
[15]杨功焕.中国控烟[M].北京:中国协和医科大学出版社,2018:23-25.
[16]屠梦吴,南奕,王立立,等.中国成人对烟草危害知晓率的现状分析[J].中国慢性病预防与控制,2017,25(6):404-408.