延吉市初中生控烟干预效果评价
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摘要
目的:了解延吉市研究对象吸烟危害健康知识的掌握程度、研究对象对吸烟的认识、态度和吸烟行为;明确控烟干预对研究对象的吸烟危害健康知识、态度和行为的效果。
     方法:本研究属于自身实验前后对照的类实验性研究,采用便利抽样方法,选取延吉市某初中一年级学生640人,共发放问卷640份,回收有效问卷627份,有效率为97.97%。对其进行为期3周,每周一次的控烟干预。研究工具采用李春玉(2008)根据世界青少年吸烟调查(Global Youth Tobacco Survey GYTS)、2004年美国全国青少年吸烟调查问卷、Johnson(2006)和中国的一些相关问卷(2007),开发的《青少年吸烟现状调查问卷》。三个月后对干预进行效果评价。所有数据利用SPSS for Windows 13.0统计软件进行整理分析。
     结果:结果显示,本次研究对象的吸烟人数为53(8.5%),吸第一支烟年龄最小为13岁,最大为16岁,吸烟的平均年龄为14.53±0.799。45(47.4%)名吸烟者第一次所吸的烟都是由朋友送的,首次吸烟最主要的原因为好奇27(57.4%),第一次吸烟的感觉多为呛咳(51.1%)和恶心(37.8%)。研究对象对于吸烟对肺部健康的影响知晓率较高,吸烟可导致肺癌的知晓率可高达85.6%,但是由于吸烟而引起心脑血管类和其他类别疾病的知晓率低,尤其是糖尿病(9.8%)、脑中风(9.6%)的知晓率偏低。研究对象对吸烟相关态度的正确持有率较高,但吸烟组与不吸烟组对于吸烟会有很多年轻朋友、看起来酷、不接受别人递烟不礼貌、应禁止一切烟草广告等态度相关问题上差异具有统计学意义(P<0.05)。吸烟组和不吸烟组学生对于将来吸烟意向差异具有统计学意义(P<0.05)。473(79.9%)的研究对象报告父母的意见对其做决定是否吸烟非常重要。261(42.0%)例研究对象报告学校偶尔开展吸烟有害于健康的教育。干预后研究对象吸烟率基本无增加,经卡方检验(χ2=1.508,P=0.68)干预前后吸烟率差异无统计学意义,研究对象吸烟情况无明显变化。干预前知识总分为6.29±2.420,干预后知识总分为8.86±2.69,经t检验(t=17.354,P=0.000)显示干预前后吸烟危害健康知识总分差异具有统计学差异。干预前后多个有关吸烟态度问题的正确率均较高,但干预前后态度的变化差异无统计学意义。仅在提高烟税和烟价、公共场所禁烟和应该全面禁止烟草广告三个问题上干预两组差异具有统计学意义(P<0.05)。干预后研究对象被动吸烟情况没有得到改变,但是能够做到劝阻周围人戒烟、劝阻他人不要在公共场所吸烟以及不要递烟的人数增多,干预前后经过卡方检验P值均小于0.05,其差异具有统计学意义。
     结论:通过本次研究证明了学校作为控烟场所的重要性,学校是学生聚集的地方,在学校对学生进行控烟干预,在短期内提高其吸烟危害健康知识知晓率成效高。学生尚未接触香烟或接触香烟的时间短,对其进行控烟干预时机及时,可在一定程度上控制吸烟率的增长,说明在学校实施吸烟干预是十分必要的。
Objective:To investigate middle school students'smoking-related health knowledge level,attitudes towards smoking and smoking behavior in Yanji city; To clarify the changes of smoking-related health knowledge,attitude and behavior after the school-based smoking prevention.
     Methods:This study is a quasi-experimental one,one group pretest-posttest design using accidental sampling method to select 640 seventh grade students in a middle school in Yanji City.640 questionnaires were distributed, while 627 valid questionnaires were effective and the effective rate is 97.97%.The intervention was lasting for three weeks, the middle school students had school-based intervention weekly."Youth Smoking Survey Questionnaire", is from Li Chunyu (2008),which is according to the World Youth Tobacco Survey (Global Youth Tobacco Survey GYTS), 2004 U.S. National Youth Tobacco Survey questionnaire, Johnson (2006) and some of the Chinese relevant questionnaire (2007).Evaluate the effect of the school-based smoking prevention intervention.Using SPSS for Windows 13.0 statistical software to analyze the data.
     Results:The results show that the number of smokers among the study objects is 53 (8.5%).The smoked study objects'minimum age is 13 years old, maximum age is 16 years old, and the average age of the smoked study objects is 14.53±0.799.45 (47.4%) smokers lit up their first cigarette was sent by friends.The main reason for the firstly smoking is curiosity27 (57.4%), the firstly feeling of smoking mostly is cough (51.1%) and nausea (37.8).Most study objects know the health effects of smoking on lung,the awareness rate of lung cancer can be as high as 85.6%, but as to cardiovascular and other diseases caused by smoking, the awareness rate is low, particularly diabetes mellitus (9.8%), stroke (9.6%).Smoking-related attitudes on the right holds a higher rate, but between the smoking group and non-smoking group the items such as smoking will have many young people friends, smoking looks cool, do not accept other people's cigarette is impolite, should prohibit all tobacco advertising, statistically significant by using Chi-square test(P<0.05).To compare the future smoking intentions of smoking group and non-smoking group of students using statistical analysis P<0.05, statistically significant.473 (79.9%) of the study objects reported the views of parents to decide whether to do their smoking is very important.261 (42.0%) study objects reported the school occasionally to carry out health education about smoking.After the intervention,there is no significant change in study objects'smoking behavior,χ2 value is 1.508, P=0.680.Knowledge score before the intervention totally is 6.29±2.420, after the intervention the total knowledge score is 8.86±2.69, t as 17.354, P as 0.000, showing that there is statistically significant in the differences of smoking-related knowledge score between the pre and post investigation.The rate of most smoking-related attitude items are high both before and after smoking prevention intervention,compared by chi-square test,there is no change in attitudes,it has not significantly different. Only on such three items,which are raised the cigarette tax and cigarette prices, smoking in public places should be a total ban and prohibit tobacco advertising, before and after smoking prevention intervention by the Chi-square test, P value is less than 0.05, the two groups was statistically significant.The situation of study objects' passive smoking problem after the intervention has not been changed, but they can persuade the people around to stop smoking, not to smoke in public places and not to passing cigrettes, before and after smoking prevention intervention through chi-square test P<0.05,statistically significant.
     Conclusion:This study indicates the importance of school-based smoking prevention intervention,school is the place which students massed in.Though out the school-base prevention intervention,the smoking-related health knowledge rate was improved in a short term.The students in middle school have not contact with cigarette or the contract time is not long,intervention in time would control the developing rate in some extent,so school-based prevention intervention is very necessary.
引文
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