中国青少年二手烟暴露现况调查
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摘要
目的了解我国初中在校中学生遭受二手烟暴露的水平、主要暴露场所,探索影响学生二手烟暴露的因素。方法采用全球青少年烟草调查统一的抽样方法和调查问卷,在全国31个省(自治区、直辖市)的初中在校学生中选取调查样本(n=155 117)。采用学生自填问卷的方式收集数据,调查的主要内容包括烟草使用、二手烟暴露、烟草制品获得与价格、控烟宣传、烟草广告和促销、对烟草的认知和态度等内容。对数据加权后,采用SAS 9.3复杂调查设计分析程序进行数据分析。结果在过去7 d内,72.9%的调查对象报告自己暴露于二手烟,男生(75.7%)高于女生(69.9%),差异有统计学意义(P<0.05),城乡之间(分别为74.4%、72.4%)差异无统计学意义(P>0.05)。室外公共场所的暴露比例最高(58.3%),其次是室内公共场所(57.2%)、家(44.4%),公共交通工具最低(37.9%)。此外,54.4%的学生报告自己过去30 d在学校内看到有人吸烟。父母吸烟(OR=2.489)、朋友中有人吸烟(OR=2.628)、没有在学校学习过烟草危害(OR=1.140)的学生更容易发生二手烟暴露。结论青少年二手烟暴露现状严峻,无烟学校创建工作亟待加强,家庭的有烟状况需要改善,建议尽快出台《公共场所控制吸烟条例》要求室内公共场所、青少年活动的主要室外场所以及公共交通工具100%无烟,并积极倡导无烟家庭。
Objective To understand the exposure to second-hand smoking(SHS) among middle school students in China and to explore the factors related to the SHS exposure among students. Methods A cross-sectional investigation was conducted among middle school students(n=155 117) in 31 provinces by the self-administrated questionnaire and sampling methods of Global Youth Tobacco Survey(GYTS). The main investigated contents included tobacco use behavior, the exposure to SHS, the access to tobacco products and prices, tobacco control advocacy, perceived tobacco advertising and promotion, their attitude and knowledge about tobacco, etc. Data were weighted and analyzed by SAS 9.3 complex survey data analysis program. Results In the past 7 days,72.9% of students(male: 75.7%, female: 69.9%) were exposed to SHS, there was significant difference between males and females(P<0.05), but there was no significant difference between urban and rural areas(74.4% vs 72.4%). The proportion of exposure in outdoor public places was the highest(58.3%), followed by indoor public places(57.2%), at home(44.4%) and public transport(37.9%). In addition, 54.4% of students found someone smoking in the campus in the past 30 days. The risk factors of the SHS exposure were that at least one of parents was smoker(OR=2.489), friends were smokers(OR=2.628) and the students had not studied the tobacco hazards in school(OR=1.140). Conclusion The exposure to SHS among youth is serious in China.Smoke-free campus policy enforcement is needed to be strengthened and smoking at home should be improved. It is suggested that"The regulation of controlling tobacco in public places" should be established as early as possible. It is required that all indoor public places, outdoor places for youth and public transport should be 100% smoke-free and smoke-free household policy should be promoted.
Objective To understand the exposure to second-hand smoking(SHS) among middle school students in China and to explore the factors related to the SHS exposure among students. Methods A cross-sectional investigation was conducted among middle school students(n=155 117) in 31 provinces by the self-administrated questionnaire and sampling methods of Global Youth Tobacco Survey(GYTS). The main investigated contents included tobacco use behavior, the exposure to SHS, the access to tobacco products and prices, tobacco control advocacy, perceived tobacco advertising and promotion, their attitude and knowledge about tobacco, etc. Data were weighted and analyzed by SAS 9.3 complex survey data analysis program. Results In the past 7 days,72.9% of students(male: 75.7%, female: 69.9%) were exposed to SHS, there was significant difference between males and females(P<0.05), but there was no significant difference between urban and rural areas(74.4% vs 72.4%). The proportion of exposure in outdoor public places was the highest(58.3%), followed by indoor public places(57.2%), at home(44.4%) and public transport(37.9%). In addition, 54.4% of students found someone smoking in the campus in the past 30 days. The risk factors of the SHS exposure were that at least one of parents was smoker(OR=2.489), friends were smokers(OR=2.628) and the students had not studied the tobacco hazards in school(OR=1.140). Conclusion The exposure to SHS among youth is serious in China.Smoke-free campus policy enforcement is needed to be strengthened and smoking at home should be improved. It is suggested that"The regulation of controlling tobacco in public places" should be established as early as possible. It is required that all indoor public places, outdoor places for youth and public transport should be 100% smoke-free and smoke-free household policy should be promoted.
引文
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[10]Fernando D,Fowles J,Woodward A,et al.Legislation reduces exposure to second-hand tobacco smoke in New Zealand bars by about 90%[J].Tob Control,2007,16(4):235-238.
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[12]Callinan JE,Clarke A,Doherty K,et al.Legislative smoking bans for reducing secondhand smoke exposure,smoking prevalence and tobacco consumption[J].Cochrane Database Syst Rev,2010(4):CD005992.
[13]Hilliard ME,Riekert KA,Hovell MF,et al.Family beliefs and behaviors about smoking and young children’s secondhand smoke exposure[J].Nicotine Tob Res,2014.pii:ntu250.
[14]Zheng P,Berg CJ,Kegler MC,et al.Smoke-free homes and home exposure to secondhand smoke in Shanghai,China[J].Int J Environ Res Public Health,2014,11(11):12015-12028.
[15]丰罗菊,杨欣.常州市青少年吸烟现状及影响因素分析[J].中国学校卫生,2012,33(5):518-520.
[16]吴曦,杨焱,姜垣.我国青少年被动吸烟现状及其影响因素分析[J].中国健康教育,2008,24(9):661-664.
[2]中华人民共和国卫生部.中国吸烟危害健康报告[R].北京:人民卫生出版社,2012:191-197.
[3]Centers for Disease Control and Prevention.The Health Consequences of Involuntary Exposure to Tobacco Smoke.The Health Consequents of Smoking:A Report of the Surgeon General[R].U.S.Atlanta,GA:2006:257-420.
[4]Di Franza JR,Lew RA.Morbidity and mortality in children associated with the use of tobacco products by other people[J].Pediatrics,1996,97(4):560-568.
[5]李云霞,姜垣,杨焱,等.中国公共场所禁止吸烟法规现状分析[J].环境与健康杂志,2007,24(4):221-223.
[6]Xiao L,Yang Y,Li Q,et al.Population-based survey of secondhand smoke exposure in China[J].Biomed Environ Sci,2010,23(6):430-436.
[7]杨功焕,胡鞍钢.控烟与中国未来——中外专家中国烟草使用语烟草控制联合评估报告[M].北京:经济日报出版社,2011:96.
[8]Liu R,Yang Y,Travers MJ,et al.A cross-sectional study on levels of secondhand smoke in restaurants and bars in five cities in China[J].Tob Control,2010,19(Suppl2):i24-i29.
[9]Akhtar PC,Currie DB,Currie CE,et al.Changes in child exposure to environmental tobacco smoke(CHETS)study after implementation of smoke-free legislation in Scotland:national cross sectional survey[J].BMJ,2007,335(7619):545-549.
[10]Fernando D,Fowles J,Woodward A,et al.Legislation reduces exposure to second-hand tobacco smoke in New Zealand bars by about 90%[J].Tob Control,2007,16(4):235-238.
[11]Gorini G,Gasparrini A,Tamang E,et al.Prevalence of second-hand smoke exposure after introduction of the Italian smoking ban:the Florence and Belluno survey[J].Tumori,2008,94(6):798-802.
[12]Callinan JE,Clarke A,Doherty K,et al.Legislative smoking bans for reducing secondhand smoke exposure,smoking prevalence and tobacco consumption[J].Cochrane Database Syst Rev,2010(4):CD005992.
[13]Hilliard ME,Riekert KA,Hovell MF,et al.Family beliefs and behaviors about smoking and young children’s secondhand smoke exposure[J].Nicotine Tob Res,2014.pii:ntu250.
[14]Zheng P,Berg CJ,Kegler MC,et al.Smoke-free homes and home exposure to secondhand smoke in Shanghai,China[J].Int J Environ Res Public Health,2014,11(11):12015-12028.
[15]丰罗菊,杨欣.常州市青少年吸烟现状及影响因素分析[J].中国学校卫生,2012,33(5):518-520.
[16]吴曦,杨焱,姜垣.我国青少年被动吸烟现状及其影响因素分析[J].中国健康教育,2008,24(9):661-664.