成人吸烟者家庭健康功能、抑郁状况与烟草依赖的关系

闵鹤葳; 吴一波; 孙昕霙

doi:10.16462/j.cnki.zhjbkz.2023.03.008

成人吸烟者家庭健康功能、抑郁状况与烟草依赖的关系

doi: 10.16462/j.cnki.zhjbkz.2023.03.008

闵鹤葳¹,
吴一波^{1, 2},
孙昕霙^1, ,

1.
100191 北京，北京大学公共卫生学院社会医学与健康教育学系
2.
712046 陕西，陕西(高校)哲学社会科学重点研究基地-健康文化研究中心

基金项目:

2022年陕西省社会科学基金年度项目 2022M090

详细信息

通讯作者:
孙昕霙，E-mail: xysun@bjmu.edu.cn

中图分类号: R163
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出版历程
- 收稿日期: 2022-03-18
- 修回日期: 2022-07-03
- 网络出版日期: 2023-04-04
- 刊出日期: 2023-03-10

Relation of family health and depression to nicotine dependence in adult smokers

MIN He-wei¹,
WU Yi-bo^{1, 2},
SUN Xin-ying^{1
, ,}

1.
Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing 100191, China
2.
Key Research Base of Philosophy and Social Sciences-Health Culture Research Center, Shaanxi 712046, China

Funds:

2022 Annual Project of Social Science Foundation of Shaanxi Province 2022M090

More Information

Corresponding author: SUN Xin-ying, E-mail: xysun@bjmu.edu.cn

摘要

摘要: 目的探究中国核心家庭中的成人现在吸烟者家庭健康功能、抑郁状况与烟草依赖的关系。方法以核心家庭中≥18岁的现在吸烟者为研究对象，调查人口学、家庭健康功能、抑郁水平及烟草依赖状况。采用二分类logistic回归分析模型分析烟草依赖的影响因素，采用结构方程模型分析家庭健康功能、抑郁状况与烟草依赖的关系。结果纳入的707例现在吸烟者，以轻度烟草依赖为主640例，占90.5%，重度烟草依赖者67例，占9.5%。logistic回归分析模型分析显示，已婚、第1次吸烟年龄＜18岁、过去12个月每天饮酒、抑郁水平高、缺乏家庭外部社会支持与重度烟草依赖存在关联(均有P＜0.05)。结构方程模型显示，家庭健康资源可能通过影响抑郁水平间接影响烟草依赖状况(β=-0.246，P＜0.001)。结论家庭健康功能既与烟草依赖直接相关，也可能通过抑郁水平间接影响烟草依赖状况。
- 烟草依赖 /
- 家庭健康功能 /
- 抑郁
Abstract: Objective To explore the relationships between family health, depression, and nicotine dependence in adult smokers in China. Methods Smokers in nuclear families aged over 18 years were selected to explore demographic characteristics, family health, depression level, and nicotine dependence status. The binary logistic regression was performed to analyze the influencing factors of nicotine dependence. And the relationships between family health, depression, and nicotine dependence were analyzed by binary logistic regression and structural equation modeling. Results A total of 707 smokers were collected. And 640(90.5%) smokers were had mild nicotine dependence, while 67(9.5%) were with severe nicotine dependence. Logistic regression showed that being married, starting smoking at a young age (under 18 years), daily drinking, depression, poor family external social support were all associated with severe nicotine dependence (all P < 0.05). Structural equation model showed that family health resources could indirectly influence nicotine dependence by affecting depression (β=-0.246, P < 0.001). Conclusion Family health was directly related to nicotine dependence and may also indirectly influence it through depression level.
- Tabacco dependence /
- Family health fuction /
- Depression

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图 1 影响烟草依赖状况的结构方程模型

Figure 1. Structural equation modeling affecting tobacco dependence status

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表 1 研究对象基本信息及烟草依赖状况[n(%)]

Table 1. General characteristics and nicotine dependence of subjects [n(%)]

调查内容	例数	轻度依赖	重度依赖	χ²值	P值	调查内容	例数	轻度依赖	重度依赖	χ²值	P值
性别				0.334	0.564	家庭人均月收入(元)				3.231	0.357
男	664(93.9)	600(90.4)	64(9.6)			≤1 500	59(8.4)	53(89.8)	6(10.2)
女	43(6.1)	40(93.0)	3(7.0)			1 501~＜6 001	403(57.0)	359(89.1)	44(10.9)
常住地				1.508	0.220	6 001~＜12 000	190(26.9)	178(93.7)	12(6.3)
城镇	503(71.2)	451(89.7)	52(10.3)			≥12 000	55(7.8)	50(90.9)	5(9.1)
农村	204(28.9)	189(92.7)	15(7.4)			第1次吸烟年龄(岁)				11.009	0.001
年龄组(岁)				4.111	0.128	＜18	298(42.2)	257(86.2)	41(13.8)
18~＜36	217(30.7)	201(92.6)	16(7.4)			≥18	409(57.9)	383(93.6)	26(6.4)
36~＜60	471(66.6)	420(89.2)	51(10.8)			过去12个月是否饮酒				0.207	0.649
≥60	19(2.7)	19(100.0)	0(0.0)			否	123(17.4)	110(89.4)	13(10.6)
文化程度				5.260	0.154	是	584(82.6)	530(90.8)	54(9.3)
小学及以下	54(7.6)	49(90.7)	5(9.3)			过去12个月饮酒频率				11.104	0.025
初中	139(19.7)	126(90.7)	13(9.4)			未饮酒	123(17.4)	110(89.4)	13(10.6)
高中或中专	148(20.9)	127(85.8)	21(14.2)			每年	106(15.0)	93(87.7)	13(12.3)
大专及以上	366(51.8)	338(92.4)	28(7.7)			每月	123(17.4)	110(89.4)	13(10.6)
婚姻状况				4.059	0.044	每周	302(42.7)	284(94.0)	18(6.0)
未婚	165(23.3)	156(94.6)	9(5.5)			每天	53(7.5)	43(81.1)	10(18.9)
已婚	542(76.7)	484(89.3)	58(10.7)

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表 2 研究对象家庭健康功能及焦虑状况[M(P₂₅, P₇₅)]

Table 2. Scores of several scales among subjects [M(P₂₅, P₇₅)]

量表	条目	得分范围^a	全部样本	轻度烟草依赖者	重度烟草依赖者	Z值	P值
家庭健康量表	10	10.0~50.0	38.0(32.0, 43.0)	38.0(32.0, 43.0)	39.0(34.0, 43.0)	-0.720	0.472
家庭内部情感交流	3	2.5~12.5	10.0(8.3, 12.5)	10.0(8.3, 12.5)	10.8(9.6, 12.5)	-1.961	0.050
家庭健康生活方式	2	2.5~12.5	10.0(8.8, 12.5)	10.0(7.5, 12.5)	10.0(10.0, 12.5)	-1.641	0.101
家庭健康资源	3	2.5~12.5	8.3(7.5, 10.8)	8.3(7.5, 10.8)	8.3(6.7, 10.4)	-0.745	0.456
家庭外部社会支持	2	2.5~12.5	10.0(7.5, 11.3)	10.0(7.5, 11.3)	10.0(7.5, 10.6)	-0.943	0.346
抑郁症筛查量表	9	0.0~27.0	5.0(1.0, 9.0)	5.0(1.0, 9.0)	7.0(3.0, 9.5)	-2.340	0.019
不想做任何事	1	0.0~3.0	1.0(0.0, 1.0)	1.0(0.0, 1.0)	1.0(0.0, 1.0)	-1.115	0.265
情绪低落	1	0.0~3.0	0.0(0.0, 1.0)	0.0(0.0, 1.0)	1.0(0.0, 1.0)	-1.211	0.226
睡眠改变	1	0.0~3.0	1.0(0.0, 1.0)	1.0(0.0, 1.0)	1.0(0.0, 1.0)	-2.472	0.013
觉得疲倦	1	0.0~3.0	1.0(0.0, 1.0)	1.0(0.0, 1.0)	0.5(0.0, 1.0)	-2.201	0.028
食欲改变	1	0.0~3.0	1.0(0.0, 1.0)	1.0(0.0, 1.0)	1.0(0.0, 1.0)	-2.736	0.006
自我评价低	1	0.0~3.0	0.0(0.0, 1.0)	0.0(0.0, 1.0)	1.0(0.0, 1.0)	-1.697	0.090
做事精力分散	1	0.0~3.0	1.0(0.0, 1.0)	0.0(0.0, 1.0)	1.0(0.0, 1.0)	-2.321	0.020
行为改变	1	0.0~3.0	0.0(0.0, 1.0)	0.0(0.0, 1.0)	0.0(0.0, 1.0)	-0.855	0.393
自伤想法	1	0.0~3.0	0.0(0.0, 1.0)	0.0(0.0, 0.0)	0.0(0.0, 1.0)	-2.222	0.026
注：^a为便于比较，家庭健康功能各维度得分范围以各维度总分/条目数×2.5处理。

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表 3 烟草依赖状况的二分类logistic回归结果

Table 3. Binary logistic regression analysis of tobacco dependence status

变量	β值	s_x	Wald χ²值	OR(95% CI)值	P值
常住地(对照：城镇)
农村	-0.594	0.324	3.351	0.552(0.293~1.043)	0.067
婚姻状况(对照：已婚)
未婚	-1.085	0.399	7.404	0.338(0.155~0.738)	0.007
第1次吸烟年龄(岁)(对照：≥18岁)
＜18	0.914	0.282	10.512	2.494(1.435~4.334)	0.001
过去12个月饮酒频率(对照：每天)			12.761		0.013
未饮酒	-0.451	0.487	0.856	0.637(0.245~1.655)	0.355
每年	-0.267	0.496	0.290	0.766(0.289~2.205)	0.590
每月	-0.496	0.488	1.035	0.609(0.234~1.584)	0.309
每周	-1.360	0.454	8.977	0.257(0.105~0.625)	0.003
抑郁状况	0.065	0.023	7.581	1.067(1.019~1.117)	0.006
家庭健康功能
家庭内部情感交流	0.267	0.068	15.530	1.306(1.143~1.491)	＜0.001
家庭外部社会支持	-0.306	0.097	10.010	0.736(0.609~0.890)	0.002
常量	-3.051	0.841	13.171	0.047	＜0.001

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