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摘要:
目的 了解武汉市从不吸烟青少年(年龄范围为11~20岁)吸烟易感性以及主要影响因素。 方法 采用横断面研究设计，运用多阶段分层整群随机抽样方法，于2019年9―11月在武汉市15个行政区所有公立和私立的初中和高中抽取调查对象，对样本数据进行加权处理，采用复杂抽样设计的logistic回归分析模型分析从不吸烟青少年吸烟易感性的影响因素。 结果 武汉市从不吸烟青少年吸烟易感率为6.2%(95% CI：5.324~7.131)，其中男性吸烟易感率为6.8%(95% CI：5.460~8.186)，女性吸烟易感率为5.6%(95% CI：4.644~6.489)。多因素logistic回归分析模型分析结果显示，从不吸烟青少年吸烟易感性升高的危险因素包括好朋友吸烟(OR=2.981，95% CI：2.269~3.917，P < 0.001)、在学校看到老师吸烟(OR=1.626，95% CI：1.302~2.029，P < 0.001)、看见过烟草广告或促销(OR=1.442，95% CI：1.189~1.750，P < 0.001)和暴露于二手烟(OR=1.267，95% CI：1.021~1.573，P=0.032);保护因素包括在媒体上看过控烟信息(OR=0.722，95% CI：0.602~0.866，P < 0.001)和每周较低可支配收入(1~＜20元)(OR=0.690，95% CI：0.487~0.978，P=0.037)。 结论 应加强媒体控烟宣传教育，全面禁止所有形式的烟草广告、促销和赞助; 并在学校实施全面无烟校园政策，开展同伴和教师健康教育以帮助戒烟; 尽快通过全面无烟立法，创造无烟环境，以降低青少年吸烟的易感性。 Abstract:Objective To estimate the susceptibility to smoking among non-smoking youth in Wuhan and identify contributing factors. Methods Using a cross-sectional study design and a multi-stage stratified cluster random sampling method, the participants were selected from all public and private, junior and senior high schools across 15 administrative districts in Wuhan from September to November 2019. The multivariate logistic regression model was used to analyze the smoking susceptibility of non-smoking youth and related factors. Results The prevalence of smoking susceptibility of non-smoking youth in Wuhan was 6.2% (95% CI: 5.324-7.131), of which the prevalence of susceptibility of male was 6.8% (95% CI: 5.460-8.186), and the prevalence of susceptibility of female was 5.6% (95% CI: 4.644-6.489). The multivariate logistic regression analysis showed risk factors for increased susceptibility to smoking in non-smoking youth, which included having good friends who smoke (OR=2.981, 95% CI: 2.269-3.917, P < 0.001), observed teachers smoking at school (OR=1.626, 95% CI: 1.302-2.029, P < 0.001), noticed tobacco advertisements or promotions (OR=1.442, 95% CI: 1.189-1.750, P < 0.001) and exposure to second-hand smoke (OR=1.267, 95% CI: 1.021-1.573, P=0.032). In contrast, protective factors included seeing anti-smoking media content (OR=0.722, 95% CI: 0.602-0.866, P < 0.001) and a weekly disposable income of 1- < 20 yuan (OR=0.690, 95% CI: 0.487-0.978, P=0.037). Conclusions It is crucial to enhance media campaigns and education on tobacco control, eliminate all forms of tobacco advertising, promotions, and sponsorships, and implement comprehensive smoke-free campus policies in schools. Health education for peers and teachers on smoking cessation should be provided. Comprehensive smoke-free legislation should be urgently enacted to create a smoke-free environment, thereby reducing the susceptibility of young people to smoking. -
Key words:
- Smoking /
- Susceptibility to smoking /
- Youth
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表 1 武汉市从不吸烟青少年的基本特征
Table 1. Basic characteristics of non-smoking youth in Wuhan, China
组别Group 类别Category 已加权Weighted 未加权样本量
Unweighted sample size样本量
Sample size占比/%
Proportion/%95% CI 居住地Residence 农村Country 165 756 46.9 35.0~58.8 5 161 城市City 187 845 53.1 41.2~65.0 5 237 性别Sex 女Female 167 457 47.4 45.1~49.6 5 098 男Male 186 143 52.6 50.4~54.9 5 300 学校类型School type 初中Junior high school 205 552 58.1 46.6~69.7 5 632 高中Senior high school 94 241 26.7 17.0~36.3 3 474 职高Professional high school 53 807 15.2 6.6~23.8 1 292 学校性质Nature of school 公立学校Public school 315 900 89.3 81.7~97.0 9 044 私立学校Private school 37 701 10.7 3.0~18.3 1 354 每周可支配收入/元Weekly disposable income/yuan ≥50 112 749 31.9 26.7~37.1 3 464 20~＜50 84 224 23.8 22.2~25.4 2 504 1~＜20 97 160 27.5 23.1~31.9 2 680 < 1 59 468 16.8 15.3~18.3 1 750 暴露于二手烟Exposure to second-hand smoking 否No 159 418 45.1 40.2~50.0 4 442 是Yes 194 183 54.9 50.0~59.8 5 956 知晓吸烟烟雾危害Be aware of the dangers of smoking smoke 否No 8 402 2.4 2.0~2.8 236 是Yes 345 199 97.6 97.2~98.0 10 162 在媒体上看过控烟信息Have seen tobacco control information in the media 否No 86 900 24.6 22.6~26.6 2 700 是Yes 266 700 75.4 73.4~77.4 7 698 看到过烟草广告或促销Have seen tobacco advertisements or promotions 否No 128 057 36.2 33.6~38.8 3 783 是Yes 173 822 49.2 45.6~52.7 5 208 父母吸烟Parental smoking 否No 196 251 55.5 52.3~58.7 5 655 是Yes 157 350 44.5 41.3~47.7 4 743 好朋友吸烟Good friends smoking 否No 287 489 81.3 77.6~85.0 8 395 是Yes 66 112 18.7 15.0~22.4 2 003 在学校看到老师吸烟Observed teachers smoking at school 否No 234 779 66.4 61.9~70.9 6 601 是Yes 118 822 33.6 29.1~38.1 3 797 合计Total 353 601 100.0 10 398 注：由于缺失值，部分百分比加起来＜100%。
Note: Some percentages add up to＜100% due to missing values.
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表 2 武汉市从不吸烟青少年吸烟易感性的单因素分析
Table 2. Univariate of susceptibility to smoking among non-smoking youth in Wuhan, China
组别Group 类别Category 未加权样本量Unweightedsample size 加权Weighted χ2值value P值value 率/%Rate /% 95% CI 居住地Residence 农村Country 326 6.5 5.009~7.895 0.214 0.644 城市City 304 6.0 4.905~7.154 性别Sex 女Female 279 5.6 4.644~6.489 2.930 0.087 男Male 351 6.8 5.460~8.186 学校类型School type 初中Junior high school 276 5.0 4.079~5.982 20.968 < 0.001 高中Senior high school 248 7.0 5.794~8.143 职高Professional high school 106 9.5 6.677~12.329 学校性质Nature of school 公立学校Public school 555 6.3 5.364~7.303 0.650 0.420 私立学校Private school 75 5.3 3.204~7.475 每周可支配收入/元Weekly disposable income/yuan ≥50 284 8.5 7.323~9.652 45.091 < 0.001 20~＜50 137 5.7 4.424~6.928 1~＜20 103 4.0 2.916~5.034 < 1 106 6.4 4.789~8.020 暴露于二手烟Exposure to second-hand smoking 否No 183 4.0 3.245~4.664 57.014 < 0.001 是Yes 447 8.1 6.765~9.423 知晓吸烟烟雾危害Be aware of the dangers of smoking smoke 否No 20 7.9 3.929~11.938 1.023 0.312 是Yes 610 6.2 5.292~7.080 在媒体上看过控烟信息Have seen tobacco control information in the media 否No 210 8.3 6.723~9.918 20.365 < 0.001 是Yes 420 5.5 4.692~6.399 看到过烟草广告或促销Have seen tobacco advertisements or promotions 否No 159 4.2 3.433~4.945 136.910 < 0.001 是Yes 417 8.6 7.340~9.806 父母吸烟Parental smoking 否No 285 4.8 4.011~5.561 26.537 < 0.001 是Yes 345 8.0 6.543~9.510 好朋友吸烟Good friends smoking 否No 323 4.0 3.384~4.604 386.368 < 0.001 是Yes 307 15.9 14.105~17.778 在学校看到老师吸烟Observed teachers smoking at school 否No 266 4.2 3.437~4.925 98.036 < 0.001 是Yes 364 10.3 8.574~11.969 合计Total 630 6.2 5.324~7.131
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表 3 武汉市从不吸烟青少年吸烟易感性多因素分析(加权后)
Table 3. Multivariable logistic regression analysis on smoking susceptibility of non-smoking youth in Wuhan, China (Weighted)
影响因素Influence factor 类别Category β s Wald值
valueOR值value
(95% CI)P值
value居住地Residence 农村Country 1.000 城市City -0.080 0.110 0.529 0.923 (0.745~1.145) 0.467 性别Sex 女Female 1.000 男Male -0.017 0.145 0.014 0.983 (0.741~1.305) 0.907 学校类型School type 初中Junior high school 1.000 高中Senior high school -0.148 0.126 1.381 0.863 (0.675~1.104) 0.240 职高Professional high school 0.126 0.185 0.465 1.134 (0.790~1.629) 0.495 学校性质Nature of school 公立学校Public school 1.000 私立学校Private school -0.134 0.118 1.293 0.875 (0.694~1.102) 0.255 每周可支配收入/元Weekly disposable income/yuan ≥50 1.000 20~＜50 -0.186 0.129 2.070 0.830 (0.645~1.070) 0.150 1~＜20 -0.371 0.178 4.352 0.690 (0.487~0.978) 0.037 < 1 0.032 0.142 0.051 1.033 (0.782~1.364) 0.822 暴露于二手烟Exposure to second-hand smoking 否No 1.000 是Yes 0.237 0.110 4.614 1.267 (1.021~1.573) 0.032 知晓吸烟烟雾危害Be aware of the dangers of smoking smoke 否No 1.000 是Yes -0.277 0.352 0.620 0.758 (0.380~1.511) 0.431 在媒体上看过控烟信息Have seen tobacco control information in the media 否No 1.000 是Yes -0.325 0.093 12.332 0.722 (0.602~0.866) < 0.001 看到过烟草广告或促销Have seen tobacco advertisements or promotions 否No 1.000 是Yes 0.366 0.099 13.790 1.442 (1.189~1.750) < 0.001 父母吸烟Parental smoking 否No 1.000 是Yes 0.178 0.113 2.487 1.195 (0.958~1.490) 0.115 好朋友吸烟Good friends smoking 否No 1.000 是Yes 1.092 0.139 61.442 2.981 (2.269~3.917) < 0.001 在学校看到老师吸烟Observed teachers smoking at school 否No 1.000 是Yes 0.486 0.113 18.442 1.626 (1.302~2.029) < 0.001
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