Analysis of smoking surveillance results among Beijing primary and secondary school staff in 2019
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摘要:
目的 了解和掌握2019年北京市中小学校教职工人群烟草使用现状以及烟草使用的认知和态度，监测影响青少年烟草使用和暴露的中小学校教职工有关因素现状，为促进学校无烟环境建设提供参考依据。 方法 2019年4—6月采用PPS抽样方法在全市范围内分别抽取小学、初中、高中和职高校的监测点校。每所监测学校随机调查20名教职员工，共纳入2 737名员工。监测内容主要包括学校在职教职员工的烟草使用现状及其烟草危害知识的认知、对待吸烟的态度等。 结果 未接受青少年控烟培训(OR=0.20，95%CI=0.14~0.28)的教职工讲解控烟知识的可能性仅为接受培训教职工的20%，不使用《学校控烟教师指导手册》(OR=0.21，95%CI=0.14~0.32)是向学生讲解控烟知识的消极影响因素; 向学生讲授过关于拒绝吸烟内容的教职工更倾向“任何人不能在校园内任何地方吸烟”(98.53%)。工作年限为20~30年的教职工(OR=3.35，95%CI=2.22~5.05)教授知识的可能性最高，差异均有统计学意义(P值均 < 0.05)。 结论 注重身体健康并有意识接受健康培训的教职工更有传播健康知识的意愿。应更加注重学校教职员工健康素养的培养，积极引导未向学生讲授控烟知识的教职工逐渐认识到青少年控烟重要性。 Abstract:Objective To understand the current situation of tobacco use in primary and secondary school staff members in Beijing in 2019, and its association with adolescent tobacco use and exposure, in order to promote the construction of smoke-free schools. Methods During April to June in 2019, PPS sampling was used to select primary schools, secondary schools and vocational high school. Each selected school randomly investigates 20 faculty members, totalling 2 737. The monitoring contents mainly include the current tobacco use, knowledge and attitude towards health risk of smoking among the school staff. Results The faculty did not receive the training of adolescent tobacco control (OR=0.20, 95%CI=0.14-0.28) were only 20% likely to teach tobacco hazard knowledge compared to the trained staff, and refusal to use tobacco control instruction manual (OR=0.21, 95%CI=0.14-0.32) was negatively associated with teaching tobacco control with students. Staff members having given lectures on tobacco refusal were more inclined to uphold "any people can't smoke anywhere on campus "(98.53%), and the interpretation of the rules tends to be more clear. Staff who has been employed for 20-30 years (OR=3.35, 95%CI=2.22-5.05) were the most probably to preach tobacco control among students(P < 0.05). Conclusion Staff caring about health and participate actively in health training were more willing to spread health knowledge. More attention should be paid to the cultivation of health literacy of school staff, and proactively guide faculty unwilling to instruct students in health hazard of smoking to gradually realize the importance of adolescent tobacco control. -
表 1 教职工人口学资料构成在是否向学生讲授控烟知识组间比较
Table 1. Comparison of demographic data composition of faculty and staff among groups of whether or not to teach students the knowledge of tobacco control
人口学资料 选项 未讲授(n=285) 讲授(n=2 452) χ2值 P值 性别 男 94(32.98) 804(32.79) 0.00 0.95 女 191(67.02) 1 648(67.21) 学历 初中以下 1(0.35) 5(0.20) 6.29 0.01 初中 3(1.05) 11(0.45) 高中 11(3.86) 28(1.14) 中专/大专 34(11.93) 158(6.44) 大学本科 184(64.56) 1 900(77.49) 硕士及以上 52(18.25) 350(14.27) 职务 领导 6(2.11) 212(8.65) 88.47 < 0.01 教务管理 20(7.02) 271(11.05) 一线教学 122(42.81) 1 278(52.12) 行政后勤 118(41.40) 483(19.70) 卫生保健 4(1.40) 132(5.38) 其他 15(5.26) 76(3.10) 健康状况 非常好 53(18.60) 499(20.35) 7.71 0.01 好 96(33.68) 992(40.46) 一般 114(40.00) 857(34.95) 不好 18(6.32) 91(3.71) 非常不好 4(1.40) 13(0.53) 注： ()内数字为构成比/%。 
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表 2 学校和教职工履行控烟职责及烟草使用认识情况在是否向学生讲授控烟知识组间比较
Table 2. Comparison of the performance of tobacco control duties and tobacco use among schools and teaching staff among groups with or without teaching tobacco control knowledge to students
指标 选项 未讲授(n=285) 讲授(n=2 452) χ2值 P值 接受青少年控烟培训 是 81(28.42) 1 937(79.00) 337.19 < 0.01 否 204(71.58) 515(21.00) 使用《学校控烟教师指导手册》 是 34(11.93) 1 334(54.40) 218.03 < 0.01 否 201(70.53) 728(29.69) 不记得 50(17.54) 390(15.91) 学校有禁止吸烟的规定 任何人不能在校园内任何地方吸烟 261(91.58) 2 416(98.53) < 0.01* 只能在校园内某些区域吸烟 12(4.21) 24(0.98) 可以在校园内任何地方吸烟 4(1.40) 2(0.08) 不清楚 8(2.81) 10(0.41) 校园内能买到烟 能 1(0.35) 8(0.33) 1.00* 不能 284(99.65) 2 444(99.67) 学校附近200 m内能买到烟 能 98(34.39) 559(22.80) 18.80 < 0.01 不能 187(65.61) 1 893(77.20) 学校禁止学生吸烟 严格执行 277(97.19) 2 390(97.47) 0.01 0.93 未严格执行 3(1.05) 16(0.65) 未执行 5(1.75) 46(1.88) 学校禁止教职员工校内吸烟 严格执行 259(90.88) 2 365(96.45) 18.54 < 0.01 未严格执行 18(6.32) 62(2.53) 未执行 8(2.81) 25(1.02) 学校禁止外来人员校内吸烟 严格执行 248(87.02) 2 339(95.39) 30.06 < 0.01 未严格执行 16(5.61) 46(1.88) 未执行 21(7.37) 67(2.73) 曾经吸烟 是 21(7.37) 428(17.46) 0.23 0.63 否 232(81.40) 2 024(82.54) 目前吸烟情况 每天都吸 25(8.77) 127(5.18) 5.42 0.02 偶尔吸 18(6.32) 151(6.16) 不吸 242(84.91) 2 174(88.66) 过去1年在校园内吸烟 是 9(3.16) 32(1.31) 0.33* 否 276(96.84) 2 420(98.69) 过去30 d平均每周和正在吸烟的人一起 0 147(51.58) 1 483(60.48) 10.49 < 0.01 呆在室内或车内的天数/d 1~2 62(21.75) 480(19.58) 3~4 26(9.12) 190(7.75) 5~6 16(5.61) 112(4.57) 7 34(11.93) 187(7.63) 过去7 d和正在吸烟的人一起呆在 0 168(58.95) 1 635(66.68) 4.53 0.03 室内或车内的天数/d 1~2 70(24.56) 487(19.86) 3~4 17(5.96) 122(4.98) 5~6 10(3.51) 78(3.18) 7 20(7.02) 130(5.30) 是否关注青少年控烟问题 非常关注 164(57.54) 2 109(86.01) 179.74 < 0.01 有点关注 87(30.53) 302(12.32) 不关注 34(11.93) 41(1.67) 如果好朋友给你烟会吸吗 肯定不会 240(84.21) 2 168(88.42) 13.60 < 0.01 可能不会 4(1.40) 93(3.79) 可能会 25(8.77) 155(6.32) 肯定会 16(5.61) 36(1.47) 别人在你旁边吸烟你会怎样做 劝他们把烟掐掉 94(32.98) 1 286(52.45) 55.37 < 0.01 躲开或要求他们去别处 133(46.67) 942(38.42) 不管 46(16.14) 185(7.54) 自己也吸 12(4.21) 39(1.59) 注： ()内数字为构成比/%; *为使用Fisher精确概率法。
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表 3 教职工开展青少年控烟宣教影响因素Logistic回归分析(n=2 737)
Table 3. Logistic regression analysis on factors impacting school staff being willing to implement adolescent tobacco control education (n=2 737)
常数与自变量 β值 标准误 Wald χ2值 P值 OR值(OR值95%CI) 常数项 6.47 1.46 19.70 < 0.01 职务 教务管理 -0.66 0.52 1.59 0.21 0.52(0.19~1.44) 一线教学 -0.10 0.48 0.05 0.83 0.90(0.35~2.31) 行政后勤 -1.48 0.48 9.49 < 0.01 0.23(0.09~0.58) 卫生保健 0.86 0.74 1.37 0.24 2.37(0.56~10.06) 其他 -0.65 0.57 1.29 0.26 0.52(0.17~1.61) 使用《学校控烟教师指导手册》 否 -1.56 0.22 48.81 < 0.01 0.21(0.14~0.32) 不记得 -0.96 0.26 13.63 < 0.01 0.39(0.23~0.64) 接受青少年控烟培训 否 -1.61 0.17 91.54 < 0.01 0.20(0.14~0.28) 是否关注青少年控烟问题 有点关注 -0.61 0.17 12.68 < 0.01 0.55(0.39~0.76) 不关注 -1.70 0.30 31.18 < 0.01 0.18(0.10~0.33) 工作年限/年 10~ < 20 0.39 0.20 3.95 0.05 1.48(1.01~2.19) 20~30 1.21 0.21 33.20 < 0.01 3.35(2.22~5.05) ≥30 0.65 0.27 6.02 0.01 1.92(1.14~3.23) 如果好朋友给你烟会吸吗 可能不会 1.04 0.54 3.66 0.06 2.82(0.97~8.17) 可能会 -0.19 0.27 0.47 0.49 0.83(0.49~1.41) 肯定会 -1.08 0.41 7.09 0.01 0.34(0.15~0.75) 学历 初中 -1.87 1.59 1.39 0.24 0.15(0.01~3.48) 高中 -2.55 1.44 3.14 0.08 0.08(0.01~1.31) 中专/大专 -1.58 1.39 1.29 0.26 0.21(0.01~3.14) 大学本科 -1.19 1.37 0.75 0.39 0.31(0.02~4.49) 硕士及以上 -1.29 1.38 0.88 0.35 0.27(0.02~4.10) 学校附近200 m内能否买到烟 不能 0.32 0.16 3.99 0.05 1.37(1.01~1.87)
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表 4 教职工控烟知识技能储备情况在是否向学生讲授控烟知识组间比较
Table 4. Comparison of the reserve of knowledge and skills of tobacco control among faculty and staff comparison between groups of whether or not to teach students the knowledge of tobacco control
知识 选项 未讲授(n=285) 讲授(n=2 452) χ2值 P值 知识 选项 未讲授(n=285) 讲授(n=2 452) χ2值 P值 公共场所全面禁烟 是 279(97.89) 2 432(99.18) 0.05* 烟草商潜移默化鼓励青 是 171(60.00) 1 505(61.38) 0.20 0.65 否 6(2.11) 20(0.82) 少年吸烟 否 114(40.00) 947(38.62) 二手烟有害健康 是 281(98.60) 2 440(99.51) 0.08* 吸烟导致疟疾 是 149(52.28) 1 299(52.98) 0.05 0.82 否 4(1.40) 12(0.49) 否 136(47.72) 1 153(47.02) 教师应该接受青少年 是 257(90.18) 2 381(97.10) 35.16 < 0.01 不确定 0 0 控烟专门培训 否 28(9.82) 71(2.90) 吸烟导致肺癌 是 276(96.84) 2 410(98.29) 2.92 0.09 学校应该出台禁止教职 是 278(97.54) 2 437(99.39) 0.01* 否 9(3.16) 42(1.71) 工校内吸烟政策 否 7(2.46) 15(0.61) 不确定 0 0 学校应该出台禁止外来 是 280(98.25) 2 447(99.80) < 0.01* 吸烟导致心脏病 是 251(88.07) 2 300(93.80) 13.24 < 0.01 人员校内吸烟政策 否 5(1.75) 5(0.20) 否 34(11.93) 152(6.20) 允许烟草商赞助学校体 是 55(19.30) 255(10.40) 20.13 < 0.01 不确定 0 0 育赛事 否 230(80.70) 2 197(89.60) 不将烟雾吸入肺中不 是 43(15.09) 296(12.07) 2.14 0.14 完全禁止烟草广告 是 261(91.58) 2 317(94.49) 3.97 0.05 会危害健康 否 242(84.91) 2 156(87.93) 否 24(8.42) 135(5.51) 偶尔吸入二手烟不会 是 41(14.39) 227(9.26) 7.60 0.01 卷烟应该涨价 是 191(67.02) 1 872(76.35) 11.97 < 0.01 危害健康 否 244(85.61) 2 225(90.74) 否 94(32.98) 580(23.65) 吸烟不上瘾，偶尔吸 是 24(8.42) 122(4.98) 6.00 < 0.01 不会危害健康 否 261(91.58) 2 330(95.02) 注： ()内数字为构成比/%; *为使用Fisher精确概率法。
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