E-cigarette usage and associated factors among Beijing primary and secondary school students
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摘要:
目的 了解和掌握北京市中小学生电子烟使用的现状及其有关因素，为促进学校无烟环境建设提供实证依据。 方法 2019年4—6月采用与规模大小成比例的概率抽样(PPS)方法在北京市范围内分别抽取小学、初中、高中和职高监测点校，各点校随机抽取班级，直至满足样本量，共18 312名知晓电子烟的中小学生纳入统计分析，监测内容主要是电子烟使用的现状及影响因素等情况。 结果 在知晓电子烟的中小学生中，女生较男生使用电子烟的可能性低(OR=0.47，95%CI=0.42~0.54)。进入初二后，使用电子烟的可能性呈递增趋势。父母均不吸烟与孩子远离电子烟呈负相关(OR=0.78，95%CI=0.69~0.88)。平均每天零花钱30~ < 150元和≥150元的中小学生使用电子烟的可能性分别是0~ < 10元零花钱的1.43倍(95%CI=1.22~1.67)和2.24倍(95%CI=1.79~2.79)。没有尝试使用卷烟的中小学生使用电子烟的可能性低于已尝试卷烟的(OR=0.16，95%CI=0.14~0.19)。 结论 应遏制电子烟在中小学生中的流行趋势，填补或纠正儿童青少年对于电子烟认知的空白或错误，采取更具创新性的方法科学引导儿童青少年远离电子烟。 Abstract:Objective To understand current situation of e-cigarette use and associated factors in primary and secondary school students in Beijing, 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 trade schools. In each selected school, randomly sampling method was conducted until the sample size was reached. There were 18 312 students included in the analysis. Surveillance information mainly included the current situation of electronic cigarette use and associated factors. Results Among primary and secondary school students who have known about e-cigarettes, female students were less likely to use e-cigarettes than male students (OR=0.47, 95%CI=0.42-0.54). After entering the second year of junior high school, the possibility of using e-cigarettes increased. Smoke-free home was associated less e-cigarettes usage (OR=0.78, 95%CI=0.69-0.88). Primary and secondary school students with average daily allowance of 30~ < 150 yuan and no less than 150 yuan were 1.43 (95%CI=1.22-1.67) times and 2.24 (95%CI=1.79-2.79) times more likely to use e-cigarettes than those with 0-10 yuan allowance, respectively. The probability of using e-cigarettes among primary and secondary school students who have not tried using cigarettes was only 16.4% compared with those who have tried cigarettes (OR=0.16, 95%CI=0.14-0.19). Conclusion It is necessary to curb the prevalence of e-cigarettes among primary and secondary school students. Actions need to be taken urgently to fill in the gaps or correct the mistakes in children and adolescents' cognition of e-cigarettes, and to adopt more innovative methods to scientifically guide children and adolescents to stay away from e-cigarettes. -
Key words:
- Tobacco /
- Health education /
- Cognition /
- Regression analysis /
- Students
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表 1 知晓电子烟中小学生吸食电子烟影响因素单因素分析
Table 1. Analysis of influencing factors of e-cigarette use among primary and secondary school students knowing e-cigarettes
组别 选项 人数 吸电子烟人数 χ2值 组别 选项 人数 吸电子烟人数 χ2值 性别 男 9 689 1 358(14.02) 414.45 ≥5 600 206(34.33) 女 8 623 436(5.06) 尝试吸烟(传统卷烟) 是 1 738 839(48.27) 3 217.01 年级 四 1 460 83(5.68) 355.53 否 16 574 955(5.76) 五 1 719 67(3.90) 过去1个月吸烟天数/d 0 17 780 1 403(7.89) 2 135.73 六 1 824 85(4.66) 1~2 149 91(61.07) 初一 1 714 103(6.01) 3~5 61 46(75.41) 初二 1 864 150(8.05) 6~9 62 44(70.97) 初三 1 668 156(9.35) 10~19 44 36(81.82) 高一 2 903 361(12.44) 20~29 35 25(71.43) 高二 2 668 392(14.69) 每天 181 149(82.32) 高三 2 492 397(15.93) 过去1周家人当面吸烟 0 12 485 1 040(8.33) 227.33 父母吸烟 仅爸爸 8 858 980(11.06) 247.33 天数/d 1~2 3 056 274(8.97) 仅妈妈 138 33(23.91) 3~4 913 123(13.47) 均吸 635 150(23.62) 5~6 368 54(14.67) 均不吸 8 681 631(7.27) 7 1 490 303(20.34) 过去半年平均每天 0~＜10 6 820 451(6.61) 321.56 过去1周室内公共场所有人 0 10 089 869(8.61) 224.16 零花钱 10~＜30 5 983 500(8.36) 当面吸烟天数/d 1~2 4 324 293(6.78) 30~＜150 4 585 618(13.48) 3~4 1 517 182(12.00) ≥150 924 225(24.35) 5~6 534 82(15.36) 学习成绩 优秀 3 361 432(12.85) 19.65 7 1 848 368(19.91) 良好 7 720 515(6.67) 吸烟有害健康 有害 17 837 1 626(9.12) 382.45 一般 6 064 620(10.22) 无害 243 101(41.56) 较差 1 167 227(19.45) 不清楚 232 67(28.88) 教师讲授控烟 有 10 676 967(9.06) 15.83 二手烟有害健康 有害 17 654 1 606(9.10) 391.07 没有 7 636 827(10.83) 无害 232 106(45.69) 学校有人吸烟 有 5 009 959(19.15) 681.91 不清楚 426 82(19.25) 无 13 303 835(6.28) 好朋友递烟会吸吗 肯定不会 16 922 1 211(7.16) 2 098.42 5个同学或朋友吸烟 0 15 957 1 084(6.79) 1 612.62 可能不会 736 215(29.21) 人数 1 831 162(19.49) 可能会 489 251(51.33) 2 575 143(24.87) 肯定会 165 117(70.91) 3 302 94(31.13) 长大会吸烟吗 肯定不会 13 892 919(6.62) 1 053.76 4 119 52(43.70) 可能不会 2 571 339(13.19) 5 528 259(49.05) 可能会 1 630 408(25.03) 任课教师吸烟人数 0 13 294 1 026(7.72) 490.34 肯定会 219 128(58.45) 1 2 491 279(11.20) 有人在你旁边吸烟 劝他们把烟掐掉 7 699 784(10.18) 1 151.73 2 1 324 184(13.90) 躲开或要求其离开 7 788 448(5.75) 3 478 76(15.90) 不管 2 661 433(16.27) 4 125 23(18.40) 自己也吸 164 129(78.66) 注： ()内数字为报告率/%；P值均＜0.01。 
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表 2 知晓电子烟的不同控烟知识技能储备中小学生吸电子烟报告率比较
Table 2. Analysis on the knowledge and skills of tobacco control among primary and secondary school students knowing e-cigarettes
控烟知识 选项 人数 吸电子烟人数 χ2值 P值 控烟知识 选项 人数 吸电子烟人数 χ2值 P值 吸烟可以提神 是 4 503 1 003(22.27) 1 051.96 ＜0.01 否 5 833 666(11.42) 否 13 809 791(5.73) 吸烟导致心脏病 是 15 018 1 224(8.15) 256.16 ＜0.01 吸烟是成熟的表现 是 1 309 612(46.75) 2 178.82 ＜0.01 否 3 294 570(17.30) 否 17 003 1 182(6.95) 开始吸烟年龄越小患癌概率 是 15 039 1 250(8.31) 210.01 ＜0.01 吸烟是独立自由的象征 是 1 078 586(54.36) 2 574.01 ＜0.01 越大 否 3 273 544(16.62) 否 17 234 1 208(7.01) 不将烟雾吸入就无害 是 2 554 694(27.17) 1 014.05 ＜0.01 吸烟很酷很潇洒 是 1 368 582(42.54) 1 794.08 ＜0.01 否 15 758 1 100(6.98) 否 16 944 1 212(7.15) 吸烟影响青少年生长发育 是 16 163 1 328(8.22) 389.34 ＜0.01 不接受别人递烟不礼貌 是 1 924 684(35.55) 1 613.61 ＜0.01 否 2 149 466(21.68) 否 16 388 1 110(6.77) 偶尔吸入二手烟无妨 是 1 639 626(38.19) 1 642.64 ＜0.01 青少年吸烟是勇于挑战权威 是 994 515(51.81) 2 099.44 ＜0.01 否 16 673 1 168(7.01) 否 17 318 1 279(7.39) 吸烟不上瘾偶尔吸着玩无妨 是 1 129 583(51.64) 2 383.65 ＜0.01 吸烟会影响肺活量及运动表现 是 12 479 1 128(9.04) 25.45 ＜0.01 否 17 183 1 211(7.05) 注： ()内数字为报告率/%。
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表 3 知晓电子烟的中小学人群中吸食电子烟影响因素Logistic回归分析(n=18 312)
Table 3. Logistic regression analysis on influencing factors of e-cigarette use among primary and secondary school students knowing e-cigarettes(n=18 312)
常数与自变量 选项 β值 标准误 Wald χ2值 P值 OR值(OR值95%CI) 常数项 -0.70 0.16 19.49 ＜0.01 - 性别 女 -0.75 0.07 125.51 ＜0.01 0.47(0.42~0.54) 年级 小学五年级 -0.15 0.19 0.60 0.44 0.86(0.60~1.25) 小学六年级 -0.06 0.18 0.10 0.75 0.95(0.66~1.35) 初一 0.26 0.17 2.26 0.13 1.29(0.92~1.81) 初二 0.40 0.16 6.04 0.01 1.50(1.09~2.07) 初三 0.56 0.17 11.51 ＜0.01 1.75(1.27~2.42) 高一 0.68 0.15 20.02 ＜0.01 1.97(1.46~2.65) 高二 0.76 0.15 25.16 ＜0.01 2.14(1.59~2.88) 高三 0.81 0.15 28.61 ＜0.01 2.25(1.67~3.04) 父母吸烟 仅妈妈吸 0.58 0.26 5.08 0.02 1.78(1.08~2.93) 均吸 0.38 0.13 8.23 ＜0.01 1.46(1.13~1.89) 均不吸 -0.25 0.06 16.40 ＜0.01 0.78(0.69~0.88) 过去半年平均每天零花钱/元 10~＜30 -0.01 0.08 0.03 0.87 0.99(0.85~1.15) 30~＜150 0.36 0.08 19.38 ＜0.01 1.43(1.22~1.67) ≥150 0.81 0.11 50.86 ＜0.01 2.24(1.79~2.79) 学习成绩 良好 -0.55 0.08 45.81 ＜0.01 0.58(0.49~0.68) 一般 -0.48 0.08 34.12 ＜0.01 0.62(0.52~0.73) 较差 -0.21 0.12 3.26 0.07 0.81(0.65~1.02) 校园见过别人吸烟 没有 -0.51 0.06 63.25 ＜0.01 0.60(0.53~0.68) 5个同学或朋友中吸烟人数 1 0.41 0.11 13.67 ＜0.01 1.51(1.21~1.88) 2 0.41 0.13 10.61 ＜0.01 1.50(1.18~1.92) 3 0.53 0.16 11.26 ＜0.01 1.70(1.25~2.32) 4 0.69 0.24 8.10 ＜0.01 2.00(1.24~3.22) 5 0.71 0.13 29.27 ＜0.01 2.04(1.58~2.65) 任课教师中吸烟人数 1 0.04 0.09 0.25 0.62 1.04(0.88~1.23) 2 0.02 0.11 0.02 0.88 1.02(0.83~1.25) 3 -0.12 0.16 0.52 0.47 0.89(0.65~1.22) 4 -0.04 0.31 0.02 0.89 0.96(0.52~1.75) ≥5 0.41 0.13 10.17 ＜0.01 1.51(1.17~1.95) 尝试吸烟(传统烟草制品) 否 -1.81 0.07 690.92 ＜0.01 0.16(0.14~0.19) 二手烟有害健康 无害 0.78 0.19 17.48 ＜0.01 2.19(1.52~3.16) 不清楚 0.04 0.16 0.05 0.82 1.04(0.76~1.42) 好朋友递烟会吸吗 可能不会 0.70 0.11 40.96 ＜0.01 2.02(1.63~2.51) 可能会 0.96 0.13 55.12 ＜0.01 2.61(2.03~3.37) 肯定会 1.25 0.24 26.63 ＜0.01 3.50(2.17~5.63) 长大后会吸烟吗 可能不会 0.07 0.08 0.77 0.38 1.08(0.92~1.26) 可能会 0.19 0.09 4.19 0.04 1.21(1.01~1.44) 肯定会 0.49 0.21 5.48 0.02 1.63(1.08~2.46)
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