Exposure to second-hand smoking among middle school students in Beijing in 2019
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摘要:
目的 了解北京市青少年二手烟暴露现状及其影响因素，为制定烟草控制措施提供数据支持。 方法 采用二阶段分层整群随机抽样方法，确定北京市16个区48所初中、34所普通高中和14所职业高中共370个班级的10 532名在校生为调查对象，使用中国疾病预防控制中心控烟办公室制定的全国青少年烟草流行监测调查问卷进行信息采集。 结果 2019年北京市中学生在过去7 d内4类场所二手烟暴露率为71.5%(95%CI=70.2%~72.7%)，其中室外公共场所的二手烟暴露率最高(60.3%)，其次是室内公共场所(48.9%)、家(34.1%)，公共交通工具最低(19.1%)。过去30 d内看到有人在学校的建筑物内或室外吸烟的比例为31.6%。多因素Logistic回归分析结果显示，父母中有人吸烟(OR=2.62)、好友中有人吸烟(OR=2.13)、在课堂上学习过烟草危害(OR=0.74)和高一到高三年级(OR=0.68~0.73)与4类场所二手烟暴露率有相关关系(P值均 < 0.05)。 结论 北京市中学生二手烟暴露维持在较高水平。应加强学校烟草危害和控烟宣传，倡导无烟家庭创建，切实保护中学生尤其初中生免受二手烟危害。 Abstract:Objective To understand the exposure to second-hand smoking (SHS) and associated factors among middle school students in Beijing, and to provide data support for tobacco control. Methods The two-stage stratified cluster random sampling method were used to select 10 532 students from 370 classes in 48 junior middle schools, 34 senior high schools and 14 vocational high schools in 16 districts of Beijing. The national unified paper questionnaire was used to collect the information. Results During the past 7 days, 71.5% (95%CI=70.2%-72.7%) of students reported exposure to SHS. The proportion of exposure was highest (60.3%) in outdoor public places, followed by indoor public places (48.9%), at home (34.1%), and public transport (19.1%). About 31.6% of students reported people smoking in the campus in the past 30 days. Risk factors of SHS exposure included one or more parents was smoker(OR=2.62), friends who smoked(OR=2.13), received education on tobacco hazards in school(OR=0.74), and senior high school(OR=0.68-0.73)(P < 0.05). Conclusion High exposure to second-hand smoking among middle school students in Beijing is common. Implementation of the regulations and the publicity of tobacco hazards and tobacco control in schools should be strengthened. Smoke-free household should be advocated, and middle school students, especially junior middle school students, should be protected from the harm of SHS. -
Key words:
- Tobacco /
- Tobacco smoke pollution /
- Regression analysis /
- Students
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 北京市不同组别中学生过去7 d内在4类场所二手烟暴露率比较/%
Table 1. Comparison of the exposure rates of secondhand smoke in four types of places in the past 7 days among middle school students in different groups in Beijing/%
组别 选项 人数 统计值 家 室内公共场所 室外公共场所 公共交通工具 4类场所合计 年级 初一 1 863 35.3(32.6~38.2) 44.9(41.9~47.9) 55.8(52.9~58.7) 17.1(14.4~20.2) 70.7(68.0~73.4) 初二 1 759 35.8(33.0~38.7) 49.8(46.7~52.8) 61.6(58.6~64.4) 19.2(16.4~22.4) 72.8(70.1~75.3) 初三 1 749 36.2(33.3~39.2) 52.1(49.0~55.2) 65.6(62.7~68.4) 21.7(18.6~25.1) 76.8(74.3~79.2) 高一 1 778 34.2(31.1~37.3) 48.9(45.6~52.2) 60.5(57.3~63.6) 18.7(15.8~21.9) 70.1(67.1~73.0) 高二 1 769 31.9(28.8~35.1) 51.3(47.8~54.7) 59.9(56.4~63.3) 20.5(17.2~24.3) 70.3(67.0~73.5) 高三 1 614 30.5(27.0~34.2) 47.3(43.0~51.7) 59.2(54.8~63.5) 17.6(14.1~21.8) 67.7(63.2~71.9) χ2值 20.70 26.69 39.90 11.27 39.40 P值 0.06 0.03 < 0.01 0.37 < 0.01 性别 男 5 444 34.8(33.1~36.6) 49.2(47.3~51.1) 59.8(57.9~61.7) 19.7(18.0~21.6) 71.5(69.6~73.2) 女 5 088 33.4(31.6~35.2) 48.5(46.5~50.5) 60.7(58.8~62.6) 18.3(16.4~20.4) 71.5(69.7~73.2) χ2值 2.30 0.55 0.90 2.32 0.01 P值 0.28 0.61 0.51 0.30 0.98 父母吸烟状态a 父母中有人吸烟 5 434 60.5(58.5~62.3) 57.0(55.1~58.9) 66.3(64.5~68.1) 21.0(19.2~23.0) 81.5(79.9~83.1) 父母均不吸烟 4 921 8.7(7.7~9.9) 41.1(39.1~43.1) 54.4(52.4~56.4) 16.8(15.0~18.8) 61.9(59.9~63.8) χ2值 3 074.79 263.12 153.09 19.69 490.46 P值 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 好友吸烟状态b 好友中有人吸烟 3 556 42.6(40.1~45.2) 62.2(59.5~64.8) 70.7(68.1~73.1) 26.7(24.0~29.5) 81.2(78.8~83.5) 好友均不吸烟 6 974 30.2(28.8~31.7) 42.7(41.1~44.3) 55.5(53.9~57.1) 15.2(13.8~16.7) 67.0(65.5~68.5) χ2值 156.95 344.23 218.61 132.37 226.52 P值 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 在课堂上学习过 学习过 5 129 33.0(31.2~34.8) 47.2(45.3~49.2) 57.3(55.4~59.2) 17.9(16.1~19.8) 68.7(66.8~70.5) 吸烟危害a 没有学习过 3 734 35.9(33.8~38.0) 51.3(49.1~53.6) 64.1(61.9~66.2) 21.3(19.1~23.7) 75.3(73.2~77.2) χ2值 8.24 15.00 42.55 10.99 47.42 P值 0.04 < 0.01 < 0.01 0.02 < 0.01 合计 10 532 34.1(32.9~35.4) 48.9(47.5~50.2) 60.3(58.9~61.6) 19.1(17.8~20.4) 71.5(70.2~72.7) 注： ()内数字为95%CI; a删除了“不知道”选项数据，b缺失2份数据。 
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表 2 北京市不同年级和性别中学生看到学校有人吸烟比例比较/%
Table 2. Comparison of the proportion of middle school students in different grades and genders who saw smokers smoking in schools in Beijing/%
年级与性别 人数 统计值 看到有人在学校的建筑物内或室外吸烟 几乎每天看见教师吸烟 年级 初一 1 863 23.7(21.2~26.4) 1.2(0.7~2.0) 初二 1 759 34.0(31.2~37.0) 2.3(1.6~3.5) 初三 1 749 32.3(29.6~35.2) 3.7(2.8~4.8) 高一 1 778 26.9(24.1~29.9) 2.1(1.3~3.5) 高二 1 769 37.7(34.3~41.2) 3.9(2.8~5.5) 高三 1 614 36.1(31.9~40.5) 5.3(3.1~9.1) χ2值 125.18 69.92 P值 < 0.01 < 0.01 性别 男 5 444 37.1(35.2~39.0) 4.3(2.5~7.5) 女 5 088 25.7(23.9~27.5) 1.5(1.0~2.3) χ2值 158.27 71.58 P值 < 0.01 < 0.01 总体 10 532 31.6(30.3~32.9) 3.0(2.5~3.6) 注： ()内数字为95%CI。
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表 3 北京市中学生4类场所二手烟暴露多因素Logistic分析(n=10 532)
Table 3. Multivariate Logistic analysis on the exposure to secondhand smoke in four types of places among middle school students in Beijing(n=10 532)
自变量 选项 β值 标准误 Wald χ2值 P值 OR值(OR值95%CI) 年级 初二 -0.03 0.11 0.09 0.76 0.97(0.79~1.19) 初三 0.12 0.11 1.28 0.26 1.13(0.91~1.40) 高一 -0.31 0.11 7.67 < 0.01 0.73(0.59~0.91) 高二 -0.37 0.12 9.15 < 0.01 0.69(0.55~0.88) 高三 -0.39 0.13 8.66 < 0.01 0.68(0.52~0.88) 性别 男 -0.03 0.07 0.17 0.68 0.97(0.85~1.12) 课堂上学习过烟 是 -0.30 0.07 16.88 < 0.01 0.74(0.64~0.86) 草危害 父母中有人吸烟 是 0.96 0.07 184.65 < 0.01 2.62(2.28~3.01) 好友中有人吸烟 是 0.76 0.09 67.57 < 0.01 2.13(1.78~2.55)
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表 4 北京市中学生家庭场所二手烟暴露多因素Logistic回归分析(n=10 532)
Table 4. Multivariate Logistic analysis on the exposure to secondhand smoke at home among middle school students in Beijing(n=10 532)
自变量 选项 β值 标准误 Wald χ2值 P值 OR值(OR值95%CI) 年级 初二 -0.07 0.12 0.37 0.54 0.93(0.74~1.17) 初三 -0.23 0.12 3.85 0.05 0.79(0.63~1.00) 高一 -0.44 0.12 12.44 < 0.01 0.65(0.51~0.82) 高二 -0.59 0.13 22.38 < 0.01 0.55(0.43~0.71) 高三 -0.40 0.15 7.58 0.01 0.67(0.50~0.89) 性别 男 0.16 0.08 4.69 0.03 1.18(1.02~1.36) 父母中有人 是 2.79 0.09 1 056.04 < 0.01 16.35(13.82~19.35) 吸烟 好友中有人 是 0.43 0.09 26.29 < 0.01 1.54(1.31~1.82) 吸烟
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表 5 北京市中学生室外公共场所二手烟暴露多因素Logistic回归分析(n=10 532)
Table 5. Multivariate Logistic analysis on the exposure to secondhand smoke at outside public places among middle school students in Beijing(n=10 532)
自变量 选项 β值 标准误 Wald χ2值 P值 OR值(OR值95%CI) 年级 初二 0.13 0.10 1.83 0.18 1.14(0.94~1.38) 初三 0.22 0.10 5.07 0.02 1.25(1.03~1.51) 高一 0.02 0.10 0.05 0.82 1.02(0.84~1.25) 高二 -0.14 0.11 1.63 0.20 0.87(0.70~1.08) 高三 -0.08 0.12 0.52 0.47 0.92(0.73~1.16) 课堂上学习过烟 是 -0.27 0.06 17.22 < 0.01 0.77(0.68~0.87) 草危害 父母中有人吸烟 是 0.47 0.06 55.03 < 0.01 1.60(1.41~1.81) 好友中有人吸烟 是 0.65 0.08 73.07 < 0.01 1.92(1.65~2.23)
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