Epidemiology and associated factors of smoking behavior among adolescents in Tibet in 2019
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摘要:
目的 了解西藏青少年烟草使用现状及影响因素, 为开展有针对性的控烟干预提供技术依据。 方法 于2019年8—10月, 采用与人口数量规模成比例的整群抽样方法抽取西藏4 983名学生进行问卷调查, 采用χ2检验和非条件Logistic回归分析探讨西藏青少年现在吸烟率的相关因素。 结果 2019年西藏青少年现在吸烟率为11.3%(563/4 983), 尝试吸烟率为21.8%(1 086/4 983), 二手烟暴露率为62.4%(3 111/4 983)。82.9%的吸烟者表示想要戒烟, 79.9%的吸烟者在过去12个月内有过尝试戒烟行为, 仅有11.7%的吸烟者表示受到过专业人员的戒烟帮助或建议。Logistic回归分析结果显示, 城市(OR=2.38)、三年级(OR=1.51)、学校类型为普通高中(OR=2.90)或职业高中(OR=3.53)、男生(OR=16.93)、每周零花钱≥50元(OR=1.93)、暴露于二手烟(OR=16.12)、认为二手烟可能会(OR=1.40)或可能不会(OR=4.89)产生危害、暴露于烟草广告(OR=1.83)、朋友吸烟(OR=7.47)、几乎每天能看到教师吸烟(OR=1.79)与青少年现在吸烟行为均呈正相关; 认为吸烟行为能减少吸引力(OR=0.54)与青少年现在吸烟行为呈负相关(P值均 < 0.05)。 结论 2019年西藏青少年吸烟及尝试吸烟行为较普遍, 二手烟暴露问题较严重, 职业高中学生是开展控烟干预的重点人群, 学校为控烟干预的重点场所。 Abstract:Objective To understand the current status and associated factors of smoking behavior among adolescents in Tibet. Methods From August to October 2019, 4 983 students were selected by PPS and cluster sampling for questionnaire survey. The Chi-square test and unconditional Logistic regression analysis were used to explore associated factors of smoking among adolescents in Tibet. Results In 2019, current smoking rate of Tibetan adolescents was 11.3% (563/4 983), attempted smoking rate was 21.8% (1 086/4 983), and the rate of second-hand smoke exposure was 62.4% (3 111/4 983). Among the 563 current smokers, 82.9% reported they wanted to quit smoking, 79.9% had made a quit attempt in the past 12 months, and only 11.7% received help or advice from professionals. Logistic regression analysis showed that city (OR=2.38), third grade (OR=1.51), high school (OR=2.90) or vocational high school (OR=3.53), boys (OR=16.93), pocket money ≥50 yuan per week (OR=1.93), exposure to second-hand smoke (OR=16.12), awareness of harm from second-hand smoke (OR=1.40), no awareness of harm from second-hand smoke (OR=4.89), exposure to tobacco advertising (OR=1.83), friend smoking (OR=7.47) and observing teacher smoking every day (OR=1.79) were associated with more teenagers' current smoking behaviors. Perceived low attractiveness in smoking behavior (OR=0.54) was associated with lower teenagers' current smoking behavior(P < 0.05). Conclusion Smoking and attempted smoking are common among Tibetan adolescents in 2019, and second-hand smoke exposure is serious. Vocational high school students are the key population for tobacco control intervention, and schools are the primary places for tobacco control intervention. -
Key words:
- Smoking /
- Behaivor /
- Tobacco smoke pollution /
- Regression analysis /
- Adolescent /
- Minority groups
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 不同人口学特征西藏青少年吸烟情况比较
Table 1. Comparison smoking status among Tibetan adolescent with different demographic characteristics
人口学指标 选项 人数 统计值 现在吸烟 尝试吸烟 性别 男 2 242 534(23.8) 897(40.0) 女 2 741 29(1.1) 189(6.9) χ2值 637.46 793.39 P值 < 0.01 < 0.01 城乡 城市 2 908 372(12.8) 749(25.8) 农村 2 075 191(9.2) 337(16.2) χ2值 15.55 64.33 P值 < 0.01 < 0.01 学段 初中 2 831 223(7.9) 438(15.5) 高中 1 712 274(16.0) 553(32.3) 职高 440 66(15.0) 95(21.6) χ2值 76.92 177.30 P值 < 0.01 < 0.01 年级 一 1 592 140(8.8) 284(17.8) 二 1 660 188(12.9) 377(22.7) 三 1 731 235(13.6) 425(24.6) χ趋势2值 18.90 21.66 P值 < 0.01 < 0.01 注：()内数字为报告率/%。 
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表 2 不同人口学特征西藏青少年二手烟暴露情况比较
Table 2. Comparison of secondhand smoke exposure among Tibetan adolescents with different demographic characteristics
人口学指标 选项 人数 统计值 家庭 室内公
共场所室外公
共场所公共交
通工具性别 男 2 242 645(28.8) 1 236(55.1) 1 283(57.2) 512(38.1) 女 2 741 482(17.6) 1 170(42.7) 1 188(43.3) 552(34.8) χ2值 88.14 76.48 95.10 3.46 P值 < 0.01 < 0.01 < 0.01 0.06 城乡 城市 2 908 692(23.8) 1 503(51.7) 1 574(54.1) 731(36.2) 农村 2 075 435(21.0) 903(43.5) 897(43.2) 333(36.6) χ2值 5.55 32.35 57.53 0.05 P值 0.02 < 0.01 < 0.01 0.82 学段 初中 2 831 601(21.2) 1 229(43.4) 1 231(43.5) 492(36.0) 高中 1 712 445(26.0) 1 040(60.7) 1 079(63.0) 494(40.2) 职高 440 81(18.4) 137(31.1) 161(36.6) 78(23.2) χ2值 18.72 185.23 195.61 33.10 P值 < 0.01 < 0.01 < 0.01 < 0.01 年级 一 1 592 353(22.2) 757(47.6) 779(48.9) 299(32.0) 二 1 660 408(24.6) 837(50.4) 852(51.3) 379(37.8) 三 1 731 366(21.1) 812(46.9) 840(48.5) 386(38.8) χ2值 5.97 4.69 3.06 11.06 P值 0.05 0.10 0.22 < 0.01 注：()内数字为暴露率/%。
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表 3 西藏青少年现在吸烟行为Logistic回归分析(n=4 983)
Table 3. Logistic regression analysis of current smoking behavior of Tibetan adolescents(n=4 983)
常量与自变量 选项 β值 标准误 Wald χ2值 P值 OR值(OR值95%CI) 城乡 农村 1.00 城市 0.87 0.23 13.77 < 0.01 2.38(1.50~3.75) 年级 一 1.00 二 0.17 0.15 1.29 0.26 1.19(0.88~1.60) 三 0.41 0.14 8.27 < 0.01 1.51(1.14~2.01) 学段 初中 1.00 高中 1.06 0.24 20.46 < 0.01 2.90(1.83~4.59) 职高 1.26 0.29 19.48 < 0.01 3.53(2.02~6.19) 性别 女 1.00 男 2.83 0.21 191.23 < 0.01 16.93(12.94~25.28) 每周可支配零花钱/元 ≤10 1.00 11~30 0.33 0.23 2.09 0.15 1.39(0.89~2.16) 31~ < 50 0.51 0.22 5.21 0.02 1.66(1.07~2.56) ≥50 0.66 0.21 9.58 < 0.01 1.93(1.27~2.92) 二手烟暴露 否 1.00 是 2.78 0.29 94.29 < 0.01 16.12(9.20~28.24) 二手烟危害认知 有 1.00 没有 -0.11 0.41 0.08 0.78 0.89(0.40~1.99) 可能没有 1.59 0.30 28.20 < 0.01 4.89(2.72~8.79) 可能有 0.34 0.14 6.16 0.01 1.40(1.07~1.84) 烟草广告暴露 否 1.00 是 0.60 0.12 26.42 < 0.01 1.83(1.45~2.30) 父母吸烟情况 都不吸烟 1.00 父母有人吸烟 0.18 0.13 2.13 0.14 1.20(0.94~1.54) 朋友吸烟情况 没人吸烟 1.00 有人吸烟 2.01 0.17 144.64 < 0.01 7.47(5.39~10.37) 吸烟行为的吸引力 更有吸引力 1.00 减少吸引力 -0.62 0.14 19.24 < 0.01 0.54(0.41~0.71) 无差别 -0.25 0.16 2.61 0.11 0.78(0.58~1.06) 看到教师吸烟频率 从未见过 1.00 几乎每天 0.59 0.21 7.53 0.01 1.79(1.18~2.73) 有时 -0.05 0.20 0.07 0.79 0.95(0.65~1.39) 不知道 -0.10 0.28 0.12 0.73 0.91(0.52~1.58) 常量 -9.64 0.49 390.52 < 0.01
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