基于多水平模型的重庆市青少年吸烟行为相关因素分析

金嘉民; 代佳男; 易静

doi:10.16835/j.cnki.1000-9817.2023.12.011

基于多水平模型的重庆市青少年吸烟行为相关因素分析

doi: 10.16835/j.cnki.1000-9817.2023.12.011

1.
重庆医科大学公共卫生学院医学与社会发展研究中心, 重庆 400016
2.
重庆市健康教育所

详细信息

作者简介:
金嘉民(1994-)，男，黑龙江佳木斯人，在读硕士，主要研究方向为烟草调查与控制、健康促进

通讯作者:
易静，E-mail: yijinga@sina.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: C913.5 F768.29 B844.2
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出版历程
- 收稿日期: 2023-06-20
- 修回日期: 2023-10-18
- 网络出版日期: 2023-12-26
- 刊出日期: 2023-12-25

Associated factors on smoking behavior among adolescents in Chongqing based on a multi-level model

JIN Jiamin¹,
DAI Jianan²,
YI Jing^{1
, ,}

1.
Medical and Social Development Research Center, School of Public Health, Chongqing Medical University, Chongqing (400016), China

摘要

摘要: 目的了解重庆市青少年吸烟行为现状及在个体和学校两个水平上的相关因素, 为青少年烟草控制对策的制定提供科学依据。方法 2021年9-10月在重庆市开展青少年烟草流行监测, 采用多阶段分层整群概率抽样法, 选取重庆市10个监测区县的9 588名在校生完成中国青少年烟草流行调查问卷。采用多水平Logistic回归模型, 对青少年吸烟行为现状及相关因素进行分析。结果重庆市青少年尝试吸烟率为17.1%, 现在吸烟率为3.9%, 青少年吸烟行为在学校水平上存在聚集性。多水平Logistic回归模型显示, 普高、职高、男生、家中有人吸烟、在室内公共场所看到有人吸烟、看到有人在学校吸烟、好朋友中有人吸烟(有一些吸、大多数吸、全部吸)、社交场合吸烟感到更舒服、使用过电子烟与尝试吸烟均呈正相关(OR值分别为1.45, 1.40, 1.91, 1.50, 1.42, 1.43, 2.05, 5.38, 6.53, 1.36, 5.04, P值均 < 0.05);吸烟使人看起来减少吸引力和社交场合吸烟感到更不舒服与尝试吸烟均呈负相关(OR值分别为0.76, 0.58, P值均 < 0.05)。职高、男生、家中有人吸烟、在室内公共场所看到有人吸烟、好朋友中有人吸烟(有一些吸、大多数吸、全部吸)、使用过电子烟与现在吸烟均呈正相关(OR值分别为1.62, 1.67, 1.69, 1.83, 5.84, 23.02, 35.84, 6.28, P值均 < 0.05);社交场合吸烟感到更不舒服与现在吸烟呈负相关(OR=0.29, P < 0.01)。结论重庆市青少年尝试吸烟和现在吸烟行为在学校水平上存在聚集性, 影响因素涵盖学校类型、性别、家庭环境、社交因素等多个方面。应加强公共场所控烟条例的实施与拓宽实施范围, 通过社会-学校-家庭的合作促进青少年的健康成长。
- 吸烟 /
- 行为 /
- 回归分析 /
- 青少年 /
- 健康教育
Abstract: Objective To investigate the current status of smoking behavior among adolescents in Chongqing and associated factors at both individual and school levels, so as to provide scientific evidence for the development of smoking control strategies for adolescents. Methods From September to October 2021, adolescents'tobacco epidemic monitoring was carried out in Chongqing.A total of 9 588 students from 10 monitoring districts and counties in Chongqing were selected to complete the Chinese adolescent tobacco epidemic survey questionnaire by multi-stage stratified cluster probability sampling method.Multi-level Logistic regression model was used to analyze smoking behavior among adolescents and associated factors. Results The attempted smoking rate among young people was 17.1%, and the current smoking rate was 3.9% in Chongqing.There was a clustering of smoking behavior among participants the school level.Multi-level Logistic regression models showed that general high school, vocational high school, male students, smoking at home, seeing someone smoking in indoor public places, seeing someone smoking at school, smoking among good friends (some smoking, most smoking, all smoking), feeling more comfortable of smoking in social occasions, using electronic cigarette, which were positively correlated with smoking attempts (OR=1.45, 1.40, 1.91, 1.50, 1.42, 1.43, 2.05, 5.38, 6.53, 1.36, 5.04, P < 0.05).Smoking making people look less attractive and feeling more uncomfortable of smoking in social occasions were negatively correlated with smoking attempts (OR=0.76, 0.48, P < 0.05).Vocational high school, male students, smoking at home, seeing someone smoking in indoor public places, smoking among good friends and using electronic cigarette, which were positively correlated with smoking now (OR=1.62, 1.67, 1.69, 1.83, 5.84, 23.02, 35.84, 6.28, P < 0.05).Feeling more uncomfortable of smoking in social occasions was negatively correlated with current smoking (OR=0.29, P < 0.01). Conclusions There is a cluster of attempted smoking and current smoking behaviors at the school level among adolescents in Chongqing, and the influencing factors include school type, gender, family environment, social factors, etc.It should strengthen the implementation and broaden the scope of smoking control regulations in public places, and promote the healthy growth of young people through social school family cooperation.
- Smoking /
- Behavior /
- Regression analysis /
- Adolescent /
- Health education
注释:

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表 1 重庆市不同组别青少年吸烟行为报告率比较

Table 1. Comparison of reported smoking behaviors among different adolescent groups in Chongqing City

组别	选项	尝试吸烟				现在吸烟
组别	选项	人数	报告人数	χ²值	P值	人数	报告人数	χ²值	P值
学校类型	初中	4 648	590(12.8)	152.40	< 0.01	4 619	115(2.5)	129.42	< 0.01
	普高	3 364	644(20.0)			3 343	96(3.1)
	职高	1 573	436(24.4)			1 555	153(8.3)
性别	女	4 688	486(9.9)	351.38	< 0.01	4 673	81(1.8)	110.81	< 0.01
	男	4 897	1 184(24.4)			4 844	283(5.9)
在家中是否有人吸烟	否	6 785	938(13.5)	223.37	< 0.01	6 744	145(2.0)	202.34	< 0.01
	是	2 789	729(26.2)			2 765	217(8.2)
在室内公共场所是否看到有人吸烟	否	5 404	622(11.3)	315.74	< 0.01	5 381	85(1.6)	184.54	< 0.01
	是	4 154	1 039(25.2)			4 113	277(7.0)
在室外公共场所是否看到有人吸烟	否	5 007	586(11.4)	262.19	< 0.01	4 988	89(1.7)	148.89	< 0.01
	是	4 563	1 077(23.9)			4 515	274(6.5)
是否看到有人在学校吸烟	否	5 346	577(10.4)	400.33	< 0.01	5 322	110(2.0)	109.60	< 0.01
	是	4 236	1 092(25.9)			4 192	254(6.2)
父母吸烟情况	都不吸	4 148	599(14.3)	61.39	< 0.01	4 128	104(2.4)	59.36	< 0.01
	都吸	329	95(29.1)			326	28(9.8)
	只有父亲吸	4 848	904(18.2)			4 812	216(4.5)
	只有母亲吸	68	15(21.4)			66	3(4.6)
好朋友中是否有人吸烟	没人吸	6 762	651(9.3)	1 352.20	< 0.01	6 737	40(0.6)	1 791.24	< 0.01
	有一些吸	2 515	792(31.1)			2 484	187(7.6)
	大多数吸	231	167(72.4)			223	99(45.9)
	全部吸	73	59(80.7)			69	38(51.2)
吸烟是否使人看起来更有吸引力	无差别	2257	614(26.4)	295.10	< 0.01	2 237	172(7.8)	174.30	< 0.01
	减少吸引力	6 683	857(12.8)			6 643	137(2.1)
	更有吸引力	637	197(29.5)			629	55(7.8)
社交场合吸烟的感觉	无差别	954	335(36.2)	579.60	< 0.01	938	126(14.7)	677.14	< 0.01
	更不舒服	8 084	1 092(13.2)			8 041	139(1.7)
	更舒服	528	240(42.7)			519	99(17.9)
是否使用过电子烟	否	8 181	899(10.7)	1 554.22	< 0.01	8 150	95(1.2)	1 029.03	< 0.01
	是	1 397	768(53.2)			1 361	269(19.1)
注： ()内数字为加权后的报告率/%；数据均存在缺失值。

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表 2 青少年尝试吸烟行为两水平Logistic回归模型(n=9 588)

Table 2. Two-level Logistic regression model of adolescents' attempted smoking behavior (n=9 588)

模型	截距与自变量	选项	β值	标准误	Wald χ²值	P值	OR值(95%CI)
固定效应	截距		-2.83	0.14	419.06	< 0.01	0.06(0.05~0.08)
	水平2
	学校类型	普高	0.37	0.10	13.04	< 0.01	1.45(1.19~1.78)
		职高	0.34	0.14	5.81	0.02	1.40(1.07~1.84)
	水平1
	性别	男	0.65	0.07	85.43	< 0.01	1.91(1.67~2.19)
	在家中是否有人吸烟	是	0.41	0.08	27.94	< 0.01	1.50(1.29~1.75)
	在室内公共场所是否看到有人吸烟	是	0.35	0.09	16.56	< 0.01	1.42(1.20~1.69)
	是否看到有人在学校吸烟	是	0.36	0.07	25.42	< 0.01	1.43(1.24~1.65)
	好朋友中是否有人吸烟	有一些吸	0.72	0.07	96.47	< 0.01	2.05(1.78~2.36)
		大多数吸	1.68	0.18	84.58	< 0.01	5.38(3.76~7.70)
		全部吸	1.88	0.36	27.19	< 0.01	6.53(3.23~13.22)
	吸烟是否使人看起来更有吸引力	减少吸引力	-0.28	0.08	13.57	< 0.01	0.76(0.65~0.88)
		更有吸引力	0.09	0.13	0.52	0.47	1.10(0.85~1.41)
	社交场合吸烟的感觉	更不舒服	-0.54	0.10	30.65	< 0.01	0.58(0.48~0.71)
		更舒服	0.31	0.15	4.51	0.03	1.36(1.02~1.81)
	是否使用过电子烟	是	1.62	0.08	464.26	< 0.01	5.04(4.34~5.84)
随机效应	水平2		0.06	0.02	6.48	0.01
	水平1(尺度参数)		1.00	0.00

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表 3 青少年现在吸烟行为两水平Logistic回归模型(n=9 588)

Table 3. Two-level Logistic regression model of adolescents' current smoking behavior (n=9 588)

模型	截距与自变量	选项	β值	标准误	Wald χ²值	P值	OR值(95%CI)
固定效应	截距		-5.29	0.30	313.14	0.01	0.01(0.00~0.01)
	水平2
	学校类型	普高	-0.24	0.21	1.26	0.26	0.79(0.52~1.19)
		职高	0.48	0.24	4.03	0.04	1.62(1.01~2.59)
	水平1
	性别	男	0.51	0.16	10.41	< 0.01	1.67(1.22~2.28)
	在家中是否有人吸烟	是	0.52	0.16	11.10	< 0.01	1.69(1.24~2.30)
	在室内公共场所是否看到有人吸烟	是	0.60	0.19	10.07	< 0.01	1.83(1.26~2.65)
	好朋友中是否有人吸烟	有一些吸	1.77	0.20	76.35	< 0.01	5.84(3.94~8.67)
		大多数吸	3.14	0.26	145.48	< 0.01	23.02(13.82~38.35)
		全部吸	3.58	0.38	87.32	< 0.01	35.84(16.91~75.99)
	社交场合吸烟的感觉	更不舒服	-1.25	0.17	56.70	< 0.01	0.29(0.21~0.40)
		更舒服	-0.03	0.21	0.02	0.89	0.97(0.65~1.46)
	是否使用过电子烟	是	1.84	0.15	154.06	< 0.01	6.28(4.70~8.39)
随机效应	水平2		0.14	0.09	2.28	0.13
	水平1(尺度参数)		1.00	0.00

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