Tobacco epidemic and related factors among junior high school students in Beijing in 2019 and 2023
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摘要:
目的 了解2019和2023年北京市初中学生烟草流行情况和相关因素，为有效开展北京市初中生控烟活动提供参考依据。 方法 于2019和2023年4—6月，采用按容量比例概率抽样法(PPS)进行抽样，两年分别有6 489和6 898名初中生接受问卷调查，共计13 387人。采用自填方式完成北京市中学生烟草监测调查问卷，内容包括人口学特征、二手烟暴露、烟草制品的使用、对烟草的态度和认识等。采用χ2检验进行率的比较、多因素Logistic回归模型分析现在吸烟的影响因素。 结果 2019年北京市在校初中生现在吸传统卷烟率和现在吸电子烟率分别为1.34%，1.88%，2023年分别下降至0.81%，1.06%(χ2值分别为8.36，15.17，P值均＜0.01)；2019年北京市在校初中生尝试吸传统卷烟率和尝试吸电子烟率分别为6.67%，6.47%，2023年分别下降至3.93%，4.16%(χ2值分别为49.99，35.26，P值均＜0.01)。2019年在家中、室内公共场所、室外公共场所的初中生二手烟暴露率分别为31.04%，44.94%和49.88%，2023年下降至22.59%，30.23%和36.14%(χ2值分别为121.63，308.60，257.41，P值均 < 0.01)。2023年男生(OR=2.88)、高年级(初二、初三)(OR值分别为4.37，4.92)、可支配零花钱>20元/周(OR=2.01)、家中(OR=2.74)和室内公共场所(OR=2.64)二手烟暴露、认为吸烟使年轻人看起来更具吸引力(OR=6.29)以及认为电子烟能够帮助戒烟(OR=4.31)的初中生使用烟草的风险更高(P值均 < 0.05)。 结论 北京市初中生烟草使用、二手烟暴露等情况整体下降。应继续对初中生进行控烟干预、重点关注电子烟的使用，促使学生身心健康发展。 Abstract:Objective To understand the prevalence and related factors of tobacco use among junior high school students in Beijing, so as to provide evidence to effectively conduct tobacco control intervention strategy. Methods From April to June in 2019 and 2023, 6 489 and 6 898 junior high school students were selected by the probability proportion to size(PPS) method, and a total of 13 387 questionnaires were completed. Questionnaire on tobacco monitoring among junior high school students in Beijing was completed by self-filling. The monitoring content included demographic information, second-hand smoke exposure, tobacco product use, tobacco awareness, etc. Chi-square test was used to compare the difference of various indicators in different groups, and multivariate Logistic regression analysis was adopted to analysis the influencing factors related to the current smoking among junior high school students. Results In 2019, the current traditional cigarettes and e-cigarette smoking rates among junior high school students in Beijing were 1.34%, 1.88%, respectively, and decreased to 0.81%, 1.06% in 2023 (χ2=8.36, 15.17, P < 0.01). The attempted traditional cigarettes and e-cigarette smoking rates among junior high school students in Beijing decreased from 6.67%, 6.47% in 2019 to 3.93%, 4.16% in 2023 (χ2=49.99, 35.26, P < 0.01). In 2019, the second-hand smoke exposure rates of junior high school students at homes, indoor public places, and outdoor public places were 31.04%, 44.94%, and 49.88% respectively which decreased to 22.59%, 30.23%, and 36.14% in 2023 (χ2=121.63, 308.60, 257.41, P < 0.01). In 2023, male students (OR=2.88), senior students (grade 2 and 3) (OR=4.37, 4.92), disposable pocket money>20 yuan/week (OR=2.01), second-hand smoke exposure at home (OR=2.74), indoor public places (OR=2.64), perception that smoking makes young people more attractive (OR=6.29), and perception that e-cigarettes help quit smoking (OR=4.31) were associated with higher tobacco use (P < 0.05). Conclusions Tobacco use and second-hand smoke among junior high school students in Beijing decrease significantly. Tobacco control interventions should be provided for junior high school students continuously with a focus on e-cigarettes use to promote physical and mental health development among students. -
Key words:
- Tobacco /
- Smoking /
- Regression analysis /
- Students
1) 利益冲突声明 所有作者声明无利益冲突。2) 秦冉与王一凡为共同第一作者。 -
表 1 北京市不同人口学特征初中生2019与2023年现在吸传统卷烟和尝试吸传统卷烟率比较
Table 1. Comparison of current and attempted traditional cigarettes smoking rates among junior high school students in Beijing in 2019 and 2023
人口学指标 选项 现在吸传统卷烟 尝试吸传统卷烟 2019年 2023年 χ2值 P值 2019年 2023年 χ2值 P值 性别 女 30(0.96) 13(0.39) 7.02 0.01 133(4.23) 90(2.70) 11.08 < 0.01 男 57(1.70) 43(1.21) 2.62 0.11 300(8.96) 181(5.09) 39.38 < 0.01 年级 初一 22(0.98) 6(0.24) 9.56 ＜0.01 112(4.98) 81(3.28) 8.20 < 0.01 初二 30(1.33) 24(1.06) 0.47 0.49 155(6.86) 90(3.98) 17.71 < 0.01 初三 35(1.77) 26(1.20) 1.94 0.16 166(8.38) 100(4.61) 23.98 < 0.01 城乡 城区 38(1.43) 16(0.50) 12.75 ＜0.01 167(6.30) 79(2.48) 51.60 < 0.01 郊区 49(1.28) 40(1.08) 0.47 0.49 266(6.93) 192(5.18) 9.82 < 0.01 住校 否 66(1.10) 50(0.77) 3.34 0.07 362(6.03) 241(3.71) 36.04 < 0.01 是 21(4.37) 6(1.51) 5.06 0.03 71(14.76) 30(7.54) 10.47 < 0.01 父母吸烟情况 均不吸烟 27(0.85) 14(0.36) 6.25 0.01 143(4.50) 102(2.65) 17.07 < 0.01 至少有一方吸烟 60(1.81) 42(1.38) 1.66 0.20 290(8.76) 169(5.53) 24.21 < 0.01 每周可支配零 ≤20 42(0.84) 30(0.57) 2.26 0.13 276(5.52) 179(3.41) 26.25 < 0.01 花钱/元a >20 43(2.89) 26(1.57) 5.72 0.02 156(10.48) 92(5.57) 25.38 < 0.01 合计 87(1.34) 56(0.81) 8.36 ＜0.01 433(6.67) 271(3.93) 49.99 < 0.01 注： a表示有缺失数据。 
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表 2 北京市不同人口学特征初中生2019与2023年现在吸电子烟和尝试吸电子烟率比较
Table 2. Comparison of current and attempted e-cigarette use among junior high school students in Beijing in 2019 and 2023
人口学指标 选项 现在吸电子烟 尝试吸电子烟 2019年 2023年 χ2值 P值 2019年 2023年 χ2值 P值 性别 女 36(1.15) 28(0.84) 1.27 0.26 118(3.76) 97(2.91) 3.40 0.07 男 86(2.57) 45(1.26) 15.08 < 0.01 302(9.02) 190(5.34) 34.79 < 0.01 年级 初一 27(1.20) 18(0.73) 2.28 0.13 98(4.36) 87(3.53) 1.94 0.16 初二 51(2.26) 37(1.64) 1.96 0.16 154(6.82) 97(4.29) 13.26 < 0.01 初三 44(2.22) 18(0.83) 12.72 < 0.01 168(8.48) 103(4.75) 23.10 < 0.01 城乡 城区 46(1.74) 18(0.56) 17.28 < 0.01 151(5.70) 79(2.48) 38.90 < 0.01 郊区 76(1.98) 55(1.48) 2.44 0.12 269(7.01) 208(5.61) 5.97 0.02 住校 否 107(1.78) 64(0.98) 14.10 < 0.01 361(6.01) 254(3.91) 29.03 < 0.01 是 15(3.12) 9(2.26) 0.32 0.57 59(12.27) 33(8.29) 3.26 0.07 父母吸烟情况 均不吸烟 38(1.20) 18(0.47) 10.74 < 0.01 138(4.34) 112(2.91) 9.93 < 0.01 至少有一方吸烟 84(2.54) 55(1.80) 3.69 0.06 282(8.52) 175(5.73) 18.10 < 0.01 每周可支配零 ≤20 66(1.32) 38(0.72) 8.44 < 0.01 259(5.18) 159(3.03) 29.61 < 0.01 花钱/元a >20 56(3.76) 34(2.06) 7.59 0.01 160(10.75) 127(7.68) 8.52 < 0.01 合计 122(1.88) 73(1.06) 15.17 < 0.01 420(6.47) 287(4.16) 35.26 < 0.01 注： a表示有缺失数据。
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表 3 北京市不同人口学特征初中生2019与2023年二手烟暴露率比较
Table 3. Comparison of second-hand smoke exposure among junior high school students in Beijing in 2019 and 2023
人口学指标 选项 家中 室内公共场所 室外公共场所 2019年 2023年 χ2值 2019年 2023年 χ2值 2019年 2023年 χ2值 性别 女 939(29.89) 732(21.92) 53.34** 1 393(44.35) 987(29.56) 151.69** 1 596(50.81) 1 194(35.76) 148.96** 男 1 075(32.11) 826(23.21) 68.06** 1 523(45.49) 1 098(30.85) 156.37** 1 641(49.01) 1 299(36.50) 110.02** 年级 初一 714(31.73) 584(23.66) 38.04** 1 025(45.56) 745(30.19) 117.95** 1 117(49.64) 885(35.86) 91.00** 初二 708(31.34) 521(23.05) 38.78** 1 031(45.64) 732(32.39) 82.81** 1 152(51.00) 892(39.47) 60.13** 初三 592(29.90) 453(20.88) 44.27** 860(43.43) 608(28.02) 106.96** 968(48.89) 716(33.00) 107.80** 城乡 城区 680(25.67) 585(18.34) 45.41** 1 211(45.72) 1 100(34.48) 75.89** 1 460(55.12) 1 422(44.58) 63.88** 郊区 1 334(34.74) 973(26.24) 63.81** 1 705(44.40) 985(26.56) 260.88** 1 777(46.28) 1 071(28.88) 242.14** 住校 否 1 884(31.36) 1 454(22.37) 128.48** 2 735(45.52) 1 984(30.52) 298.35** 3 049(50.75) 2 398(36.89) 243.29** 是 130(27.03) 104(26.13) 0.05 181(37.63) 101(25.38) 14.45** 188(39.09) 95(23.87) 22.41** 父母吸烟情况 均不吸烟 236(7.43) 166(4.32) 30.56** 1 129(35.53) 860(22.37) 147.60** 1 353(42.57) 1 141(29.68) 125.68** 至少有一方吸烟 1 778(53.70) 1 392(45.58) 41.58** 1 787(53.97) 1 225(40.11) 121.87** 1 884(56.90) 1 352(44.27) 100.91** 每周可支配零 ≤20 1 534(30.69) 1 128(21.52) 111.32** 2 227(44.55) 1 544(29.45) 249.96** 2 507(50.15) 1 881(35.88) 212.10** 花钱/元a >20 479(32.19) 427(25.83) 15.12** 688(46.24) 540(32.67) 59.98** 728(48.92) 610(36.90) 45.80** 合计 2 014(31.04) 1 558(22.59) 121.63** 2 916(44.94) 2 085(30.23) 308.60** 3 237(49.88) 2 493(36.14) 257.41** 注： a表示有缺失数据；**P < 0.01。
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表 4 北京市初中生现在吸传统卷烟相关因素多因素Logistic回归分析
Table 4. Multivariate Logistic regression analysis of current traditional cigarettes smoking related factors among junior high school students in Beijing
常数项与自变量 选项 2019年(n=6 489) 2023年(n=6 898) β值 标准误 Wald χ2值 P值 OR值(95%CI) β值 标准误 Wald χ2值 P值 OR值(95%CI) 常数项 -7.42 0.62 142.17 < 0.01 -10.09 0.89 129.12 < 0.01 性别 女 1.00 1.00 男 0.58 0.24 5.91 0.02 1.78(1.12~2.85) 1.06 0.33 10.24 < 0.01 2.88(1.51~5.50) 年级 初一 1.00 1.00 初二 0.26 0.29 0.81 0.37 1.30(0.73~2.31) 1.47 0.47 9.87 < 0.01 4.37(1.74~10.95) 初三 0.51 0.29 3.08 0.08 1.66(0.94~2.93) 1.59 0.47 11.65 < 0.01 4.92(1.97~12.28) 住校 否 1.00 1.00 是 1.39 0.29 23.43 < 0.01 4.01(2.28~7.03) 0.33 0.48 0.47 0.50 1.39(0.54~3.56) 每周可支配零花钱/元 ≤20 1.00 1.00 >20 1.16 0.23 25.90 < 0.01 3.20(2.05~5.01) 0.70 0.29 5.68 0.02 2.01(1.13~3.58) 二手烟暴露在家中 否 1.00 1.00 是 1.39 0.32 19.05 < 0.01 4.03(2.16~7.53) 1.01 0.39 6.55 0.01 2.74(1.27~5.94) 二手烟暴露在室内公共场所 否 1.00 1.00 是 0.73 0.38 3.69 0.05 2.07(0.99~4.33) 0.97 0.47 4.26 0.04 2.64(1.05~6.62) 认为开始吸烟后很难戒掉 否 1.00 1.00 是 -0.71 0.26 7.39 0.01 0.49(0.29~0.82) -0.42 0.31 1.89 0.17 0.66(0.36~1.20) 认为吸烟使年轻人看起来 否 1.00 1.00 更具吸引力 是 1.97 0.25 64.89 < 0.01 7.20(4.46~11.65) 1.84 0.31 34.64 < 0.01 6.29(3.41~11.61) 认为电子烟能帮助戒烟 否 1.00 1.00 是 -0.11 0.26 0.16 0.69 0.90(0.54~1.51) 1.46 0.29 24.92 < 0.01 4.31(2.43~7.66)
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