青春期性发育对青少年吸烟行为的影响

The contribution of pubertal maturation timing to adolescent smoking behavior

目的 研究青春期性发育早晚对青少年吸烟行为的影响。方法 2 0 0 0年 11月对随机整群抽取的 14 5 3名上海市高中学生进行横断面问卷调查 ,获取青少年吸烟、男孩首次遗精年龄、女孩月经初潮年龄及可能影响青少年吸烟的社会心理因素等信息。结果 男生的尝试吸烟率在性发育较晚组中最高 (2 8.6 % ) ,其次为发育较早 (2 1.3% )和中等组 (2 1.7% ) ;现在吸烟率在性发育较早组最高(16 .4 % ) ,然后依次为发育较晚 (7.1% )和中等组 (4.8% ) ;女生的曾经吸烟率在性发育早、中、晚各组中依次为 2 4 .2 %、12 .0 %、6 .3%。在控制影响青少年吸烟的一系列社会心理因素后 ,性发育较早是导致男生现在吸烟的独立危险因素 (OR =3.6 8,95 %CI :1.2 3～ 10 .99) ,也是女生吸烟的危险因素(OR =2 .2 3,95 %CI:0 .89～ 5 .6 0 ) ;而性发育较晚可能导致男生尝试吸烟 (OR =1.4 8,95 %CI :0 .72～ 3.0 6 ) ,对女生却可能有一定的保护作用 (OR =0 .6 4 ,95 %CI:0 .2 2～ 1.86 )。结论 学校、家庭和社会应该关心、引导性发育时间偏离正常的男女青少年 。

Objective To study the contribution of puberty maturation to smoking behavior in Chinese adolescents. Methods A cross sectional survey was carried out. One thousand four hundred and fifty three senior middle school students aged from 15 18 years were recruited in Shanghai in 2000. A standardized self administrated questionnaire was designed to obtain information on smoking, age at first nocturnal ejaculation in boys, age at menarche in girls and variables that might be associated with smoking in adolescents. Results In boys, the prevalence of experimental smoking was highest among later maturers ( 28.6 %), followed by the earlier ( 21.3 %) and the average ( 21.7 %), and the prevalence of current smoking was highest among earlier maturers ( 16.4 %), followed by the later ( 7.1 %) and then the average ( 4.8 %). In girls, the prevalence of ever smoked among earlier, average and later maturers were as follows: 24.2 %, 12.0 %, 6.3 % respectively. When psychosocial variables which might be associated with smoking were under control, early maturation was a significant risk factor for current smoking in boys ( OR = 3.68 , 95% CI : 1.23 10.99 ), and might be a risk factor for ever smoked in girls ( OR = 2.23 ,95% CI : 0.89 5.60 ). Whereas late maturation might have been a risk factor for boys to experiment smoking ( OR = 1.48 , 95% CI : 0.72 3.06), while in girls it might be protective ( OR = 0.64 ,95% CI : 0.22 1.86 ). Conclusion Earlier or later matured boys and earlier matured girls were at higher risk of smoking. Pubertal changes and timing need to be considered in smoking prevention.