健康促进学校初中生控制吸烟干预效果评价

Effect of health promotion school model on smoking prevention and control in secondary school students

目的评价健康促进学校模式预防和控制青少年吸烟的一年干预效果。方法在广州市黄埔区4所中学进行专项预防和控制初中生吸烟的随机对照试验(n=2 343),通过1年的随访评价其干预效果。结果干预组学生的吸烟相关知识平均分由基线调查时的9.0分增至1年后的11.5分,对照组则由8.1分上升至9.5分,前者增幅高于后者。干预前,对照组和干预组学生的尝试吸烟率分别为21.5%和18.6%,两者差异无统计学意义(P>0.05);干预后,对照组的尝试吸烟率升至25.8%,干预组的升至21.5%,两者差异有统计学意义(P<0.05)。基线时2组每周吸烟率差异无统计学意义(对照组和干预组分别为5.1%和4.1%,P>0.05),1年后差异有统计学意义(对照组9.8%,干预组5.3%,P<0.001)。同期,对照组的现在吸烟率由3.88%升至7.27%,而干预组的由2.54%升至4.26%,后者升幅低于前者。对照组规律吸烟学生的尝试戒烟率由2004年的72.5%降至2005年的65.6%,而干预组的则明显上升。结论本研究的干预措施明显提高了学生们吸烟相关知识得分,一定程度上抑制了学生吸烟行为的快速增长,但对吸烟相关态度的影响较小。将健康促进学校模式应用于青少年控烟可行有效,值得推广。

Objective To evaluate the effect of health promotion school model smoking prevention and control in adolescence. Methods A cluster randomized control trial was conducted among the 2 343 adolescents in four secondary schools in Huangpu district of Guangzhou and the intervention effect was evaluated after one year. Results The average score of smoking- related knowledge for the experimental group increased from 9.0 at baseline to 11.5 after one year while it increased from 8.1 to 9.5 for the control group; and the rise was higher in the experimental group than in the control group. At the baseline, the prevalence of experimental smoking in the control group and the experimemal group was 21.5 % and 18.6 % respectively, and the difference between them was not significant（ P 〈 0.05 ）. But after one year of the intervention, the prevalence of experimental smoking increased to 21.5 % in the intervention group while that to 25.8 % in the control group, and the difference between them was statistically significant （ P 〈 0.05 ）. Similarly, there was no significant difference for the prevalence of weekly smoking between the two groups at baseline（5.1% in the control group vs. 4.1% in the experimental group, P 〉 0.05）, but a significant difference was obtained after one year of the intervention（9.8 % in the control group vs. 5.3 % in the experimental group, P 〈 0.001 ）. Concurrently, the prevalence of current smoking increased from 3.88 % at the baseline to 7.27 % for the control group while it did from 2.54 % to 4.26＇% for the experimental group after one-year intervention, and the increase of the later was lower than the former. The prevalence of quitting smoking in the regular smokers of the control group decreased from 72.5 % at the baseline to 65.6 % after one-year intervention, on the contrary, the prevalence of quitting smoking increased in the experimental group. Conclusion The intervention measures could improve the students＇ smoking - related knowledge, and partly prohibited the increasing of smoking prevalence among them, but had less impact on smoking - related attitude. Therefore, it is applicable and valuable for us to prevent and control smoking among Chinese adolescents with health promotion school model.