《上海市公共场所控制吸烟条例》对降低网吧被动吸烟水平的效果评估

The Effect Evaluation of Shanghai Smoke Control Legislation on Secondhand Smoking in Internet Cafes in Shanghai

目的评估《上海市公共场所控制吸烟条例》对降低网吧被动吸烟水平的效果。方法选择上海市中心城区、城乡结合区、郊区各一行政辖区,每个行政辖区抽取10家网吧,共30家网吧纳为研究对象。分别于《上海市公共场所控制吸烟条例》实施前3个月(2009年12月)及实施后5个月(2010年8月),对该30家网吧进行两次重复横断面调查,包括现场观察、环境PM2.5监测及网吧员工问卷调查。结果条例实施前抽样网吧室内外PM2.5浓度差值为623.79μg/m3,实施后为462.10μg/m(3t=1.37,P=0.181);中心城区网吧室内外PM2.5浓度差值从实施前821.38μg/m3下降为实施后369.78μg/m(3t=3.52,P<0.01)。员工在网吧场所的被动吸烟率从实施前63.93%下降为实施后36.36%(χ2=17.88,P<0.01);自报被动吸烟程度为"一般"或"严重"的百分率从74.36%下降为45.45%(χ2=10.19,P<0.01);每天被动吸烟小时数从(6.08±3.92)h下降为(4.23±4.44)h(t=2.37,P<0.05)。员工对网吧全面禁烟支持率从实施前49.47%上升为实施后75.14%(χ2=25.49,P<0.01);工作场所全面禁烟支持率从44.68%上升为66.48%(χ2=17.46,P<0.01);劝阻顾客吸烟行为意愿率从24.35%上升为79.10%(χ2=110.69,P<0.01)。结论《上海市公共场所控制吸烟条例》一定程度地降低网吧被动吸烟水平,但效果有限,该条例应得到进一步的有效实施。

Objective To evaluate the impact of smoke-control legislation on reduction of secondhand smoke in internet cafes in Shanghai. Methods A total of 30 interact cafes were selected from three districts representing central, rural-urban and suburban areas of Shanghai, and surveyed through pre and post-ban with cross-sectional studies. Field observation, indoor and outdoor PM2.5 monitoring and questionnaire interview among the workers were conducted each time. Results The overall average difference value of pre-ban PM2.5 between indoor and outdoor air was 623.79μg/m3, while that was 462.10 μg/m3 during the post-ban period （t=1.37, P=0.181）. The PM2.5 difference level in the central area declined from 821.38 μg/m3 （pre-ban） to 369.78μg/m3 （post-ban） （t=3.52, P〈0.01）. The percentage of exposing to secondhand smoke among the staff declined from 63.98% （pre-ban） to 36.07% （post-ban） （X2=17.88, P〈0.01）; the percentage of who reported ＂moderately＂ or ＂severely＂ exposed to secondhand smoke declined from 74.36% to 25.64% （X^2=10.19, P〈0.01）; and the average time of exposing to secondhand smoke at workplaces per day declined from（6.08±3.92 ）to （4.23±4.44） h （t=2.37, P〈0.05）. The pre-ban rates of supporting to the smoke-free interact cafes and smoke-free working sites among the staff were 49.47% and 44.68% respectively, compared to post-ban level of 75.14% and 66.48% （X2=25.49,P〈0.01; X2=17.46,P〈0.01 ）. The percentage of who reported willing to discourage guests from smoking increased from 24.35% to 79.10% （X^2=110.69,P〈0.01）. Conclusion Overall, this study shows the positive impact of the legislation on reducing SHS in internet cafes, but not greatly. Therefore, it is necessary to strengthen the implementation of smokecontrol legislation in Shanghai.