2010—2011年上海市医院工作人员吸烟及控烟状况调查

Investigation of smoking status and tobacco control in hospital staffs in Shanghai during 2010 -2011

目的了解上海市各医院工作人员的吸烟现状、控烟知识、态度和行为以及医务工作者的控烟能力。方法将2010年9月至2011年6月上海市78家医院内的9330位临床及行政、辅助检查、后勤等各科室的医院工作人员作为调查对象，发放吸烟及控烟基线调查问卷，内容主要包括被调查人员的基本信息、吸烟情况及医院的控烟状况。结果上海市医院工作人员的总吸烟率为21．8％（2036／9330），其中男性（χ^2=1751．09，P〈0．01）、41～50岁年龄段（χ^2=84．610，P〈0．01）和大专学历（χ^2=509．068，P〈0．01）者吸烟率较高。吸烟的主要原因包括缓解紧张情绪（40．5％，825／2036）和习惯（54．3％，1106／2036）。尼古丁依赖检测量表（FTND）评估显示多数吸烟者对尼古丁依赖程度为轻度，FTND评分为（3．75±2．63）分。56．9％（1158／2036）的医院工作人员曾经尝试过戒烟，但不愿意戒烟者的主要原因为担心戒不掉，占67．9％（1382／2036）。94．3％（8798／9330）的医院工作人员对吸烟诱发的常见疾病的知晓率较高，但仅33．7％（3144／9330）知晓尼古丁替代疗法等戒烟方法。52．0％（3456／6643）的医生在日常诊疗过程中曾询问过患者是否吸烟，但只有24．9％（1654／6643）的医生对提醒建议患者戒烟有高度意识，且81．7％（5427／6643）的医生无写戒烟医嘱的工作习惯。结论有必要在医院工作人员中进行控烟知识宣传及方法内容更新培训，在提高医院工作人员自身控烟意识的同时，给患者提供更全面详细的控烟知识教育及控烟服务。

Objective To identify the current status of smoking in hospital staffs and their ability to participate in tobacco control, and therefore to increase their awareness and active behavior on tobacco control. Methods A total of 9330 hospital staffs from clinical, administrative, logistic and laboratory diagnosis departments in 78 hospitals located in various districts in Shanghai were surveyed with a questionnaire on smoking status and tobacco control from September 2010 to June 2011. The questionnaire mainly included the basic information and smoking status of the participants, as well as the tobacco control ability of the hospitals. Results The total smoking rate in Shanghai hospital staffs was 21.8% （2036/9330）. The proportion of smoking in males （χ^2= 1751.09, P 〈 0. 01 ）, in the 41 - 50 age group （χ^2 = 84. 610, P 〈 0. 01 ） and the associate degree （ χ^2 = 509. 068, P 〈 0. 01 ） group were significant higher than those in the other groups. The most frequent reasons for smoking were relieving nervous tension which accounting for 40. 5% （825/2036） and habits which accounting for 54. 3% （1106/2036）. The average score of the Fagerstrom Test of Nicotine Dependence （YFND） was 3.75 ± 2.63, which was generally considered as mild dependence on nicotine. 56. 9% （1158/2036）of the hospital staffs had the history of smoking cessation but the major reason for unwillingness to try quitting was worrying about failure to quit, which accounted for 67.9% （1382/2036）. 94. 3% （8798/9330）of the hospital staffs had a good awareness of common diseases associated with smoking, but only 33.7% （3144/9330） of them had a better comprehension of smoking cessation scientific methods, such as nicotine replacement drugs. 52.0% （ 3456/6643 ） of the doctors had asked patients whether they were smoking while only 24. 9% （ 1654/6643 ） of them had suggested them to quit smoking. Even more, as many as 81.7% （5427/6643） of the doctors did not write orders of smoking cessation in their practice. Conclusion The resuhs indicate that it is necessary to carry out tobacco control training and to improve the awareness of tobacco control for hospital staffs, and more detailed instruction for smoke cessation and service are needed for the patients.