山西省县级医疗卫生机构人员吸烟状况调查

Investigation on the status of smoking behaviors among health care workers in counties of Shanxi Province

目的了解山西省县级医疗卫生机构人员吸烟行为、烟草危害知识与态度及提供戒烟服务的现状，为制定控烟干预策略提供科学依据。方法采用面对面问卷调查的方法，对山西省2011年中央补助地方烟草控制项目的18县（市、区）卫生行政部门、综合医院、中医院、妇幼保健院（站）、疾控中心和健康教育所共94个单位9637名在职职工进行调查。结果医务人员吸烟率为9．83％，其中男性吸烟率为28．82％，女性吸烟率为0．53％，差异有统计学意义（x。=1921．23，P〈0．01）。有87．00％的医务人员知晓本单位规定“不能在室内任何区域吸烟”，吸烟的医务人员中有80．10％在上班时吸烟；吸烟危害健康知识知晓率为62．82％；医生在就诊时从不或很少询问病人吸烟情况占72．10％。吸烟者与非吸烟者对吸烟危害相关知识与态度情况的知晓情况（×。=101．88，P〈0．01）和对吸烟、被动吸烟与疾病关系知识知晓隋况（x2=14．87，P〈0．01）差异均有统计学意义。对“过滤嘴可以降低吸烟的危害”（P=0．000，OR=1．007，95％C1：1．005～1．105）和“外国烟的危害比国产烟的危害小”（P=0．013，OR：1．002，95％CI：1．001—1．004）知晓率高是促使不吸烟的保护因素，男性是吸烟的危险因素（P=0．000，OR=1．319，95％c，：1．303-1．335），高学历是不吸烟的保护因素（P=0．000，OR=1．023，95％C1：1．016～1．030）。结论山西省县级医疗卫生机构控烟环境尚未形成，需进一步加强医务人员烟草危害知识和技能培训，提高其控烟意识，强化控烟监督力度，推进创建无烟单位工作。

Objective To understand the status of smoking behaviors, knowledge and attitudes to tobacco among health care workers （HCWs）, and provide evidence for making strategies and prevention methods for smoking con- trol. Methods A total of 9637 HCWs from 94 medical units （ Health administrative departments, General hospitals, Chi- nese medicine hospitals, Maternal and Child Health Hospitals/Stations, CDCs and Health Education Institutes） in 18 counties/cities/districts, which were included in Shanxi Province central subsidies for local tobacco control project in 2011, were investigated by face-to-face questionnaire survey method. Results Among HCWs, the overall smoking rate was 9. 83%, and the smoking rate in male （28.82%） was significantly higher than that in female （0. 53% , X2 = 1921.23, P 〈0. 01 ）. 87.00% of HCWs knew the regulation ＂not smoking in any indoor area＂ in their unit. Among the smoking staff, 80. 10% of them smoked during work. The awareness rate of tobacco harm only was 62.82%. 72. 10% of them never or rare- ly asked their patients whether smoking or not. There were significant differences between smokers and non-smokers in the hazards of smoking, knowledge and attitudes （X2 = 101. 88, P 〈 0.01 ） and the relationship of smoking, passive smoking （ x2 = 14. 87, P 〈 0.01 ）, the awareness of smokers were lower. The higher awareness of ＂filter can reduce the dangers of smoking＂ （P =0. 000, OR = 1. 007, 95% CI： 1. 005 -1. 105） and ＂the dangers of foreign cigarettes has less harmful than domestic cigarettes＂ （P =0. 013, OR = 1. 002, 95% CI： 1. 001 - 1. 004） were the protective factors of non-smok- ing. Male was risk factor （P =0. 000, OR = 1. 319, 95% CI： 1. 303 - 1. 335）. Higher education level was protective fac- tors of non-smoking （P = 0. 000, OR = 1. 023, 95 % CI： 1. 016 - 1. 030）. Conclusion Smoking control environment in medical and health institutions of county level in Shanxi Province is not formed yet. Efforts on training of tobacco harm knowl- edge and skills of HCWs to improve tobacco control awareness should be strengthened for promoting smoke-free units.