中国初中学生烟草广告和促销暴露现况调查

Exposure to tobacco advertisement and promotion programs among Chinese middle school students： a cross-sectional survey

目的了解中国初中在校学生烟草广告和促销暴露的现状。方法采用多阶段分层整群随机抽样的方法，在全国31个省（自治区、直辖市）初中在校学生中选取调查样本（n=155117）。采用学生自填问卷方式收集数据，内容主要包括烟草使用、二手烟暴露、烟草制品获得与价格、控烟宣传、烟草广告和促销、对烟草的认知和态度等。对数据加权后，采用SAS9-3软件进行数据分析。结果在过去的30d内，48．5％的初中生见过烟草广告或促销。其中通过电视的比例最高（21．3％），其次为户外广告牌（20．1％）、烟草零售点（17．5％）和互联网（15．6％）。此外，4．6％的学生报告自己有印着烟草产品品牌的物品；2．0％的学生得到过烟草公司工作人员提供的免费烟草产品；25．2％的吸烟学生最近一次购买卷烟是按“支”购买的；69．7％的学生报告在电视／录像／电影中看到吸烟镜头。从未使用过烟草产品的学生中，暴露于烟草广告和促销者认为吸烟更有吸引力、好朋友给烟可能会或肯定会吸、未来12个月可能会或肯定会吸烟、吸烟令人感到更舒服、自己可能会喜欢吸烟的比例均高于非暴露组（P〈0．0001）。结论中国初中学生暴露于烟草广告和促销的现状相当严重，暴露使学生更容易对烟草使用持正向态度。现有法律法规已不能充分有效保护青少年，建议尽快修订《广告法》，全面禁止烟草广告、促销和赞助。

Objective To exam the exposure status to tobacco advertisement and promotion programs in Chinese middle school students. Methods Stratified multi-stage cluster sampling was used to select participated grade 7-9 middle school students in 31 provinces （n=155 117）. A self-administrated questionnaire was used in which questions related to behavior on tobacco use, exposure to second-hand smoking （SHS） , access to tobacco products and prices, tobacco control advocacy, exposure to tobacco advertisement, and promotion as well as attitude and knowledge towards tobacco, etc. Data was weighted and analyzed, using the complex survey module of SAS 9.3 software. Results In the past 30 days, 48.5% of the students had a chance to see advertisement or promotion programs on tobacco. Tobacco advertisement or promotion were most frequently seen on TV （21.3%） among students, followed by outdoor billboard （20.1%）, at the stands for sale （17.5%）, and Internet （15.6%）. In addition, 4.6% of the students reported having kept the items related to brand logos of tobacco products; 2.0% reported having been offered a free tobacco product by tobacco company representatives; 69.7% reported having seen scenes related to smoking on TV/videos/movie screens. Twenty five point two percent of the student smokers reported buying individual sticks at last purchase. Among those students who had never been exposed to tobacco, the ones who had been exposed to tobacco advertisement and promotion programs reported that they were more likely to feel smoking attractive than those who had not. They also reported that if a cigarette was offered by friends, they might try to smoke within the next 12 months, feeling that smoking would make him/ her comfortable, and finally to feel that they might enjoy smoking （P〈0.000 1）. Conclusion Adolescents had been heavily exposed to tobacco advertisement and promotion programs in China. Students who had been exposed to tobacco advertisement or promotions were more likely to express positive attitude to tobacco use. It is urgent to make amendments to China＇ s Advertising Law to completely prohibit tobacco advertisement, promotion and sponsorship programs, to keep the young people away from tobacco.