农村社区老年男性吸烟人群尼古丁依赖程度与认知行为的相关性分析

Analysis of correlation of nicotine dependence and cognition and behaviors of elderly male smokers in the rural community

目的调查农村社区老年男性吸烟人群的尼古丁依赖程度,分析不同依赖程度对其吸烟、戒烟行为以及吸烟危害认知等方面的影响。方法采取多阶段抽样方法,对上海市嘉定区769名免费体检的老人进行一对一询问方式的问卷调查。描述性分析老年男性吸烟者的尼古丁依赖程度现状;根据尼古丁依赖检测量表(FIND)评分进行分组,并对尼古丁依赖程度与认知行为进行相关性分析,对尼古丁依赖程度的人口学影响因素进行分析。结果根据769名老年男性吸烟者的尼古丁依赖程度,分为低依赖组519例(67.5%),高依赖组250例(32.5%)。家庭人均月收入低于中位数是尼古丁高依赖的危险因素(OR=1.984,P<0.001);其他社会人口学因素对尼古丁依赖程度均无影响。尼古丁高依赖组与低依赖组比较,认为吸烟有益/无所谓者较多(r=-0.173),开始吸烟年龄较早(r=0.086),平均每月吸烟花费较多(r=-0.295),吸烟持续年限较长(r=-0.088),未尝试过戒烟的比例较高(r=0.076),最近一次戒烟持续时间较短(r=0.140),社交最频繁的5人中吸烟者人数较多(r=-0.151),休闲娱乐方式为打麻将或打牌者较多(r=0.095),饮酒过量者较多(r=-0.171),差异均有统计学意义(P<0.05)。结论社会人口学因素对尼古丁依赖程度的影响甚微;尼古丁依赖程度对认知具有一定影响,对吸烟、戒烟行为及生活方式具有重要影响。要改变农村老年男性吸烟人群的吸烟行为,促成戒烟,除提供健康教育及社会支持外,有必要进行适当的临床尼古丁戒断治疗。

Objective To investigate the nicotine dependence of elderly male smokers in rural areas and to analyze the effects of different degrees of nicotine dependence on smoking and quitting behaviors and cognition of the harmfulness of smoking. Methods A total of 769 old people in Jiading District of Shanghai who underwent the free medical examination were selected and multi-stage sampling method was adopted to conduct the questionnaire survey. Descriptive analysis was used to analyze the degree of nicotine dependence of elderly male smokers. The respondents were categorized according to scores of Fagerstrom test for nicotine dependence（ FIND）. The correlation of the degree of nicotine dependence, cognitvon and behaviors was analyzed.Demographic factors of the degree of nicotine dependence were also analyzed. Results According to the degree of nicotine dependence, 769 elderly male smokers were divided into the low nicotine dependence group（ n = 519, 67. 5 %） and high dependence group（ n = 250, 32. 5 %）. The family income per capita below the median was a risk factor of high nicotine dependence（ OR = 1. 984, P〈0. 001）. Other social and demographic factors had no effect on nicotine dependence. Compared with the low dependence group, more respondents in high dependence group considered that smoking was ok or beneficial（ r =- 0. 173）; the age of starting smoking was earlier（ r = 0. 086）, average monthly tobacco cost was higher（ r =- 0. 295）; smoking history was longer（ r =- 0. 088）; less likely to have quitting experience（ r = 0. 076）; recent cessation period was shorter（ r = 0. 140）; there were more smokers in 5 most closest friends（ r =- 0. 151）; main entertainments were playing mahjong or cards（ r = 0. 095）; and more respondents in high dependence group drink too much（ r =-0. 171）. The differences were statistically significant（ P〈0. 05）. Conclusion Social and demographic factors have little effect on the nicotine dependence. Nicotine dependence has certain influence on the cognition and important impact on smoking cessation behaviors and lifestyle. In order to change smoking behaviors of rural elderly male smokers and achieve smoking cessation, it is necessary to conduct proper clinical nicotine withdrawal treatment as well as health education and social support.