温州市部分城市与农村吸烟者吸烟和戒烟现况及影响因素分析

Survey on smoking/smoking cessation status and related factors of smoking cessation between urban and rural adult smokers in Wenzhou

目的了解浙江省温州市成人吸烟者的吸烟和戒烟现况并分析其影响因素。方法采用多阶段分层按规模大小成比例的概率抽样（PPS抽样）方法和简单随机抽样方法进行抽样。先从全市11个县（市、区）中抽取鹿城、瓯海、龙湾、瑞安、乐清和永嘉，再从6个县（市、区）中各抽取1-2个街道（乡镇），在抽中的街道（乡镇）中各抽取2个居委会（社区），再从每个居委会简单随机法抽取300户家庭进行登记，再自完成家庭登记的成年人中抽取40名吸烟者，2014年10至12月调查员通过面对面和一问一答的方式对吸烟者的一般情况、吸烟行为、戒烟现状及影响戒烟因素进行询问并让其填写问卷。对城市吸烟者和农村吸烟者的吸烟、戒烟行为现况等进行描述，对构成比和率进行χ2检验，并对影响吸烟者戒烟的行为因素做单因素和多因素logistic回归分析。结果被调查者现在吸烟率为22．3％（3310/14817），其中男性吸烟率为43．0％（3252／7556），女性吸烟率为0．8％（58／7261）；城市男性吸烟率为42．O％（1411／3365），农村男性为43．9％（1841／4191）；城市女性吸烟率为1．0％（33／3464），农村女性为0．7％（25／3798）。现在吸烟者中每天吸烟的占81．4％（522/641），平均每天吸烟20支及以上的占46．2％（295/641）；农村吸烟者最开始尝试吸烟的年龄早于城市吸烟者[（19．65±4．30）岁vs.（21．87±7．30）岁，（t=-7．941，P〈O．01）1，吸烟者开始每天吸烟时的年龄为（25．32±15．06）岁，城市与农村吸烟者相比差异无统计学意义：被调查吸烟者的戒烟率为37．8％（242/641），过去12个月尝试戒烟1次以上的占41．3％（100/242）；影响戒烟行为多因素非条件logistics回归分析发现过去一年生病、关心／担心自己的健康、朋友或熟人完全戒烟是城市吸烟者戒烟的促进因素；而农村吸烟者戒烟的促进因素除了过去一年生病，经济原因也不可忽视。结论被调查的温州市成人居民现在吸烟率未见明显下降，但随着吸烟者朋友或熟人戒烟行为的发生和吸烟者对自身健康关注的提高，配合重点人群吸烟及被动吸烟的全面健康危害知识宣传的加强、医生和专业结构提供有效戒烟帮助能力的提升，有希望促进现在吸烟者戒烟行为、提升戒烟成功率。

Objective To study the behaviors of smoking/smoking cessation and the factors related to smoking cessation in adult smokers of Wenzhou. Methods Stratified multi-stage probability proportionate to size sampling （PPS） method and simply random sampling were carried out step by step to select subjects; Lucheng, Ouhai, Longwan, Rui＇an, Yueqing, Yongjia were selected from the 11 counties of Wenzhou in the first step, then 1 or 2 streets were selected by PPS within the chosen district or county, after that, 2 communities were selected from every street with PPS, and 300 families were chosen with simply random sampling method and registered as well, then, by the random sampling method, 40 aduh smokers were chosen among the registered ones. General information, smoking status, smoking cessation and its associated factors of the 40 smokers were collected by face to face interviews with a questionnaire between October and December of 2014. At the end, the rates and constituent ratios were compared by X2 test, and the Logistic regression was used to explore the influential factors of smoking cessation among the smokers. Results Present smoking rate among Wenzhou male residents aged 18 years or over was 22.3% （3 310/ 14 817）, in males it was 43.0% （3 252/7 556）, （urban male 42.0%, rural male 43.9%）, and in female it was 0.8% （58/7 261） （ urban female 1.0%, rural female 0.7%）. The average age of their first time smoking among rural smokers was earlier than the urban ones＇（19.65±4.30 vs. 21.87±7.30, P〈0.01）, with 81.4% （522/641） of the smokers smoked every day and started their daily smoking patterns since the average age of （25.32± 15.06）, besides these, 46.2% （295/641） of them smoked more than 20 cigarettes per day. Among the smokers investigated, the total smoking-quitting rate was 37.8% （242/641）, with 41.3% （100/242） of smokers trying to quit smoking more than once in the last 12 months. The results of muhi-variate logistic regression demonstrated that getting ill in the past year （OR=2.608, 95% CI： 1.217 - 3.810）, friends quitted smoking successfully （OR=1.490, 95%CI： 1.124 - 1.750）, concerning about their health （0R=1.616, 95%CI： 1.127 - 2.319） were associated with urban smokers＇ intention to quit smoking; people being in good health would not take quitting smoking into account （OR=0.761, 95% CI=0.582 - 0.994）. As to rural smokers, except for getting ill in the past year （OR=2.997, 95%CI： 1.651 - 5.435）, and shortage of money was another important reason that could promote them to quit smoking （0R=1.519, 95% CI： 1.076 - 2.142）. Conclusion Knowledge of smoking harmfulness among smokers was still insufficient, and the smokers＇ intention to quit smoking was associated with individual and environmental factors. To promote smokers to quit, smoking cessation service providing and education for tobacco control should be strengthened.