2013年中国成年人吸烟状况与多种慢性病的关联研究

Relations between cigarette smoking and chronic diseases of Chinese adults in 2013

目的 研究我国成年人吸烟现状及不同吸烟人群与多种慢性病的关联。方法 基于2013年全国慢性病及其危险因素监测，覆盖31个省份的298个监测县（区），按多阶段分层整群抽样方法抽取全国≥ 18岁居民176 534人。利用询问调查收集对象前12个月的吸烟行为（吸烟状态、现在吸烟者日均吸烟量、现在每日吸烟者吸烟年限等）、慢性病（高血压、糖尿病、高TC血症和高TG血症）相关信息，测量血压，检测血糖和血脂。采用基于复杂抽样设计的权重对指标进行分析。结果 共收集有效样本175 386人。其中男性占42.7%，女性占57.3%。成年人男性吸烟者高血压、高TC血症和高TG血症患病率分别为30.4%、7.2%和18.0%，高于非吸烟者；女性吸烟者高血压、糖尿病、高TC血症和高TG血症患病率分别为35.6%、14.0%、10.3%和15.9%，均高于非吸烟者，差异均有统计学意义（均P〈0.05）。多因素分析结果显示，我国成年人男性吸烟者比非吸烟者高血压患病风险有所降低，患高TG血症风险比非吸烟者高19%（OR=1.19，95% CI：1.10~1.30）。其中，现在日均吸烟≥ 20支男性高TG血症患病风险比非吸烟者高41%（OR=1.41，95% CI：1.28~1.55）。我国成年人女性吸烟者比非吸烟者高TG血症患病风险高40%（OR=1.40，95% CI：1.15~1.70）；每日吸烟年限≥ 20年者高TG血症比〈20年者高60%（OR=1.60，95% CI：1.31~1.95）。结论 吸烟者比非吸烟者总体慢性病患病率高，且吸烟年限长或现在每日吸烟量大的人群患病风险大幅增加。

Objective To explore the relations between the prevalence of multiple chronic diseases and cigarette smoking behavior in the Chinese adults. Methods Based on the results from the 2013 Chronic Disease Risk Factor Surveillance （NCD Surveillance）, 176 534 Chinese residents aged 18 years and above, covering 298 counties （districts） in 31 provinces, was randomly recruited, using the multi-stage stratified clustering sampling method. Information on demographics, cigarette smoking （status, quantity and period） was obtained through face-to-face interviews and questionnaires. Anthropometric data and blood samples were collected and properly stored for analysis. Results In total, 175 386 adults were included for statistical analyses, with 42.7% as males and 57.3% as females. The prevalence rates of hypertension, high total cholesterol and high triglycerides were 30.4%, 7.2% and 18.0% in male smokers, 35.6%, 14.0%, 10.3% and 15.9% in female smokers respectively, which were all higher than those in the respective non-smokers. Male smokers were found under lower risk on hypertension, but 19% higher on total glycerides when compared with non-smokers of the same sex （OR=1.19, 95% CI：1.10-1.30）, when multiple risk factors were under control. Male current smokers with more than 20 cigarettes per day have 41% （OR=1.41, 95% CI：1.28-1.55） higher risk of high TG than non-smokers. Female smokers presented 40% （OR=1.40, 95% CI：1.15-1.70） higher risk in high glycerides than the non-smokers. Specifically, women smoking longer than 20 years have 60% （OR=1.60, 95% CI：1.31-1.95） higher risk of high TG than women smoking less than 20 years. Conclusions Prevalence rates of certain chronic diseases were seen higher in smokers of both genders. People with longer history of smoking or being heavier smokers, appeared at advanced risk on developing chronic diseases.