无烟支持性环境构建与吸烟者戒烟行为的关联性研究

The study of relationship between the construction of smoke-free environment and smoking cessation behavior

目的研究无烟支持性环境与吸烟者戒烟行为之间的关联,为进一步了解我国吸烟者的戒烟行为及影响因素提供线索。方法本研究数据来源于2016-2017年中国成人烟草调查数据,采用分层多阶段整群抽样的方法,抽取广东、上海、安徽、湖北、宁夏和云南六省(市)15岁及以上人群作为研究对象,采用全球烟草监测系统中的标准问卷-烟草调查问卷(TQS),使用平板电脑调查研究对象的基本情况、烟草使用、戒烟、二手烟、烟草价格和控烟宣传等内容,共得到有效问卷18 739份。采用SAS 9.4进行复杂抽样方法的加权计算,并进行χ~2检验和多因素非条件logistic回归分析。结果本研究共纳入调查对象22 000例,得到有效问卷18 739份,6个省市居民吸烟率为29.93%,其中男性为50.24%,女性为1.18%;过去12个月尝试戒烟率为16.04%,其中男性为16.03%,女性为16.68%。不同特征人群过去12个月尝试戒烟率的差异均无统计学意义(P>0.05)。单因素分析结果显示,家中不允许吸烟的吸烟者的尝试戒烟率(25.96%)高于家中允许吸烟的吸烟者(12.56%),看到过"吸烟危害或者鼓励人们戒烟的信息"者的尝试戒烟率(18.16%)高于未看到者(12.17%),过去12个月接受了医生简短戒烟建议者的尝试戒烟率(24.29%)高于未接受者(17.45%),差异均有统计学意义(P<0.05,P<0.01)。多因素非条件logistic分析结果显示,家中有严格无烟规定者尝试戒烟的可能性高于未规定者(OR=2.395,95%CI:2.368~2.422),家中没有同住吸烟者对戒烟行为有促进作用(OR=1.259,95%CI:1.246~1.273),工作场所有严格无烟规定者尝试戒烟的可能性高于未规定者(OR=1.657,95%CI:1.631~1.683),过去30 d看到过"吸烟危害或者鼓励人们戒烟的信息"对尝试戒烟行为有促进作用(OR=1.317,95%CI:1.030~1.684),接受过医生简短戒烟建议者尝试戒烟的可能性高于未接受者(OR=1.562,95%CI:1.236~1.974),均有统计学意义(P<0.05,P<0.01)。结论无烟环境的构建对吸烟者的戒烟行为存在促进作用,此外还需通过提高吸烟危害认知,提供戒烟帮助等多种途径共同构建多维度的无烟支持性环境,遏制我国的烟草流行现状。

Objective To study the relationship between the construction of smoke-free environment and smoking cessation behavior and to provide the basis for understanding the influencing factors of smoking cessation in China. Methods The data were from the Investigation Program of Adult Tobacco in China during 2016 to 2017. The multistage stratified cluster sampling was used to select the residents（15 years old） from Guangdong, Shanghai, Anhui, Hubei, Ningxia and Yunnan, as the subjects. The TQS was used to collect the basic information, tobacco use, cessation, secondhand smoking, tobacco price, tobacco control propaganda and so on. Total of 18 739 effective questionnaires were collected. SAS 9.4 software was used for sample weighting of complex sampling method, and the data were analyzed by χ-2 test and the non-conditional logistic regression. Results There were 22 000 subjects and 18 739 effective questionnaires in present investigation. The smoking rate was 29.93%（male： 50.24%, female：1.18%）; the rate of smoking cessation in past 12 months was 16.04%（male： 16.03%, female： 16.68%）. There was no significant difference of smoking cessation rate between different groups（P〉0.05）.The single factor analysis showed that the smoking cessation rate（25.96%） in no smoking family was significantly higher than that（12.56%） in smoking family; the smoking cessation rate（18.16%） in smokers after seeing the smoking cessation information of smoking danger was significantly higher than that（12.17%） in smokers never seeing the smoking cessation information of smoking danger; the smoking cessation rate（24.29%）in smokers accepting the brief smoking cessation suggestion was significantly higher than that（17.45%） in smokers no accepting the brief smoking cessation suggestion（P〈0.05 or P〈0.01）. The multiple factors non-conditional logistic regression showed that the smoking cessation possibility in smokers with family of strict smoking cessation regulation was significantly higher than that in smokers without family of strict smoking cessation regulation（OR=2.395, 95%CI： 2.368-2.422）. Living with non-smokers could promote the smoking cessation for smokers（OR=1.259, 95%CI： 1.246-1.273）. The smoking cessation possibility of smokers in workshops with strict smoking cessation regulation was significantly higher than that of smokers in workshops without strict smoking cessation regulation（OR=1.657, 95%CI： 1.631-1.683）. The seeing ＂the information of smoking hazard＂ in past 30 days could promote the smoking cessation for smokers（OR =1.317, 95% CI： 1.030-1.684）.The smoking cessation possibility of smokers accepting brief smoking cessation suggestion from doctors was significantly higher than that of smokers not accepting brief smoking cessation suggestion from doctors（OR =1.562,95% CI：1.236-1.974）. Conclusion The construction of no smoking environment could improve the smoking cessation behavior for smokers. The environment of no smoking was constructed by improving the awareness of smoking hazard and providing the help of smoking cessation to improve the present situation of tobacco prevalence in China.