中国6个城市中学生健康素养与吸烟行为的关联分析

Association of health literacy and smoking behaviors among middle school students in six cities of China

目的探讨中学生健康素养与吸烟行为的关联。方法2015年11月至2016年1月采用多阶段整群抽样方法,在辽宁省沈阳市、安徽省蚌埠市、河南省新乡市、内蒙古自治区乌兰察布、重庆市和广东省阳江市6个城市抽取中学生进行问卷调查,收集研究对象的基本特征、健康素养和吸烟行为等情况。共发放问卷23137份,收回有效问卷为22628份。按照健康素养得分进行高、中、低三分位分组,采用多因素logistic回归模型分析健康素养与吸烟行为的关联。结果调查对象年龄为(15.4±1.8)岁,健康素养得分为(104.1±18.7)分,曾经吸烟、最近吸烟、被动吸烟比例分别为9.2%(2071名)、2.8%(635名)和27.9%(6304名),曾经吸烟者中尝试戒烟比例为50.1%(1037/2071)。调整性别、学校类型、户口所在地、家庭结构、住宿类型、父母文化程度、自评家庭经济状况等因素后,与高水平健康素养相比,低水平健康素养者曾经吸烟[OR(95%CI):1.85(1.61~2.13)]、最近吸烟[OR(95%CI):1.68(1.33~2.14)]和被动吸烟[OR(95%CI):1.34(1.23~1.46)]的风险较高,尝试戒烟[OR(95%CI):0.70(0.53~0.92)]的可能性会较低。结论中学生健康素养与吸烟行为有关。

Objective To explore the association between the health literacy(HL)and smoking behaviors in middle school students.Methods From November 2015 to January 2016,middle school students in Shenyang City of Liaoning Province,Bengbu City of Anhui Province,Xinxiang City of Henan Province,Ulanqab City of Inner Mongolia Autonomous Region,Chongqing City and Yangjiang City of Guangdong Province were enrolled by using a multistage stratified cluster sampling method.A total of 23137 questionnaires were issued and 22628 questionnaires were valid.A questionnaire survey was conducted to collect demographic information,HL and smoking behaviors.The low,middle,and high-level group were classified according to the tertile of HL score.A multiple logistic regression model was conducted to explore the association between the HL and smoking behaviors.Results The age of subjects was(15.4±1.8)years old,and HL score was(104.1±18.7)points.The proportion of former smoking,recent smoking and passive smoking was 9.2%(2071),2.8%(635)and 27.9%(6304),respectively.The proportion of former smokers who tried to quit smoking was 50.1%(1037/2071).Compared to the high-level HL,the low-level HL increased the risk of former smoking[OR(95%CI):1.85(1.61−2.13)],recent smoking[OR(95%CI):1.68(1.33−2.14)]and passive smoking[OR(95%CI):1.34(1.23−1.46)],and decreased the likelihood of smoking cessation[OR(95%CI):0.70(0.53−0.92)],after adjusting for the gender,school type,registered residence,household structure,accommodation type,educational level of patients,and self-reported family economic status.Conclusion The HL of middle school students was related to their smoking behaviors.