广州市医疗机构就诊者控烟相关认知和态度分析

Analysis on the cognition and attitude related to tobacco control among medical patients in Guangzhou

目的了解广州市医疗机构就诊者对控烟相关知识和态度的变化趋势,评价控烟措施执行情况,为有针对性、科学有效开展医疗机构控烟健康传播和干预提供依据。方法采用多阶段分层随机抽样的方法,随机抽取三级医院、二级医院和社区卫生服务机构(包括乡镇卫生院),应用简单随机抽样的方法在医疗机构内抽取1 944位就诊者,自行设计问卷并对知识、态度等进行调查。结果不吸烟就诊者对各控烟条目的知晓率均高于吸烟就诊者,对"过滤嘴可以降低吸烟的危害"知晓率最低,2018年吸烟就诊者的知晓率为32.4%,不吸烟就诊者为42.4%。"开窗通风可以避免同室内的人受到二手烟的危害"知晓率也较低,三次调查均在60.3%以下。就诊者对吸烟和被动吸烟会导致的疾病知晓情况呈现随年份增加而增加趋势,相比2012年和2015年,2018年就诊者对吸烟和被动吸烟会导致的疾病知晓率均有较大提高。就诊者对医院控烟氛围的态度总体上呈现2012年和2018年高,2015年低状态。结论男性吸烟就诊者仍是控烟干预的重点人群,就诊者对烟草相关知识认知不足,医院控烟氛围尚需提高。应加强烟草危害的教育,转化戒烟意愿为动机,提高人群戒烟率。

Objective To understand the trends of knowledge and attitudes related to tobacco control among the patients of medical institutions in Guangzhou, and to evaluate the implementation of tobacco control measures, in order to provide reference for targeted, scientific and effective dissemination and intervention of tobacco control in medical institutions. Methods Multi-stage stratified random sampling method was used to randomly select tertiary hospitals, secondary hospitals and community health service institutions(including township health centers), and then the simple random sampling method was used to select 1944 patients from the selected institutions.Self-designed questionnaire was used to investigate the knowledge, attitude, etc. Results The awareness rates on smoking control items of non-smoking patients were higher than that of smoking patients. The awareness rate of "filters can reduce the harm of smoking" was the lowest, which was only 32.4% for smoking patients and only 42.4% for non-smoking patients in 2018. The awareness rate of "opening the window could protect people in the same room to avoid the harm of second-hand smoke" was also lower, the results of three investigations were all below 60.3%. The patients’ awareness of the diseases caused by smoking and by passive smoking showed an increasing trend year by year(P<0.05), and this rate was increased significantly in 2018 compared with the rate in 2012 and 2015. The attitude of the patients towards the hospitals’ tobacco control atmosphere was generally high in 2012 and 2018, but low in 2015.Conclusion Male smoking patients are still the key population of tobacco control intervention. The patients had insufficient knowledge about tobacco-related knowledge. And the hospitals’ tobacco control atmospheres should be improved. It is necessary to strengthen the education of tobacco hazards, so as to turn the willingness of smoking cessation into motivation, and to increase the rate of smoking cessation among the smokers.