北京市初中生烟草使用与环境感知系统的关联分析

Association between tobacco use and social environment support among junior high school students in Beijing

目的了解北京市控烟条例实施前后环境感知系统对初中生烟草使用情况影响,为制定青少年控烟策略提供科学依据。方法采用两阶段抽样方法,分别于禁烟令实施前后,使用全球青少年烟草流行调查问卷对北京市顺义区随机抽取的3所初中学校进行问卷调查。结果研究共发放调查问卷3020份,收回有效问卷2987份,有效率为98.91%。控烟实施前后,顺义区初中生现在吸烟率、尝试吸烟率差异有统计学意义(χ^(2)=9.221,P=0.002;χ^(2)=12.113,P=0.001)。在家里及公共场所暴露于二手烟对初中生现在吸烟率(χ^(2)=13.802,P=0.003;χ^(2)=27.909,P<0.001)、尝试吸烟率(χ^(2)=31.757,P<0.001;χ^(2)=37.691,P<0.001)的影响差异均有统计学意义。环境感知系统中初中生烟草使用态度和认识及周边人际环境中的好朋友吸烟率是影响初中生烟草使用共同的危险因素。其中,环境感知系统中身边好朋友吸烟的初中生发生现在吸烟的概率是未吸烟的21.417倍,控烟实施后,降低至5.244倍;身边好朋友吸烟的初中生发生尝试吸烟的概率由4.518倍降低至3.416倍。结论在禁烟令实施后,初中生烟草使用整体情况不容乐观。环境感知系统中各项因素均与初中生烟草使用行为有着密切关系,其中同伴效应最为明显,改善环境感知系统有利于预防和控制青少年吸烟。

Objective To understand the impact of social environmental support on tobacco use among junior high school students before and after the implementation of Beijing Tobacco Control Regulations,and to provide scientific basis for formulating adolescent tobacco control strategies and intervention measures.Methods The two-stage sampling method was used to conduct a questionnaire survey among three junior middle schools randomly selected from Shunyi District of Beijing using the global adolescent tobacco epidemic questionnaire before and after the ban was implemented.Results After the implementation of tobacco control,the influence of exposure to second-hand smoking at home and in public places on the current smoking rate of junior high school students(χ^(2)=13.802,P=0.003;χ^(2)=27.909,P<0.001),the attempting smoking rate(χ^(2)=31.757,P<0.001;χ^(2)=37.691,P<0.001)was statistically significant.The junior high school students′attitude and cognition of tobacco use and the smoking rate of good friends are common risk factors affecting junior high school students′tobacco use.After the implementation of smoking control,the probability of smoking among junior high school students with good friends around them decreased from 21.417 times to 5.244 times;The probability of attempting smoking decreased from 4.518 times to 3.416 times.Conclusion After the smoking ban,the overall situation of tobacco use of junior high school students is not optimistic.All the factors in environmental perception system are closely related to junior high school students′tobacco use behavior,and the peer effect is the most obvious.Improving the environmental perception system is conducive to the prevention and control of adolescent smoking.