四川省资中县农村青少年心理健康之生活满意度对烟草使用的影响

Effect of mental health on tobacco use among adolescents in rural Sichuan:mediation of life satisfaction

【目的】了解四川省农村青少年烟草使用现况及其影响因素,探究四川省农村青少年吸烟行为与心理健康、生活满意度间的关系,为预防和控制农村青少年吸烟提供科学依据。【方法】以自行编制的《青少年健康调查问卷》为调查工具,对四川省资中县2所乡镇中学的八年级和十一年级2671名学生进行问卷调查。采用Mplus 7.0软件拟合青少年烟草使用行为与心理健康及生活满意度间关系的结构方程模型。【结果】有28.3%(756/2671)的青少年尝试过烟草制品,9.5%(255/2671)的青少年在过去30 d内使用过烟草制品,其中男生(16.6%)高于女生(3.5%),十一年级学生(21.9%)高于八年级学生(7.3%),差异均有统计学意义(χ^(2)=131.99、4.24,均P<0.05)。现在烟草使用率随每月生活费增加而增高(χ^(2)=46.96,P<0.05)。心理健康状况可直接预测吸烟行为,有正向影响,并通过生活环境满意度对吸烟行为有间接影响;生活环境满意度直接预测吸烟行为,有负向影响,生活环境满意度在心理健康状况和吸烟行为间起中介作用,中介效应占总效应的19.2%,非标准化中介效应及其95%CI为0.007(0.002~0.012)。【结论】青少年吸烟行为是一个复杂的心理社会行为,四川农村青少年烟草使用形势严峻。青少年吸烟行为干预策略应重点关注如何减少心理健康问题和提高生活满意度。

[Objective]To understand the current situation of tobacco use among rural adolescents in Sichuan Province and its influencing factors,to explore the relationship between smoking behavior and psychosocial influencing factors of rural adolescents in Sichuan Province,and to provide a scientific basis for the prevention and control of smoking among rural adolescents.[Methods]An"Adolescent Health Questionnaire"was used as the survey tool to investigate 2671 students in the 8th and 11th grades of two township middle schools in Zizhong County,Sichuan Province.The structural equation model in Mplus 7.0 was used to analyze the relationship between adolescent tobacco use behavior,mental health,and life satisfaction.[Results]Among the surveyed adolescents,28.3%(756/2671)had tried tobacco products,and 9.5%(255/2671)had used tobacco products in the past 30 days.The prevalence of tobacco use was higher among boys(16.6%)than girls(3.5%),and among 11th grade students(21.9%)compared to 8th grade students(7.3%),with statistically significant differences(χ^(2)=131.99 and 4.24,both P<0.05).The current tobacco use rate increased with the increase in monthly allowance(χ^(2)=46.96,P<0.05).The structural equation model of smoking behavior showed that mental health had a positive and direct impact on smoking behavior,and an indirect impact on smoking behavior through living environment satisfaction.Living environment satisfaction had a negative and direct impact on smoking behavior with the mediating effect accounting for 19.2%of the total effect.The non-standardized mediating effect of mental health on smoking behavior through life environment satisfaction and its 95%CI were 0.007(0.002‒0.012).[Conclusion]Adolescent smoking behavior is a complex psychosocial behavior,and the situation of adolescent tobacco use in rural areas in Sichuan is severe.There is a correlation between adolescent tobacco use behavior and psychosocial influencing factors.Psychosocial influencing factors can predict adolescents’tobacco use behavior.