云南省某三甲医院内科住院患者吸烟情况调查

Investigation on smoking status of hospitalized patients in the internal medicine department of a tertiary hospital in Yunnan province

目的了解云南省某三甲医院内科住院患者吸烟情况,为此部分特殊人群控烟策略的制定提供参考。方法本研究为横断面研究,整群抽取2022年2~3月云南省某三甲综合医院呼吸内科、心血管内科、内分泌科、消化内科、肾脏风湿免疫科、神经内科、肿瘤科和血液科的2033例住院患者进行问卷调查,内容包括基本人口学特征、吸烟量、戒烟意愿和Fagerström烟草依赖评估量表(FTND)。由专人在巡回病房时现场发放和回收问卷,并整理和分析数据。计算总体、不同性别患者的吸烟率,以及各科室男性患者的吸烟率和戒烟率。比较不同年龄(15~24岁、25~44岁、45~64岁、65~80岁),学历(初中及以下、高中及以上),婚姻(已婚、其他婚姻情况),家庭人均月收入(<3000元、3000~6000元、>6000元)和民族(汉族、其他民族)的男性吸烟患者吸烟率、每日吸烟量、戒烟意愿和FTND≥7分的分布情况。结果本次调查共发放问卷2033份,收回有效问卷1941份,有效回收率为95.5%,其中男1116例(57.5%),女825例(42.5%)。总体吸烟率为22.4%(435/1941),其中男性患者吸烟率为38.8%(433/1116),女性患者吸烟率为0.2%(2/825)。呼吸内科、心血管内科、内分泌科、消化内科、肾脏风湿免疫科、神经内科、肿瘤科和血液科男性患者吸烟率37.0%(61/165)、44.1%(112/254)、47.5%(58/112)、43.4%(46/106)、38.6%(44/114)、43.3%(58/134)、31.1%(33/106)、18.3%(21/115),戒烟率分别为51.2%(64/125)、35.3%(61/173)、24.7%(19/77)、19.3%(11/57)、32.3%(21/65)、32.6%(28/86)、57.7%(45/78)、53.3%(21/45)。83.4%(361/433)的男性吸烟患者吸烟量≥10支/d。87.3%(378/433)的男性吸烟患者属于中重度尼古丁依赖,61.0%(264/433)的男性吸烟患者有戒烟意愿。男性患者戒烟率为38.7%(273/706)。不同年龄的内科男性住院患者吸烟率比较,总体差异有统计学意义(χ2=11.56,P=0.009)45~64岁年龄段的吸烟率较65~80岁年龄段的吸烟率高(45.1%比28.5%,P<0.01)。不同家庭人均月收入的内科男性住院患者吸烟率比较,总体差异有统计学意义(χ^(2)=15.69,P<0.001);<3000元的吸烟率较3000~6000元和>6000元的吸烟率高(90.4%比37.9%、26.1%,P<0.01)。不同年龄、学历、婚姻、家庭人均月收入、民族的内科男性住院吸烟患者每日吸烟量≥10支、有戒烟意愿和FTND≥7分的占比差异均无统计学意义(均P>0.05)。结论云南省某三甲医院内科男性住院患者吸烟率、尼古丁依赖程度、每日吸烟量均高,但戒烟意愿也高。制定控烟策略应重点关注心血管内科、神经内科和内分泌科等收治烟草相关疾病的科室,以及中青年、低收入的内科男性住院吸烟患者。

ObjectiveTo investigate the smoking status of inpatients in the internal medicine department of a tertiary hospital in Yunnan Province,and to provide references for the formulation of tobacco control strategies for special populations.MethodsThis was a cross-sectional study involving 2,033 inpatients from the Departments of Respiratory Medicine,Cardiovascular Medicine,Endocrinology,Gastroenterology,Nephrorheumatology,Neurology,Oncology,and Hematology in a tertiary hospital in Yunnan Province from February to March 2022 was selected using the cluster sampling.They were surveyed for demographic characteristics,smoking volume,willingness to quit smoking,and Fagerstrom Test for Nicotine Dependence(FTND).Questionnaires were distributed and returned on-site by a specially-assigned investigator while making the rounds of the wards,and data were collated and analyzed.The overall smoking rate,female and male smoking rate,and male smoking rate and smoking cessation in each department were calculated.Male smoking rate,daily smoking volume,willingness to quit smoking and distribution of FTND≥7 points in subgroups assigned by age(15-24 years,25-44 years,45-64 years,65-80 years),education(junior high school and below,high school and above),marriage(married,other marital status),per capita monthly household income(<3,000 yuan,3,000-6,000 yuan,>6,000 yuan)and race(Han,other ethnic groups)were calculated.ResultsA total of 2,033 questionnaires were distributed in this survey,and 1,941 valid questionnaires were returned,including 1,116 males(57.5%)and 825 females(42.5%),with an effective recovery rate of 95.5%.The overall smoking rate was 22.4%(435/1,941),and the male and female smoking rate was 38.8%(433/1,116)and 0.2%(2/825),respectively.The male smoking rate in the Departments of Respiratory Medicine,Cardiovascular Medicine,Endocrinology,Gastroenterology,Renal Rheumatology and Immunology,Neurology,Oncology and Hematology was 37.0%(61/165),44.1%(112/254),47.5%(58/112),43.4%(46/106),38.6%(44/114),43.3%(58/134),31.1%(33/106)and 18.3%(21/115),respectively.The smoking cessation rate in male patients of the above departments was 51.2%(64/125),35.3%(61/173),24.7%(19/77),19.3%(11/57),32.3%(21/65),32.6%(28/86),57.7%(45/78)and 53.3%(24/45),respectively.83.4%(361/433)of male patients smoked≥10 cigarettes per day.87.3%(378/433)of male patients had moderate-to-severe dependent on nicotine,and 61.0%(264/433)of male smoking patients had the willingness to quit smoking.The smoking cessation rate of male patients was 38.7%(273/706).There was a significant difference in the smoking rate of male patients admitted in internal medicine departments at different age groups(χ^(2)=11.56,P=0.009).The smoking rate in male patients at 45-64 years of age was significantly higher than that aged 65-80 years(45.1%vs 28.5%,P<0.01).There was a significant difference in the smoking rate of male patients admitted in internal medicine departments at different household income groups(χ2=15.69,P<0.001).The smoking rate in male patients with<3,000 yuan of per capita monthly household income was significantly higher than those with 3,000-6,000 yuan and>6,000 yuan(90.4%vs 37.9%or 26.1%,P<0.01).There were no significant differences in the proportions of male smoking patients admitted in internal medicine departments who smoked≥10 cigarettes a day,had the willingness to quit smoking and had FTND≥7 points among different age,education,marriage,per capita monthly household income and ethnic groups(all P>0.05).ConclusionsMale inpatients in the Department of Internal Medicine of a tertiary hospital in Yunnan Province have a high smoking rate,nicotine dependence,and daily smoking,but they are also willing to quit smoking.Development of smoking control strategies should focus on departments admitted to tobacco-related diseases such as cardiovascular medicine,neurology,and endocrinology,as well as young and middle-aged and low-income medical male inpatients.