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[目的]了解《上海市公共场所控制吸烟条例》(简称《条例》)实施五年后,上海市徐汇区15岁以上居民吸烟状况及其行为影响因素的变化情况。[方法]分别于2010年和2015年开展徐汇区居民健康状况与卫生服务利用监测,均采用多阶段人口规模比例随机抽样方法,先后完成吸烟情况调查11 347和10 388人。本次研究对吸烟行为信息进行描述性分析,并采用logistic回归模型分析居民吸烟和戒烟行为的影响因素。[结果]2010—2015年徐汇区15岁以上居民的标化现在吸烟率从17.6%下降到14.7%(男性从35.2%到29.8%,女性从1.3%到1.0%),标化戒烟率从17.6%上升到22.8%。吸烟者开始吸烟年龄提前0.9岁。无论前后,45~59岁年龄段男性居民的吸烟率、现在吸烟率、现在每日吸烟率和重型吸烟率在所有男性调查者中均是最高的。30~59岁和75岁及以上男性居民吸烟率下降,戒烟率升高,且差别具有统计学意义(P<0.01)。男性(OR_(adj)=51.479)、45~59岁者(OR_(adj)=1.825)、离婚/丧偶者(OR_(adj)=1.498)、料理家务者(OR_(adj)=18.279)、无业或待业者(OR_(adj)=16.625)、离退休者(OR_(adj)=12.057)、在业者(OR_(adj)=15.453)、饮酒者(每周1~2次者OR_(adj)=3.190,每周≥3次者OR_(adj)=5.221)吸烟的危险性较高;而大专及以上文化程度(OR_(adj)=0.510)、未婚者(OR_(adj)=0.738)吸烟的危险性较低。男性(OR_(adj)=0.336)、每周饮酒≥3次者(OR_(adj)=0.467)较不易戒烟;而年长者(60~74岁者OR_(adj)=6.583,75~岁者OR_(adj)=28.521)相对更愿意戒烟。[结论]《条例》的实施对降低中青年男性吸烟率有积极作用,但仍面临巨大挑战,应采取更有针对性的措施加强控烟工作。
[Objective] To understand the changes of smoking status and behavior influencing factors among residents over the age of 15 in Xuhui District, Shanghai, five years after the implementation of the “Shanghai Regulations on the Control of Smoking in Public Places” (the “Regulations”). [Methods] The health status and health service utilization monitoring of residents in Xuhui District were conducted in 2010 and 2015. Random sampling method of multi-stage population scale was adopted. 11 347 and 10 388 people were surveyed successively. This study conducted a descriptive analysis of smoking behavior information and analyzed the factors influencing smoking and smoking cessation behavior using logistic regression model. [Results] The current smoking rate of residents aged 15 and over in Xuhui District from 2010 to 2015 now dropped from 17.6% to 14.7% (from 35.2% to 29.8% for males and from 1.3% to 1.0% for females), and the standardized smoking cessation rate decreased from 17.6 % Rose to 22.8%. Smokers begin smoking at the age of 0.9 years in advance. No matter before and after, 45 to 59 male population smoking rates, the current smoking rate, and now the daily smoking rate and heavy smoking rates in all male investigators are the highest. The prevalence of smoking among 30- to 59-year-old men and 75-year-old men and above decreased while smoking cessation rates increased with a statistically significant difference (P <0.01). (OR_ (adj) = 51.479), 45 ~ 59 years old (OR_ (adj) = 1.825), divorced / widowed (OR_ (adj) = 1.498, OR_ (adj) = 18.279) (OR_ (adj) = 16.625, OR_ (adj) = 12.057, OR_ (adj) = 15.453), drinkers (once or twice a week, OR_ (adj) = 3.190, OR_ (adj) = 5.221), the risk of smoking was higher; while the educational level of junior college and above (OR_ (adj) = 0.510) and the unmarried (OR_ (adj) = 0.738) Sex is lower. (OR_ (adj) = 0.336), alcohol consumption ≥3 times a week (OR_ (adj) = 0.467) was less likely to quit smoking than that of the elderly (OR_ (adj) of 60-74 years) OR_ (adj) = 28.521) is more willing to quit smoking. [Conclusion] The implementation of the “Regulations” has a positive effect on reducing smoking prevalence among young and middle-aged men, but it still faces great challenges. More targeted measures should be taken to strengthen tobacco control.