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背景烟草危害健康是目前全球的公共卫生难题,针对吸烟和戒烟行为的监控、研究具有重大意义。目的了解当前广东省珠江三角洲居民的吸烟和戒烟行为流行现况,并进一步探讨该地区成年人戒烟行为的影响因素,以期为相关卫生机构制定有效的烟草控制措施提供充分的证据。方法 2015年7月—2016年10月采用多阶段整群随机抽样的方法,先在广东省珠江三角洲地区9个城市中随机抽取深圳、珠海、东莞共3个城市,再在每个城市随机抽取1个城区(镇)作为研究点,然后在每个研究点随机抽取不低于1 500户家庭,最终共选取18 102例18岁以上常住居民为调查对象。采用国家卫生计生委制定的家庭健康询问调查表的部分内容进行调查,调查内容包括居民的人口学特征(性别、年龄、户籍所在地、婚姻状况、文化程度)、疾病情况[高血压、糖尿病、心脏病、脑卒中、慢性阻塞性肺疾病(COPD)、肿瘤]情况、吸烟行为、每日吸烟量、起始吸烟年龄。结果 18 102例居民中,不吸烟14 740例(81.43%),吸烟2 885例(15.94%),戒烟477例(2.63%)。男性吸烟率高于女性(P<0.05);35~64岁居民吸烟率高于18~34岁、≥65岁居民(P<0.05);本地户籍居民吸烟率低于外地户籍居民(P<0.05);大专、本科及以上文化程度居民吸烟率低于小学及以下文化程度居民和初中、中专或高中文化程度居民(P<0.05)。男性吸烟居民每日吸烟量大于女性(P<0.05);不同性别吸烟居民起始吸烟年龄比较,差异无统计学意义(P>0.05)。患有高血压、糖尿病、心脏病、脑卒中、COPD的有吸烟史居民戒烟率均高于未患疾病有吸烟史居民(P<0.05);患有肿瘤的有吸烟史居民戒烟率与未患有肿瘤的有吸烟史居民比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,性别[OR=1.823,95%CI(1.283,2.592)]、年龄[35~64岁:OR=3.610,95%CI(2.172,6.001);≥65岁:OR=13.760,95%CI(8.102,23.367)]、文化程度(大专、本科及以上)[OR=1.846,95%CI(1.327,2.568)]、高血压[OR=1.903,95%CI(1.491,2.429)]、脑卒中[OR=3.376,95%CI(1.884,6.048)]、COPD[OR=2.081,95%CI(1.115,3.882)]是居民戒烟行为的影响因素(P<0.05)。结论广东省珠江三角洲居民的吸烟率、戒烟率均较低;而女性,≥35岁,大专、本科及以上文化程度和疾病因素(高血压、脑卒中、COPD)可促进居民戒烟。今后仍需持续关注和监测居民吸烟流行状况,并加强重点人群的健康宣教及干预措施,争取早期控制吸烟、成功戒烟,避免发生与吸烟相关的疾病,从而促进人群健康。
Background Tobacco harm to health is the current global public health problem, for smoking and smoking cessation behavior monitoring, research of great significance. Objective To understand the prevalence of smoking and smoking cessation among residents in the Pearl River Delta of Guangdong Province and to explore the influencing factors of smoking cessation among adults in this area in order to provide sufficient evidence for effective health control measures. Methods From July 2015 to October 2016, a total of 9 cities in Shenzhen, Zhuhai and Dongguan were randomly selected from 9 cities in the Pearl River Delta of Guangdong Province by random sampling using multistage cluster sampling method. Random sampling was conducted in each city 1 urban area (town) as research sites, and then randomly selected no less than 1,500 households from each research site. A total of 18,102 permanent residents over the age of 18 were selected as the survey subjects. The questionnaire surveyed by the National Health and Family Planning Commission on Family Health Questionnaire was conducted to investigate the demographic characteristics (sex, age, place of residence, marital status and education level), disease status [hypertension, diabetes, heart Sickness, Stroke, Chronic Obstructive Pulmonary Disease (COPD), Tumor], Smoking Behavior, Daily Smoking Amount, Start Smoking Age. Results Among 18 102 residents, 14 740 (81.43%) did not smoke, 2885 (15.94%) smoked and 477 (2.63%) quit smoking. The prevalence of smoking in males was higher than that in females (P <0.05). The rates of smoking in 35-64-year-old residents were higher than those in 18-34 years old and ≥65-year-old residents (P <0.05) ). The smoking prevalence rate of residents with junior college degree or above education level is lower than that of residents with primary education or below and residents with junior high school, technical secondary school or high school education (P <0.05). Residents in male smokers smoked more daily than women (P <0.05). There was no significant difference in smoking age among smokers with different sexes (P> 0.05). Residents with smoking history with high blood pressure, diabetes, heart disease, stroke, and COPD had higher smoking cessation rates than those without smoking history (P <0.05); smoking history with smoking history residents quit smoking rate There is a history of smoking residents with smoking history, the difference was not statistically significant (P> 0.05). The results of multivariate logistic regression analysis showed that the age of the patients with age of 35-64 years (OR = 3.610,95% CI 2.172,6.001) or ≥65 years of age (OR = 1.823,95% CI 1.283,2.592) (OR = 1.846, 95% CI 1.327, 2.568), hypertension (OR = 1.903, 95% CI 1.491, 2.297 ), Stroke (OR = 3.376,95% CI 1.884,6.048), and COPD (OR = 2.081,95% CI 1.115,3.882) were the influencing factors of smoking cessation behavior among residents (P <0.05). Conclusions Smoking prevalence and smoking cessation rate are all lower in Pearl River Delta of Guangdong Province. However, female, ≥35 years of age, tertiary education, college education or above and disease factors (hypertension, stroke, COPD) can promote residents to quit smoking. In the future, we need to continue to pay attention to and monitor the prevalence of smoking among residents and strengthen the health education and intervention programs for key populations so as to promote early control of smoking, successful smoking cessation, prevention of smoking-related diseases and promotion of population health.