山东省小学生烟草暴露现状及影响因素研究

发布时间：2018-03-30 01:31

本文选题：小学生　切入点：吸烟　出处：《山东大学》2013年硕士论文

【摘要】：[背景] 烟草危害是当今世界最严重的公共卫生问题之,中国既是世界上最大的烟草生产和消费国,也是世界上吸烟者人数最多的国家,同时还是因吸烟导致相关疾病而死亡人数最多的国家,每年因吸烟引起的相关疾病所致死亡人数超过100万。由于吸烟导致的疾病和死亡具有明显的滞后性,因此可以预期,未来的死亡人口规模将更为庞大,烟草流行已成为中国人群健康的“第一杀手”。研究证明,大多数吸烟者始自青少年,开始吸烟的年龄越早,成为常吸者的可能性越大,成年后的吸烟量越大,受烟草的危害也越大,戒烟的可能性越小。若延迟青少年开始吸烟的时间,则可大大降低人群吸烟率及因此导致的各种疾病的罹患率和死亡率。不仅如此,吸烟还是青少年物质滥用的“入门物”,与青少年行为问题的产生密切相关,吸烟的青少年常伴有诸如学业、品德、心理等一系列的行为问题。因此青少年历来是控烟工作的重点人群,教育青少年远离烟草,是关系到他们身心健康成长、阻断烟民后继队伍、提高中华民族素质的百年大计青少年正处在生长发育时期,各器官系统都尚未成熟,对外界环境有害因素的抵抗力较成人弱,对毒物危害敏感,身体的正常生长发育容易受到损害,因此,被动吸烟对青少年有着更大的危害性。有研究指出被动吸烟会导致儿童认知能力缺陷,儿童发生行为问题的几率也会大大增力11,16-18岁的孩子如果经常被动吸烟,他们的学习成绩会受到较大程度的影响,无法通过考试的几率比其他正常孩子高出30%。 2010年GATS显示,我国现在吸烟者为3.01亿,还有约7.4亿非吸烟者遭受二手烟危害,其中有1.8亿是青少年。43.9%的青少年在家庭遭受二手烟雾的危害,55.8%的青少年在公共场所遭受二手烟雾的危害。88.2%的学生报告与其关系密切的人中有吸烟者。2005年调查显示,我国青少年13岁前吸完一整支烟的比例较1998年增加了15.0%；2008年山东省的调查亦显示,山东省曾经吸过烟的青少年在13岁前吸完一整支烟的报告率达49.8%,52.5%的中学生报告在过去7天里曾被动吸烟。小学时期正是人生观、价值观和行为习惯养成的关键时期,也是进行各种健康危险行为干预的最佳时期,小学生接受健康知识快,易形成健康行为,干预的依从性和配合度高,另外小学阶段学习压力相对较小,系统进行干预的可操作性也更强,最重要的是,从小学开始进行控烟干预其健康受益时间也史长。有效的学校控烟健康教育和行为干预不仅对学生控烟作用巨大,而用对整个社会的控烟都具有深远意义,正是基于此我们开展了此次研究,通过问卷调查了解我省小学生烟草暴露情况及其影响因素、烟草危害知识的掌握情况和知识来源情况,并就被动吸烟对学习成绩的影响进行初步探讨,为在小学更有针对性、更有效地开展控烟健康教育和行为干预提供科学依据。 [研究目的] 掌握我省小学生吸烟行为和被动吸烟的现状及其影响因素,初步探讨被动吸烟对学习成绩的影响,了解我省小学生烟草相关知识的掌握情况、知识来源及对烟草使用的态度,为更有效地开展学校控烟宣教和对控烟干预进行评价提供基线资料和依据。 [研究方法] 本调查采用多阶段分层整群随机抽样的方法,在山东省抽取威海、莱芜和聊城3个市13所学校的6050名学生及其家长作为调查对象,使用项目组自行设计的调查问卷,由经过统一培训的调查员以班为单位对学生进行集体问卷调查,家长问卷由学生带回,由家长自行填写后交回学校,学生和家长均匿名填写问卷。对有效问卷使用Epidata3.0建立数据库,使用SPSS16.0对调查对象的人口学特征、烟草暴露现状及其影响因素、烟草危害相关知识知晓现状进行统计分析。 [主要结果] 1、山东省小学生的尝试吸烟率为6.0%,现在吸烟率为1.2%。初次吸烟的平均年龄为7.8±2.1岁,尝试吸烟的前三位原因分别为“好奇”、“同伴给烟”和“心情不好/好”,所吸香烟的主要来源为“取自家中”和“自己购买”。学生吸烟行为的主要危险因素有男生、非独生子女、学习成绩较差、烟草危害知识不及格、家人吸烟、同学吸烟、看到教师吸烟和地区差异等。 2、山东省小学生所有场所的被动吸烟率为50.5%,城市高于农村,聊城高于莱芜和威海。小学生被动吸烟比较严重的场所依次为饭店/餐厅、商场、家里和公共汽车。城乡和不同地区间的分布均有差异。 3、山东省小学生家庭被动吸烟率为49.7%。家庭被动吸烟率农村高于城市,独生子女高于非独生子女,家庭结构比较以隔代家庭最高,重组家庭和大家庭次之。家庭中的主要吸烟者是父亲和祖父/外祖父,43.42%的父亲和73.96%的祖父/外祖父的烟龄在10年以上,66.78%的父亲和61.56%的祖父/外祖父的日吸烟量为1-10支,且在家中吸烟的位置都是以“到处吸”和“在客厅吸”为主。家庭被动吸烟的主要危险因素是大家庭和隔代家庭、独生子女、父母的文化程度较低和地区差异。 4、调查显示,有27.4%的小学生表示曾经在学校见到过教师吸烟,农村高于城市,聊城高于莱芜和威海。 5、山东省小学生烟草危害知识的知晓率较低,吸烟对呼吸系统危害的知晓率较高,对心血管疾病和癌症等方面危害的知晓率和被动吸烟危害的知晓率较低。山东省小学生获得的烟草危害相关知识较多的渠道依次为“电视/广播”、“网络”和“报刊杂志”,城乡小学生控烟知识来源渠道有差异。仅有44.3%的学生选择了从“学校健康教育课”获得控烟知识。 6、调查显示,被动吸烟是学生成绩的影响因素,有家庭被动吸烟的学生其学习成绩较差的报告率高于无家庭被动吸烟的学生,且每周被动吸烟的天数越多,学习成绩优秀和中上的越少,成绩中下和较差的越多。 [主要结论] 1、山东省小学生尝试吸烟行为有低龄化趋势,且烟草危害知识的知晓率较低,农村和城市小学生的控烟知识知晓率和来源渠道略有不同,提示我省应重视对小学生的控烟教育,特别应加强“拒吸第一支烟”的技能培训,控烟宣教应根据城乡不同特点因材施教。 2、学生吸烟行为的发生既有个人因素的影响,亦有家庭因素和周围环境因素的原因,提示学生控烟工作应以学校为重点,家庭和社区相互配合才能达到更好的效果。在加强学生控烟工作的同时,也不能忽视社会宣传和对学生家长、教师的控烟干预和戒烟帮助。 3、我省的公共场所吸烟现象较严重,提示应加快推出地方性公共场所控烟法规,遏制公共上场所的吸烟现象。
[Abstract]:[background]
The dangers of tobacco is one of the most serious public health problems in the world, China is the world's largest tobacco producer and consumer, is the world's largest number of smokers, but also caused by smoking related diseases and the country with the largest number of deaths each year due to smoking related diseases caused more than 1 million deaths due to smoking. The disease and death is obviously lagging behind, so it can be expected that the future will be more large scale deaths, the tobacco epidemic has become Chinese health "the first killer". Studies have shown that most smokers since youth, age to start smoking earlier, is likely to become more often smokers, smoking the adult is greater, the greater the harm by tobacco smoking, the smaller the possibility of delay. If young people start smoking time, can greatly reduce the smoking rate and population The morbidity and mortality caused by various diseases. Moreover, smoking or adolescent substance abuse "entry", and adolescent behavior problems are closely related to smoking, teenagers often accompanied by such as academic, moral, psychological and behavioral problems. Therefore a series of youth has always been the focus in tobacco control work, the education of young people stay away from tobacco, is related to the growth of their physical and mental health, improve long-term smokers blocking the subsequent team, the quality of the Chinese nation
Teenagers are in the growth period, various organ systems are not mature, to environmental harmful factors in the resistance is weak to adult, sensitive to toxic substances, the body's normal growth and development of vulnerable, therefore, passive smoking has a greater harm to teenagers. Studies have shown that passive smoking can lead to children's cognitive ability the probability of defects, children behavior problems will be greatly increased if 11,16-18 years old children often passive smoking, their academic performance will be affected greatly, can not pass the exam than other normal children is higher than 30%.
In 2010 GATS, China's 301 million smokers now, there are about 740 million non-smokers suffer from secondhand smoke, 180 million of whom are teenagers.43.9% in secondhand smoke from young family, 55.8% teenagers in public places suffer students report hazards.88.2% of second-hand smoke close people in a survey of smokers.2005 the youth of our country before the age of 13, smoked a whole cigarette proportion increased by 15% from 1998 to 2008 in Shandong province; survey also shows that Shandong province had smoked a whole cigarette smoked youth report before the age of 13 reached 49.8%, 52.5% of the students reported in the past 7 days have been passive smoking.
Primary school period is the key period of outlook on life, values and behavior habits, the best period is the health risk behavior intervention, students accept the health knowledge quickly, easy to form a healthy behavior, intervention and compliance with high, in addition to primary school learning pressure is relatively small, the system of intervention operability stronger, most importantly, from the primary school start time is the health benefits of smoking cessation intervention. Long history of smoking on school health education and behavior intervention is effective not only for students with great role in tobacco control, tobacco control in the whole society has far-reaching significance, is based on this we carried out this research, through the questionnaire survey to understand the factors and the influence of our province students exposure to tobacco, tobacco harm knowledge and the knowledge source, and the effect of passive smoking on learning achievement of This study provides a scientific basis for more targeted, more effective health education and behavioral intervention for tobacco control in primary schools.
[research purposes]
To master the current situation and influencing factors of smoking and passive smoking behavior among pupils in our province, to investigate the effect of passive smoking on learning achievement, I understand pupils in tobacco related knowledge, sources of knowledge and attitude on tobacco use, to more effectively carry out school education and tobacco control on tobacco control intervention was evaluated to provide baseline data and references.
[research methods]
The survey used a multi-stage stratified random sampling, in Shandong Province, from Weihai, 6050 students and their parents in Laiwu and Liaocheng 3 city 13 schools as the research object, using a questionnaire designed by the project team, by trained investigators to class collective questionnaires for students unit. The parent questionnaire by the students to return to school, by parents to fill in, students and parents are anonymous questionnaire. Use Epidata3.0 to establish a database of effective questionnaires, using SPSS16.0 demographic characteristics of the subjects, the status and influencing factors of tobacco exposure, the harm of tobacco related knowledge status were analyzed.
[main results]
1, primary school students in Shandong province attempt smoking rate was 6%, the average age of the current smoking rate of 1.2%. for the first time smoking was 7.8 + 2.1 years ago, three causes of attempting smoking were "curiosity", "peer to smoke" and "bad / good", the main source of cigarettes for "home" and "purchase". The main risk factors of smoking behavior of students are boys, non child, poor academic performance, the harm of tobacco knowledge fail, family smoking, smoking students, teachers to see the difference between smoking and other areas.
2, the passive smoking rate of pupils in all places in Shandong is 50.5%, the city is higher than that of the countryside, and Liaocheng is higher than that of Laiwu and Weihai.
3, Shandong Province, the primary home passive smoking rate 49.7%. passive smoking rate in rural areas than in the city, the only child is higher than non only child, family structure compared to inter generational family is highest, the reorganization of the family and family time. Main smokers in the family is father and grandfather / grandfather, father and grandfather of 43.42% / 73.96% my grandfather smoked in more than 10 years, 66.78% of the 61.56% father and grandfather / smoking grandfather for 1-10, and smoking in the home position is a "full absorption" and "in the living room ceiling". The main risk factors of the risk of passive smoking in family is big and inter generational family that only children, parents with lower levels of cultural differences and regions.
4, the survey showed that 27.4% of the primary school students said they had seen teachers smoking in school, the countryside was higher than the city, and Liaocheng was higher than Laiwu and Weihai.
5, primary school students in Shandong Province tobacco harm knowledge awareness rate is low, the harm of smoking on the respiratory system of the high awareness, such as cardiovascular disease and cancer hazard awareness and awareness of the hazards of passive smoking rate is relatively low. Primary school students in Shandong province from the dangers of tobacco related knowledge more channels are "TV / radio", "network" and "newspapers and magazines", urban and rural primary school's knowledge sources are different. Only 44.3% of the students chose to get knowledge of tobacco control from the "school health education curriculum".
6, survey shows that passive smoking is the factors affecting student achievement, a family of passive smoking students with poor grades reported higher than households without passive smoking students, and the more the number of days per week of passive smoking, excellent grades and in less, and more poor grades.
[main conclusions]
1, primary school students in Shandong province have tried smoking behavior trend of younger age, and tobacco harm knowledge awareness rate is low, and the awareness of rural pupils in city's knowledge rate and the source channel is slightly different, suggesting that our province should pay attention to school education of primary school students, especially should strengthen the "to first cigarette" skills training, tobacco control according to the different characteristics of urban and rural education should be individualized.
2, smoking behavior of students have not only personal factors, there is a reason for family factors and environment factors, suggesting that tobacco control work should be based on the focus on school, family and community to cooperate with each other in order to achieve better results. To strengthen students' tobacco control work at the same time, also can not ignore the social propaganda and parents of students. Teachers and help to quit smoking cessation intervention.
3, smoking in public places in our province is serious. It is suggested that the smoking regulation of local public places should be accelerated and smoking in public places should be stopped.

【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R179

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