既往戒烟次数相关影响因素的研究

发布时间：2018-08-03 21:08

【摘要】：研究背景烟草使用严重危害人群健康、给人类社会带来沉重的经济负担,目前已成为全球范围内亟待解决的公共卫生问题。在众多遭受烟草之害的国家中,我国受害尤为严重,这与我国烟草的高生产和高消费水平有紧密的关系。此外,我国农村人口众多,与城市居民相比,农村人群的吸烟率更高,吸烟量也更多。因此,针对我国农村地区制定切实可行的烟草控制策略和措施,对控制烟草流行、促进人群健康意义重大。控烟工作是一项系统工程,控烟措施涉及方方面面,其中最直接、最为经济有效的手段是促进吸烟者成功戒烟。吸烟者能否戒烟成功受到许多因素的影响,如戒烟原因、自我效能、烟草危害认知、每天吸烟量、周围吸烟者数量等,既往戒烟经历也是其中重要的影响因素之一。目前,关于既往戒烟经历与戒烟成功关系的研究存在争议。有研究认为,有过戒烟经历的人将来的戒烟意愿更高,也更倾向于再次尝试戒烟;并且在成功戒烟前,戒烟者一般要经历若干次的戒烟尝试,有数据表明一般平均需要尝试戒烟14次才可成功。而有的研究则认为成功戒烟者一般一次戒烟即成功,而戒烟失败者虽然曾经尝试过很多次但仍未成功,即戒烟次数越多越不容易戒烟成功。针对上述戒烟次数研究中存在的问题,本研究采用横断面调查的方法,探讨农村地区男性人群既往戒烟次数与戒烟成功的关系,在此基础上,探讨现在吸烟者既往戒烟次数的影响因素,为将来制定符合客观实际的控烟干预策略和措施提供有力的理论指导。研究目的1.探讨既往戒烟次数与戒烟成功的关系2.探讨现在吸烟者戒烟次数的影响因素研究方法本研究建立在山东大学卫生研究基地队列的基础上,该队列创建于2009年。2010年8月于队列所在地临沂莒南、济宁梁山和济南平阴这3个县中,每个县分别抽取3个自然村,采用《农村居民烟草暴露问卷》,对抽取的9个自然村中15岁及以上的常住居民进行问卷调查,排除由于务工或其他原因不在当地生活3个月以上者。问卷收集的内容主要包括研究对象的一般人口学特征、烟草使用状况、戒烟的情况、对吸烟的态度和烟草危害认知情况等。本研究中选取现在吸烟者和已经戒烟者作为对象。将研究对象按照年龄划分为青年(小于45岁)、中年(45岁至59岁)和老年(大于等于60岁);将婚姻状况划分为已婚和其他两种类型;将文化水平划分为低、中、高三个等级,分别代表小学以下、小学和初中、高中及以上;将职业类型划分成务农和其他两类。吸烟包年数定义为每天吸烟支数/20支×吸烟年数;将戒烟原因分成患病或担心患病和其他原因;对待吸烟的态度和吸烟危害认知,将各项目得分求和得到态度、危害认知总分,采用三分位数法将总分进行划分,分别代表态度的错误、中立、正确和危害认知的低、中、高三个等级;在戒烟次数的影响因素研究中,将既往从未戒过烟的人的戒烟次数定义为0,一同纳入戒烟次数影响因素的分析中。运用多因素logistic模型探讨既往戒烟次数与戒烟成功的关系;采用倾向性评分值作为logistic回归模型中的协变量将年龄、婚姻状况、教育程度、职业类型、开始吸烟年龄、戒烟的原因等作为潜在的混杂因素予以调整;采用Hurdle计数模型探究戒烟次数的影响因素。研究结果1.戒烟成功和失败者在年龄分组、吸烟包年数、吸烟年限、每天吸烟量、既往戒烟次数和戒烟原因等方面的差异均具有统计学显著性(P0.05),而在婚姻状况、文化程度、职业类型和开始吸烟年龄方面无显著统计学差异。2.Logistic回归结果显示,调整混杂因素年龄、文化程度、职业类型、婚姻状况、开始吸烟年龄和戒烟原因之后,既往戒烟次数与戒烟成功呈显著负相关(OR=0.417,95%CI=0.343-0.506)。3.戒过烟者和从未戒过烟者相比,两组人群在年龄分组、吸烟年限、吸烟包年数、婚姻状况、对待吸烟的态度和吸烟危害认知等方面差异均具有统计学显著性(P0.05),而在教育水平、职业类型、开始吸烟年龄、每天吸烟量方面无显著统计学差异。4.Hurdle计数模型结果分为两部分。Logistic部分结果表明,影响现在吸烟者是否曾经戒过烟的因素主要有婚姻状况(已婚vs.其他,β=0.540,P= 0.004)、教育程度(β=0.195,P=0.040)以及吸烟危害认知水平(β=0.238,P=0.009)。零截尾Poisson回归部分显示,对于有过至少一次戒烟经历的人来说,开始吸烟年龄在20岁之前的相对于20岁之后开始吸烟的人戒烟次数更多(β=0.202,P=0.010),吸烟危害认知水平(β=0.141,P= 0.024)与既往戒烟次数呈正相关。结论1.既往戒烟次数越多,成功戒烟的可能性越低。2.在既往戒烟次数的影响因素中,过去是否戒烟和戒烟的次数这两个过程的影响因素不完全相同。婚姻状况、文化程度和烟草危害认知程度是影响是否戒烟的主要因素;而开始吸烟年龄和烟草危害认知水平主要与既往戒烟次数有关。在以后的工作中,应该纠正关于戒烟的错误认识,鼓励吸烟者尝试戒烟,同时应该促进戒烟维持防止复吸从而达到成功戒烟的目的。
[Abstract]:Background tobacco use seriously endangering the health of the population, bringing a heavy economic burden to the human society, has become an urgent problem of public health in the world. In many countries suffering from tobacco damage, our country is particularly injured, which is closely related to the high production and high consumption level of China's tobacco. In addition, The country has a large population in rural areas. Compared with the urban residents, the smoking rate of the rural population is higher and the amount of smoking is more. Therefore, it is of great significance to control the tobacco epidemic and promote the health of the population by making practical tobacco control strategies and measures aimed at the rural areas in China. The most direct, most economical means is to promote smokers to quit smoking successfully. The success of smokers is affected by many factors, such as smoking cessation, self-efficacy, tobacco hazard cognition, daily smoking, the number of smokers around, and the past smoking cessation experience is one of the most important factors. There is a dispute over the study of the relationship between smoking cessation success. There are studies that people who have had the experience of smoking cessation are more willing to give up smoking in the future and are more likely to try again. The result of the study is that successful quitting smokers usually give up smoking or success, while smokers who have tried many times but still fail to succeed, that is, the more the number of quitting smoking is not easy to succeed. On the basis of the relationship between the number of smokers and the success of smoking cessation, the influence factors of the number of smoking cessation in the past are discussed in order to provide effective theoretical guidance for the future development of smoking control strategies and measures in accordance with the objective reality. Purpose 1. to explore the influence of the number of smoking cessation and the success of smoking cessation on the influence of the number of smoking cessation in the present smokers. Based on the cohort of the Shandong University health research base, this study was established in the 3 counties of Junan, Linyi, Jining, Liangshan and Pingyin, Ji'nan, 2009, where 3 natural villages were selected from each county in the 3 counties of Junan, Jining, Liangshan and Ji'nan. The tobacco exposure questionnaire for rural residents was used for 15 years in 9 natural villages. Questionnaire survey was conducted to exclude people who had not been living for more than 3 months due to work or other reasons. The contents of the questionnaire mainly included the general demographic characteristics of the subjects, the status of tobacco use, the situation of smoking cessation, the attitude to smoking and the cognition of tobacco danger. The subjects were divided into young people (less than 45 years old), middle-aged (45 to 59 years old) and older (more than 60 years old); the marital status was divided into married and other two types; the cultural level was divided into lower, middle and higher levels, representing primary and junior high school, high school and above, respectively; The occupational types were divided into two categories of farming and other types. The number of years of smoking package was defined as the number of /20 branches per day and the number of years of smoking; the reasons for smoking cessation were divided into illness or worry and other reasons; the attitude of smoking and the cognition of smoking hazards were treated, the scores of each item were gained and the total score of the risk of danger was obtained, and the total score was carried out by the method of three quantiles. In the study of the influencing factors of the number of smoking cessation, the number of smokers who had never given up smoking was defined as 0, and the influence factors of smoking cessation were included in the analysis. The number of smoking cessation and smoking cessation were discussed by the multi factor Logistic model. Successful relationship; use the tendency score value as the covariate in the logistic regression model to adjust age, marital status, education, career type, smoking age, and cause of smoking cessation as potential confounding factors; use the Hurdle counting model to explore the influence factors of the number of smoking abstinence. Study results 1. the success and loss of smoking cessation. The differences in age groups, years of smoking, smoking years, smoking, smoking, smoking, and smoking cessation were statistically significant (P0.05), but there was no significant difference in marital status, educational level, occupational type and smoking age..2.Logistic regression results showed that the adjustment of confounding factors Age, educational level, occupation type, marital status, smoking age and smoking cessation cause, the number of previous smoking cessation was significantly negatively correlated with the success of smoking cessation (OR=0.417,95%CI=0.343-0.506) the two groups were divided into age groups, years of smoking, year of smoking, marital status, attitude and attitude towards smoking, compared with those who had never quit smoking. The differences in smoking hazard cognition are statistically significant (P0.05), but there is no significant difference in the level of education, occupation type, smoking age, and daily smoking. The results of.4.Hurdle count model are divided into two parts.Logistic part results show that the main factors affecting whether smokers have ever quit smoking are mainly married. Marital status (married vs., beta =0.540, P= 0.004), educational level (beta =0.195, P=0.040) and smoking hazard cognitive level (beta =0.238, P=0.009). Zero truncated Poisson regression section showed that people who started smoking at least 20 years of age at least once were smoking cessation times before the age of 20. (beta =0.202, P=0.010), the cognitive level of smoking hazards (beta =0.141, P= 0.024) was positively correlated with the number of previous smoking cessation. Conclusion 1. the more the number of smoking cessation, the lower the likelihood of successful smoking cessation, the more the factors affecting the number of previous smoking cessation in the past, the factors affecting the past two processes of smoking cessation and smoking cessation are not exactly the same. The marital status, The degree of culture and the degree of cognition of tobacco harm are the main factors that affect the smoking cessation, and the age of smoking and the cognitive level of tobacco harm are mainly related to the number of previous smoking cessation. In the future work, we should correct the wrong knowledge of smoking cessation, encourage smokers to try to quit smoking, and should promote smoking cessation to prevent relapse from smoking. To succeed in smoking cessation.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R163

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