Fernandez E, Schiaffino A, La Vecchia C, Borrás J M, Nebot M, Saltó E, Tresserras R, Rajmil L, Villalbí J R, Segura A
Institut Universitari de Salut Pública de Catalunya, L'Hospitalet, Barcelona, Spain.
Prev Med. 1999 Apr;28(4):361-6. doi: 10.1006/pmed.1998.0433.
Few studies have investigated the association between age at starting smoking and the average number of cigarettes smoked per day in adulthood. To provide further evidence on this issue, we analyzed data from the Catalan Health Interview Survey (CHIS).
The CHIS was conducted in 1994 on a randomly selected sample (N = 15,000) of the population of Catalonia, Spain. A total of 4,897 current or exsmokers (3,276 males and 1,621 females) were included for analysis. Age-standardized proportions of subjects smoking <15, 15-24, and >/=25 cigarettes/day, age-standardized mean number of cigarettes smoked per day, and multivariate odds ratios (OR) of being a heavy smoker (>/=25 cigarettes/day) according to age at starting smoking (<15, 15-17, 18-19, >/=20 years) were computed.
Men who started smoking before the age of 15 smoked on average 5.5 cigarettes more than those who started at age 19 or over. Women who started smoking early in life smoked, on average, 6.8 cigarettes/day more than women who started later. The proportion of smokers of <15 cigarettes/day was higher among subjects who started smoking later. Both for males and for females, the OR of being a heavy smoker significantly increased with decreasing age at starting smoking (OR = 2.4 for males and 4.5 for females who started at age <15 versus >/=20 years). The level of education did not modify the relationship in males, whereas the association with age at starting was only apparent for more educated women.
This study confirms that age at starting smoking is inversely and strongly associated to the number of cigarettes smoked per day. Thus, actions aimed at the prevention or delay of smoking onset among adolescents would have an important beneficial effect.
很少有研究调查开始吸烟的年龄与成年后每天吸烟的平均数量之间的关联。为了就此问题提供进一步的证据，我们分析了加泰罗尼亚健康访谈调查（CHIS）的数据。
CHIS于1994年在西班牙加泰罗尼亚人口的随机抽样样本（N = 15000）中进行。总共纳入4897名当前吸烟者或曾经吸烟者（3276名男性和1621名女性）进行分析。计算了年龄标准化的每天吸烟少于15支、15 - 24支以及≥25支的受试者比例，年龄标准化的每天吸烟平均数，以及根据开始吸烟年龄（<15岁、15 - 17岁、18 - 19岁、≥20岁）成为重度吸烟者（≥25支/天）的多变量优势比（OR）。
15岁之前开始吸烟的男性平均比19岁及以上开始吸烟的男性多吸5.5支烟。早年开始吸烟的女性平均每天比晚开始吸烟的女性多吸6.8支烟。开始吸烟较晚的受试者中，每天吸烟少于15支的吸烟者比例更高。对于男性和女性而言，成为重度吸烟者的OR均随着开始吸烟年龄的降低而显著增加（开始吸烟年龄<15岁的男性OR = 2.4，女性OR = 4.5，而开始吸烟年龄≥20岁的男性和女性OR分别为1）。教育水平并未改变男性的这种关系，而对于受教育程度较高的女性，与开始吸烟年龄的关联才较为明显。
本研究证实开始吸烟的年龄与每天吸烟的数量呈强烈负相关。因此，旨在预防或推迟青少年开始吸烟的行动将产生重要的有益效果。
