Siahpush Mohammad, Borland Ron, Scollo Michelle
VicHealth Centre for Tobacco Control, The Cancer Council, Victoria, Australia.
Nicotine Tob Res. 2003 Aug;5(4):597-602. doi: 10.1080/1462220031000118711.
The association of sociodemographic and selected behavioral and social environmental factors with successful smoking cessation was examined using cross-sectional data from the 1998 Australian National Drug Strategy Household Survey, which used an area multistage stratified design. Data collection involved a mixture of interviews and self-administered questionnaires. We used a subsample of 2,526 Australians aged 14 years and older. The outcome measure distinguished between current smokers and those who had stopped smoking in the past 2 years and had not smoked for at least 1 month prior to the survey. Knowing that environmental tobacco smoke is harmful and having first smoked at age 14 or younger were associated with a higher likelihood of cessation. The odds of having quit smoking were 4.5 times greater for respondents who lived in households where smoking was not permitted than for those in households with no smoking restrictions. The odds of having quit were 3.2 times greater for respondents who reported that few or none of their friends smoked than for those who said most or all of their friends smoked. After including social environmental variables, associations of education and cessation disappeared. The study confirmed the difficulty of quitting if the proximal social environment is filled with smokers. Results call for an integrated approach in which smoking cessation interventions target the social environment as well as the individual. Efforts to intervene in smoking behavior will have limited effectiveness unless they take into account the social contexts in which smoking behavior takes place.
利用1998年澳大利亚国家毒品战略家庭调查的横断面数据,研究了社会人口学因素以及某些行为和社会环境因素与成功戒烟之间的关联。该调查采用区域多阶段分层设计,数据收集涉及访谈和自填问卷相结合的方式。我们使用了一个由2526名14岁及以上澳大利亚人组成的子样本。结果指标区分了当前吸烟者与那些在过去两年内已戒烟且在调查前至少1个月未吸烟的人。知晓环境烟草烟雾有害以及初次吸烟年龄在14岁及以下与更高的戒烟可能性相关。居住在禁止吸烟家庭的受访者戒烟的几率是没有吸烟限制家庭受访者的4.5倍。报告称很少有或没有朋友吸烟的受访者戒烟的几率是那些表示大多数或所有朋友都吸烟的受访者的3.2倍。纳入社会环境变量后,教育与戒烟之间的关联消失了。该研究证实,如果身边的社会环境中吸烟者众多,戒烟就会很困难。研究结果呼吁采取一种综合方法,即戒烟干预措施既要针对个人,也要针对社会环境。除非考虑到吸烟行为发生的社会背景,否则干预吸烟行为的努力效果将有限。