Chaix Basile, Guilbert Phillipe, Chauvin Pierre
Research Unit in Epidemiology and Information Sciences, National Institute of Health and Medical Research (INSERM U444), Paris, France.
Eur J Public Health. 2004 Jun;14(2):186-90. doi: 10.1093/eurpub/14.2.186.
Both the predictors for tobacco use and the determinants of the amounts of tobacco consumed by smokers should be taken into account when designing prevention programmes.
Using a sample of 12,948 individuals representative of the French population in 1999, multilevel models were used to carry out a comparative investigation for the predictors of tobacco use and the determinants of the amount of tobacco consumed by smokers.
At the individual level, a combination of risks (higher risk of smoking and larger amounts of tobacco consumed by smokers) was found for males, for individuals with a low level of education and for divorcees. At the level of the area of residence, both the risk of smoking (odds ratio 1.07, 95% confidence interval: 1.01-1.12 for an increase by one standard deviation) and the amount of tobacco consumed among smokers (percentage variation +4%, 95% confidence interval: 0% - +8%) increased with the gross domestic product per capita.
This study justifies the combined use, in such analyses, of consumption levels for smokers in addition to the risk of smoking, in order to identify the profiles with the highest risk. It was possible to identify various groups with both a high risk of tobacco use and a high level of consumption among smokers, on the basis of individual (male, divorced or less educated) and environmental (living in a high GDP area) factors. The prevention efforts should thus be focused on such groups.
在设计预防方案时，应同时考虑烟草使用的预测因素和吸烟者烟草消费量的决定因素。
以1999年具有法国人口代表性的12948人为样本，使用多水平模型对烟草使用的预测因素和吸烟者烟草消费量的决定因素进行比较研究。
在个体层面，发现男性、低教育水平个体和离婚者存在多种风险组合（吸烟风险较高且吸烟者烟草消费量较大）。在居住地区层面，吸烟风险（优势比1.07，95%置信区间：人均国内生产总值每增加一个标准差为1.01 - 1.12）和吸烟者烟草消费量（百分比变化 +4%，95%置信区间：0% - +8%）均随人均国内生产总值的增加而增加。
本研究证明在这类分析中除了吸烟风险外还应结合吸烟者的消费水平，以便识别风险最高的人群特征。基于个体（男性、离婚或受教育程度较低）和环境（生活在高国内生产总值地区）因素，有可能识别出吸烟者中烟草使用风险高且消费水平高的各类群体。因此，预防工作应聚焦于这类群体。
