Townsend J, Wilkes H, Haines A, Jarvis M
MRC Epidemiology and Medical Care Unit, Northwick Park Hospital, Harrow, Middlesex.
BMJ. 1991 Oct 19;303(6808):947-50. doi: 10.1136/bmj.303.6808.947.
To compare physical, lifestyle, and health characteristics of adolescent smokers and non-smokers and their initial response to anti-smoking counselling.
Adolescents aged 13, 15, and 17 years were identified from age-sex registers and invited by letter for a general practice health check.
Three general practices in the MRC general practice research framework.
Blood pressure, body mass index, saliva cotinine concentration, peak flow rate, alcohol consumption, exercise, duration of sleep, and stated persistent health problems.
73% of the adolescents (491) attended for the health check. A total of 68 (14%) were regular smokers. By age 17 those who smoked regularly had a significantly lower systolic blood pressure than those who had never smoked regularly (by 6 mm Hg; p = 0.025) despite a significantly higher body mass index (by 1.5; p <0.001) [corrected]. Cotinine concentrations increased with smoking exposure, from 0.7 ng/ml when no family member smoked to 155 ng/ml in active smokers of six or more cigarettes a week. Significantly more regular smokers than never regular smokers drank greater than or equal to 8 g alcohol a day (chi 2 = 15.2 adjusted for age and sex p less than 0.001); regular smokers exercised less (1.0 hrs/week in boys and 0.8 hrs/week in girls v 3.4 hrs/week in boys and 2.2 hrs/week in girls; p less than 0.001) and slept less (8.0 hrs/night v 8.5 hrs/night at age 17; p less than 0.005). Persistent health problems, mostly asthma or allergic symptoms, were reported by 25% (17/68) of the smokers and 16% (60/381) of the non-smokers. Of the smokers given counselling, 60% (26/43) made an agreement with the practice doctor or nurse to give up smoking.
General practice is an appropriate setting for adolescents to receive advice on healthy lifestyle, which should not focus solely on smoking.
比较青少年吸烟者与非吸烟者的身体、生活方式及健康特征，以及他们对戒烟咨询的初始反应。
从年龄-性别登记册中识别出13岁、15岁和17岁的青少年，并通过信件邀请他们进行全科医疗健康检查。
医学研究委员会全科医疗研究框架中的三家全科医疗诊所。
血压、体重指数、唾液可替宁浓度、峰值流速、饮酒量、运动量、睡眠时间以及所述的持续性健康问题。
73%的青少年（491名）参加了健康检查。共有68名（14%）为经常吸烟者。到17岁时，经常吸烟的青少年收缩压显著低于从不经常吸烟的青少年（低6毫米汞柱；p = 0.025），尽管体重指数显著更高（高1.5；p <0.001）[校正后]。可替宁浓度随吸烟暴露增加，从不吸烟家庭成员时的0.7纳克/毫升增加到每周吸6支或更多香烟的现吸烟者的155纳克/毫升。每天饮用大于或等于8克酒精的经常吸烟者显著多于从不经常吸烟者（经年龄和性别校正的卡方值=15.2，p<0.001）；经常吸烟者运动量较少（男孩每周1.0小时，女孩每周0.8小时，而男孩为每周3.4小时，女孩为每周2.2小时；p<0.001）且睡眠时间较少（17岁时为每晚8.0小时对8.5小时；p<0.005）。25%（17/68）的吸烟者和16%（60/381）的非吸烟者报告有持续性健康问题，主要是哮喘或过敏症状。在接受咨询的吸烟者中，60%（26/43）与诊所医生或护士达成了戒烟协议。
全科医疗是青少年接受健康生活方式建议的合适场所，且建议不应仅专注于吸烟。
