de Vries Hein
University of Maastricht, The Netherlands.
Prev Med. 2007 Aug-Sep;45(2-3):119-20. doi: 10.1016/j.ypmed.2007.04.014. Epub 2007 May 22.
Chen and colleagues describe social factors that are related with Chinese adolescent smoking behaviors [Chen, W., Wen, X., Muscat, J., et al., 2007-this issue. Modifiable family and school environmental factors associated with smoking status among adolescents in Guangzhou, China. Prev. Med. doi:10.1016/j.ypmed.2007.02.009]. These types of studies in China are very much needed given the fact that smoking is a significant health problem in China. Environmental factors may be more important than sometimes thought, since some studies suggest that smoking onset may not be such a 'reasoned' process by youngsters (Kremers, S.P., Mudde, A.N., de Vries, N.K., Brug, J., de Vries, H., 2004. Unplanned smoking initiation: new insights and implications for interventions. Patient Educ. Couns. 55 (3), 345-52.). Studies indicate that a multitude of factors are related to smoking onset, and thus deserve attention in a smoking prevention approach (see, e.g., [Tyas, S., Pederson, L., 1998. Psychosocial factors related to adolescent smoking: a critical review of the literature. Tob. Control 7, 409-420; Lantz, P., Jacobson, P., Warner, K., et al., 2000. Investing in youth tobacco control: a review of smoking prevention and control strategies. Tob. Control 9, 47-63]). The study conclusions were derived from a cross-sectional report. Consequently, one needs to be careful in making conclusions about causal pathways [Bauman, K., Fisher, L., 1986. On the measurement of friend behavior in research on friend influence and selection: findings from longitudinal studies of adolescent smoking and drinking. J. Youth Adolesc. 15 (4), 345-353]. Longitudinal studies also suggest the impact of selection mechanisms implying that adolescents were not pressured to start to smoke, but selected smoking friends. Chen, W., Wen, X., Muscat, J., et al.'s [2007-this issue. Modifiable family and school environmental factors associated with smoking status among adolescents in Guangzhou, China. Prev. Med. doi:10.1016/j.ypmed.2007.02.009.] work is important because it describes one of the many steps that are needed in China for realizing effective smoking prevention programs, a study that could be described as one of the first steps in the planning cycle of health promotion [Green, L., Kreuter, M., 1999. Health Promotion Planning: An Educational and Ecological Approach. Mayfield Publishing Company, Mountain View, CA]. Ultimately Chen and colleagues may want to develop smoking prevention interventions. These interventions should indeed incorporate the modifiable social factors, and - as the Chinese data suggest - should be gender sensitive. Consequently, the great challenge for Chen and several other Chinese colleagues will be to develop an integral long-term approach for their country to prevent smoking onset as effectively as possible using comprehensive approaches.
陈及其同事描述了与中国青少年吸烟行为相关的社会因素[陈，W.，文，X.，马斯卡特，J.等，2007年 - 本期。中国广州青少年吸烟状况相关的可改变家庭和学校环境因素。预防医学。doi:10.1016/j.ypmed.2007.02.009]。鉴于吸烟在中国是一个重大的健康问题，此类在中国的研究非常必要。环境因素可能比有时认为的更为重要，因为一些研究表明青少年开始吸烟的过程可能并非如此“理性”（克雷默斯，S.P.，穆德，A.N.，德弗里斯，N.K.，布鲁格，J.，德弗里斯，H.，2004年。无计划开始吸烟：对干预措施的新见解及启示。患者教育与咨询。55(3)，345 - 52）。研究表明众多因素与开始吸烟有关，因此在预防吸烟的方法中值得关注（例如，见[泰亚斯，S.，佩德森，L.，1998年。与青少年吸烟相关的心理社会因素：文献综述。烟草控制。7，409 - 420；兰茨，P.，雅各布森，P.，华纳，K.等，2000年。投资于青少年烟草控制：吸烟预防与控制策略综述。烟草控制。9，47 - 63]）。该研究结论源自一份横断面报告。因此，在得出关于因果途径的结论时需谨慎[鲍曼，K.，费舍尔，L.，1986年。关于在朋友影响和选择研究中对朋友行为的测量：青少年吸烟和饮酒纵向研究的结果。青少年与青少年研究杂志。15(4)，345 - 353]。纵向研究也表明选择机制的影响，这意味着青少年并非受到压力才开始吸烟，而是选择了吸烟的朋友。陈，W.，文，X.，马斯卡特，J.等[2007年 - 本期。中国广州青少年吸烟状况相关的可改变家庭和学校环境因素。预防医学。doi:10.1016/j.ypmed.2007.02.009]的工作很重要，因为它描述了中国实现有效吸烟预防项目所需的众多步骤之一，该研究可被视为健康促进规划周期中的第一步之一[格林，L.，克鲁特，M.，1999年。健康促进规划：教育与生态方法。梅菲尔德出版公司，加利福尼亚州山景城]。最终，陈及其同事可能希望制定吸烟预防干预措施。这些干预措施确实应纳入可改变的社会因素，并且 - 正如中国的数据所表明的 - 应具有性别敏感性。因此，陈和其他几位中国同事面临的巨大挑战将是为他们的国家制定一种综合的长期方法，以尽可能有效地采用综合方法预防吸烟开始。
