Lindström Martin, Janzon Ellis
Department of Clinical Sciences, Malmö University Hospital, Sweden.
Scand J Public Health. 2007;35(5):460-7. doi: 10.1080/14034940701246090.
The associations between vertical (institutional) trust in the healthcare system and the mass media (newspapers and television), and daily smoking and smoking cessation were investigated.
The 2004 public-health survey in Scania is a cross-sectional study. A total of 27,757 persons aged 18-80 years answered a postal questionnaire, which represents 59% of the random sample. A logistic regression model was used to investigate the associations between institutional trust in the healthcare system and the mass media, and daily smoking and smoking cessation. A multivariate analysis was performed to investigate the importance of possible confounders (age, country of origin, education, economic stress, generalized trust in other people) on the differences in daily smoking and smoking cessation according to trust in the healthcare system and the mass media.
14.9% of the men and 18.1% of the women were daily smokers. Middle-aged respondents were daily smokers to a significantly higher extent than the young. Respondents with low trust in the healthcare system had significantly higher odds ratios of daily smoking, 1.88 (95% CI 1.38-2.57) among men and 2.05 (95% CI 1.51-2.78) among women, while respondents with low trust in the mass media had no significant odds ratios of daily smoking, 1.01 (0.67-1.52) among men and 1.55 (0.97-2.47) among women, after multiple adjustments.
Institutional (vertical) trust in the healthcare system but not the mass media was significantly associated with lower odds of daily smoking and higher odds of having quit smoking if ever smoker. The healthcare system seems to be a potent arena for tobacco prevention.
研究对医疗保健系统和大众媒体（报纸和电视）的垂直（机构）信任与每日吸烟及戒烟之间的关联。
斯堪尼亚2004年的公共卫生调查是一项横断面研究。共有27757名年龄在18至80岁之间的人回答了一份邮寄问卷，这占随机样本的59%。采用逻辑回归模型研究对医疗保健系统和大众媒体的机构信任与每日吸烟及戒烟之间的关联。进行多变量分析以研究可能的混杂因素（年龄、原籍国、教育程度、经济压力、对他人的普遍信任）对根据对医疗保健系统和大众媒体的信任程度在每日吸烟和戒烟差异方面的重要性。
14.9%的男性和18.1%的女性为每日吸烟者。中年受访者每日吸烟的比例明显高于年轻人。对医疗保健系统信任度低的受访者每日吸烟的优势比显著更高，男性为1.88（95%置信区间1.38 - 2.57），女性为2.05（95%置信区间1.51 - 2.78），而对大众媒体信任度低的受访者在多次调整后每日吸烟的优势比无显著差异，男性为1.01（0.67 - 1.52），女性为1.55（0.97 - 2.47）。
对医疗保健系统而非大众媒体的机构（垂直）信任与每日吸烟几率较低以及曾经吸烟者戒烟几率较高显著相关。医疗保健系统似乎是预防烟草的一个有力领域。
