Division of Epidemiology and Biostatistics, San Diego State University, California, USA.
BMC Public Health. 2010 Jan 14;10:16. doi: 10.1186/1471-2458-10-16.
Tobacco use is a leading cause of global morbidity and mortality. Much of the epidemiologic research on tobacco focuses on smoking, especially cigarette smoking, but little attention on smokeless tobacco (SLT).
Using data from the Republic of Congo Global Youth Tobacco Survey (GYTS) of 2006, we estimated the prevalence of SLT use among in-school adolescents. We also assessed the association between SLT use and cigarette smoking as well as the traditional factors which are associated with cigarette smoking among adolescents (e.g. age, sex, parental or peer smoking). Unadjusted odds ratios (OR) and adjusted odds ratios (AOR) together with their 95% confidence intervals (CI) were used to measure magnitudes of associations.
Of the 3,034 respondents, 18.0% (18.0% males and 18.1% females) reported having used smokeless tobacco (chewing tobacco, sniff or dip) in the last 30 days. In multivariate analysis, no significant associations were observed between age and sex on one hand and current smokeless tobacco use on the other. Cigarette smokers were more than six times likely to report current use of smokeless tobacco (AOR = 6.65; 95% CI [4.84, 9.14]). Having parents or friends smokers was positively associated with using smokeless tobacco (AOR = 1.98; 95% CI [1.51, 2.59] for parents who smoked cigarettes, AOR = 1.82; 95% CI [1.41, 2.69] for some friends who smoked cigarettes, and AOR = 2.02; 95% CI [1.49, 2.47] for most or all friends who smoked cigarettes). Respondents who reported have seen tobacco advertisement on TV, billboards and in newspapers/magazines were 1.95 times more likely to report current use of smokeless tobacco (AOR = 1.95; 95% CI [1.34, 3.08]). Perception that smoking was harmful to health was negatively associated with current use of smokeless tobacco (AOR = 0.60; 95% CI [0.46, 0.78]).
Prevention programs aimed to reduce teen [cigarette] smoking must also be designed to reduce other forms of tobacco use. The teenagers environment at home, at school and at leisure must also be factored in order to prevent their uptake or maintenance of tobacco use.
吸烟是导致全球发病率和死亡率的主要原因之一。大多数关于烟草的流行病学研究都集中在吸烟上，尤其是香烟，但对无烟烟草（SLT）的关注甚少。
利用刚果共和国 2006 年全球青少年烟草调查（GYTS）的数据，我们估计了在校青少年使用 SLT 的流行率。我们还评估了 SLT 使用与吸烟之间的关联，以及与青少年吸烟相关的传统因素（例如年龄、性别、父母或同伴吸烟）。未调整的优势比（OR）和调整的优势比（AOR）及其 95%置信区间（CI）用于衡量关联的大小。
在 3034 名受访者中，18.0%（男性 18.0%，女性 18.1%）报告在过去 30 天内使用过无烟烟草（咀嚼烟草、鼻吸或舔吸）。在多变量分析中，年龄和性别与当前无烟烟草使用之间没有显著关联。吸烟者报告当前使用无烟烟草的可能性是六倍以上（AOR=6.65；95%CI[4.84,9.14]）。父母或朋友吸烟与使用无烟烟草呈正相关（AOR=1.98；95%CI[1.51,2.59]对于吸烟的父母，AOR=1.82；95%CI[1.41,2.69]对于一些吸烟的朋友，AOR=2.02；95%CI[1.49,2.47]对于大多数或所有吸烟的朋友）。报告在电视、广告牌和报纸/杂志上看到烟草广告的受访者使用无烟烟草的可能性是前者的 1.95 倍（AOR=1.95；95%CI[1.34,3.08]）。认为吸烟有害健康与当前使用无烟烟草呈负相关（AOR=0.60；95%CI[0.46,0.78]）。
旨在减少青少年[香烟]吸烟的预防计划也必须设计用于减少其他形式的烟草使用。还必须考虑青少年在家、在学校和在闲暇时的环境，以防止他们开始或维持吸烟。
