Estivals M, Dubus J-C, Porcher S, Auquier P, Dieudonné-Loundou A, Missotte I, Besson-Leaud L, Laumond-Barny S
Service de Pneumologie, CHT G-Bourret, BP J5, 98849 Nouméa cedex, Nouvelle-Calédonie, France.
Rev Mal Respir. 2011 May;28(5):636-46. doi: 10.1016/j.rmr.2011.03.010. Epub 2011 Apr 15.
New Caledonia is situated in the western South Pacific 20000 km from France. In this Overseas Territory (pays d'outre-mer [POM]) the prevalence of tobacco smoking is very high and estimated at 30% among men and 34% among women. Experimenting with cannabis is also very widespread. The incidence of chronic respiratory illness and lung cancer remains high in the Territory. Modern laws protecting non-smokers still do not exist. This study aims at describing the behaviour of young people from 14 to 18 years old, at school in the public sector of Noumea, with respect to tobacco and marijuana consumption. This survey examines the way this behaviour varies according to age, sex, community, place of residence and socioeconomic conditions, in order to identify the most exposed groups. Finally, we study the effect of this consumption on the respiratory health of young school people.
The enquiry was undertaken from May 4th to 15th 2009 in 16 classes drawn randomly from the colleges and secondary schools of Noumea (439 pupils). The survey consisted of an anonymous questionnaire containing 48 questions grouped into five subjects: a sociodemographic description of the subject and his/her family, the family lifestyle, tobacco consumption, marijuana consumption and a respiratory questionnaire. The completion of the questionnaires took, on average, 25 minutes and took place in class in the presence of the doctor undertaking the survey. The data were analysed with Ethnos-4 software. The analysis was made in two stages: a descriptive study after uni- and bivariate analysis and an analytical study to identify the risk factors of the addictive practices. The statistical tests used were Pearson's chi(2) test and the Hosmer-Lemeshow test for calculation of odds ratio.
The participation rate was 95.2% (n = 415). The sample was predominantly female (56.6%) and 31% of the pupils were less than 16 years old. The number of tobacco smokers was considerable at 41.1%, 27.3% were regular daily smokers including 38.5% who smoked more than six cigarettes a day. The results were dependent on sex (female predominence) but independent of ethnic origin and socioeconomic factors. The number of cannabis smokers was 48% among whom 32% were regular consumers. The daily smokers were uniquely boys and the custom was more frequent among the Melanesian population. Only 11% of the pupils were worried about their consumption and, among them, only the regular smokers were more at risk of bronchial infection.
In New Caledonia, tobacco consumption levels are higher than those in developed countries. We did not find a falling trend compared with previous data. The use of cannabis remains very widespread at an early age, with a male predominance for daily consumption. For both, these addictions the perception of the risk and the desire to stop are weak. The population studied is representative of teenagers in the public sector schools in Grand-Noumea but probably does not reflect the situation on the whole territory. The results obtained suggest the value of a study of the whole of New Caledonia, the eventual purpose being to guide the public health authorities towards policies that help the young people of the country.
新喀里多尼亚位于南太平洋西部，距离法国20000公里。在这个海外领地，吸烟率非常高，据估计男性吸烟率为30%，女性为34%。吸食大麻的现象也很普遍。该领地慢性呼吸道疾病和肺癌的发病率仍然很高。目前仍没有保护非吸烟者的现代法律。本研究旨在描述努美阿公立学校14至18岁青少年在烟草和大麻消费方面的行为。本次调查研究了这种行为如何因年龄、性别、社区、居住地点和社会经济状况而变化，以便确定受影响最大的群体。最后，我们研究了这种消费对在校青少年呼吸健康的影响。
2009年5月4日至15日，对从努美阿的学院和中学随机抽取的16个班级（439名学生）进行了调查。该调查包括一份匿名问卷，其中包含48个问题，分为五个主题：受试者及其家庭的社会人口学描述、家庭生活方式、烟草消费、大麻消费和一份呼吸问题问卷。问卷平均需要25分钟完成，在进行调查的医生在场的情况下在课堂上完成。使用Ethnos - 4软件对数据进行分析。分析分两个阶段进行：单变量和双变量分析后的描述性研究以及确定成瘾行为风险因素的分析性研究。所使用的统计检验为Pearson卡方检验和用于计算比值比的Hosmer - Lemeshow检验。
参与率为95.2%（n = 415）。样本中女性占主导（56.6%），31%的学生年龄小于16岁。吸烟者数量相当可观，占41.1%，27.3%为每日规律吸烟者，其中38.5%每天吸烟超过6支。结果取决于性别（女性占主导），但与种族和社会经济因素无关。大麻吸烟者占48%，其中32%为经常吸食者。每日吸烟者均为男性，这种习惯在美拉尼西亚人群中更为常见。只有11%的学生担心自己的消费行为，其中只有规律吸烟者患支气管感染的风险更高。
在新喀里多尼亚，烟草消费水平高于发达国家。与之前的数据相比，我们没有发现下降趋势。大麻在早年的使用仍然非常普遍，每日消费以男性为主。对于这两种成瘾行为，对风险的认知和戒烟的意愿都很薄弱。所研究的人群代表了大努美阿公立学校的青少年，但可能无法反映整个领地的情况。所获得的结果表明对整个新喀里多尼亚进行研究的价值，最终目的是引导公共卫生当局制定有助于该国年轻人的政策。
