Swan A V, Creeser R, Murray M
United Medical School, Guy's Hospital, London, UK.
Int J Epidemiol. 1990 Jun;19(2):323-30. doi: 10.1093/ije/19.2.323.
Most investigations of smoking in children focus on prevalence in which uptake and maintenance are confounded. This paper reports an analysis of pure incidence data in a cohort of over 6000 Derbyshire schoolchildren followed for ten years investigated using survival data analysis techniques. Over 70% of the cohort tried at least one cigarette before the end of the fifth year of secondary school. Some 40% identified themselves as regular smokers while at school. The risks of taking up regular smoking were higher if, at the age of 11.7-12.7 years, the children had smoking siblings, opposite sex friends, were dismissive of the health hazards and susceptible to peer pressure. More girls than boys in that age range spent time with opposite sex companions and in organized social activities which in turn were significantly associated with the risk of taking up smoking. Thus the earlier physical and emotional development of girls may help explain recent findings that adolescent girls are now more likely to smoke than boys of the same age. The greatest incidence of regular smoking occurred when the average age was increasing from 14.2 to 15.2 years. This has very clear implications for the timing of anti-smoking interventions.
大多数针对儿童吸烟的调查关注的是吸烟率，而在吸烟率中，开始吸烟和持续吸烟的情况相互混淆。本文报告了对一个超过6000名德比郡学童的队列进行的纯发病率数据分析，该队列随访了十年，采用生存数据分析技术进行研究。超过70%的队列成员在中学五年级结束前至少尝试过一支香烟。约40%的人在上学期间自称是经常吸烟者。如果在11.7 - 12.7岁时，孩子有吸烟的兄弟姐妹、异性朋友，对健康危害满不在乎且易受同伴压力影响，那么开始经常吸烟的风险就更高。在那个年龄段，花时间与异性同伴相处以及参与有组织社交活动的女孩比男孩更多，而这又与开始吸烟的风险显著相关。因此，女孩更早的身心发展可能有助于解释最近的研究结果，即现在青春期女孩比同龄男孩更有可能吸烟。经常吸烟的最高发病率出现在平均年龄从14.2岁增长到15.2岁时。这对于反吸烟干预措施的时机具有非常明确的意义。
