Physiotherapy Department, South London and Maudsley NHS Foundation Trust, Denmark Hill, London, SE5 8AZ, United Kingdom.
Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, De Crespigny Park, London, Box SE5 8AF, United Kingdom.
Sci Rep. 2017 Aug 8;7(1):7597. doi: 10.1038/s41598-017-07579-w.
Within recent years, there has been a seismic shift in smoking rates from high-income to low- and middle-income countries (LMICs). Evidence indicates that perceived stress may comprise a barrier for smoking cessation, but little is known about the association of perceived stress and smoking in LMICs. We conducted a cross-sectional, community-based study comprising 217,561 people [mean age 38.5 (SD = 16.1) years, 49.4% males]. A perceived stress score [range 2 (lowest-stress) 10 (highest-stress)] was computed from the Perceived Stress Scale. Multivariable logistic regression analyses were conducted. In the overall sample, a one-unit increase in perceived-stress resulted in a 5% increased odds of smoking (OR = 1.05; 95%CI = 1.03-1.06). Increased stress was associated with smoking in Africa (OR = 1.06; 95%CI = 1.04-1.09), Americas (OR = 1.03; 95%CI = 1.01-1.05), and Asia (OR = 1.06; 95%CI = 1.04-1.08), but not Europe (OR = 0.99; 95%CI = 0.95-1.02). Increasing levels of perceived stress were significantly associated with heavy smoking (≥30 cigarettes per day) among daily smokers (OR = 1.08; 95%CI = 1.02-1.15). A country-wide meta-analysis showed that perceived stress is associated with daily smoking in most countries. Prospective studies are warranted to confirm/refute this relationship, which may have meaningful public health implications.
近年来，高收入国家和中低收入国家（LMICs）的吸烟率发生了重大转变。有证据表明，感知到的压力可能是戒烟的一个障碍，但人们对 LMICs 中感知到的压力与吸烟之间的关系知之甚少。我们进行了一项基于社区的横断面研究，共纳入了 217561 人[平均年龄 38.5（SD=16.1）岁，49.4%为男性]。感知压力得分（范围 2（压力最低）至 10（压力最高））是根据感知压力量表计算得出的。进行了多变量逻辑回归分析。在整个样本中，感知压力增加一个单位，吸烟的可能性增加 5%（OR=1.05；95%CI=1.03-1.06）。在非洲（OR=1.06；95%CI=1.04-1.09）、美洲（OR=1.03；95%CI=1.01-1.05）和亚洲（OR=1.06；95%CI=1.04-1.08），但在欧洲（OR=0.99；95%CI=0.95-1.02），压力增加与吸烟无关。在每日吸烟者中，感知压力水平的升高与重度吸烟（每天吸烟≥30 支）显著相关（OR=1.08；95%CI=1.02-1.15）。一项全国范围的荟萃分析表明，在大多数国家，感知压力与每日吸烟有关。需要前瞻性研究来证实/反驳这种关系，因为这可能对公共卫生具有重要意义。
