2015 年肯尼亚世卫组织 STEPS 调查中的烟草使用及其决定因素。
Tobacco use and its determinants in the 2015 Kenya WHO STEPS survey.
机构信息
Yale School of Medicine, New Haven, CT, USA.
Division of Non-Communicable Diseases, Ministry of Health, Nairobi, Kenya.
出版信息
BMC Public Health. 2018 Nov 7;18(Suppl 3):1223. doi: 10.1186/s12889-018-6058-5.
BACKGROUND
According to the World Health Organization (WHO), in 2015, over 1.1 billion people smoked tobacco, which represents around 15% of the global population. In Africa, around one in five adults smoke tobacco. The 2014 Kenya Global Adult Tobacco Survey reported that 2.5 million adults use tobacco products. The objective of our study was to describe patterns and determinants of tobacco use from the 2015 Kenya STEPS survey, including use of "smokeless" tobacco products and the more novel e-cigarettes.
METHODS
The WHO STEPwise approach to surveillance (STEPS) was completed in Kenya between April and June 2015. Logistic regression analyses was used to assess factors affecting prevalence and frequency of tobacco use. Sociodemographic variables associated with tobacco use were considered: age, sex, level of education, wealth quintile, and residence. The relationship with alcohol as an intervening risk factor was also assessed. Our main outcomes of interest were current tobacco use, daily tobacco use and use of smokeless tobacco products.
RESULTS
Of 4484 respondents, 605 (13.5%) reported being current tobacco users. Most active tobacco users were male (n = 507/605, 83.8%). Three out of four tobacco users (n = 468/605, 77.4%) reported being less than 50 years old, with the average start age being 21 (20.6, 95% CI 19.3-21.8) and the average quit age 27 (27.2, 95% CI 25.8-28.6). Most tobacco users had only ever attended up to primary school (n = 434/605, 71.7%). Men had nearly seven times higher odds of being tobacco users as compared to women (OR 7.63, 95% CI 5.63-10.33). Alcohol use had a positive effect on tobacco use. Finally, less than ten respondents reported having used e-cigarettes.
CONCLUSION
The 2015 Kenya WHO STEPS provided primary data on the status of tobacco use in the country and other leading NCD risk factors, such as alcohol, and associated diseases. Our findings highlight key target populations for tobacco cessation efforts: young people, men, those with lower levels of education, and alcohol consumers. Further data is needed on the use of smokeless tobacco, and its impact on smoked tobacco products, as well as on the novel use of e-cigarettes.
背景
根据世界卫生组织（WHO）的数据，2015 年全球有超过 11 亿人吸烟，占全球人口的 15%左右。在非洲，大约五分之一的成年人吸烟。2014 年肯尼亚全球成人烟草调查显示，有 250 万成年人使用烟草制品。我们的研究目的是描述 2015 年肯尼亚 STEPS 调查中烟草使用的模式和决定因素，包括使用“无烟”烟草制品和更新颖的电子烟。
方法
世卫组织 STEP 式监测方法（STEPS）于 2015 年 4 月至 6 月在肯尼亚进行。逻辑回归分析用于评估影响烟草使用流行率和频率的因素。与烟草使用相关的社会人口变量包括年龄、性别、教育程度、财富五分位数和居住地。还评估了与酒精作为中间危险因素的关系。我们主要关注的结果是当前吸烟、每日吸烟和使用无烟烟草制品。
结果
在 4484 名受访者中，有 605 人（13.5%）报告正在吸烟。大多数活跃的烟草使用者为男性（n=507/605，83.8%）。四分之三的烟草使用者（n=468/605，77.4%）报告年龄在 50 岁以下，平均开始年龄为 21 岁（20.6，95%CI 19.3-21.8），平均戒烟年龄为 27 岁（27.2，95%CI 25.8-28.6）。大多数烟草使用者只上过小学（n=434/605，71.7%）。男性吸烟的可能性是女性的近七倍（OR 7.63，95%CI 5.63-10.33）。饮酒对烟草使用有积极影响。最后，不到 10 名受访者报告使用过电子烟。
结论
2015 年肯尼亚世卫组织 STEPS 提供了该国烟草使用状况以及其他主要非传染性疾病风险因素（如酒精）和相关疾病的主要数据。我们的研究结果突出了烟草戒断工作的重点目标人群：年轻人、男性、受教育程度较低的人群和饮酒者。需要进一步的数据来了解无烟烟草的使用情况及其对吸烟烟草制品的影响，以及电子烟的新用途。
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