印度成年人对烟草不良影响的认知：全球成人烟草调查二次数据分析结果。
Awareness regarding the adverse effect of tobacco among adults in India: findings from secondary data analysis of Global Adult Tobacco Survey.
机构信息
Department of Community & Family Medicine, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India.
Department of Community & Family Medicine, All India Institute of Medical Sciences Bathinda, Bathinda, Punjab, India
出版信息
BMJ Open. 2021 Jun 28;11(6):e044209. doi: 10.1136/bmjopen-2020-044209.
OBJECTIVE
To quantify the extent of awareness regarding the harmful effects of tobacco among the users (both smoked and smokeless) and non-users in India, and explore the determinants of comprehensive knowledge among the participants of the Global Adult Tobacco Survey (GATS), India.
DESIGN
Cross-sectional study.
SETTING AND PARTICIPANTS
The nationally representative GATS I (2009-2010) included 69 296 participants using a multistage sampling method, while GATS II (2015-2016) interviewed 74 037 respondents aged >15 years using a similar sampling method from all the states and union territories in India.
PRIMARY AND SECONDARY OUTCOME MEASURES
Comprehensive score were derived from nine items that explored awareness regarding the adverse effects of tobacco use among both users and non-users of tobacco in GATS II. Secondary outcome included predictors of awareness regarding adverse effects of tobacco and changes in the awareness compared with the previous round of the survey.
RESULTS
About 60.2%, 57.5% and 66.5% of the smokers, smokeless tobacco (SLT) users and non-users were aware of the adverse effects of tobacco, respectively. The awareness depicted significant age, gender, marital status, education status, urban-rural, wealth and regional disparities (p<0.05). Intention to quit tobacco use also varied significantly with awareness. Among smokers, awareness was high in those residing in eastern India and the poorest participants. Among SLT users, awareness was more among male participants, those who were poorest and lived in western India. Among non-users, awareness was more among middle-aged, more educated, rich participants of west India. Compared with GATS I, an increase in awareness was observed in GATS II across gender, age groups, residential areas and geographical regions in India.
CONCLUSIONS
Comprehensive awareness of tobacco's harmful effects is far from desirable among Indian users. We recommend further customised health promotion campaigns to counter the regional disparities, adopt a gender-neutral approach and target adolescents.
目的
量化印度烟民（包括吸烟和非吸烟）和非烟民对烟草危害的认知程度，并探讨全球成人烟草调查（GATS）印度参与者综合知识的决定因素。
设计
横断面研究。
地点和参与者
全国代表性的 GATS I（2009-2010 年）采用多阶段抽样方法，纳入 69296 名参与者；GATS II（2015-2016 年）采用类似的抽样方法，对印度所有邦和联邦属地的 74037 名年龄大于 15 岁的受访者进行了调查。
主要和次要结果
从 GATS II 中探索烟民和非烟民对烟草使用的不良影响的九个项目中得出综合评分。次要结果包括对烟草不良影响的认知的预测因素，以及与前一轮调查相比认知的变化。
结果
约 60.2%、57.5%和 66.5%的吸烟者、无烟烟草（SLT）使用者和非使用者分别意识到烟草的不良影响。这种意识存在显著的年龄、性别、婚姻状况、教育程度、城乡、贫富和地区差异（p<0.05）。戒烟意图也随着认知的变化而显著变化。在吸烟者中，居住在印度东部和最贫穷的参与者的意识较高。在 SLT 用户中，男性参与者、最贫穷和居住在印度西部的参与者的意识较高。在非使用者中，年龄较大、受教育程度较高、富裕的印度西部参与者的意识较高。与 GATS I 相比，在 GATS II 中，印度的性别、年龄组、居住地区和地理区域的认知度都有所提高。
结论
印度烟民对烟草危害的全面认知远不理想。我们建议进一步开展有针对性的健康促进活动，以应对地区差异，采取性别中立的方法，并针对青少年。
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