Fan J, Fang L W, Cong S, Wang N, Wang W J, Wu J
National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2024 Jan 10;45(1):95-104. doi: 10.3760/cma.j.cn112338-20231031-00260.
To understand the passive smoking exposure status in adults aged ≥40 years in China. Local residents aged ≥40 years were enrolled as study subjects from 125 areas of chronic obstructive pulmonary disease (COPD) surveillance during 2014-2015 and 2019-2020 in 31 provinces of China. A total of 74 559 adults aged ≥40 years were selected through multi-stage stratified cluster sampling for a face to face questionnaire survey and the data from 64 142 study subjects were used for the analysis. The passive smoking exposure rate, the proportions of the adults reporting passive smoking exposure at four types of places and the proportion of the adults living with daily smokers were described by using complicated sampling weighting method, the related factors were analyzed and the results were compared with the data of COPD surveillance during 2014-2015. The passive smoking exposure rate in the adults aged ≥40 years was 46.4% (95%: 44.1%-48.8%) in China during 2019-2020, and the rate was higher in women (47.2%, 95%:44.8%-49.7%) than in men (44.8%, 95%:42.0%-47.6%) and lower in the older people. The office workers had the highest passive smoking exposure rate. The proportions of those reporting passive smoking exposure at homes, workplaces, restaurants, and public transports were 24.3% (95%:22.2%-26.4%)、23.3% (95%:21.1%-25.5%)、6.6% (95%:5.3%-7.9%) and 2.2% (95%:1.6%-2.7%). The higher education level the adults had, the less passive smoking exposure at home they reported. The proportions of those living with daily smokers before 14 years old and since 14 years old were 56.4% and 59.2%. Compared with the data during 2014-2015, the overall passive smoking exposure rate in the adults aged ≥40 years during 2019-2020 showed an increase, and the difference was not significant (0.356); The passive smoking exposure rate at homes declined, but the exposure rate at workplaces increased, with the biggest increase found in those being engaged in farming, forestry, husbandry, fishery and water conservancy. Multivariate analysis indicated that the factors influencing the passive smoking exposure and the exposure proportions at different places included gender, age, occupation, and education level. The passive smoking exposure rate in China is still high, especially in those being engaged in farming, forestry, husbandry, fishery and water conservancy. It is necessary to strengthen supervision of the enforcement of current smoking bans in public places and promote the legislation of ban smoking in public places. More attention should be paid to smoking ban and protection against passive smoking exposure in women, people with lower education level and people being engaged in in farming, forestry, husbandry, fishery and water conservancy.
为了解我国40岁及以上成年人的被动吸烟暴露状况。2014 - 2015年以及2019 - 2020年期间，从我国31个省份125个慢性阻塞性肺疾病（COPD）监测地区招募40岁及以上当地居民作为研究对象。通过多阶段分层整群抽样共选取74559名40岁及以上成年人进行面对面问卷调查，采用复杂抽样加权法描述被动吸烟暴露率、报告在四类场所被动吸烟暴露的成年人比例以及与每日吸烟者共同生活的成年人比例，分析相关因素并将结果与2014 - 2015年COPD监测数据进行比较。结果显示，2019 - 2020年我国40岁及以上成年人被动吸烟暴露率为46.4%（95%：44.1% - 48.8%），女性（47.2%，95%：44.8% - 49.7%）高于男性（44.8%，95%：42.0% - 47.6%），且老年人中该比例较低。办公室工作人员被动吸烟暴露率最高。报告在家中、工作场所、餐馆和公共交通工具上被动吸烟暴露的比例分别为24.3%（95%：22.2% - 26.4%）、23.3%（95%：21.1% - 25.5%）、6.6%（95%：5.3% - 7.9%）和2.2%（95%：1.6% - 2.7%）。成年人受教育程度越高，报告在家中被动吸烟暴露越少。14岁以前和14岁以后与每日吸烟者共同生活的比例分别为56.4%和59.2%。与2014 - 2015年数据相比，2019 - 2020年40岁及以上成年人总体被动吸烟暴露率呈上升趋势，但差异无统计学意义（0.356）；家中被动吸烟暴露率下降，工作场所暴露率上升，从事农、林、牧、渔业和水利业的人群上升幅度最大。多因素分析表明，影响被动吸烟暴露及不同场所暴露比例的因素包括性别、年龄、职业和受教育程度。我国被动吸烟暴露率仍较高，尤其是从事农、林、牧、渔业和水利业的人群。有必要加强公共场所现行禁烟令执行情况的监督，并推动公共场所禁烟立法。应更加关注女性、低教育水平人群以及从事农、林、牧、渔业和水利业人群的禁烟和被动吸烟暴露防护。
