Ji Yuanyi, Cheng Yongzhong, Yang Ting, Zhang Jing, Liu Qiaolan
West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
Shuangliu District Center for Disease Control and Prevention, Chengdu, China.
Nicotine Tob Res. 2024 Sep 5. doi: 10.1093/ntr/ntae211.
Most adult smokers develop their addiction by trying smoking during adolescence. Elucidation of the psychosocial mechanisms underlying smoking initiation may be crucial for the prevention of adolescent tobacco use. The study aimed to identify key psychosocial factors in order to provide a scientific basis for preventing and reducing the occurrence of initial smoking behaviour among adolescents.
A total of 2671 students from rural middle schools in western China were surveyed three times as part of a two-year longitudinal study. The adolescent health questionnaire included the Global Youth Tobacco Survey, the Mental Health Inventory of Middle-School Students, the Social Support Rating Scale and the Adolescent Life Satisfaction Scale. Structural equation modelling was used to analyse the direct or indirect relationships between smoking initiation and psychosocial factors.
The prevalence of trying smoking among adolescents was 28.3%, with boys (38.3%) having a higher rate than girls (19.7%) (P<0.05). Mental health problems were positively associated with trying smoking (β=0.112, P<0.05). Greater life satisfaction had a negative direct effect on trying smoking (β=-0.125, P<0.05) and also played a mediating role in the relationship between mental health problems and trying smoking (β=0.016, 95%CI: 0.008 to 0.025), accounting for 20.7% of the total effect. Social support had a full mediating effect on smoking initiation through both mental health problems and life satisfaction (β=-0.022, 95%CI: -0.028 to -0.016).
The behaviour of young people who try smoking is associated with complex psychosocial factors. Interventions aimed at preventing adolescent tobacco use should prioritize the provision of social support and the promotion of life satisfaction.
The study elucidated the direct and indirect relationships between psychosocial factors and trying smoking behaviour. In order to prevent adolescents from trying smoking, it is essential to intervene through external social support and internal development of mental health and well-being to improve adolescents' social support, increase their life satisfaction and maintain their mental health.
大多数成年吸烟者是在青少年时期尝试吸烟后染上烟瘾的。阐明吸烟起始背后的社会心理机制对于预防青少年烟草使用可能至关重要。本研究旨在确定关键的社会心理因素，以便为预防和减少青少年初次吸烟行为的发生提供科学依据。
作为一项为期两年的纵向研究的一部分，对中国西部农村中学的2671名学生进行了三次调查。青少年健康问卷包括全球青少年烟草调查、中学生心理健康量表、社会支持评定量表和青少年生活满意度量表。采用结构方程模型分析吸烟起始与社会心理因素之间的直接或间接关系。
青少年尝试吸烟的 prevalence为28.3%，男孩（38.3%）的发生率高于女孩（19.7%）（P<0.05）。心理健康问题与尝试吸烟呈正相关（β=0.112，P<0.05）。更高的生活满意度对尝试吸烟有负向直接影响（β=-0.125，P<0.05），并且在心理健康问题与尝试吸烟之间的关系中也起中介作用（β=0.016，95%CI：0.008至0.025），占总效应的20.7%。社会支持通过心理健康问题和生活满意度对吸烟起始具有完全中介作用（β=-0.022，95%CI：-0.028至-0.016）。
尝试吸烟的年轻人的行为与复杂的社会心理因素有关。旨在预防青少年烟草使用的干预措施应优先提供社会支持并促进生活满意度。
该研究阐明了社会心理因素与尝试吸烟行为之间的直接和间接关系。为了防止青少年尝试吸烟，必须通过外部社会支持以及心理健康和幸福感的内部发展进行干预，以改善青少年的社会支持，提高他们的生活满意度并保持他们的心理健康。
