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印度儿童二手烟暴露流行率的变化:GATS 调查(2009-2017)的二次分析。

Changes in Prevalence of Childhood Exposure to Secondhand Smoke in India: A Secondary Analysis of GATS Survey (2009-2017).

机构信息

Population Research Centre, Institute for Social and Economic Change, India.

Tata Institute of Social Sciences, Mumbai, India.

出版信息

Asian Pac J Cancer Prev. 2024 Sep 1;25(9):3087-3096. doi: 10.31557/APJCP.2024.25.9.3087.

Abstract

BACKGROUND

Children are susceptible to early life inequalities stemming from their limited control over their environment and their physical incapability to handle the health and developmental consequences of smoke exposure. Additionally, their lack of awareness regarding the detrimental effects of secondhand smoke (SHS) exposure on their well-being emphasizes the crucial need to comprehend the extent of SHS exposure among the younger population.

OBJECTIVE

The study aims to analyze the magnitude and factors influencing SHS exposure among children under 15 years, along with the shifts in SHS exposure in India and its states between 2009-10 and 2016-17.

METHODS

The study utilized two rounds of the nationally representative cross-sectional Global Adult Tobacco Survey (GATS) conducted in 2009-10 and 2016-17, respectively. The study included a total of 47,494 households with 108,814 children under 15 years of age for GATS1 and 46,874 households with 1,000,167 children under 15 years of age for GATS2. Bivariate analysis and Multivariable logistic regression was employed.

RESULTS

Forty-five percent of children experienced SHS exposure at home. Although most states saw a reduction in exposure rates, Jammu and Kashmir, Punjab, and Tamil Nadu  exhibited increases between 2009-10 and 2016-17. Multivariate analysis revealed that children from the North-Eastern (OR = 6.51, CI = (5.93-7.15)) and North (OR = 7.51, CI = 6.88-8.19)) regions, rural areas (OR = 1.45, CI = (1.37-1.52)), Scheduled Tribes (OR = 1.76, CI = (1.63-1.90)),  and those with household adults lacking knowledge of SHS's harmful health effects on children (OR = 1.15, CI = (1.04-1.27)) were more likely to be exposed to SHS at home.

CONCLUSION

India has made strides in reducing child SHS exposure, yet challenges persist in rural and impoverished homes. Comprehensive tobacco control measures can break the cycle of poverty driven by smoking-related expenses, fostering a tobacco-free generation.

摘要

背景

儿童易受到源于其对环境有限的控制和无法应对暴露于烟雾对健康和发育影响的生理能力的生命早期不平等的影响。此外,他们对二手烟暴露对其健康福祉的有害影响缺乏认识,这强调了理解较小年龄群体中二手烟暴露程度的重要性。

目的

本研究旨在分析 15 岁以下儿童中二手烟暴露的程度和影响因素,以及印度及其各州在 2009-10 年至 2016-17 年期间二手烟暴露情况的变化。

方法

本研究使用了分别于 2009-10 年和 2016-17 年进行的两轮全国代表性横断面全球成人烟草调查(GATS)的数据。GATS1 共包括 47494 户家庭和 108814 名 15 岁以下儿童,GATS2 共包括 46874 户家庭和 1000167 名 15 岁以下儿童。采用了双变量分析和多变量逻辑回归。

结果

45%的儿童在家中经历二手烟暴露。尽管大多数州的暴露率有所下降,但查谟和克什米尔邦、旁遮普邦和泰米尔纳德邦在 2009-10 年至 2016-17 年期间有所上升。多变量分析显示,来自东北地区(OR=6.51,CI=(5.93-7.15))和北部地区(OR=7.51,CI=(6.88-8.19))、农村地区(OR=1.45,CI=(1.37-1.52))、在册部落(OR=1.76,CI=(1.63-1.90))和家中成年人不了解二手烟对儿童健康的有害影响的儿童(OR=1.15,CI=(1.04-1.27))更有可能在家中接触二手烟。

结论

印度在减少儿童二手烟暴露方面取得了进展,但在农村和贫困家庭中仍存在挑战。全面的烟草控制措施可以打破与吸烟相关费用驱动的贫困循环,培养一个无烟的一代。

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