Dappen A, Schwartz R H, O'Donnell R
Department of Pediatrics, Fairfax Hospital, Falls Church, Virginia, USA.
J Am Board Fam Pract. 1996 Jan-Feb;9(1):7-13.
Most adults who smoke regularly started during adolescence. To understand adolescent smoking trends better, we investigated smoking patterns, and habits among vocational high school students.
One hundred fifty-four students, aged 14 to 20 years from two vocational schools, completed a 23-item questionnaire. The 99 who were smokers further completed a 55-item questionnaire investigating smoking patterns, criteria for addiction, health concerns, and quitting experiences. All students were tested for objective laboratory measures of smoking, including exhaled carbon monoxide and salivary cotinine.
Sixty-five percent of the student sample smoked at least 10 cigarettes a day, began smoking by 13 years, and easily purchased tobacco over-the-counter. Predictors for smoking included a close friend, parent, or sibling who was a smoker. Significantly poorer grade performance and higher use of alcohol and marijuana were found among smokers. Student's knowledge of health risks of smoking exceeded 95 percent but was of little concern for 70 percent of the smokers. More than one half of smokers had multiple unsuccessful quitting attempts. Exhaled carbon monoxide readings accurately detected smokers and proved more immediate, more sensitive, and less costly than salivary cotinine measurements.
The high association for poor school performance and alcohol and marijuana use among adolescent smokers is a growing trend. These issues carry immediate short-term health and social implications, which physicians should explore. Almost all the smokers had tried at least once to quit but relapsed rapidly. One third remain highly motivated to quit. Physicians should not hesitate to offer smoking cessation assistance; one third might be willing to listen.
大多数经常吸烟的成年人始于青少年时期。为了更好地了解青少年吸烟趋势，我们调查了职业高中学生的吸烟模式和习惯。
来自两所职业学校的154名年龄在14至20岁之间的学生完成了一份包含23个项目的问卷。99名吸烟者进一步完成了一份包含55个项目的问卷，该问卷调查吸烟模式、成瘾标准、健康问题和戒烟经历。所有学生都接受了吸烟的客观实验室检测，包括呼出一氧化碳和唾液可替宁。
65%的学生样本每天至少吸10支烟，13岁开始吸烟，并且能轻松地在柜台购买烟草。吸烟的预测因素包括有吸烟的密友、父母或兄弟姐妹。吸烟者的学业成绩明显较差，酒精和大麻的使用频率更高。学生对吸烟健康风险的知晓率超过95%，但70%的吸烟者对此并不太在意。超过一半的吸烟者有多次戒烟未成功的尝试。呼出一氧化碳读数能准确检测出吸烟者，并且比唾液可替宁测量更即时、更敏感、成本更低。
青少年吸烟者学业成绩差以及使用酒精和大麻之间的高度关联是一个日益增长的趋势。这些问题会带来直接的短期健康和社会影响，医生应该对此进行探究。几乎所有吸烟者都至少尝试过一次戒烟，但很快就复吸了。三分之一的人仍有强烈的戒烟意愿。医生应毫不犹豫地提供戒烟帮助；三分之一的人可能愿意倾听。
