Birkett N J
Department of Epidemiology and Community Medicine, University of Ottawa, Ontario, Canada.
Prev Med. 1997 Jul-Aug;26(4):534-41. doi: 10.1006/pmed.1997.0169.
Smoking patterns have changed markedly over the past 70 years. Previous studies have shown that examination of smoking patterns within birth cohorts can identify important changes in tobacco adoption and cessation. This paper examines temporal trends in the prevalence of smoking and the age of smoking adoption and cessation for birth cohorts born between 1940 and 1975.
The underlying data were obtained from the Ontario Health Survey (conducted in 1990), which used a multistage stratified area sampling strategy to obtain interviews on 29,843 people age 12 or older. Self-reported smoking histories were used as the basis for a reconstructed cohort analysis of prevalence rates. A life events methodology was employed to examine the age at starting smoking and the time of smoking cessation.
There has been a steady drop in peak smoking prevalence for men. This trend appears to be continuing among the most recent cohorts. However, for women, peak smoking prevalence increased until the 1960 birth cohort, after which time the peak prevalence has been dropping. Prevalence of smoking was much higher for men then for women among the earlier birth cohorts but, by the 1960 cohort, the prevalence for men and women was essentially the same. Examination of the age of smoking onset reveals that there was a statistically significant interaction between sex and birth cohort on the relative risk of starting smoking. The rate of smoking cessation has increased uniformly across all birth cohorts among both men and women.
This study confirms recent trends in smoking reduction and provides no evidence to suggest a diminution of the effect. Trends in recent birth cohorts of women are encouraging. There is a clear need for public health initiatives directed at older children and teenagers in order to further reduce the onset of smoking. Efforts to prohibit advertising directed toward minors, sponsorship of sporting and cultural events, and the sale of tobacco to minors should receive high priority.
在过去70年里，吸烟模式发生了显著变化。先前的研究表明，对出生队列中的吸烟模式进行研究能够识别出烟草使用和戒烟方面的重要变化。本文研究了1940年至1975年出生队列的吸烟流行率以及开始吸烟和戒烟年龄的时间趋势。
基础数据来自安大略省健康调查（于1990年开展），该调查采用多阶段分层区域抽样策略，对29843名12岁及以上的人群进行访谈。自我报告的吸烟史被用作患病率重建队列分析的基础。采用生活事件方法来研究开始吸烟的年龄和戒烟时间。
男性的吸烟高峰流行率呈稳步下降趋势。这一趋势在最近的队列中似乎仍在持续。然而，对于女性而言，吸烟高峰流行率在1960年出生队列之前有所上升，此后高峰流行率一直在下降。在早期出生队列中，男性的吸烟流行率远高于女性，但到1960年队列时，男性和女性的流行率基本相同。对开始吸烟年龄的研究表明，在开始吸烟的相对风险方面，性别和出生队列之间存在统计学上的显著交互作用。男性和女性在所有出生队列中的戒烟率均呈一致上升趋势。
本研究证实了近期吸烟减少的趋势，且没有证据表明这种效果有所减弱。女性近期出生队列的趋势令人鼓舞。显然需要针对大龄儿童和青少年开展公共卫生倡议，以进一步减少吸烟的开始。禁止针对未成年人的广告、体育和文化活动的赞助以及向未成年人销售烟草的努力应得到高度重视。
