Ahsan H, Underwood P, Atkinson D
Department of General Practice, University of Western Australia, Fremantle Hospital, Western Australia, Australia.
Prev Med. 1998 Jan-Feb;27(1):70-6. doi: 10.1006/pmed.1997.0239.
Smoking is now recognized as a major public health problem in the developing world. Despite this, there is a dearth of relevant data on smoking prevalence and on the characteristics and attitudes of smokers: in particular, studies are lacking among teenagers and young adults, the group in which the habit frequently begins. The present study addresses this issue by examining the smoking patterns of a sample of teenagers in Dhaka, Bangladesh, during 1991.
The study investigated smoking behavior and attitudes among two groups of male teenagers: the first consisted of 555 students, age 12-20 years, selected from two metropolitan high schools; the second, chosen to provide a broad comparison group from a different socioeconomic stratum, contained 112 males of similar age residing in an urban slum. Data were collected largely by interview supplemented by some direct observation and relevant secondary data.
The results showed that 29% of the students and 68% of the slum dwellers said they were regular smokers. In addition, the slum youths smoked substantially more and had smoked for longer than the students. While the study suggests both groups of smokers had been influenced to take up smoking by the smoking behavior of peers and parents, peers were more important for the students. Advertising may also have been a important influence on students since smokers in this group could better identify tobacco advertisements compared with their nonsmoking peers. No significant association was found between respondents' knowledge of the health risks of smoking and their actual smoking behavior.
This study demonstrates that in Bangladesh, smoking is very common among middle-class male teenagers and even more prevalent among youths from nearby slums. Clearly, local and national programs that draw on relevant knowledge from other countries, but are appropriate to Bangladesh, need to be developed to tackle a major epidemic.
吸烟如今被视为发展中世界的一个主要公共卫生问题。尽管如此，关于吸烟流行率以及吸烟者的特征和态度的相关数据却很匮乏：尤其是在青少年和年轻人这一经常开始养成吸烟习惯的群体中，此类研究尚付阙如。本研究通过调查1991年孟加拉国达卡市一组青少年的吸烟模式来解决这一问题。
该研究调查了两组男性青少年的吸烟行为和态度：第一组由555名年龄在12至20岁之间的学生组成，他们选自两所大城市的高中；第二组由112名年龄相仿的男性组成，选自城市贫民窟，作为一个不同社会经济阶层的广泛对照组。数据主要通过访谈收集，并辅以一些直接观察和相关二手数据。
结果显示，29%的学生和68%的贫民窟居民表示他们是经常吸烟者。此外，贫民窟青少年吸烟量明显更多，吸烟时间也比学生更长。虽然研究表明两组吸烟者都受到同龄人及父母吸烟行为的影响而开始吸烟，但同龄人对学生的影响更大。广告可能对学生也有重要影响，因为与不吸烟的同龄人相比，该组吸烟者能更好地识别烟草广告。在受访者对吸烟健康风险的认知与他们实际的吸烟行为之间未发现显著关联。
本研究表明，在孟加拉国，吸烟在中产阶级男性青少年中非常普遍，在附近贫民窟的年轻人中更为流行。显然，需要制定借鉴其他国家相关知识、但适合孟加拉国国情的地方和国家项目，以应对这一重大流行病。
