Gaeta G, Del Castello E, Cuomo S, Effuso L, Boccalatte A
Divisione di Cardiologia, Azienda Ospedaliera di Rilievo Nazionale A. Cardarelli, Napoli.
G Ital Cardiol. 1998 Mar;28(3):259-66.
Smoking is the leading preventable cause of death. Most cigarette smokers take up the habit during adolescence. The purpose of this study was to assess the prevalence of cigarette smoking behavior among the students of a metropolitan high school as compared to those attending a non-metropolitan high school, examining age, sex and demographic and socioeconomic differences, as well as the influence of smoking models (family members and friends) on smoking behavior among adolescents.
Nine hundred seventy-eight students (544 males, 434 females; mean age 15.8 +/- 1.5 years) attending a high school in the city of Naples and 467 students (235 males, 232 females; mean age 16 +/- 1.5 years) from a high school of Capua, a small town 40 kilometers away from Naples, filled out an extensive questionnaire on smoking. The prevalence of smokers was 24.2% (males 21.8%, females 28.2%; p = 0.02) in Naples and 23.8% in Capua (males 29.8%, females 19.2%; p < 0.001) and was related to age (p < 0.001) both in Naples and in Capua. In Naples, smoking behavior among male students was associated with smoking by sibling (p = 0.00005), whereas an association with father (p = 0.0003), mother (p = 0.00005), parental (p = 0.0002) and sibling (p = 0.00002) smoking was observed among females. In Capua, an association was evident only between smoking in female students and sibling smoking habits (p = 0.02). In both Naples and Capua, smoking status of the students was related to smoking habits of best friends of the same sex, best friends of the opposite sex and friends. Multivariate analysis showed an independent relationship in Naples between adolescent smoking behavior and smoking status of siblings (p = 0.01), best friends of the same sex (p < 0.001) and best friends of the opposite sex (p < 0.001). In males, smoking behavior was associated with the smoking behavior of best friends of the same (p < 0.001) and of the opposite sex (p = 0.01), whereas in females, it was linked with the smoking behavior of siblings (p = 0.05), mother (p < 0.05) and best friends of the same sex (p < 0.001). In Capua, student smoking was related to smoking among friends (p < 0.001) and this held true for both males (p = 0.05) and females (p < 0.0001).
The prevalence of smoking habits among teenagers is similar in two distinct populations of high school students from a city and from a small town. Smoking showed a higher prevalence among females in the city and among males in the small town. It increases with age and is related to peer and family smoking models. This study has identified several variables associated with smoking status among adolescents. We thus feel that these findings may contribute to a better understanding of smoking behavior among teenagers and may have prevention implications.
吸烟是可预防的首要死因。大多数吸烟者在青少年时期养成这一习惯。本研究的目的是评估一所大城市高中学生与一所非大城市高中学生的吸烟行为患病率，研究年龄、性别、人口统计学和社会经济差异，以及吸烟榜样（家庭成员和朋友）对青少年吸烟行为的影响。
978名学生（544名男性，434名女性；平均年龄15.8±1.5岁）就读于那不勒斯市的一所高中，467名学生（235名男性，232名女性；平均年龄16±1.5岁）来自距离那不勒斯40公里的小镇卡普阿的一所高中，他们填写了一份关于吸烟的详尽问卷。那不勒斯吸烟者的患病率为24.2%（男性21.8%，女性28.2%；p = 0.02），卡普阿为23.8%（男性29.8%，女性19.2%；p < 0.001），且在那不勒斯和卡普阿均与年龄相关（p < 0.001）。在那不勒斯，男学生的吸烟行为与兄弟姐妹吸烟有关（p = 0.00005），而在女学生中观察到与父亲（p = 0.0003）、母亲（p = 0.00005）、父母（p = 0.0002）和兄弟姐妹（p = 0.00002）吸烟有关。在卡普阿，仅女学生吸烟与兄弟姐妹吸烟习惯之间存在明显关联（p = 0.02）。在那不勒斯和卡普阿，学生的吸烟状况均与同性最好的朋友、异性最好的朋友及朋友的吸烟习惯有关。多变量分析显示，在那不勒斯，青少年吸烟行为与兄弟姐妹的吸烟状况（p = 0.01）、同性最好的朋友（p < 0.001）及异性最好的朋友（p < 0.001）之间存在独立关系。在男性中，吸烟行为与同性（p < 0.001）及异性（p = 0.01）最好的朋友的吸烟行为有关，而在女性中，它与兄弟姐妹（p = 0.05）、母亲（p < 0.05）及同性最好的朋友（p < 0.001）的吸烟行为有关。在卡普阿，学生吸烟与朋友吸烟有关（p < 0.001），这在男性（p = 0.05）和女性（p < 0.0001）中均成立。
来自城市和小镇的两个不同高中生群体中青少年吸烟习惯的患病率相似。吸烟在城市女性和小镇男性中患病率较高。吸烟率随年龄增长而上升，且与同伴和家庭吸烟榜样有关。本研究确定了几个与青少年吸烟状况相关的变量。因此，我们认为这些发现可能有助于更好地理解青少年的吸烟行为，并可能具有预防意义。
