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目的探讨家庭创建无烟环境的有效措施。方法于2014年在天津市选取两个社区进行干预。采用多阶段整群抽样的方法,抽取住户,以户为单位,联合社区居委会、学校及社区卫生服务保健机构对其进行干预,主要形式包括大众媒体宣传、发放宣传材料、主题巡展、控烟讲座、烟草危害知识竞赛、微博转发、无烟家庭申报等宣传活动,干预前后调查该户全部15岁以上家庭成员的烟草使用情况及上一周内所有家庭成员及来访客人在家庭中吸烟情况。结果共调查976人,总吸烟率为21.3%。其中男性468人,女性508人,男性吸烟率为41.0%,女性为3.1%,干预后调查人群吸烟率较干预前下降了0.4%,但变化差异无统计学意义(P=0.87)。干预后“不想戒烟”的比例由干预前的74.3%下降至58.3%,差异有统计学意义(P=0.000)。干预后家庭成员或客人在家中吸烟、用香烟招待客人、把香烟作为礼物送给别人的比例较干预前有所下降,下降比例分别为19.6%、32.5%和63.0%,差异有统计学意义(P=0.000)。对吸烟及二手烟对健康危害的认知均得到较大程度的提升。无烟环境布置情况均有较大改善,摆放香烟及烟灰缸的现象由62.1%和58.1%分别下降至37.9%和41.9%,有烟蒂(34.7%vs.65.3%)及烟味(35.4%vs.64.6%)的比例也有较大幅度下降。结论在社区居委会、学校及社区卫生服务保健机构的共同配合下,通过在家庭中实施简单易行的控烟干预方式即可以取得良好的控烟效果。
Objective To explore effective measures for family to create a smoke-free environment. Methods In 2014, two communities were selected for intervention in Tianjin. It adopts multi-stage cluster sampling method to collect tenants and households, and intervenes with community neighborhood committees, schools and community health service and health institutions. The main forms include mass media publicity, publicity material, theme tour, tobacco control lecture, Tobacco Hazard Contest, Weibo Forwarding, and Declaration on Tobacco-Free Households. Before and after the intervention, the tobacco use of all family members over the age of 15 in the household and the smoking in the household of all family members and visiting guests in the previous week were investigated. Results A total of 976 people surveyed, the total smoking rate was 21.3%. Among them, 468 were males and 508 were females, smoking rates were 41.0% for males and 3.1% for females. After the intervention, the prevalence of smoking in the investigated population decreased by 0.4% compared with that before the intervention, but the difference was not statistically significant (P = 0.87). After intervention, the rate of “do not want to quit smoking” dropped from 74.3% before intervention to 58.3%, the difference was statistically significant (P = 0.000). After intervention, the percentage of family members or guests who smoked cigarettes at home, cigarettes guests, and cigarettes as gifts to others decreased by 19.6%, 32.5% and 63.0% respectively, with significant difference P = 0.000). Cognition of the health hazards of smoking and second-hand smoking have been greatly improved. The smoke-free environment arrangement improved significantly. The number of cigarettes and ashtrays dropped from 62.1% and 58.1% to 37.9% and 41.9% respectively, with cigarette stems (34.7% vs.65.3%) and cigarette smoke (35.4% vs.64.6%) also have a more substantial decline in the proportion. Conclusion With the cooperation of community committees, schools and community health service and health care institutions, a good tobacco control effect can be achieved through simple and convenient tobacco control interventions in the family.