[h2]Relationships between smoking duration, smoking intensity, hypothetical tobacco price increases, and smoking habit change intention among current smokers in Shanghai[/h2]![]()
J INT MED RES research-article
Early Recent, Aug 20, 2019
10.1177/0300060519868131
本文由“天纳”临床学术信息人工智能系统自动翻译
点击文末“阅读原文”下载本文PDF[h2]Objectives[/h2]We conducted a cross-sectional study to explore the effect of a hypothetical tobacco retail price increase on smoking habit change intention, and the role of smoking duration and intensity in smoking change intention.我们进行了一项横断面研究，探讨假设的烟草零售价格上涨对吸烟习惯改变意愿的影响，以及吸烟持续时间和吸烟强度在吸烟改变意愿中的作用。[h2]Methods[/h2]In 2016 and 2017, we collected questionnaire data from 36,698 residents aged over 18 years in Songjiang district, Shanghai. Chi-square tests and weighted logistic regression were used for data analyses.2016年和2017年，我们收集了上海市松江区36698名18岁以上居民的问卷数据。采用卡方检验和加权逻辑回归进行数据分析。[h2]Results[/h2]The prevalence of current smoking was 19.78% (men: 48.36% and women: 0.22%). A total of 10.83% (men: 10.89% and women: 2.04%) and 9.39% of smokers (men: 9.42% and women: 6.12%) expressed the intention to smoke less or quit, respectively, given tobacco retail price increases. If the current tobacco retail price doubled, 75% of smokers stated that they would smoke less and 60% of smokers would consider quitting. Smokers with longer smoking duration and lower smoking intensity were more sensitive to tobacco price increases and more likely to change their smoking habits.目前吸烟率为19.78%（男性48.36%，女性0.22%）。考虑到烟草零售价格上涨，10.83%（男性：10.89%，女性：2.04%）和9.39%的吸烟者（男性：9.42%，女性：6.12%）分别表示打算减少吸烟或戒烟。如果目前的烟草零售价格翻番，75%的吸烟者表示他们将减少吸烟，60%的吸烟者将考虑戒烟。吸烟时间长、吸烟强度低的吸烟者对烟草价格上涨更为敏感，更容易改变吸烟习惯。[h2]Conclusions[/h2]An increase in tobacco retail prices could induce some smokers to change their smoking behavior, particularly those with longer smoking duration and lower smoking intensity. A tobacco retail price increase is recommended, which should apply to all cigarette brands.烟草零售价格的上涨可能会促使一些吸烟者改变他们的吸烟行为，特别是那些吸烟时间较长、吸烟强度较低的吸烟者。建议提高烟草零售价格，这应适用于所有香烟品牌。[h1]Fulltext[/h1][h2]Background[/h2]Smoking has negative health effects and is the single largest preventable cause of morbidity and mortality worldwide.[sup]1,2[/sup] The World Health Organization has estimated that over 1 billion people have tobacco smoking addiction, that 5 million people die from tobacco-related diseases each year and that this figure will rise to over 8 million by 2030 if current trends continue.[sup]3,4[/sup] Tobacco smoking is a recognized risk factor for many chronic diseases[sup]5–7[/sup] and is associated with heavy health, economic, and social costs in all countries.[sup]8[/sup]吸烟对健康有负面影响，是全球最大的可预防发病和死亡原因。世界卫生组织估计，超过10亿人有吸烟成瘾，每年有500万人死于与烟草有关的疾病，以及如果目前的趋势继续下去，到2030年这一数字将超过800万。吸烟是许多慢性病的公认风险因素，并与所有国家的沉重健康、经济和社会成本有关。Raising tobacco prices by increasing excise taxes and enacting tobacco control laws by prohibiting smoking in public places are the most effective ways of reducing smoking rates and the associated health burden.[sup]9–11[/sup] According to the International Agency for Research on Cancer,[sup]12[/sup] higher tobacco consumption costs are strongly associated with lower smoking prevalence and reduced tobacco consumption. Research on US adults demonstrates that a 10% tobacco price increase results in a 3% to 5% decrease in cigarette demand.[sup]13[/sup] In 2011, a study in Jiangxi, China, indicated that 45% of smokers would smoke fewer cigarettes and 5% would attempt to quit smoking if the retail cigarette price increased by 50%. Therefore, a tax-induced cigarette price increase may be a key policy option to promote smoking cessation.[sup]14,15[/sup]通过增加消费税和通过在公共场所禁止吸烟来提高烟草价格是降低吸烟率和相关健康负担的最有效方法。根据国际癌症研究机构的数据，烟草消费成本上涨与较低的吸烟率和烟草消费量密切相关。对美国成年人的研究表明，10%的烟草价格上涨导致卷烟需求下降3%至5%。2011年在中国江西省的一项研究显示，如果零售卷烟价格上涨50%，45%的吸烟者将减少吸烟，5%的吸烟者将试图戒烟。因此，由税收引起的香烟价格上涨可能是促进戒烟的关键政策选择。The 2010 Global Adult Survey indicated that 300 million adults in China are current smokers, and 1 million deaths are attributable to tobacco consumption each year.[sup]7,8,15–19[/sup] Because of the heavy disease burden of smoking, China introduced a cigarette tax increase in 2009; however, the tax changes have been absorbed at the producer level and have had no impact on tobacco price.[sup]18[/sup] This was a missed opportunity to investigate how tobacco price increases affect changes in smoking habits among smokers in China. Studies in Western countries have demonstrated that smokers who are younger, and have lower incomes and lower smoking intensity, are more sensitive to tobacco price increases.[sup]20[/sup] However, there are limited data on relationships between smoking duration, intensity, tobacco retail price increases, and smoking habit change in China.2010年全球成人调查显示，中国目前有3亿成年人吸烟者，每年有100万人死于烟草消费。由于吸烟的疾病负担沉重，中国在2009年增加了香烟税；但是，税收的变化在生产商层面被吸收，对烟草价格没有影响。这是一个错失的机会，无法调查烟草价格上涨如何影响中国吸烟者吸烟习惯的变化。西方国家的研究表明，年轻、收入较低、吸烟强度较低的吸烟者对烟草价格上涨更为敏感。然而，关于吸烟时间、吸烟强度、烟草零售价格上涨和中国吸烟习惯的变化的数据有限。We conducted a cross-sectional study in Shanghai, China. We investigated smoking prevalence, the effect of a hypothetical tobacco retail price increase on smoking habits, and the role of smoking duration and smoking intensity in the effect of the price increase on smoking habits.我们在中国上海进行了一项横断面研究。我们调查了吸烟率、假设烟草零售价格上涨对吸烟习惯的影响，以及吸烟时间和吸烟强度在价格上涨对吸烟习惯影响中的作用。[h2]Methods[/h2][h3]Study population[/h3]This cross-sectional study was conducted in Songjiang district, Shanghai, from June 2016 to October 2017. Songjiang district is located in southwestern Shanghai and had a population of 1.76 million in 2016. We used a multistage sampling method to recruit participants from the 15 subdistricts of Songjiang. In stage one, we purposively selected 4 of the 15 Songjiang subdistricts: ZS, XQ, SS, and MG. In stage two, 9, 18, 4, and 16 neighborhood committees were randomly selected from XQ, ZS, SS, and MG subdistricts. In stage 3, we recruited all individuals aged over 18 years who had lived in Songjiang for 5 years or longer from each of the 47 selected neighborhood committees. A total of 37,543 residents were sampled and invited to participate in this study. Each participant provided written informed consent before the questionnaire interview. A final total of 36,698 residents completed the interview and were included in the final analysis.本研究于2016年6月至2017年10月在上海市松江区进行。松江区位于上海西南部，2016年人口176万。采用多阶段抽样方法，对松江市15个街道的参加者进行了抽样调查。在第一阶段，我们有目的地选择了松江15个街道中的4个：zs、xq、ss和mg。第二阶段，从XQ、ZS、SS和MG街道中随机抽取9、18、4和16个居委会。在第三阶段，我们从47个选定的社区委员会中挑选了所有在松江居住5年或更长时间的18岁以上的成年人。共对37543名居民进行了抽样调查，并邀请他们参与本研究。每个参与者在调查问卷访谈前提供书面知情同意书。最终共有36698名居民完成了访谈，并纳入最终分析。[h3]Data collection[/h3]Data collection was carried out using interviews. These utilized self-designed Android pad-assisted software that allows paperless data input. The interviewer read out every question to participants and entered their responses onto the forms on the pad. Each interview lasted approximately 30 minutes. The questionnaire was designed by the School of Public Health, Fudan University, and comprised four parts. Part A contained 8 demographic questions. Part B contained 10 items to collect information about tobacco-related chronic disease. Part C assessed 36 health-related behaviors (tobacco use, alcohol consumption, tea drinking, and sleep habits). We designed 14 questions to collect information about tobacco use: Q1: Have you smoked at least one cigarette every day for over 6 months?; Q2: How old were you when you smoked your first cigarette?; Q3: How many cigarettes do you usually smoke each day?; Q4: Do you still smoke now?; Q5: How old were you when you quit smoking?; Q6: What is your monthly expense for tobacco purchases?; Q7: What is your average monthly income?; Q8: What is the retail price per pack for the tobacco you usually smoke?; Q9: If the tobacco retail price increased, at what price per pack would you consider smoking less?; Q10: If the tobacco retail price increased, at what price per pack would you consider quitting smoking?; Q11: Have you ever tried to quit smoking for over 24 hours in the last year?; Q12: How many times have you tried to quit smoking in recent years?; Q13: Do you live with anyone who has smoked in the last year?; Q14: Do you work with anyone who has smoked in the last year? Part D contained personal contact information for the investigator and the participant.数据收集是通过访谈进行的。这些采用了自主设计的Android Pad辅助软件，允许无纸化数据输入。面试官把每一个问题都念给参与者听，并把他们的回答写在便笺簿上的表格上。每次面试持续了大约30分钟。问卷由复旦大学公共卫生学院设计，由四部分组成。A部分包含8个人口统计学问题。B部分包含10项关于烟草相关慢性病的信息收集项目。C部分评估了36种健康相关行为（吸烟、饮酒、喝茶和睡眠习惯）。我们设计了14个问题来收集关于烟草使用的信息：问题1：在超过6个月的时间里，你每天至少抽一支烟吗？；问题2：你第一次抽烟的时候是几岁？；问题3：你每天通常抽几支烟？Q4：你现在还抽烟吗？问题5：戒烟时你多大了？；问题6：您每月购买烟草的费用是多少？问题7：你的月平均收入是多少？；问题8：您通常吸烟的烟草，每包的零售价是多少？；问题9：如果烟草零售价格上涨，您认为每包烟的价格是多少？；问题10：如果烟草零售价格上涨，你会考虑以每包多少价格戒烟？问11：你去年有没有尝试戒烟超过24小时？问题12：最近几年你有多少次尝试戒烟？问13：你和去年吸烟的人住在一起吗？问题14：你和去年吸烟的人一起工作吗？D部分包含研究者和参与者的个人联系信息。[h3]Definitions and index calculation[/h3]We defined a current smoker as someone who had smoked at least one cigarette every day for 6 months or more over their whole lifetime and still smoked at the time of the study. The prevalence of current smoking was calculated as the number of current smokers divided by the total number of participants. Smoking duration was defined as the time interval (year) between age at investigation and age at smoking onset for current smokers, and classified into four groups: |
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