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2023年中国中学生获得烟草来源及购烟时未被拒绝情况分析

Access to and unrestricted purchase of smoked or smokeless tobacco among secondary school students in China, 2023: a nationwide cross-sectional survey

  • 摘要:
    目的 了解2023年中国中学生获得烟草来源及购买时未被拒绝情况,为评价控烟相关法律法规的实施效果提供参考依据。
    方法 于2023年9—12月采用多阶段随机整群抽样方法在我国31个省(直辖市、自治区)抽取912所初中、590所普通高中和274所职业高中共1 776所中学的273 154名中学生进行问卷调查。
    结果 最终纳入分析的261 454名中国中学生中,有14 199(加权后4 678 233)名和4 643(加权后1 483 681)名中学生曾在过去30 d内获得过卷烟和电子烟。获得过卷烟的中学生中有75.8%的中学生仅使用1种方式获得,有24.2%的中学生使用≥2种方式获得,其获得卷烟的主要3种方式为零售店购买(58.7%)、别人给的(42.3%)和家里拿的(13.4%);获得过电子烟的中学生中有84.4%的中学生仅使用1种方式获得,有15.6%的中学生使用≥2种方式获得,其获得电子烟的主要3种方式为网上购买(44.2%)、电子烟体验店或零售店购买(33.1%)和商场(超市、便利店、杂货店)购买(28.3%)。有4 738(加权后1 585 135)和2 333(加权后791 337)名现在吸烟的中学生在过去30 d内购买卷烟和电子烟时未被拒绝,购买卷烟和电子烟时未被拒绝的比例分别为71.7%和66.7%。购买卷烟时,女生未被拒绝的比例(76.0%)高于男生(70.7%),高中生未被拒绝的比例(75.2%)高于初中生(66.8%),差异均有统计学意义(均P<0.05);购买电子烟时,高中生未被拒绝的比例(69.7%)高于初中生(64.9%),差异有统计学意义(χ2=3.900,P=0.048)。
    结论 2023年中国中学生获得卷烟和电子烟的方式依然以烟草零售店和网络为主;中学生在购买卷烟和电子烟时未被拒绝的比例较高,建议加强对烟草零售店和网络平台的监管,保护未成年人远离烟草。

     

    Abstract:
    Objective  To understand different ways of obtaining and unrestricted access to purchase cigarettes and e-cigarettes among Chinese secondary school students to provide evidence to evaluate the effectiveness of tobacco control laws and regulations.
    Methods  Study participants were 273 154 students recruited using a multistage stratified cluster random sample from 912 junior high schools, 590 regular high schools, and 274 vocational high schools in 31 provincial-level administrative divisions of China. On-site, anonymous, self- administered surveys were conducted from September to December 2023 using the questionnaire developed by the Tobacco Control Office, Chinese Center for Disease Control and Prevention.
    Results Of the 261 454 participants who provided valid responses, 14 199 (corresponding to a national estimate of 4 678 233 students) and 4 643 (corresponding to a national estimate of 1 483 681 students), based on sampling, non-response, and post-stratification weighting, self-reported having purchased cigarettes and e-cigarettes, respectively, in the past 30 days. Among cigarette purchasers, 75.8% obtained cigarettes through a single channel, while 24.2% used two or more channels. The top three access channels were retail outlets (58.7%), sharing from others (42.3%), and obtaining them at home (13.4%). Similarly, among e-cigarette purchasers, 84.4% accessed e-cigarettes through one channel, and 15.6% used two or more channels. The main access channels for e-cigarettes were online shopping (44.2%), experience shops or retail outlets (33.1%), and shopping malls, supermarkets, convenience stores, or grocery stores (28.3%). Among current school smokers surveyed, 71.7% (4 738 corresponding to a national estimate of 1 585 135 students) and 66.7% (2 333, corresponding to a national estimate of 791 337 students) reported unrestricted access to purchase cigarettes and e-cigarettes, respectively, in the past 30 days. Higher rates of unrestricted access to cigarettes were observed among female smokers compared with male smokers (76.0% vs. 70.7%, P<0.05) and among high school smokers compared with middle school smokers (75.2% vs. 66.8%, P<0.05). Similarly, unrestricted access to e-cigarettes was higher among high school smokers than among middle school smokers (69.7% vs. 64.9%, χ2=3.900; P=0.048).
    Conclusions In 2023, a significant proportion of secondary school student smokers in China reported easy access to purchasing both traditional cigarettes and e-cigarettes, primarily through retail stores and online platforms. This concerning trend highlights the urgent need to strengthen regulatory measures and enforcement in tobacco retail operations and e-commerce channels to effectively prevent underage tobacco use among secondary school students.

     

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