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中国≥15岁女性非现在吸烟者二手烟暴露与睡眠质量关联性：一项2024年横断面研究

Association between secondhand smoke exposure and sleep quality among female non-current smokers aged 15 years and above in China: a cross-sectional in 2024

    摘要
  • 摘要:
    目的 探讨中国≥15岁女性非现在吸烟者二手烟暴露与睡眠质量的关联，为制定控烟干预策略、改善睡眠质量提供参考。
    方法 于2024年3—10月利用横断面调查，从中国7个省（直辖市）采用多阶段分层整群随机抽样方法抽取21 870名≥15岁女性非现在吸烟者为调查对象，使用电子问卷通过面对面调查收集其二手烟暴露和睡眠的相关变量。基于复杂抽样加权方法描述调查对象的人口学特征以及二手烟暴露情况，采用Rao-Scott χ2检验评估亚组间的差异，使用多因素logistic回归模型分析二手烟暴露和睡眠质量的关联。
    结果 21 870名≥15岁女性非现在吸烟者中城市居民为12 082人（45.32%），农村居民9 788人（54.68%）。总体二手烟暴露率为44.01%，在家中二手烟暴露率为22.79%，高于在工作场所的二手烟暴露率（15.90%）。单因素分析结果显示，在女性非现在吸烟者中，总体水平上暴露于二手烟的人群出现睡眠质量差的比例为32.54%，非暴露人群出现失眠质量差的比例为23.59%，差异有统计学意义（χ2=26.97，P<0.01）。按暴露场所分析结果显示，在家中和在工作场所中暴露于二手烟的人群出现睡眠质量差的比例分别为36.10%和29.50%，非暴露人群出现睡眠质量差的比例分别为25.00%和18.00%，暴露组与非暴露组之间差异均有统计学意义（均P<0.01）。调整混杂因素后，多因素logistic回归分析结果显示，总体水平上（OR=1.87，95%CI=1.56～2.23）、在家中（OR=1.76，95%CI=1.47～2.12）和在工作场所中（OR=1.62，95%CI=1.19～2.20）暴露于二手烟均与睡眠质量差存在正向关联。
    结论 中国≥15岁女性非现在吸烟者二手烟暴露与睡眠质量差之间存在显著关联，提示二手烟暴露可能是女性睡眠质量差的危险因素。

     

    Abstract:
    Objective To examine the association between secondhand smoke (SHS) exposure and sleep quality among female non-current smokers aged ≥15 years in China, thereby providing evidence for formulating tobacco control strategies to improve sleep health.
    Methods A cross-sectional survey was conducted between March and October 2024. Through a multistage stratified cluster random sampling design, a total of 21 870 female non-current smokers aged ≥15 years were recruited from seven provinces (autonomous regions, municipalities) in China. Data on SHS exposure and sleep-related variables were collected through face-to-face electronic questionnaires administered by trained investigators. Complex sampling weights were adopted to describe the demographic characteristics and SHS exposure of participants. Rao-Scott chi-square tests were conducted to assess subgroup differences, and multivariate logistic regression models were employed to evaluate the association between SHS exposure and sleep quality after adjusting for potential confounders.
    Results Among the 21 870 participants, 12 082 (45.32%) resided in urban areas and 9 788 (54.68%) in rural areas. The overall prevalence of SHS exposure was 44.01%, with a higher exposure rate at home (22.79%) than in the workplace (15.90%). Univariate analysis revealed that females exposed to SHS had higher prevalence of poor sleep quality than those unexposed (32.54% vs. 23.59%, χ2 = 26.97, P < 0.01). Specifically, SHS exposure at home was associated with higher prevalence of poor sleep quality than non-exposure (36.10% vs. 25.00%, P < 0.01). A similar trend was observed in the workplace (29.50% vs. 18.00%, P < 0.01). After adjusting for confounders, multivariate logistic regression showed that SHS exposure was a significant risk factor for poor sleep quality at the overall level (OR = 1.87, 95%CI: 1.56–2.23), at home (OR = 1.76, 95%CI: 1.47–2.12), and in the workplace (OR = 1.62, 95%CI: 1.19–2.20).
    Conclusions SHS exposure was significantly associated with poor sleep quality among female non-current smokers aged ≥15 years in China, indicating that SHS exposure may be a modifiable risk factor for poor sleep quality in females.

     

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