Addressing Ethnic Disparities in Adolescent Smoking: Is Reducing Exposure to Smoking in the Home a Key?
Addressing Ethnic Disparities in Adolescent Smoking: Is Reducing Exposure to Smoking in the Home a Key?
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DOI：
10.1093/ntr/nty053
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发表时间：
2019-04-01
影响因子：
4.7
通讯作者：
Edwards, Richard
中科院分区：
文献类型：
--
作者：
Ball, Jude;Sim, Dalice;Edwards, Richard
简介 自 2000 年以来，新西兰 (NZ) 青少年吸烟率有所下降，但种族差异仍然明显。为了为预防工作提供信息，我们调查了毛利人（新西兰原住民）和整个青少年青少年吸烟的已知预测因素的暴露程度和相对重要性，以及这些预测因素如何随时间而变化。方法我们使用了 2003 年至 2015 年对 14 至 15 岁青少年进行的全国调查（每年 N = 20 443-31 696）的重复横断面数据。对于总体样本以及毛利人和非毛利人，我们计算了调整后的比值比 (aOR)，以评估每年经常吸烟与危险因素之间的关联：一位或多位父母吸烟、最好的朋友吸烟、年长的兄弟姐妹吸烟以及过去一周在家中吸烟。我们计算了 2003 年和 2015 年危险因素的人群归因风险 (PAR)。 结果 2003 年至 2015 年期间，家庭吸烟暴露的 aOR 总体从 1.7（95% CI 1.6% 至 1.8%）增加至 2.6（2.1% 至 3.1%），从 1.8（1.6% 至 2.1%）增加至 3.4毛利人（2.5% 至 4.5%）；最好的朋友吸烟的 aOR 也有所增加，而兄弟姐妹吸烟和父母吸烟的 aOR 没有显着变化。家庭吸烟暴露的 PAR 整体从 17% 增加到 31%，毛利人从 28% 增加到 57%，而其他危险因素的 PAR 则下降。 结论 随着时间的推移，家庭吸烟暴露与青少年吸烟的相关性越来越强，并且是人口层面日益重要的危险因素（独立于父母吸烟），特别是对于毛利人。鉴于国际上青少年吸烟的危险因素和趋势相似。我们的研究结果表明，减少家庭二手烟暴露可能会减少吸烟率。由于毛利儿童的暴露程度更高，而且似乎更容易受到家庭吸烟的影响，因此减少室内吸烟的干预措施可能会对毛利人产生不同的积极影响。有必要对减少家庭吸烟进行更多的研究和政策关注。
Introduction Smoking among New Zealand (NZ) adolescents has declined since 2000, but ethnic disparities remain pronounced. To inform prevention efforts, we investigated exposure to and relative importance of known predictors of adolescent smoking and how these have changed over time, for Maori (NZ's indigenous population) and adolescents overall.Methods We used repeat cross-sectional data, 2003-2015, from a national survey of 14- to 15-year olds (N = 20 443-31 696 per year). For the overall sample and for Maori and non-Maori, we calculated adjusted odds ratios (aORs) to assess the association between regular smoking and risk factors each year: one or more parents smoke, best friend smokes, older sibling(s) smoke, and past week exposure to smoking in the home. We calculated population attributable risk (PAR) for risk factors in 2003 and 2015.Results Between 2003 and 2015, aORs for exposure to smoking in the home increased from 1.7 (95% CI 1.6% to 1.8%) to 2.6 (2.1% to 3.1%) overall and from 1.8 (1.6% to 2.1%) to 3.4 (2.5% to 4.5%) for Maori; aORs for best friend smokes also increased, while aORs for sibling smoking and parental smoking did not change meaningfully. PAR for exposure to smoking in the home increased from 17% to 31% overall and from 28% to 57% for Maori, while PARs for other risk factors decreased.Conclusions Exposure to smoking in the home has become more strongly associated with adolescent smoking over time and is an increasingly important risk factor at the population level (independent of parental smoking), particularly for Maori.Implications Our findings have implications for reducing smoking uptake and ethnic disparities in NZ, and potentially elsewhere, given the similarity in risk factors and trends for adolescent smoking internationally. Our findings suggest that reducing second-hand smoke exposure in homes will likely reduce uptake of smoking. Because Maori children are both more exposed and appear to be more strongly influenced by exposure to smoking in the home, interventions to reduce indoor smoking could have differentially positive effects for Maori. Greater research and policy attention to reducing smoking in homes is warranted.