Tobacco Exposure Status And Its Influencing Factors Among Adults Aged 15 And Over In Chongqing In 2017

Objective: To understand the current status of tobacco exposure,tobacco hazard awareness and tobacco advertising and tobacco control information,and to analyze the influencing factors of tobacco exposure in population aged 15 and over in Chongqing in 2017,in order to provide the basis for evaluating the effects of tobacco control and developing effective tobacco interventions in Chongqing.Methods: A stratified multi-stage cluster random sampling method was used to extract 7802 households in 16 districts and counties in Chongqing.The tobacco prevalence survey was conducted in adults aged15 and over in Chongqing by household survey.The survey included demographic characteristics,smoking status,secondhand smoke exposure,tobacco hazard awareness tobacco propoganda and tobacco control information.The data were collected by handheld computers.After the data was weighted,SPSS 22.0 was used to analyze the data by descriptive statistical methods,single factor chi-square test and multi-factor Logistic regression.Results: The effective sample of this survey was 6,478.After weighting the sample data,it was more representative of the adults aged 15 and over in Chongqing.1.Status of smokingThe current smoking rate among adults aged 15 and over in Chongqing was 25.5%,with 6.451 million people smoking now.The smoking prevalence in rural areas was 26.3%,slightly higher than that in urban area(24.2%).Different sex,age groups,education levels,occupations,home and indoor workplaces,whether to support warning labels for cigarette packs,and raising tobacco taxes are factors influencing the current smoking rate.The current smoking rate in males was 48.5%,which was significantly higher than that in females(1.6%).When age was concerned,the smoking rate of 45-64 years old was 28.7%,the highest among all age groups.When it came to education level,the smoking rate of people with junior college education and above was 21.4%,the lowest among all education level;while the smoking rate of people with junior high school education was 32.1%,the highest among all education level.When career was concerned,enterprise staff/business worker/service workers had the highest current smoking rate of 31.4%.The smoking rate of people with smoking bans at home and indoor workplaces,as well as people who support cigarette packs warning signs and increased tobacco taxes were lower than people not subject to smoking bans and notsupportive of cigarette control measures.Multivariate logistic analysis showed that male,low education levels,and staff/business worker/service workers were risk factors for current smoking.2.Status of secondhand smoke exposureThe rate of secondhand smoke exposure in adults aged 15 and over in Chongqing was 71.4%,with 63.9% of current non-smokers exposed to secondhand smoke.For the current non-smokers aged 15 and over in Chongqing,there were statistically significant differences in the rates of secondhand smoke exposure among different age groups,occupations,family income,and smoking bans at home(P<0.05).The rate of secondhand smoke exposure of 25-44 years old was 71.7%,the highest among all age groups.When the occupation was concerned,the highest rate of secondhand smoke exposure,counted 75.4%,fell into staff/business worker/service workers.Concerning the social/economical level,the highest rate of secondhand smoke exposure,69.3%,went to families earning 10000-50000 RMB per year.The rate of secondhand smoke exposure with no smoking regulations at home were lower than that of people without no smoking regulations at home.The rate of secondhand smoke exposure at home and indoor workplaces were 42.4% and 41.8%,respectively.Nevertheless,the rate of secondhand smoke exposure in various indoor public places were different,with 85.2% for Internet cafes,80.1% for bars/KTV/nightclubs,69.2% for restaurants,31.6% foruniversities,28.7% for government buildings,27.6% for taxis,and 26.9%for medical institutions,26.0% for public transport vehicles,24.6% for primary and secondary schools.Multivariate logistic analysis showed that the olderly and smoking bans at home were protective factors for non-smokers exposed to secondhand smoke.3.Status of tobacco hazard awarenessFor adults aged 15 and over in Chongqing,the awareness rates of smoking hazard in inducing lung cancer,heart disease,stroke,erectile dysfunction and all four diseases were 81.8%,49.2%,42.0%,25.0% and22.1%,respectively.The awareness rates of secondhand smoke hazard in inducing adulthood lung cancer,childhood lung disease,adulthood heart disease and all three diseases were 69.8%,64.6%,42.7% and 39.6%,respectively.Only 13.7% of the investigated had the correct recognition on the misconception that "low tar is equal to low harm." People living in rural areas,with higher age and low education levels,engaging in agricultural,and earning low family income had lower awareness of tobacco hazards compared with others.4.Tobacco propoganda and tobacco control informationThe proportion of adults aged 15 and over in Chongqing who saw any tobacco promotion advertisements and sponsorships was 13.9%.Specifically,6.2% of adults saw advertisements or signs promoting tobacco products in stores selling cigarettes.On the other hand,the proportion ofadults aged 15 and over in Chongqing who saw tobacco control information on newspapers / magazines,TV,radio and billboards was21.6%,44.1%,9.4% and 22.2% respectively.Overall,people with higher age,low education level,engaging in agricultural,,and low family income saw fewer tobacco control information than others.Conclusion:(1)The smoking rate of adults aged 15 and over in Chongqing is lower than that of national level in 2015.However,compared with other cities in China,the tobacco epidemic in Chongqing was still grim.Smoking rates in males,middle-aged population,people with low education level,staff/business worker/service workers,and people from low income families were higher than others,making them the key targets for smoking control.Smoking bans at home,supporing for the printing of warning pictures on cigarette packs,and supporting for raised tobacco taxes were the protective factors for smoking.(2)The status of secondhand smoke exposure in Chongqing was serious.The exposure of secondhand smoke in indoor public places was the most severe compared with indoor working places and indoor living spaces,with especially high level in Internet cafes,bars/KTV/nightclubs and restaurants.Young and middle-aged residents were heavily exposed to secondhand smoke,thus the key groups in Chongqing to be protected.(3)The awareness rate of smoking and secondhand smoke hazard was low among Chongqing residents aged 15 and above years old,needing to beimproved.Most of the residents only knew that smoking and secondhand smoke could induce lung cancer,rather than other diseases.People in rural areas,with higher age,lower education level,low incomes,engaging in agricultural were the key targets for tobacco hazard publicity and education.(4)Tobacco advertising and promotion activities in Chongqing was popular,especially in tobacco retail outlets.(5)The propaganda of tobacco control in Chongqing still needed to be improved,especially in rural areas,where tobacco control information was seldom spread.