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BMJ open：在学校开设吸烟相关课程能能否有效阻止青少年吸烟？

2015-03-14 徐媛媛 MedSci原创

青少年吸烟
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目的 探究在学校开设吸烟预防教育是否能有效长期阻止儿童吸烟。 本次研究数据来源为：(1966+), EMBASE (1974+), Cinahl, PsycINFO (1967+), ERIC (1982+), Cochrane CENTRAL, Health Star, Dissertation Abstracts, conference proceedings等，并利用pooled a


目的 探究在学校开设吸烟预防教育是否能有效长期阻止儿童吸烟。

本次研究数据来源为：(1966+), EMBASE (1974+), Cinahl, PsycINFO (1967+), ERIC (1982+), Cochrane CENTRAL, Health Star, Dissertation Abstracts, conference proceedings等，并利用pooled analyses, fixed-effects models, adjusted ORs偏移评估工具来评估数据。

基于学校开设相关吸烟课程收纳了50项随机对照试验，不吸烟参与者143495人，年龄5-18岁，并随访≥6个月，参与者没有时间/语言的局限性。

课程设置为：信息课程、社会影响课程、社会能力课程、社会影响/能力课程和多模式课程。

在所有课程共同统计时，小于一年的随访与对照组相比无显著统计学差异(OR 0.91(0.82 - 1.01))，但将社交影响/能力课程与多模式课程联合后对预防吸烟有显著影响(7个试验,OR 0.59(95% CI 0.41 - 0.85))。所有课程在最长的随访期限情况下与对照组相比有显著预防效果(OR 0.88(0.82 - 0.95))，社交能力课程(OR0.65(0.43 - 0.96))以及结合社会影响/能力课程(OR 0.60(0.43 - 0.83))同样也有显著性影响。社会影响课程或多模式课程没有显著影响。按性别分的话，在不同期限的随访中试验课程的开设对女性均有显著影响，而对男性无影响。

最长随访时间发现与对照组相比整体显著影响平均减少12%,但在随访1年以内对所有的受试者并无影响。然而，社交能力/社会影响课程在随后的随访期产生了显著的影响。

原始出处

Thomas RE1, McLellan J2, Perera R2.Effectiveness of school-based smoking prevention curricula: systematic review and meta-analysis.BMJ Open. 2015 Mar 10

小知识：青少年吸烟的危害

由于青少年时期各系统和器官的发育尚不完善，功能尚不健全，抵抗力弱，与成年人相比吸烟的危害就更大。此外，由于青少年呼吸道比成年人狭窄，呼吸道粘膜纤毛发育也不健全，因此吸烟会使呼吸道受到损害并产生炎症，增加呼吸的阻力，使肺活量下降，影响青少年胸廓的发育，进而影响其整体的发育。

有关医学研究表明，人身体的任何部位都不能幸免于抽烟引起的不良后果，抽烟的不利影响在数年后就会显示出来。香烟燃烧时释放的多种致癌化学物质，不仅有可能导致肺癌、食道癌、子宫癌、肝癌和各种心血管病，而且会降低抽烟者对各种疾病的自身免疫力。此外，抽烟还会导致脱发、听力下降和骨质疏松。妇女抽烟还会增加不孕率。

烟草中含有的大量尼古丁对脑神经也有毒害作用，会使学生记忆力减退、精神不振、学习成绩下降。此外，青少年正处在性发育的关键时期，吸烟会使睾丸酮分泌下降20%~30%，使精子减少和畸形；使少女初潮期推迟，经期紊乱。

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    2016-01-27 gaoxiaoe

    #BMJ#

    0

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    2015-11-16 feather89

    #PE#

    0

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    2015-03-24 sky0909

    很难

    0

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    2015-03-24 sky0909

    很难

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1847662, encodeId=435f184e662a4, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Wed Jan 27 20:52:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725783, encodeId=2ea01e257839a, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Mon Nov 16 16:52:00 CST 2015, time=2015-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18795, encodeId=13e518e9564, content=很难, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=sky0909, createdTime=Tue Mar 24 21:24:00 CST 2015, time=2015-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18796, encodeId=3e7218e96cb, content=很难, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=sky0909, createdTime=Tue Mar 24 21:24:00 CST 2015, time=2015-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18797, encodeId=9f4c18e97d2, content=很难, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=sky0909, createdTime=Tue Mar 24 21:24:00 CST 2015, time=2015-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18700, encodeId=48b018e009a, content=很难, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLBzoPY0a1ZQrECBF90v8AkFiaxRlNpGj1mLzD1B7ibnyBjmDEjiauBSDpOw6w4tI7YxmjdWaIW0SXL4/0, createdBy=35951605658, createdName=等你一年又一年, createdTime=Tue Mar 24 00:38:00 CST 2015, time=2015-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18327, encodeId=2f451832ed9, content=难, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3yz0JbjHQ7nicJU7lHMOu0Itf3Zv3VBzEvK3k4AFPBXhiaxIRNGVI33GicoRXQEjkaasjdlWKwZuwcyhDP9Jibqt5ct/0, createdBy=f1281613275, createdName=zhouanxiu, createdTime=Sun Mar 15 07:25:00 CST 2015, time=2015-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18317, encodeId=39db1831e09, content=阻止青少年吸烟并不乐观, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96871613250, createdName=medcardio, createdTime=Sat Mar 14 20:50:00 CST 2015, time=2015-03-14, status=1, ipAttribution=)]
    2015-03-24 sky0909

    很难

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1847662, encodeId=435f184e662a4, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Wed Jan 27 20:52:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725783, encodeId=2ea01e257839a, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Mon Nov 16 16:52:00 CST 2015, time=2015-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18795, encodeId=13e518e9564, content=很难, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=sky0909, createdTime=Tue Mar 24 21:24:00 CST 2015, time=2015-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18796, encodeId=3e7218e96cb, content=很难, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=sky0909, createdTime=Tue Mar 24 21:24:00 CST 2015, time=2015-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18797, encodeId=9f4c18e97d2, content=很难, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=sky0909, createdTime=Tue Mar 24 21:24:00 CST 2015, time=2015-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18700, encodeId=48b018e009a, content=很难, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLBzoPY0a1ZQrECBF90v8AkFiaxRlNpGj1mLzD1B7ibnyBjmDEjiauBSDpOw6w4tI7YxmjdWaIW0SXL4/0, createdBy=35951605658, createdName=等你一年又一年, createdTime=Tue Mar 24 00:38:00 CST 2015, time=2015-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18327, encodeId=2f451832ed9, content=难, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3yz0JbjHQ7nicJU7lHMOu0Itf3Zv3VBzEvK3k4AFPBXhiaxIRNGVI33GicoRXQEjkaasjdlWKwZuwcyhDP9Jibqt5ct/0, createdBy=f1281613275, createdName=zhouanxiu, createdTime=Sun Mar 15 07:25:00 CST 2015, time=2015-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18317, encodeId=39db1831e09, content=阻止青少年吸烟并不乐观, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96871613250, createdName=medcardio, createdTime=Sat Mar 14 20:50:00 CST 2015, time=2015-03-14, status=1, ipAttribution=)]
    2015-03-24 等你一年又一年

    很难

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1847662, encodeId=435f184e662a4, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Wed Jan 27 20:52:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725783, encodeId=2ea01e257839a, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Mon Nov 16 16:52:00 CST 2015, time=2015-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18795, encodeId=13e518e9564, content=很难, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=sky0909, createdTime=Tue Mar 24 21:24:00 CST 2015, time=2015-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18796, encodeId=3e7218e96cb, content=很难, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=sky0909, createdTime=Tue Mar 24 21:24:00 CST 2015, time=2015-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18797, encodeId=9f4c18e97d2, content=很难, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=sky0909, createdTime=Tue Mar 24 21:24:00 CST 2015, time=2015-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18700, encodeId=48b018e009a, content=很难, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLBzoPY0a1ZQrECBF90v8AkFiaxRlNpGj1mLzD1B7ibnyBjmDEjiauBSDpOw6w4tI7YxmjdWaIW0SXL4/0, createdBy=35951605658, createdName=等你一年又一年, createdTime=Tue Mar 24 00:38:00 CST 2015, time=2015-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18327, encodeId=2f451832ed9, content=难, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3yz0JbjHQ7nicJU7lHMOu0Itf3Zv3VBzEvK3k4AFPBXhiaxIRNGVI33GicoRXQEjkaasjdlWKwZuwcyhDP9Jibqt5ct/0, createdBy=f1281613275, createdName=zhouanxiu, createdTime=Sun Mar 15 07:25:00 CST 2015, time=2015-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18317, encodeId=39db1831e09, content=阻止青少年吸烟并不乐观, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96871613250, createdName=medcardio, createdTime=Sat Mar 14 20:50:00 CST 2015, time=2015-03-14, status=1, ipAttribution=)]
    2015-03-15 zhouanxiu

    难

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1847662, encodeId=435f184e662a4, content=<a href='/topic/show?id=2977356edc' target=_blank style='color:#2F92EE;'>#BMJ#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3567, encryptionId=2977356edc, topicName=BMJ)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=148754, createdName=gaoxiaoe, createdTime=Wed Jan 27 20:52:00 CST 2016, time=2016-01-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1725783, encodeId=2ea01e257839a, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Mon Nov 16 16:52:00 CST 2015, time=2015-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18795, encodeId=13e518e9564, content=很难, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=sky0909, createdTime=Tue Mar 24 21:24:00 CST 2015, time=2015-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18796, encodeId=3e7218e96cb, content=很难, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=sky0909, createdTime=Tue Mar 24 21:24:00 CST 2015, time=2015-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18797, encodeId=9f4c18e97d2, content=很难, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=sky0909, createdTime=Tue Mar 24 21:24:00 CST 2015, time=2015-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18700, encodeId=48b018e009a, content=很难, beContent=null, objectType=article, channel=null, level=null, likeNumber=98, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLBzoPY0a1ZQrECBF90v8AkFiaxRlNpGj1mLzD1B7ibnyBjmDEjiauBSDpOw6w4tI7YxmjdWaIW0SXL4/0, createdBy=35951605658, createdName=等你一年又一年, createdTime=Tue Mar 24 00:38:00 CST 2015, time=2015-03-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18327, encodeId=2f451832ed9, content=难, beContent=null, objectType=article, channel=null, level=null, likeNumber=116, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3yz0JbjHQ7nicJU7lHMOu0Itf3Zv3VBzEvK3k4AFPBXhiaxIRNGVI33GicoRXQEjkaasjdlWKwZuwcyhDP9Jibqt5ct/0, createdBy=f1281613275, createdName=zhouanxiu, createdTime=Sun Mar 15 07:25:00 CST 2015, time=2015-03-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=18317, encodeId=39db1831e09, content=阻止青少年吸烟并不乐观, beContent=null, objectType=article, channel=null, level=null, likeNumber=99, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=96871613250, createdName=medcardio, createdTime=Sat Mar 14 20:50:00 CST 2015, time=2015-03-14, status=1, ipAttribution=)]
    2015-03-14 medcardio

    阻止青少年吸烟并不乐观

    0

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