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Prevalence Survey of smoking in the country area of Guangdong, China

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Background
As is well known, smoking is harmful to health. Cigarette smoke contains more than 4500 kinds of harmful substances [1], keeping human body under attack of a serious of diseases including: lung cancer, cardiovascular and cerebrovascular diseases, Chronic obstructive pulmonary diseases (COPD), and neoplastic disorder etc... [2] Statistics indicates that compare to nonsmokers, long-term cigarette smokers are 10 to 20 times more likely to develop lung cancer; 6 to 10 times higher to suffer from laryngocarcinoma; doubly or triply vulnerable to cardiovascular disease; 3 times higher to the destruction of circulatory system; 2 to 8 times higher to the incidence of (COPD) [3]. Worse still, inhalation of second-hand smoke by a pregnant woman increases the risk of teratogenicity [4].
It is also investigated that children from smoking families under the age of 16 suffer more from respiratory disease than non-smoking households [5]. In detail, 44.5% of the children under age 5 in the smoking households had respiratory symptom, comparing with 33.5% in the non-smoking households [6].

China, therefore, announces its decision to ratify tobacco control measures, such as establishment of smoking cessation programs, smoking bans in public places, smoking cessation clinic and smoke-free hospital. Yet cigarette smokers are still everywhere----whether in schools, factories and other workplaces, or in the party, entertainment places, hotels and other public places. To find out the smoking prevalence, under the guidance of epidemiologists, I designed a questionnaire on the prevalence survey of smoking and participated in an epidemiological survey on (COPD) in the country area of Guangdong, China in July 2013. By the analysis of the smoking prevalence in Guangdong, this survey aims at giving supports to smoking cessation.

Objects & Methods
This study was carried-out in a door-to-door interview to all the residents above 20-year-old (totally 755) in Longpucun, Longpuzhen, Lianpingxian, Heyuan City, Guangdong Province of China. A self-completion questionnaire was administered to all the respondents. Designed questions included: 1) Your age? 2) Your gender? 3) Have you intaked more than 100 cigarettes in your lifetime? 4) Are you a current smoker? 5) How many packs of cigarettes do you have per day? 6) When did you start smoking? 7) When did you quit smoking (if applicable)? 8) Do you have cravings in tobacco? 9) Did your mother smoke during pregnancy? 10) Did your mother inhale second-hand smoking during pregnancy? (in details as listed below)
Questionnaire

Question
Answer
1
Your age?
??? years
2
Your gender?
Male ?
Female ?
3
Have you intaked more than 100 cigarettes in your lifetime?
Yes ? No ?
4
Are you a current smoker?
Yes ? No ?
5
How many packs of cigarettes do you have per day?
???? pack-years
6
When did you start smoking?
???? years
7
When did you quit smoking (if applicable)?
???? years
8
Do you have cravings in tobacco?
Yes ? No ?
Don't know ?
9
Did your mother smoke during pregnancy?
Yes ? No ?
Don't know ?
10
Did your mother inhale second-hand smoking during pregnancy?
Yes ? No ?
Don't know ?

Results
Complete data were obtained from 730 respondents (96.7%), average age 48.67±13.15 (years old). Overall, 32.5% (237/730) of the respondents were smokers, the age of whom started smoking were 21.85±7.17. The smokers consume an average amount of 1.1±0.6 packs (20 cigarettes per pack) of cigarettes per day. Among these smokers, 58.2% (138/237) have cravings in tobacco. 24.8?(181/730) were current smokers. Overall, 7.7% (56/730) of the respondents had successfully quit smoking at the age of 48.77±12.53.
Besides, 78.7? (236/300) of the male respondents were smokers; 60.6? (180/300) were current smokers; 8.7% (56/300) had quitted smoking. Only one female respondent smoked. (statistics are shown in table 1)

Smoking prevalence among the young was lower than that in the old. (i.e. non-smokers were at a high percentage among the young). Data showed that for those who were at the age between 20 and 29, 86.5% never smoked (i.e. only 13.5% are smokers) comparing with 52.9% non-smokers (i.e. 47.1% smokers) among those over 70 years old. (statistics were shown in table 2). Besides, 1.2% (9/730) of the smokers' mothers appeared to smoke during pregnancy, while 47.9% (236/300) reported that they inhaled second-hand smoking when they were pregnant.

Table 1. Smoking prevalence by gender. All numbers are represented as number of persons ahead and percentages behind in the brackets.
Non-smokersEx-smokersCurrent smokers
Male 64 (21.3)56 (18.7)180 (60.0)
Female429 (99.8) 0 (0.0)1 (0.2)
Total493 (67.5)56 (7.7)181 (24.8)


Table 2. Smoking prevalence by age. All numbers are represented as number of persons ahead and percentages behind in the brackets.
Non-smokers Ex-smokersCurrent smokers
20-29 45 (86.5) 0 (0.0)7 (13.5)
30-39112 (83.0)3 (2.2) 20 (14.8)
40-49 147 (73.1)9 (4.5)45 (22.4)
50-59 100 (54.9)24 (13.2)58 (31.9)
60-69 62 (56.9)13 (11.9)34 (31.2)
≥7027 (52.9)7 (13.7)17 (33.3)
Total493 (67.5)56 (7.7)181 (24.8)


Discussion
According to the above analysis, the prevalence of smoking among peasants in Guangdong, China remains high. Among all the potential elements that harm the human health, cigarette smoke is still one of the most threatens to people's health, in particular to those in the rural areas, who are lack of knowledge on the danger of smoking and have poor awareness of quitting smoking. According to the “smoking and health” report released by the Ministry of Health in 2006, the smoking prevalence among those over 15-year-old accounted for 35.8% in 2002, in which 66.0% were male smokers while 3.1% female smokers [7].

Therefore, it is estimated that there are about 350,000,000 smokers in China, one third of the world's total smoking population. The amount of annual sales of cigarettes in China is up to 1.6 trillion and China contributes to one third of the world's cigarette consumption. Nowadays, nearly 1,000,000 of the Chinese die from smoking every year. The good news is that the number of young non-smokers in China is increasing, which reveals that cigarette control policy has seen relative expected results. But the remaining 24.8% smoking people in the country area of China still need more attention and could result in fundamental challenges to China tobacco control.




References

1. Brown BG, Borschke AJ, Doolittle DJ (2003) An analysis of the role of tobacco-specific nitrosamines in the carcinogenicity of tobacco smoke. Nonlinearity Biol Toxicol Med 1: 179-198.
2. Mathers CD, Loncar D (2006) Projections of global mortality and burden of disease from 2002 to 2030. PLoS Med 3: e442.
3. Raherison C, Girodet PO (2009) Epidemiology of COPD. Eur Respir Rev 18: 213-221.
4. Barnoya J, Glantz SA (2005) Cardiovascular effects of secondhand smoke: nearly as large as smoking. Circulation 111: 2684-2698.
5. Jarvie JA, Malone RE (2008) Children's secondhand smoke exposure in private homes and cars: an ethical analysis. Am J Public Health 98: 2140-2145.
6. Tsai CH, Huang JH, Hwang BF, Lee YL (2010) Household environmental tobacco smoke and risks of asthma, wheeze and bronchitic symptoms among children in Taiwan. Respir Res 11: 11.
7. China Ministry of Health (2006) China's "Smoking & Health" Report.




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