目的 比较近年来全国烟草流行调查,筛选最准确可靠的调查数据反映中国烟草流行水平.方法 对比"2002年行为危险因素监测"、"2002年中国居民营养与健康状况调查"和"2003年第三次全国卫生服务调查"中的烟草流行调查数据,筛选出较为可靠的中国烟草流行数据.筛选原则:(1)基于调查结果估计的烟草消费量应与当年的烟草实际供给量相当;(2)根据国际控烟经验,男性现在吸烟率平均每年下降幅度应不超过1%.结果 根据"2002年行为危险因素监测"结果计算的卷烟消费量与实际供给量相差最少(510.7亿支),根据"2002年中国居民营养与健康状况调查"结果计算的卷烟消费量与实际供给量相差次之(629.4亿支),根据"2003年第三次全国卫生服务调查"估计的结果与实际供给量相差最大(2171.1亿支);与1996年全国烟草流行率相比,根据"2002年行为危险因素监测"结果,烟草流行率平均每年下降0.9%,根据"2002年中国居民营养与健康状况调查"结果,烟草流行率平均每年下降2.2%,而根据"2003年第三次全国卫生服务调查"结果,烟草流行率平均每年下降2.0%.因此,"2002年行为危险因素监测"的烟草流行数据更为可靠.结论 "2002年行为危险因素监测"的结果可以用于反映中国烟草流行水平.由于烟草流行率是控烟政策制订必需的关键信息,因此亟需建立一个标准的国家监测系统以监测烟草流行状况.%Objective To determine the accuracy of prevalence data sets on tobacco use so as to measure the risk of tobacco use and the impact of tobacco control in China.Methods Three published data sets on nation-wide survey were reviewed,and compared.Two principles were applied to determine the accuracy of the data on prevalence: ) The estimated consumption of cigarettes based on the currentprevalence rate on smokers should have been close to the actual cigarette consumption level; ii) change on the annual prevalence of male current smokers should be around 1% in China,since the international experience on the prevalence of current smokers tended to decrease at a rate of around 1% per year in the presence of comprehensive tobacco control strategies.Results The differences between the estimated cigarette consumption and the actual cigarette consumption for the three surveys were 51.07 billion through Behavior Risk Factor Surveillance System (BRFSS 2002),62.94 billion through the Chinese Citizen Nutrition & Health Survey (CCNHS 2002),and 217.11 billion through the China Health Service Survey (CHSS 2003).In comparison with the national tobacco use survey in 1996,the prevalence of male current smokers apparently dropped by 0.9% in BRFSS 2002,2.2% in CCNHS 2002 and 2.0% per year in CHSS 2003.Thus,the prevalence of current smokers in BRFSS (2002) was more reliable,comparing to the results from the other two surveys.Conclusion The prevalence of current smokers as determined by the BRFSS should be used to reflect the epidemic of tobacco use when implementing the FCTC in China.However,the reporting prevalence rates of tobacco use were different in the different surveys regarding tobacco use,suggesting that the capacity of surveillance on tobacco control should be strengthened,including the standardization of definitions on 'ever-smoker' and 'current smoker',as well as on standardized questionnaire,sampling strategy and the process of data analysis,quality of field work etc.Precise estimation of prevalence appears to be the key point for understanding how many current smokers so as to develop control policy,including setting up 'quit' clinics and evaluating the impact of tobacco control programs.There is an urgent need to establish a national standardized surveillance system to monitor the tobacco epidemics.
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