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Article(id=1241522923069043610, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522919977841545, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202310135, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1696867200000, receivedDateStr=2023-10-10, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773931731239, onlineDateStr=2026-03-19, pubDate=1710000000000, pubDateStr=2024-03-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773931731239, onlineIssueDateStr=2026-03-19, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773931731239, creator=13701087609, updateTime=1773931731239, updator=13701087609, issue=Issue{id=1241522919977841545, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='5', pageStart='769', pageEnd='960', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773931730503, creator=13701087609, updateTime=1773931880386, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241523548695622547, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522919977841545, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241523548695622548, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522919977841545, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=854, endPage=858, ext={EN=ArticleExt(id=1241522923417170853, articleId=1241522923069043610, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Study on the relationship between nicotine dependence and depression in rural Dai elderly in Jinggu county, Yunnan Province, columnId=1228016572892119056, journalTitle=Modern Preventive Medicine, columnName=Primary Health Services, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the relationship between nicotine dependence and depression among the elderly of Dai ethnic group in Jinggu county, Yunnan Province.

Methods

By using the method of multi-stage stratified random sampling,1 409 rural Dai people aged 60 and over in Jinggu county, Yunnan Province were investigated by face-to-face questionnaire.

Results

The current smoking rate of rural Dai elderly in Jinggu county, Yunnan Province was 18.6% (37.1% for males and 0.8% for females). The smoking rate of males was significantly higher than that of females (P < 0.01). At present, the nicotine dependence rate of smokers was 32.8% (32.4% for males and 50.0% for females). There was no significant difference in nicotine dependence among Dai elderly people of different genders (P > 0.05), age groups (P > 0.05), education (P > 0.05), and annual family per capita income (P > 0.05). The prevalence rate of depression in the surveyed population was 52.0% (49.4% for males and 54.5% for females). Multivariate Logistic regression model analysis showed that patients with nicotine dependence were more likely to suffer from depression than those without nicotine dependence (OR=1.517, 95%CI: 1.066-2.158).

Conclusion

Nicotine dependence is positively correlated with depression in the elderly of Dai ethnic group in Yunnan Province. Taking effective measures to reduce the nicotine dependence rate of smokers is helpful to improve the mental health level of the elderly.

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目的

分析云南景谷县农村傣族老年人尼古丁依赖现状及与抑郁的关系。

方法

采用多阶段分层随机抽样方法抽取云南景谷县1 409名60岁及以上农村傣族老年人进行面访问卷调查。

结果

云南景谷县农村傣族老年人的现在吸烟率为18.6%，其中男性为37.1%、女性为0.8%，男性的吸烟率明显高于女性（χ2=305.947，P<0.01）。现在吸烟者的尼古丁依赖率为32.8%，其中男性为32.4%、女性为50.0%；不同性别（χ2=0.822，P>0.05）、年龄组（χ2=1.433，P>0.05）、文化程度（χ2=2.054，P>0.05）、家庭年人均收入（χ2=0.654，P>0.05）的傣族老年人的尼古丁依赖率差异均无统计学意义。调查人群抑郁的患病率为52.0%，其中男性患病率为49.4%、女性为54.5%。多因素logistic回归模型分析结果显示，尼古丁依赖者比非尼古丁依赖者更容易患抑郁（OR=1.517，95%CI：1.066～2.158）。

结论

云南省傣族老年人尼古丁依赖与抑郁的发生呈正相关。采取有效措施降低吸烟人群的尼古丁依赖率，有助于提高老年人的心理健康水平。

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蔡乐，E-mail:
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=GS9LyFimvoDTzgmaDExpbQ==, magXml=GGOvuXcSBwN+tB4LzcK5JA==, pdfUrl=null, pdf=pl93ZGJKfyvc0MlGztZggw==, pdfFileSize=542426, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=FPmR9yrkYHU0uwxkzvtWMw==, mapNumber=null, authorCompany=null, fund=null, authors=

李芹（1997—），女，硕士在读，研究方向：流行病与卫生统计学

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李芹（1997—），女，硕士在读，研究方向：流行病与卫生统计学

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李芹（1997—），女，硕士在读，研究方向：流行病与卫生统计学

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Prevelance of smoking and nicotine dependence among rural Dai elders with different characteristics

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变量现在吸烟情况尼古丁依赖情况
现在吸烟人数现在吸烟率（%）χ2值P值尼古丁依赖人数尼古丁依赖率（%）χ2值P值
性别
男25637.1**305.947<0.0018332.40.8220.365
女60.8350.0
年龄组（岁）
60～647620.7*3.8370.0502431.61.4330.698
65～699020.23134.4
70～745416.52037.0
≥754215.71126.2
文化程度
文盲8511.747.992<0.0013338.82.0540.152
小学及以上17726.0**5329.9
家庭年人均收入
低14322.1**9.8840.0025035.00.6540.419
高11915.63630.3
合计26218.68632.8
), ArticleFig(id=1241678326289453589, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522923069043610, language=CN, label=表1, caption=

不同特征农村傣族老年人现在吸烟和尼古丁依赖现状

, figureFileSmall=null, figureFileBig=null, tableContent=
变量现在吸烟情况尼古丁依赖情况
现在吸烟人数现在吸烟率（%）χ2值P值尼古丁依赖人数尼古丁依赖率（%）χ2值P值
性别
男25637.1**305.947<0.0018332.40.8220.365
女60.8350.0
年龄组（岁）
60～647620.7*3.8370.0502431.61.4330.698
65～699020.23134.4
70～745416.52037.0
≥754215.71126.2
文化程度
文盲8511.747.992<0.0013338.82.0540.152
小学及以上17726.0**5329.9
家庭年人均收入
低14322.1**9.8840.0025035.00.6540.419
高11915.63630.3
合计26218.68632.8
), ArticleFig(id=1241678327023456797, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522923069043610, language=EN, label=Table 2, caption=

Prevalence of depression among Dai rural elderly with different characteristics

, figureFileSmall=null, figureFileBig=null, tableContent=
变量抑郁患病人数抑郁患病率（%）χ2值P值
性别
男34049.34.0890.043
女39354.7
年龄组（岁）
60～6415843.18.0150.005
65～6924554.9
70～7418757.0
≥7514353.4
文化程度
文盲38853.20.8730.350
小学及以上34550.7
家庭年人均收入
低35354.63.2840.070
高38049.8
合计73352.0
), ArticleFig(id=1241678327690351140, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522923069043610, language=CN, label=表2, caption=

不同特征农村傣族老年人的抑郁现状

, figureFileSmall=null, figureFileBig=null, tableContent=
变量抑郁患病人数抑郁患病率（%）χ2值P值
性别
男34049.34.0890.043
女39354.7
年龄组（岁）
60～6415843.18.0150.005
65～6924554.9
70～7418757.0
≥7514353.4
文化程度
文盲38853.20.8730.350
小学及以上34550.7
家庭年人均收入
低35354.63.2840.070
高38049.8
合计73352.0
), ArticleFig(id=1241678328285942317, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522923069043610, language=EN, label=Table 3, caption=

Comparison of the prevalence of depression in nicotine-dependent older people

, figureFileSmall=null, figureFileBig=null, tableContent=
尼古丁依赖抑郁患病人数抑郁患病率（%）χ2值P值
否7240.98.8630.003
是5260.5
合计12447.3
), ArticleFig(id=1241678328638263865, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522923069043610, language=CN, label=表3, caption=

尼古丁依赖老年人的抑郁患病率的比较

, figureFileSmall=null, figureFileBig=null, tableContent=
尼古丁依赖抑郁患病人数抑郁患病率（%）χ2值P值
否7240.98.8630.003
是5260.5
合计12447.3
), ArticleFig(id=1241678329451958843, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522923069043610, language=EN, label=Table 4, caption=

Multivariate logistic regression analysis of the relationship nicotine dependence and depression among rural Dai ethnic minority older adults

, figureFileSmall=null, figureFileBig=null, tableContent=
变量B Wald χ2值P值OR值（95%CI）
尼古丁依赖（对照组：否）0.4170.1805.3720.0201.517(1.066～2.158)
), ArticleFig(id=1241678329913332295, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522923069043610, language=CN, label=表4, caption=

农村傣族老年人尼古丁依赖与抑郁的关系的多因素logistic回归分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量B Wald χ2值P值OR值（95%CI）
尼古丁依赖（对照组：否）0.4170.1805.3720.0201.517(1.066～2.158)
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云南景谷县农村傣族老年人尼古丁依赖现状及与抑郁的关系研究
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李芹 1, 2 , 李国晖 1, 2 , 刘岚 1, 2 , 刘杜丽 1, 2 , 余孜孜 1, 2 , 左梅 1, 2 , 黄友 1, 2 , 蔡乐 1, 2
现代预防医学 | 基层卫生服务 2024,51(5): 854-858
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现代预防医学 | 基层卫生服务 2024, 51(5): 854-858
云南景谷县农村傣族老年人尼古丁依赖现状及与抑郁的关系研究
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李芹1, 2, 李国晖1, 2, 刘岚1, 2, 刘杜丽1, 2, 余孜孜1, 2, 左梅1, 2, 黄友1, 2, 蔡乐1, 2
作者信息
  • 1.国家卫健委毒品依赖和戒治重点实验室，云南 昆明 650500
  • 2.昆明医科大学公共卫生学院，云南 昆明 650500

    • 李芹（1997—），女，硕士在读，研究方向：流行病与卫生统计学

通讯作者:

蔡乐，E-mail:
Study on the relationship between nicotine dependence and depression in rural Dai elderly in Jinggu county, Yunnan Province
Qin LI1, 2, Guo-hui LI1, 2, Lan LIU1, 2, Du-li LIU1, 2, Zi-zi YU1, 2, Mei ZUO1, 2, You HUANG1, 2, Le CAI1, 2
Affiliations
  • School of Public Health, Kunming Medical University, Kunming, Yunnan 650500, China
出版时间: 2024-03-10 doi: 10.20043/j.cnki.MPM.202310135
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摘要
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目的

分析云南景谷县农村傣族老年人尼古丁依赖现状及与抑郁的关系。

方法

采用多阶段分层随机抽样方法抽取云南景谷县1 409名60岁及以上农村傣族老年人进行面访问卷调查。

结果

云南景谷县农村傣族老年人的现在吸烟率为18.6%，其中男性为37.1%、女性为0.8%，男性的吸烟率明显高于女性（χ2=305.947，P<0.01）。现在吸烟者的尼古丁依赖率为32.8%，其中男性为32.4%、女性为50.0%；不同性别（χ2=0.822，P>0.05）、年龄组（χ2=1.433，P>0.05）、文化程度（χ2=2.054，P>0.05）、家庭年人均收入（χ2=0.654，P>0.05）的傣族老年人的尼古丁依赖率差异均无统计学意义。调查人群抑郁的患病率为52.0%，其中男性患病率为49.4%、女性为54.5%。多因素logistic回归模型分析结果显示，尼古丁依赖者比非尼古丁依赖者更容易患抑郁（OR=1.517，95%CI：1.066～2.158）。

结论

云南省傣族老年人尼古丁依赖与抑郁的发生呈正相关。采取有效措施降低吸烟人群的尼古丁依赖率，有助于提高老年人的心理健康水平。

傣族  /  尼古丁依赖  /  抑郁  /  农村  /  老年人
Objective

To analyze the relationship between nicotine dependence and depression among the elderly of Dai ethnic group in Jinggu county, Yunnan Province.

Methods

By using the method of multi-stage stratified random sampling,1 409 rural Dai people aged 60 and over in Jinggu county, Yunnan Province were investigated by face-to-face questionnaire.

Results

The current smoking rate of rural Dai elderly in Jinggu county, Yunnan Province was 18.6% (37.1% for males and 0.8% for females). The smoking rate of males was significantly higher than that of females (P < 0.01). At present, the nicotine dependence rate of smokers was 32.8% (32.4% for males and 50.0% for females). There was no significant difference in nicotine dependence among Dai elderly people of different genders (P > 0.05), age groups (P > 0.05), education (P > 0.05), and annual family per capita income (P > 0.05). The prevalence rate of depression in the surveyed population was 52.0% (49.4% for males and 54.5% for females). Multivariate Logistic regression model analysis showed that patients with nicotine dependence were more likely to suffer from depression than those without nicotine dependence (OR=1.517, 95%CI: 1.066-2.158).

Conclusion

Nicotine dependence is positively correlated with depression in the elderly of Dai ethnic group in Yunnan Province. Taking effective measures to reduce the nicotine dependence rate of smokers is helpful to improve the mental health level of the elderly.

Dai ethnic group  /  Nicotine dependence  /  Depression  /  Rural areas  /  Elderly
李芹, 李国晖, 刘岚, 刘杜丽, 余孜孜, 左梅, 黄友, 蔡乐. 云南景谷县农村傣族老年人尼古丁依赖现状及与抑郁的关系研究. 现代预防医学, 2024 , 51 (5) : 854 -858 . DOI: 10.20043/j.cnki.MPM.202310135
Qin LI, Guo-hui LI, Lan LIU, Du-li LIU, Zi-zi YU, Mei ZUO, You HUANG, Le CAI. Study on the relationship between nicotine dependence and depression in rural Dai elderly in Jinggu county, Yunnan Province[J]. Modern Preventive Medicine, 2024 , 51 (5) : 854 -858 . DOI: 10.20043/j.cnki.MPM.202310135
正文
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抑郁是老年人常见的心理健康问题，严重影响老年人的身心健康和生命质量，甚至引起自杀[1]。世界卫生组织报告指出，吸烟每年造成全球超过800多万人死亡[2]，成为公共卫生的优先问题。在中国致死率最高的五大危险因素中，吸烟与其中四项均有关联[3]。烟草中的尼古丁会使长期吸烟者产生成瘾性，对戒烟行为产生巨大阻碍[4]。大量研究表明，吸烟与抑郁之间关系复杂，有抑郁症状的人更容易发生吸烟行为[5]，并且长期吸烟者发生抑郁的可能性较大[6]。烟草是云南省重要的支柱产业，同时也是景谷县主要的经济作物之一。景谷县是以傣族、彝族为主的少数民族自治县，拥有云南省最多的少数民族种类，其中傣族是云南省独有的少数民族之一，相关研究表明吸烟率、尼古丁依赖率和抑郁患病率存在民族差异[7-8]，但目前针对傣族老年人尼古丁依赖和抑郁的研究较少。本研究通过调查云南省景谷县农村傣族老年人尼古丁依赖现状及与抑郁的关系，旨在为云南省景谷县农村傣族老年人心理健康问题的防治和控烟工作提供科学依据。
1　资料与方法
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1.1　资料来源
资料来源于2021年7月对云南省景谷县≥60岁的1 409名农村傣族老年居民的问卷调查。本研究通过昆明医科大学医学伦理委员会批准（审查批准号：KMMU2020MEC030），调查前获得调查对象的知情同意，并签署知情同意书。
1.2　方法
1.2.1　抽样方法
采用多阶段分层随机抽样方法抽取样本。第一阶段采用分层随机抽样，根据景谷县当地居民的经济状况，将云南省景谷县辖内10个乡/镇划分为好和差2个等级，从2个等级中分别随机抽取1个乡/镇，共抽取2个乡/镇。第二阶段根据各行政村的人口规模，采用比例概率抽样（probability proportionate to size sampling，PPS）的方法，在抽取的2个乡镇中各随机抽取3个行政村，共抽取6个行政村。第三阶段采用单纯随机抽样，分别从6个行政村中随机抽取≥60岁农村傣族老年人作为研究对象，取其知情同意后进行现场问卷调查。
1.2.2　样本量的确定
根据横断面研究样本量的计算公式：
p为农村老年人尼古丁依赖检出率为8.64%[9]，δ（容许误差）通常取p的一半，设计效应deff取1，α（检验水准）取0.05。估算出每个样本村抽取样本量为162人，考虑到10%～15%的无应答率，预计每个样本村调查186人，本研究共抽取6个行政村，即最小样本量为1 116人。
1.2.3　现场调查方法
采用尼古丁依赖检测量表（fagerstrom test of nicotine dependence，FTND）、老年抑郁量表( the geriatric depression scale，GDS)和经过预调查校正的自行设计的调查问卷，由培训合格的调查员进行面访调查。问卷内容包括：基本人口学资料（性别、年龄、民族、文化程度、家庭年人均收入等）、吸烟情况、尼古丁依赖情况和抑郁情况等。
1.2.4　相关定义
（1）现在吸烟者：调查前30 d内有吸烟史，且到目前为止吸烟量超过100支或150g烟叶者。（2）尼古丁依赖：对现在吸烟者采用FTND量表进行评估。该量表共有6个问题，采用5级评分，总分0～10分。总分<5分为非尼古丁依赖型，≥5分为尼古丁依赖型[10]。（3）抑郁：采用GDS测量，该量表共包括30个条目，其中有10个反序计分条目，20个正序计分条目，每个条目1分，共30分。其中0～10分为无抑郁，10分为抑郁（其中：11～20分为轻度抑郁，21～30分为中重度抑郁）。4）家庭年人均收入以中位数划分，<6 565元为低收入，≥6 565元为高收入。
1.3　统计分析方法
采用EpiData 3.1软件对数据资料进行双录入核查，运用SPSS 26.0软件进行数据整理和统计分析。计数资料用［n（%）］描述，采用χ2检验比较不同特征人群现在吸烟率、尼古丁依赖率和抑郁患病率的差异；采用趋势χ2检验分析老年人现在吸烟率、尼古丁依赖率和抑郁患病率随年龄变化的趋势；采用多因素logistic回归分析老年人尼古丁依赖现状与抑郁的关系。检验水准α=0.05。
2　结果
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2.1　调查人群基本情况
本次调查共发放问卷1 450份，回收有效问卷1 409份，问卷有效回收率97.17%。其中男性690人(占49.0%)，女性719人(占51.0%)；调查对象平均年龄为（69.2±6.4）岁，60～64岁367人(占26.0%)，65～69岁446人(占31.7%)，70～74岁328人(占23.3%)，75岁及以上268人(占19.0%)；家庭年人均收入低者646人(占45.8%)，高收入者763人(占54.2%)；文盲729人(占51.7%)，小学及以上文化程度680人(占48.3%)。
2.2　云南景谷县农村傣族老年人吸烟和尼古丁依赖现状
分析结果显示，云南景谷县农村傣族老年人的现在吸烟率为18.6%，其中男性现在吸烟率为37.1%，女性为0.8%，男性的现在吸烟率显著高于女性（χ2=305.947，P<0.001）；随着年龄的增大，老年人现在吸烟率逐渐降低（χ2趋势=3.837，P=0.05）；文盲的现在吸烟率显著低于小学及以上文化程度者（χ2=47.992，P<0.001）；家庭年人均收入低者的现在吸烟率显著高于高收入老年人（χ2=9.884，P=0.002）。
在所调查的262名傣族老年人现在吸烟者中，尼古丁依赖率为32.8%，其中男性为32.4%，女性为50.0%，不同特征老年人的尼古丁依赖情况无统计学差异（均P>0.05）。见表1。
2.3　云南景谷县农村傣族老年人抑郁的流行现状
结果显示，云南景谷县农村傣族老年人抑郁患病率为52.0%，其中男性患病率为49.4%，女性为54.5%；老年女性抑郁患病率显著高于男性（P<0.05）；老年人抑郁的患病率随年龄增大而升高（χ2趋势=8.015，P<0.01）；其他人口学特征方面抑郁的患病率差异无统计学意义（均P>0.05）。见表2。
2.4　云南景谷县农村傣族老年人尼古丁依赖与抑郁的关系分析
2.4.1　云南景谷县农村傣族老年人尼古丁依赖与抑郁关系的单因素分析
单因素分析结果显示，所调查的262名现在吸烟的傣族老年人中，尼古丁依赖老年人的抑郁患病率较高（χ2=8.863，P=0.003）。见表3。
2.4.2　云南景谷县农村傣族老年人尼古丁依赖与抑郁关系的多因素分析
在多因素分析中，纳入单因素分析有差异的性别和年龄组两个变量进行控制，分析老年人尼古丁依赖与抑郁的关系。分别以老年人是否抑郁为应变量（0=否，1=是），选择性别（0=男，1=女）、年龄组（岁）（1=60～64，2=65～69，3=70～74，4=75）和尼古丁依赖（0=否，1=是）作为抑郁的影响因素，变量选入水准α=0.05，剔出水准β=0.10。多因素logistic回归分析结果显示，在控制了性别、年龄组的影响后，尼古丁依赖者发生抑郁的可能性大于非尼古丁依赖者（OR=1.517，95%CI:1.066～2.158）。见表4。
3　讨论
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本次调查结果显示，云南景谷县农村傣族老年人的现在吸烟率为18.6%，低于苏州市（28.5%）[11]和云南省汉族（28.5%）、纳西族（32.2%）和白族（30.5%）[7]老年人的现在吸烟率，略高于北京市（12.7%）[12]和全国（16.7%）[13]老年人的吸烟率，傣族居民居住地的自然环境决定其以烟草等作为其主要经济来源，长期以来形成的吸烟习俗可能影响老年人的吸烟行为。提示景谷县农村傣族老年人的吸烟现状不容忽视。本研究中男性的现在吸烟率显著高于女性，这与国内外相关研究结果一致[14-16]；可能由于女性相对于男性有更高的吸烟危害认知[17]，并且传统观念和社会大环境对女性吸烟行为的约束。应加强男性的控烟宣传，增强其危害认知，降低吸烟行为的发生。此外，景谷县傣族老年人的现在吸烟率存在明显的年龄差异。随着年龄的增大，老年人现在吸烟率逐渐降低，这与刘太一[18]的研究结果一致；可能由于随着年龄的增长，老年人身体机能逐渐下降，加之长期吸烟导致的呼吸系统疾病或者其他慢性疾病的增加，有意识地采取一些戒烟行为。
尼古丁作为一种成瘾性物质，会影响吸烟者的吸烟和戒烟行为。相关研究[19]表明，不同烟草类型、开始吸烟年龄、吸烟年限等因素均会对吸烟者的尼古丁依赖产生影响。本次调查的傣族老年人现在吸烟者中，尼古丁依赖率为32.8%，高于浙江省老年人尼古丁依赖率（23.1%）[20]，略低于云南省白族老年人尼古丁依赖率（34.9%）[21]。可能由于云南农村少数民族地区经济发展相对落后，生活压力较大，缺乏适宜的娱乐项目，长期靠吸烟缓解压力，容易产生尼古丁依赖。提示该地区尼古丁依赖情况不容乐观，应加强对老年人尼古丁依赖的改善和控制。
景谷县农村傣族老年人抑郁的患病率为52.0%，高于全国（22.1%）[22]和贵州省（38.8%）[23]农村老年人的抑郁率，可能与当地基层卫生服务缺乏对老年人心理健康问题的关注和管理，老年人心理健康问题得不到及时诊治有关。提示调查地区老年人抑郁患病形式严峻，相关机构应加强对老年人心理健康问题的重视。老年人抑郁患病率随年龄增大而升高，与Maier等人[24]研究结果一致，究其原因，可能是随着年龄的增长，机体各组织器官功能减退，慢性病患病风险增加，并且老年人对负面情绪的调节能力弱，长此以往容易出现心理健康问题。政府应加大基层医疗卫生投资，积极开展老年人心理健康筛查和治疗，提高老年人心理健康水平，其中需重点关注高龄老人。
本研究发现尼古丁依赖与老年人抑郁的发生成正相关，尼古丁依赖者发生抑郁的风险高于非尼古丁依赖者。国外关于成年人尼古丁依赖与抑郁的关系研究也得出相似的结论[25]。可能的原因一是老年人长期吸烟，导致尼古丁依赖程度逐渐增加，尼古丁在体内通过神经生物学途径，干扰神经系统的正常运行，影响抑郁的发生；二是吸烟者容易形成对吸烟缓解情绪的错误认知，形成尼古丁依赖与抑郁的恶性循环。国内外关于老年人吸烟与抑郁的众多研究中，较少涉及尼古丁依赖情况。众多研究者对吸烟（包括少量尼古丁依赖）与抑郁的时间顺序和因果关系展开研究，提出了吸烟与抑郁存在双向关联[6,26]。有些研究者认为，抑郁症状可能会促使吸烟行为的发生，并对吸烟行为所带来的快感的追求逐渐增强，久而久之发展为尼古丁依赖；另一些研究者则认为，尼古丁依赖是一种神经毒性作用，会对人体的脑神经产生影响，增加了抑郁的可能性[27]。所以关注老年人的心理健康和控制老年人的吸烟行为是相辅相成的，需要共同推进，以便更好地提高老年人的生命质量。
基金
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  • 国家自然科学基金资助项目(72064026)
  • 云南省哲学社会科学创新团队(2023CX11)
  • 云南省创新团队(202005AE160002)
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2024年第51卷第5期
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doi: 10.20043/j.cnki.MPM.202310135
  • 接收时间：2023-10-10
  • 首发时间：2026-03-19
  • 出版时间：2024-03-10
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  • 收稿日期：2023-10-10
基金
国家自然科学基金资助项目(72064026)
云南省哲学社会科学创新团队(2023CX11)
云南省创新团队(202005AE160002)
作者信息
    1.国家卫健委毒品依赖和戒治重点实验室，云南 昆明 650500
    2.昆明医科大学公共卫生学院，云南 昆明 650500

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2种不同金属材料的力学参数
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Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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