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Article(id=1321170447945814264, tenantId=1146029695717560320, journalId=1319373219989389464, issueId=1321170430187130949, articleNumber=null, orderNo=null, doi=10.11847/zgggws1145605, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1722528000000, receivedDateStr=2024-08-02, revisedDate=1731859200000, revisedDateStr=2024-11-18, acceptedDate=1737820800000, acceptedDateStr=2025-01-26, onlineDate=1792921180950, onlineDateStr=2026-10-25, pubDate=1739116800000, pubDateStr=2025-02-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1792921180950, onlineIssueDateStr=2026-10-25, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1792921180950, creator=13701087609, updateTime=1792921180950, updator=13701087609, issue=Issue{id=1321170430187130949, tenantId=1146029695717560320, journalId=1319373219989389464, year='2025', volume='41', issue='2', pageStart='129', pageEnd='256', issueExtLink='null', onlineDate='null', pubDate='1739116800000', pubDateStr='2025-02-10', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1792921176716, creator='13701087609', updateTime=1792921176716, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=161, endPage=164, ext={EN=ArticleExt(id=1321170448163918073, articleId=1321170447945814264, tenantId=1146029695717560320, journalId=1319373219989389464, language=EN, title=Access to and unrestricted purchase of smoked or smokeless tobacco among secondary school students in China, 2023: a nationwide cross-sectional survey, columnId=1320427696342020970, journalTitle=Chinese Journal of Public Health, columnName=Epidemiological Research, runingTitle=null, highlight=null, articleAbstract=
Objective

To understand different ways of obtaining and unrestricted access to purchase cigarettes and e-cigarettes among Chinese secondary school students to provide evidence to evaluate the effectiveness of tobacco control laws and regulations.

Methods

Study participants were 273 154 students recruited using a multistage stratified cluster random sample from 912 junior high schools, 590 regular high schools, and 274 vocational high schools in 31 provincial-level administrative divisions of China. On-site, anonymous, self- administered surveys were conducted from September to December 2023 using the questionnaire developed by the Tobacco Control Office, Chinese Center for Disease Control and Prevention.

Results

Of the 261 454 participants who provided valid responses, 14 199 (corresponding to a national estimate of 4 678 233 students) and 4 643 (corresponding to a national estimate of 1 483 681 students), based on sampling, non-response, and post-stratification weighting, self-reported having purchased cigarettes and e-cigarettes, respectively, in the past 30 days. Among cigarette purchasers, 75.8% obtained cigarettes through a single channel, while 24.2% used two or more channels. The top three access channels were retail outlets (58.7%), sharing from others (42.3%), and obtaining them at home (13.4%). Similarly, among e-cigarette purchasers, 84.4% accessed e-cigarettes through one channel, and 15.6% used two or more channels. The main access channels for e-cigarettes were online shopping (44.2%), experience shops or retail outlets (33.1%), and shopping malls, supermarkets, convenience stores, or grocery stores (28.3%). Among current school smokers surveyed, 71.7% (4 738 corresponding to a national estimate of 1 585 135 students) and 66.7% (2 333, corresponding to a national estimate of 791 337 students) reported unrestricted access to purchase cigarettes and e-cigarettes, respectively, in the past 30 days. Higher rates of unrestricted access to cigarettes were observed among female smokers compared with male smokers (76.0% vs. 70.7%, P<0.05) and among high school smokers compared with middle school smokers (75.2% vs. 66.8%, P<0.05). Similarly, unrestricted access to e-cigarettes was higher among high school smokers than among middle school smokers (69.7% vs. 64.9%, χ2=3.900; P=0.048).

Conclusions

In 2023, a significant proportion of secondary school student smokers in China reported easy access to purchasing both traditional cigarettes and e-cigarettes, primarily through retail stores and online platforms. This concerning trend highlights the urgent need to strengthen regulatory measures and enforcement in tobacco retail operations and e-commerce channels to effectively prevent underage tobacco use among secondary school students.

, authors=Mingxin QI, Xiaokai JIA, Xinying ZENG, Shiwei LIU, Lin XIAO, authorsList=Mingxin QI, Xiaokai JIA, Xinying ZENG, Shiwei LIU, Lin XIAO, authorCompany=null, correspAuthors=Lin XIAO, authorNote=null, correspAuthorsNote=
XIAO Lin, E mail：
, copyrightStatement=Copyright © 2025 Chinese Journal of Public Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1321170448516239610, articleId=1321170447945814264, tenantId=1146029695717560320, journalId=1319373219989389464, language=CN, title=2023年中国中学生获得烟草来源及购烟时未被拒绝情况分析, columnId=1320427696509793132, journalTitle=中国公共卫生, columnName=流行病学研究, runingTitle=null, highlight=null, articleAbstract=
目的

了解2023年中国中学生获得烟草来源及购买时未被拒绝情况，为评价控烟相关法律法规的实施效果提供参考依据。

方法

于2023年9—12月采用多阶段随机整群抽样方法在我国31个省（直辖市、自治区）抽取912所初中、590所普通高中和274所职业高中共1 776所中学的273 154名中学生进行问卷调查。

结果

最终纳入分析的261 454名中国中学生中，有14 199（加权后4 678 233）名和4 643（加权后1 483 681）名中学生曾在过去30 d内获得过卷烟和电子烟。获得过卷烟的中学生中有75.8%的中学生仅使用1种方式获得，有24.2%的中学生使用≥2种方式获得，其获得卷烟的主要3种方式为零售店购买（58.7%）、别人给的（42.3%）和家里拿的（13.4%）；获得过电子烟的中学生中有84.4%的中学生仅使用1种方式获得，有15.6%的中学生使用≥2种方式获得，其获得电子烟的主要3种方式为网上购买（44.2%）、电子烟体验店或零售店购买（33.1%）和商场（超市、便利店、杂货店）购买（28.3%）。有4 738（加权后1 585 135）和2 333（加权后791 337）名现在吸烟的中学生在过去30 d内购买卷烟和电子烟时未被拒绝，购买卷烟和电子烟时未被拒绝的比例分别为71.7%和66.7%。购买卷烟时，女生未被拒绝的比例（76.0%）高于男生（70.7%），高中生未被拒绝的比例（75.2%）高于初中生（66.8%），差异均有统计学意义（均P<0.05）；购买电子烟时，高中生未被拒绝的比例（69.7%）高于初中生（64.9%），差异有统计学意义（χ2=3.900，P=0.048）。

结论

2023年中国中学生获得卷烟和电子烟的方式依然以烟草零售店和网络为主；中学生在购买卷烟和电子烟时未被拒绝的比例较高，建议加强对烟草零售店和网络平台的监管，保护未成年人远离烟草。

, authors=祁明新, 贾孝凯, 曾新颖, 刘世炜, 肖琳*, *, authorsList=祁明新, 贾孝凯, 曾新颖, 刘世炜, 肖琳, authorCompany=null, correspAuthors=肖琳, authorNote=

祁明新（1998—），硕士在读，研究方向：青少年控烟

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肖琳，E-mail：
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(2016-10-25)[2024-11-18]. https://www.gov.cn/gongbao/content/2016/content_5133024.htm., articleTitle=null, refAbstract=null)], funds=null, companyList=[AuthorCompany(id=1321170448713371899, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170447945814264, xref=null, ext=[AuthorCompanyExt(id=1321170448725954812, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170447945814264, companyId=1321170448713371899, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing 100050, China), AuthorCompanyExt(id=1321170448734343421, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170447945814264, companyId=1321170448713371899, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=中国疾病预防控制中心控烟办，北京 100050)])], figs=[ArticleFig(id=1321170450613391647, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170447945814264, language=EN, label=Tab.1, caption=

Weighted proportions of different ways of obtaining cigarettes/e-cigarettes among 14 199/4 643 Chinese secondary school students (corresponding to a national total of 4 678 233/1 483 681 students estimated from sampling, non-response and post-stratification weighting) with access to tobacco in the past 30 days

, figureFileSmall=null, figureFileBig=null, tableContent=
获得方式分类调查人数加权人数加权占比/%
卷烟零售店购买a8 6502 744 36858.7
别人给的5 7121 980 40142.3
家里拿的1 802625 41913.4
网上购买914274 2225.9
酒吧和KTV等娱乐场所购买852253 8715.4
其他b695246 5715.3
自动售货机购买561179 8953.8
电子烟网上购买2 022656 25144.2
电子烟体验店或零售店购买1 515491 13033.1
商场、超市、便利店和杂货店购买1 339419 45328.3
其他c32896 9706.5
酒吧和KTV等娱乐场所购买28485 3465.8
自动售货机购买25081 2405.5
), ArticleFig(id=1321170450680500512, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170447945814264, language=CN, label=表1, caption=

中国中学生过去30 d内卷烟和电子烟获得方式

, figureFileSmall=null, figureFileBig=null, tableContent=
获得方式分类调查人数加权人数加权占比/%
卷烟零售店购买a8 6502 744 36858.7
别人给的5 7121 980 40142.3
家里拿的1 802625 41913.4
网上购买914274 2225.9
酒吧和KTV等娱乐场所购买852253 8715.4
其他b695246 5715.3
自动售货机购买561179 8953.8
电子烟网上购买2 022656 25144.2
电子烟体验店或零售店购买1 515491 13033.1
商场、超市、便利店和杂货店购买1 339419 45328.3
其他c32896 9706.5
酒吧和KTV等娱乐场所购买28485 3465.8
自动售货机购买25081 2405.5
), ArticleFig(id=1321170450747609377, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170447945814264, language=EN, label=Tab.2, caption=

Weighted proportions of unrestricted access to purchase cigarettes and e-cigarettes in the past 30 days among 4 738/2 333 current secondary school smokers (corresponding to a national total of 1 585 135/791 337 students estimated from sampling, non-response and post-stratification weighting) in China by gender, urban/rural residence and school type

, figureFileSmall=null, figureFileBig=null, tableContent=
特征分类卷烟电子烟
调查人数加权人数加权占比 /%χ2值P值调查人数加权人数加权占比 /%χ2值P值
性别男生3 8421 269 71170.71 635562 74865.5
女生896315 42476.06.0330.014698228 58870.02.3470.126
居住地城市2 291667 67470.21 183346 49667.7
农村2 447917 46172.91.1530.2831 150444 84166.00.5590.455
学校类型初中1 418603 75466.81 226477 79664.9
高中3 320981 38175.219.384<0.0011 107313 54169.73.9000.048
), ArticleFig(id=1321170450835689762, tenantId=1146029695717560320, journalId=1319373219989389464, articleId=1321170447945814264, language=CN, label=表2, caption=

中国不同特征现在吸烟中学生过去30 d内买烟时未被拒绝情况比较

, figureFileSmall=null, figureFileBig=null, tableContent=
特征分类卷烟电子烟
调查人数加权人数加权占比 /%χ2值P值调查人数加权人数加权占比 /%χ2值P值
性别男生3 8421 269 71170.71 635562 74865.5
女生896315 42476.06.0330.014698228 58870.02.3470.126
居住地城市2 291667 67470.21 183346 49667.7
农村2 447917 46172.91.1530.2831 150444 84166.00.5590.455
学校类型初中1 418603 75466.81 226477 79664.9
高中3 320981 38175.219.384<0.0011 107313 54169.73.9000.048
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2023年中国中学生获得烟草来源及购烟时未被拒绝情况分析
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祁明新 , 贾孝凯 , 曾新颖 , 刘世炜 , 肖琳 *, *
中国公共卫生 | 流行病学研究 2025,41(2): 161-164
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中国公共卫生 |流行病学研究 2025 , 41 (2) : 161 -164
2023年中国中学生获得烟草来源及购烟时未被拒绝情况分析
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祁明新, 贾孝凯, 曾新颖, 刘世炜, 肖琳*, *
作者信息
  • 中国疾病预防控制中心控烟办，北京 100050
通讯作者:
肖琳，E-mail：
作者简介:

祁明新（1998—），硕士在读，研究方向：青少年控烟

Access to and unrestricted purchase of smoked or smokeless tobacco among secondary school students in China, 2023: a nationwide cross-sectional survey
Mingxin QI, Xiaokai JIA, Xinying ZENG, Shiwei LIU, Lin XIAO
Affiliations
  • Tobacco Control Office, Chinese Center for Disease Control and Prevention, Beijing 100050, China
    • Corresponding Author:
    XIAO Lin, E mail：
出版时间: 2025-02-10 doi: 10.11847/zgggws1145605
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摘要
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目的

了解2023年中国中学生获得烟草来源及购买时未被拒绝情况，为评价控烟相关法律法规的实施效果提供参考依据。

方法

于2023年9—12月采用多阶段随机整群抽样方法在我国31个省（直辖市、自治区）抽取912所初中、590所普通高中和274所职业高中共1 776所中学的273 154名中学生进行问卷调查。

结果

最终纳入分析的261 454名中国中学生中，有14 199（加权后4 678 233）名和4 643（加权后1 483 681）名中学生曾在过去30 d内获得过卷烟和电子烟。获得过卷烟的中学生中有75.8%的中学生仅使用1种方式获得，有24.2%的中学生使用≥2种方式获得，其获得卷烟的主要3种方式为零售店购买（58.7%）、别人给的（42.3%）和家里拿的（13.4%）；获得过电子烟的中学生中有84.4%的中学生仅使用1种方式获得，有15.6%的中学生使用≥2种方式获得，其获得电子烟的主要3种方式为网上购买（44.2%）、电子烟体验店或零售店购买（33.1%）和商场（超市、便利店、杂货店）购买（28.3%）。有4 738（加权后1 585 135）和2 333（加权后791 337）名现在吸烟的中学生在过去30 d内购买卷烟和电子烟时未被拒绝，购买卷烟和电子烟时未被拒绝的比例分别为71.7%和66.7%。购买卷烟时，女生未被拒绝的比例（76.0%）高于男生（70.7%），高中生未被拒绝的比例（75.2%）高于初中生（66.8%），差异均有统计学意义（均P<0.05）；购买电子烟时，高中生未被拒绝的比例（69.7%）高于初中生（64.9%），差异有统计学意义（χ2=3.900，P=0.048）。

结论

2023年中国中学生获得卷烟和电子烟的方式依然以烟草零售店和网络为主；中学生在购买卷烟和电子烟时未被拒绝的比例较高，建议加强对烟草零售店和网络平台的监管，保护未成年人远离烟草。

获得烟草来源  /  购烟时未被拒绝  /  中学生  /  中国
Objective

To understand different ways of obtaining and unrestricted access to purchase cigarettes and e-cigarettes among Chinese secondary school students to provide evidence to evaluate the effectiveness of tobacco control laws and regulations.

Methods

Study participants were 273 154 students recruited using a multistage stratified cluster random sample from 912 junior high schools, 590 regular high schools, and 274 vocational high schools in 31 provincial-level administrative divisions of China. On-site, anonymous, self- administered surveys were conducted from September to December 2023 using the questionnaire developed by the Tobacco Control Office, Chinese Center for Disease Control and Prevention.

Results

Of the 261 454 participants who provided valid responses, 14 199 (corresponding to a national estimate of 4 678 233 students) and 4 643 (corresponding to a national estimate of 1 483 681 students), based on sampling, non-response, and post-stratification weighting, self-reported having purchased cigarettes and e-cigarettes, respectively, in the past 30 days. Among cigarette purchasers, 75.8% obtained cigarettes through a single channel, while 24.2% used two or more channels. The top three access channels were retail outlets (58.7%), sharing from others (42.3%), and obtaining them at home (13.4%). Similarly, among e-cigarette purchasers, 84.4% accessed e-cigarettes through one channel, and 15.6% used two or more channels. The main access channels for e-cigarettes were online shopping (44.2%), experience shops or retail outlets (33.1%), and shopping malls, supermarkets, convenience stores, or grocery stores (28.3%). Among current school smokers surveyed, 71.7% (4 738 corresponding to a national estimate of 1 585 135 students) and 66.7% (2 333, corresponding to a national estimate of 791 337 students) reported unrestricted access to purchase cigarettes and e-cigarettes, respectively, in the past 30 days. Higher rates of unrestricted access to cigarettes were observed among female smokers compared with male smokers (76.0% vs. 70.7%, P<0.05) and among high school smokers compared with middle school smokers (75.2% vs. 66.8%, P<0.05). Similarly, unrestricted access to e-cigarettes was higher among high school smokers than among middle school smokers (69.7% vs. 64.9%, χ2=3.900; P=0.048).

Conclusions

In 2023, a significant proportion of secondary school student smokers in China reported easy access to purchasing both traditional cigarettes and e-cigarettes, primarily through retail stores and online platforms. This concerning trend highlights the urgent need to strengthen regulatory measures and enforcement in tobacco retail operations and e-commerce channels to effectively prevent underage tobacco use among secondary school students.

tobacco retailers  /  unrestricted purchase of tobacco  /  secondary school students  /  China
祁明新, 贾孝凯, 曾新颖, 刘世炜, 肖琳. 2023年中国中学生获得烟草来源及购烟时未被拒绝情况分析. 中国公共卫生, 2025 , 41 (2) : 161 -164 . DOI: 10.11847/zgggws1145605
Mingxin QI, Xiaokai JIA, Xinying ZENG, Shiwei LIU, Lin XIAO. Access to and unrestricted purchase of smoked or smokeless tobacco among secondary school students in China, 2023: a nationwide cross-sectional survey[J]. Chinese Journal of Public Health, 2025 , 41 (2) : 161 -164 . DOI: 10.11847/zgggws1145605
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根据世界卫生组织2023年全球烟草流行报告，每年有>800万人死于烟草相关疾病，烟草控制仍为全球卫生优先事项[1]。研究表明，大多数吸烟者在<18岁就开始使用烟草[2–3]，烟草及其烟雾中的化学成分对青少年的危害很大[4]，且青少年的吸烟行为可能会导致其他危险行为的增加[5]。中国2021年青少年烟草调查结果显示，在校中学生尝试吸烟率高达16.7%，其中66.1%在≤13岁开始吸第一支烟[6]。2013—2014年全球青少年烟草调查结果显示，有一半以上的青少年吸烟者从商店、街头小贩或报刊亭等购买卷烟[7]，表明世界卫生组织《烟草控制框架公约》[8]第十六条“禁止向未成年人售烟”在全球范围内尚未得到有效实施。为保护青少年远离烟草，我国多部法律明确要求任何人不得向未成年人销售烟草制品，不得通过互联网销售卷烟和电子烟[9–10]。为了解2023年中国中学生获得烟草来源及购买时未被拒绝情况，为评价控烟相关法律法规的实施效果提供参考依据，本研究于2023年9—12月采用多阶段随机整群抽样方法在31个省（直辖市、自治区）抽取912所初中、590所普通高中和274所职业高中共1 776所中学的273 154名中学生进行问卷调查。结果报告如下。
1　对象与方法
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1.1　对象
采用多阶段随机整群抽样的方法，首先在31个省（自治区、直辖市）中随机抽取310个区/县作为监测点，其次采用按规模大小成比例的概率抽样方法在各监测点内分别抽取3所初中、2所普通高中和1所职业高中作为样本中学（没有职业高中的用普通高中代替，监测点学校数量不足者以实际数量为准），再次从每所样本中学的每个年级中随机抽取1个班级作为样本班级，最后整群抽取调查当日样本班级内所有到校的学生作为调查对象进行问卷调查。共抽取912所初中、590所普通高中和274所职业高中共 1 776所中学的273 154名学生进行调查，完成调查学生261 454人，应答率为95.7%。本研究经中国疾病预防控制中心伦理委员会审查批准（批号：202301），且所有调查对象均签署了知情同意书。
1.2　方法
采用中国疾病预防控制中心控烟办设计的《2023年中国中学生烟草流行调查问卷》，内容包括基本信息、电子烟使用、烟草制品获得/价格、控烟宣传、烟草广告/促销、对烟草的认知和态度等，本研究主要涉及基本信息、卷烟和电子烟售卖等信息部分。在过去30 d内获得过卷烟的中学生中获得卷烟的来源根据问题“在过去的30 d内，你从哪里获得的卷烟？（可多选）”计算“网上购买” “零售店购买（包括商场、超市、商店、便利店和杂货店购买）” “自动售货机购买” “酒吧和KTV等娱乐场所购买” “家里拿的” “别人给的”和“其他（包括参加酒席时给的、地上捡的、老师给的和超市购买）”7种卷烟来源的比例；在过去30 d内获得过电子烟的中学生中获得电子烟的来源根据问题“在过去的30 d内，你从哪里购买电子烟？（可多选）”计算“网上购买” “电子烟体验店或零售店购买” “商场、超市、便利店和杂货店购买” “自动售货机购买”“酒吧和KTV等娱乐场所购买”和“其他（包括同学/朋友送的、家人给的、地上捡的和学校门口小贩购买）”6种电子烟来源的比例；现在吸卷烟者和现在使用电子烟者在过去30 d中买卷烟时未因为年龄原因而被拒绝的比例则根据问题“在过去30 d内，是否有人因为你的年龄而拒绝卖给你卷烟？”和问题“在过去30 d内，是否有人因为你的年龄而拒绝卖给你电子烟？”计算得出。问卷由调查对象匿名自行填写，填写完成后当场回收。为保证参与调查的学生在不受干扰的情况下做出真实回答，要求调查现场的班主任及校方人员全程回避，并告知学生回答问卷没有对错之分，调查结果将严格保密等。此外，在调查现场及调查结束后，分别进行质量控制工作，确保问卷的完整性及减少逻辑错误的出现。
1.3　统计分析
采用SAS 9.4软件进行复杂抽样设计的数据清洗、样本加权和统计学分析。分类变量用频数、加权频数（加权调整后计算得出的频数）和加权占比（加权调整后计算得出的占比）表示。每个样本的权重由抽样权重、无应答校正权重和事后分层权重相乘得出。单因素占比的组间比较采用基于复杂抽样设计的Rao-Scott χ2检验。检验水准为双侧检验α=0.05。
2　结　果
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2.1　基本情况
最终纳入分析的261 454名中国中学生中，男生 136 859人（52.3%），女生124 595人（47.7%）；城市学生141 280人（54.0%），农村学生120 174人（46.0%）；初中生134 768人（51.5%），高中学生126 686人（48.5%）。
2.2　中国中学生卷烟和电子烟获得情况和获得方式（表1）
最终纳入分析的261 454名中国中学生中，有14 199（加权后4 678 233）名中学生曾在过去30 d内获得过卷烟；有75.8%（10 763/14 199） 的中学生仅使用1种方式获得卷烟，有24.2%（3463/14 199）的中学生使用≥2种方式获得卷烟；获得卷烟的3种主要方式为零售店购买、别人给的和家里拿的。有4 643（加权后1 483 681）名中学生曾在过去30 d内获得过电子烟；有84.4%（3 919/4 643）的中学生仅使用1种方式获得电子烟，有15.6%（724/4 643）的中学生使用≥2种方式获得电子烟；获得电子烟的3种主要方式为网上购买、电子烟体验店或零售店购买和商场（超市、便利店、杂货店）购买。
2.3　中国现在吸烟中学生买烟未被拒绝情况（表2）
有4 738（加权后1 585 135）名和2 333（加权后791 337）名现在吸烟的中学生在过去30 d内购买卷烟和电子烟时未被拒绝，购买卷烟和电子烟时未被拒绝的比例分别为71.7%和66.7%。购买卷烟时，女生未被拒绝的比例高于男生，高中生未被拒绝的比例高于初中生，差异均有统计学意义（均P<0.05）；购买电子烟时，高中生未被拒绝的比例高于初中生，差异有统计学意义（χ2=3.900，P=0.048）。
3　讨　论
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本次调查结果显示，中国中学生在过去30 d内获得卷烟的主要方式为零售店购买和别人给的，这与胡佩瑾等[11]在京津沪开展的中学生卷烟来源研究结果一致。2010—2018年全球青少年烟草调查（Global Youth Tobacco Survey，GYTS）显示，在140个国家/地区的12～16岁青少年中，有51.2%的青少年吸烟者获得卷烟的方式是从商贩（包括商店、报刊亭、街头摊贩）购买，其中西太平洋地区的比例最低为44.9%，美洲区为46.9%，非洲区为53.8%，欧洲区为54.2%，东南亚地区最高为57.8%[12]。相比之下，我国2023年有58.7%的中学生获得卷烟的方式是从零售店购买的，处于较高水平，表明我国《中华人民共和国未成年人保护法》[9]中关于禁止向未成年人售烟的规定尚未得到很好地执行。
本次调查结果显示，2023年中国高中生购买卷烟未被拒绝比例（75.2%）高于初中生（66.8%），这可能是因为高中生看起来较初中生更成熟，销售人员可能更容易认为他们已经达到合法购买烟草产品的年龄，从而降低了拒绝销售的概率。针对此种现象，建议面对难以辨别年龄的人群应要求其在购买烟草时出示身份证，同时建立便捷的举报平台和奖励机制以鼓励公众进行监督。2019年中国中学生在过去30 d内购买卷烟未被拒绝的比例为83.3%[13]，2021年为77.2%[6]，2023年为71.7%，显示出逐年降低的流行趋势，这表明越来越多的中学生前往零售点购买卷烟会被拒绝，但我国中学生购买卷烟未被拒绝的比例依然明显高于全球水平的39.6%[12]。尽管我国存在相关的控烟政策和措施，但仍然有大量中学生能够在烟草零售点购买到卷烟，这一现象的存在也反映了多个层面的问题：第一，法律宣传的力度不够，或者在实际执行中存在漏洞和不足，例如，左玉婷等[14]2021年在北京市校外烟草销售情况的调查结果显示只有55%的售烟点了解关于《北京市卷烟零售点合理布局标准》[15]中的校门外百米范围内禁止售烟的规定；第二，执法机构的检查和处罚力度不足；第三，社会监督机制不健全、举报机制不完善，导致违规行为未能得到有效举报和查处。
本次调查结果显示，中学生在过去30 d内获得电子烟的主要方式为网上购买（44.2%），这与Alabdulqader M等[16]研究中网络平台（34.9%）为男性青少年购买电子烟主要来源的结果一致，Frost等[17]的定性研究表明这些售卖电子烟的网络平台主要是通过同伴分享扩散开来的。虽然我国已经施行了电子烟“线上禁售令”，但中学生电子烟获得的主要途径依然是网络购买，这表明在线销售平台没有遵守相关的规定，而我国在互联网监管这方面亦存在着严重漏洞。此外，还有33.1%和28.3%的中学生从电子烟体验店或零售店和商场、超市、便利店、杂货店中获得电子烟，提示相关执法单位对电子烟实体店的监管和处罚力度不足，应严格执法，并通过宣传教育提高售烟者对未成年人健康和法律责任的认识。2023年我国中学生购买电子烟时未被拒绝的比例为66.7%，低于购买卷烟时未被拒绝比例的71.7%，这可能与我国公安部、国家烟草专卖局、国家市场监督管理总局和教育部在2022年联合开展了清理整治向未成年人销售电子烟的专项行动有关。通过这一专项行动，清理了一批校园周边的电子烟销售网点和电子烟自动售卖机，有效降低了青少年获取电子烟的机会。因此，建议相关部门将卷烟和电子烟纳入同样的打击范围，全面排查学校周边烟草零售网点，净化校园周边环境，进一步减少青少年接触烟草产品的机会。
综上所述，我国中学生卷烟和电子烟的获得方式依然以烟草零售店和网络销售为主，前往零售店购买烟草因年龄原因而被拒绝的比例仍然较高，因此国家应加强对零售店销售人员的教育和培训、提高执法力度、完善社会监督机制，形成全社会共同监督和抵制的氛围，有效减少向未成年人售烟，保护未成年人身心健康，从而达到降低吸烟率，实现“健康中国2030”[18]的战略目标。

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2025年第41卷第2期
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doi: 10.11847/zgggws1145605
  • 接收时间：2024-08-02
  • 首发时间：2026-10-25
  • 出版时间：2025-02-10
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  • 收稿日期：2024-08-02
  • 修回日期：2024-11-18
  • 录用日期：2025-01-26
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    中国疾病预防控制中心控烟办，北京 100050

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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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