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Article(id=1325500932670227226, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1325500677975318675, articleNumber=null, orderNo=null, doi=10.16835/j.cnki.1000-9817.2025062, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1715184000000, receivedDateStr=2024-05-09, revisedDate=1734624000000, revisedDateStr=2024-12-20, acceptedDate=null, acceptedDateStr=null, onlineDate=1793953648965, onlineDateStr=2026-11-06, pubDate=1740412800000, pubDateStr=2025-02-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793953648965, onlineIssueDateStr=2026-11-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793953648965, creator=13701087609, updateTime=1793953648965, updator=13701087609, issue=Issue{id=1325500677975318675, tenantId=1146029695717560320, journalId=1256213402557890569, year='2025', volume='46', issue='2', pageStart='153', pageEnd='304', issueExtLink='null', onlineDate='null', pubDate='1740412800000', pubDateStr='2025-02-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793953588241, creator='13701087609', updateTime=1793953588241, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=196, endPage=199, ext={EN=ArticleExt(id=1325500933815272219, articleId=1325500932670227226, tenantId=1146029695717560320, journalId=1256213402557890569, language=EN, title=Effectiveness evaluation of smoking control intervention based on social network theory among vocational college students, columnId=1259565859148804482, journalTitle=Chinese Journal of School Health, columnName=Health Education and Promotion, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the effectiveness of smoking control intervention guided by social network theory at a vocational college in Guangzhou City, so as to provide a reference for school smoking control intervention.

Methods

From April to May 2023, a combination of convenience sampling and cluster random sampling method was adopted to select 781 students from different majors in 4 campuses of a certain vocational college. They were randomly divided into a control group (422 students before intervention, 399 students after intervention) and an intervention group (359 students before intervention, 329 students after intervention). Based on social network theory, a 6-month tobacco control intervention was carried out in the intervention group by strengthening the existing tobacco control network connections in schools, establishing new control smoking social networks, and enhancing the role of the new control smoking social networks by members of the project team. Both the control group and intervention group received smoking control intervention in the school environment. The difference was compared by t test andχ2 test.

Results

After intervention, the knowledge score of the intervention group (8.9±4.8) was higher than that of the control group (7.6±5.0) and before intervention (7.0±5.0) (t=3.30, 4.91, P < 0.01). After intervention, the current smoking rate (4.0%) in the intervention group was lower than before intervention (8.1%, χ2=5.10), and the number of half or more smoking peers (11.2%) was lower than before intervention(16.7%) (χ2=4.24)(P < 0.05); and there was no statistically significant difference between the control group before and after intervention (χ2=1.49, 0.16, P>0.05). The proportion of holding a negative attitude to school smokers was higher than before intervention (χ2=12.34, P < 0.05), with the proportion of "strongly negative and suggest no smoke around oneself" increasing from 25.1% before intervention to 35.9% after intervention; and the proportion of student who kept a distance from smokers was higher than before intervention (χ2=18.21, P < 0.05), with the proportion of "maintaining a distance of 3 m" increasing from 30.4% before the intervention to 40.1% after the intervention. There was no statistically significant difference in the control group before and after intervention (χ2=3.89, 2.50, P>0.05).

Conclusions

The smoking control intervention at vocational colleges based on social network theory improve the correct tobacco knowledge, attitudes and practice of vocational college students, and reduce the smoking rates.

, authors=Minhong LUO1, Ai SUN1, Yunqing DENG2, Huimin LI1, Wenya HE1, Jianwei CHEN*, 1, authorsList=Minhong LUO, Ai SUN, Yunqing DENG, Huimin LI, Wenya HE, Jianwei CHEN, authorCompany=null, correspAuthors=Jianwei CHEN, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2025 Chinese Journal of School 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=1325500934775767836, articleId=1325500932670227226, tenantId=1146029695717560320, journalId=1256213402557890569, language=CN, title=基于社会网络理论的高等职业院校学生控烟干预效果评价, columnId=1259565859903779205, journalTitle=中国学校卫生, columnName=健康教育与健康促进, runingTitle=null, highlight=null, articleAbstract=
目的

探讨在广州市某高等职业(高职)院校开展以社会网络理论为指导的控烟干预实践效果，为开展学校控烟干预提供参考。

方法

于2023年4—5月，采用方便抽样与整群随机抽样相结合的方法，抽取某高职院校4个校区781名学生，随机分成对照组(干预前422名，干预后399名)和干预组(干预前359名，干预后329名)。基于社会网络理论，通过加强学校现有控烟网络联系，建立新的控烟社会网络以及通过项目组成员加强新控烟社会网络的手段在干预组开展6个月控烟同伴教育; 对照组和干预组均接受学校大环境控烟干预。采用t检验和χ2检验比较干预前后组间差异。

结果

干预后，干预组烟草知识得分(8.9±4.8)高于对照组(7.6±5.0)和干预前(7.0±5.0)(t值分别为3.30，4.91，P值均 < 0.01)。干预后，干预组现在吸卷烟率(4.0%)低于干预前(8.1%)(χ2=5.10)，同伴≥50%吸卷烟人数比例(11.2%)低于干预前(16.7%)(χ2=4.24)(P值均 < 0.05); 对照组干预前后差异均无统计学意义(χ2值分别为1.49，0.16，P值均>0.05)。干预后，干预组对在学校吸烟者持反感态度比例高于干预前(χ2=12.34，P < 0.05)，其中“很反感，劝不要在自己身边吸烟”的比例由干预前的25.1%上升到干预后的35.9%; 遇到吸烟者保持一定距离的比例高于干预前(χ2=18.21，P < 0.05)，其中“距离保持3 m外”的比例从干预前的30.4%上升到干预后的40.1%; 对照组干预前后差异均无统计学意义(χ2值分别为3.89，2.50，P值均>0.05)。

结论

基于社会网络理论在高职院校开展控烟干预，可提高学生的正确烟草知识和控烟态度及行为，降低吸烟率。

, authors=罗敏红1, 孙爱1, 邓韵卿2, 李慧敏1, 何文雅1, 陈建伟*, 1, authorsList=罗敏红, 孙爱, 邓韵卿, 李慧敏, 何文雅, 陈建伟, authorCompany=null, correspAuthors=陈建伟, authorNote=

罗敏红(1986-)，女，广东佛山人，硕士，副主任医师，主要从事健康教育与健康促进工作

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陈建伟，E-mail：
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Specific measures for smoking control intervention among vocational college students based on social network theory

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干预策略干预活动具体措施
加强现有社会网络学校创造控烟氛围全校范围内，学校倡议学生签署不吸烟协议书，发布全体学生禁烟倡议书，建立禁烟奖惩机制的秋季学期学生控烟教育专项行动等。
发展新的控烟社会网络招募控烟社会网络核心人物班主任推荐并结合同学推荐确定35名同伴教育者，召开动员大会，介绍同伴教育者的特征、重要性、目的、任务、教育方式; 组建同伴教育者微信群。
建立控烟社会网络每个同伴教育者与长期关系较近的8~10名同学组建控烟社会网络，建立相应微信群。
建立控烟社会网络互助信息支持：在新建的社会网络中利用微信群和线下场所，由经过培训的中心人物利用专业报告、权威机构的科普文章和视频，以讲座、小组讨论、情景模拟、案例分析等方式进行科普渗透，成员积极参与并反馈。
情感和评价支持：以控烟为行为规范，网络中心人物维护推行这个行为规范，网络中成员受中心人物影响遵守网络行为规范，相互之间表现出反对吸烟行为，拒吸二手烟，共同维护无烟环境，态度一致，相互认可; 若网络中有吸烟成员，中心人物及成员之间对其进行友善劝导，成员之间也对吸烟者进行鼓励和情绪安抚，肯定、赞许取得进步的控烟成员，形成良好积极的情感反馈。
物质支持：对每名学生发放《吸烟的危害》和《帮你戒烟》2本小册子。
通过项目组成员加强控烟社会网络确定项目组负责人项目组负责人长期负责戒烟门诊工作，具有一定的控烟经验，对有戒烟需求的学生可单独提供戒烟干预服务。
项目组成员提供控烟信息、技能培训等对同伴教育者进行技能和信息培训，由同伴教育者辐射至所负责的控烟社会网络进行控烟干预。
技能培训：通过线下讲座介绍、小组讨论、情景模拟和案例分析等同伴教育分享活动的开展形式，场地、时间选择的合适性，线上分享电子版手册材料的技巧。阐述烟草危害、国内外烟草流行与肺癌发病率的关联、烟盒的国内外包装区别、烟草成瘾原理、戒烟的12个误区、戒烟方法等内容; 每周至少一次线上培训烟草相关知识。介绍如何及时对群成员提供控烟的情感、信息、评价支持，拒吸二手烟技能等。
控烟信息提供：及时转发权威机构的科普控烟文章、视频并进行重点内容解读。
监督控烟社会网络项目组成员加入到35个控烟社会网络微信群，实时监督网络中的同伴教育开展情况及其他学生反馈。对未及时开展小组活动的同伴教育者单独提醒，对开展方式欠合理的建议合适的方式。
), ArticleFig(id=1325500946414961483, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500932670227226, language=CN, label=表1, caption=

基于社会网络理论的高职院校学生控烟干预具体措施

, figureFileSmall=null, figureFileBig=null, tableContent=
干预策略干预活动具体措施
加强现有社会网络学校创造控烟氛围全校范围内，学校倡议学生签署不吸烟协议书，发布全体学生禁烟倡议书，建立禁烟奖惩机制的秋季学期学生控烟教育专项行动等。
发展新的控烟社会网络招募控烟社会网络核心人物班主任推荐并结合同学推荐确定35名同伴教育者，召开动员大会，介绍同伴教育者的特征、重要性、目的、任务、教育方式; 组建同伴教育者微信群。
建立控烟社会网络每个同伴教育者与长期关系较近的8~10名同学组建控烟社会网络，建立相应微信群。
建立控烟社会网络互助信息支持：在新建的社会网络中利用微信群和线下场所，由经过培训的中心人物利用专业报告、权威机构的科普文章和视频，以讲座、小组讨论、情景模拟、案例分析等方式进行科普渗透，成员积极参与并反馈。
情感和评价支持：以控烟为行为规范，网络中心人物维护推行这个行为规范，网络中成员受中心人物影响遵守网络行为规范，相互之间表现出反对吸烟行为，拒吸二手烟，共同维护无烟环境，态度一致，相互认可; 若网络中有吸烟成员，中心人物及成员之间对其进行友善劝导，成员之间也对吸烟者进行鼓励和情绪安抚，肯定、赞许取得进步的控烟成员，形成良好积极的情感反馈。
物质支持：对每名学生发放《吸烟的危害》和《帮你戒烟》2本小册子。
通过项目组成员加强控烟社会网络确定项目组负责人项目组负责人长期负责戒烟门诊工作，具有一定的控烟经验，对有戒烟需求的学生可单独提供戒烟干预服务。
项目组成员提供控烟信息、技能培训等对同伴教育者进行技能和信息培训，由同伴教育者辐射至所负责的控烟社会网络进行控烟干预。
技能培训：通过线下讲座介绍、小组讨论、情景模拟和案例分析等同伴教育分享活动的开展形式，场地、时间选择的合适性，线上分享电子版手册材料的技巧。阐述烟草危害、国内外烟草流行与肺癌发病率的关联、烟盒的国内外包装区别、烟草成瘾原理、戒烟的12个误区、戒烟方法等内容; 每周至少一次线上培训烟草相关知识。介绍如何及时对群成员提供控烟的情感、信息、评价支持，拒吸二手烟技能等。
控烟信息提供：及时转发权威机构的科普控烟文章、视频并进行重点内容解读。
监督控烟社会网络项目组成员加入到35个控烟社会网络微信群，实时监督网络中的同伴教育开展情况及其他学生反馈。对未及时开展小组活动的同伴教育者单独提醒，对开展方式欠合理的建议合适的方式。
), ArticleFig(id=1325500946511430476, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500932670227226, language=EN, label=Tab.2, caption=

Comparison of attitudes towards school smokers between two groups of subjects before and after intervention

, figureFileSmall=null, figureFileBig=null, tableContent=
组别干预前干预后
人数无所谓不喜欢，但能接受很反感，但只能忍受很反感，劝不要在自己身边吸烟人数无所谓不喜欢，但能接受很反感，但只能忍受很反感，劝不要在自己身边吸烟
对照组42263(14.9)88(20.9)133(31.5)138(32.7)39945(11.3)80(20.1)122(30.6)152(38.1)
干预组35979(22.0)84(23.4)106(29.5)90(25.1)32949(14.9)65(19.8)97(29.5)118(35.9)
), ArticleFig(id=1325500946905695053, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500932670227226, language=CN, label=表2, caption=

两组研究对象干预前后对学校吸烟者的态度构成

, figureFileSmall=null, figureFileBig=null, tableContent=
组别干预前干预后
人数无所谓不喜欢，但能接受很反感，但只能忍受很反感，劝不要在自己身边吸烟人数无所谓不喜欢，但能接受很反感，但只能忍受很反感，劝不要在自己身边吸烟
对照组42263(14.9)88(20.9)133(31.5)138(32.7)39945(11.3)80(20.1)122(30.6)152(38.1)
干预组35979(22.0)84(23.4)106(29.5)90(25.1)32949(14.9)65(19.8)97(29.5)118(35.9)
), ArticleFig(id=1325500947249627982, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500932670227226, language=EN, label=Tab.3, caption=

Comparison of distance between two groups of subjects before and after intervention when encountering smokers in school

, figureFileSmall=null, figureFileBig=null, tableContent=
组别干预前干预后
人数不会，很随意1 m外2 m外3 m外没遇到过人数不会，很随意1 m外2 m外3 m外没遇到过
对照组42250(11.8)84(19.9)98(23.2)158(37.4)32(7.6)39944(11.0)70(17.5)85(21.3)162(40.6)38(9.5)
干预组35970(19.5)88(24.5)72(20.1)109(30.4)20(5.6)32939(11.9)56(17.0)74(22.5)132(40.1)28(8.5)
), ArticleFig(id=1325500947329319759, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500932670227226, language=CN, label=表3, caption=

两组研究对象干预前后对在学校遇到吸烟者保持距离构成

, figureFileSmall=null, figureFileBig=null, tableContent=
组别干预前干预后
人数不会，很随意1 m外2 m外3 m外没遇到过人数不会，很随意1 m外2 m外3 m外没遇到过
对照组42250(11.8)84(19.9)98(23.2)158(37.4)32(7.6)39944(11.0)70(17.5)85(21.3)162(40.6)38(9.5)
干预组35970(19.5)88(24.5)72(20.1)109(30.4)20(5.6)32939(11.9)56(17.0)74(22.5)132(40.1)28(8.5)
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基于社会网络理论的高等职业院校学生控烟干预效果评价
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罗敏红 1 , 孙爱 1 , 邓韵卿 2 , 李慧敏 1 , 何文雅 1 , 陈建伟 *, 1
中国学校卫生 | 健康教育与健康促进 2025,46(2): 196-199
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中国学校卫生 |健康教育与健康促进 2025 , 46 (2) : 196 -199
基于社会网络理论的高等职业院校学生控烟干预效果评价
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罗敏红1, 孙爱1, 邓韵卿2, 李慧敏1, 何文雅1, 陈建伟*, 1
作者信息
  • 1广州市卫生健康宣传教育中心健康指导部，广东 510630
  • 2广东省外语艺术职业学院小学教育系
通讯作者:
陈建伟，E-mail：
作者简介:

罗敏红(1986-)，女，广东佛山人，硕士，副主任医师，主要从事健康教育与健康促进工作

Effectiveness evaluation of smoking control intervention based on social network theory among vocational college students
Minhong LUO1, Ai SUN1, Yunqing DENG2, Huimin LI1, Wenya HE1, Jianwei CHEN*, 1
Affiliations
  • 1Department of Health Guidance, Guangzhou Health Publicity and Education Center, Guangzhou(510630), Guangdong Province, China
出版时间: 2025-02-25 doi: 10.16835/j.cnki.1000-9817.2025062
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摘要
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目的

探讨在广州市某高等职业(高职)院校开展以社会网络理论为指导的控烟干预实践效果，为开展学校控烟干预提供参考。

方法

于2023年4—5月，采用方便抽样与整群随机抽样相结合的方法，抽取某高职院校4个校区781名学生，随机分成对照组(干预前422名，干预后399名)和干预组(干预前359名，干预后329名)。基于社会网络理论，通过加强学校现有控烟网络联系，建立新的控烟社会网络以及通过项目组成员加强新控烟社会网络的手段在干预组开展6个月控烟同伴教育; 对照组和干预组均接受学校大环境控烟干预。采用t检验和χ2检验比较干预前后组间差异。

结果

干预后，干预组烟草知识得分(8.9±4.8)高于对照组(7.6±5.0)和干预前(7.0±5.0)(t值分别为3.30，4.91，P值均 < 0.01)。干预后，干预组现在吸卷烟率(4.0%)低于干预前(8.1%)(χ2=5.10)，同伴≥50%吸卷烟人数比例(11.2%)低于干预前(16.7%)(χ2=4.24)(P值均 < 0.05); 对照组干预前后差异均无统计学意义(χ2值分别为1.49，0.16，P值均>0.05)。干预后，干预组对在学校吸烟者持反感态度比例高于干预前(χ2=12.34，P < 0.05)，其中“很反感，劝不要在自己身边吸烟”的比例由干预前的25.1%上升到干预后的35.9%; 遇到吸烟者保持一定距离的比例高于干预前(χ2=18.21，P < 0.05)，其中“距离保持3 m外”的比例从干预前的30.4%上升到干预后的40.1%; 对照组干预前后差异均无统计学意义(χ2值分别为3.89，2.50，P值均>0.05)。

结论

基于社会网络理论在高职院校开展控烟干预，可提高学生的正确烟草知识和控烟态度及行为，降低吸烟率。

烟草  /  健康知识，态度，实践  /  干预性研究  /  学生
Objective

To explore the effectiveness of smoking control intervention guided by social network theory at a vocational college in Guangzhou City, so as to provide a reference for school smoking control intervention.

Methods

From April to May 2023, a combination of convenience sampling and cluster random sampling method was adopted to select 781 students from different majors in 4 campuses of a certain vocational college. They were randomly divided into a control group (422 students before intervention, 399 students after intervention) and an intervention group (359 students before intervention, 329 students after intervention). Based on social network theory, a 6-month tobacco control intervention was carried out in the intervention group by strengthening the existing tobacco control network connections in schools, establishing new control smoking social networks, and enhancing the role of the new control smoking social networks by members of the project team. Both the control group and intervention group received smoking control intervention in the school environment. The difference was compared by t test andχ2 test.

Results

After intervention, the knowledge score of the intervention group (8.9±4.8) was higher than that of the control group (7.6±5.0) and before intervention (7.0±5.0) (t=3.30, 4.91, P < 0.01). After intervention, the current smoking rate (4.0%) in the intervention group was lower than before intervention (8.1%, χ2=5.10), and the number of half or more smoking peers (11.2%) was lower than before intervention(16.7%) (χ2=4.24)(P < 0.05); and there was no statistically significant difference between the control group before and after intervention (χ2=1.49, 0.16, P>0.05). The proportion of holding a negative attitude to school smokers was higher than before intervention (χ2=12.34, P < 0.05), with the proportion of "strongly negative and suggest no smoke around oneself" increasing from 25.1% before intervention to 35.9% after intervention; and the proportion of student who kept a distance from smokers was higher than before intervention (χ2=18.21, P < 0.05), with the proportion of "maintaining a distance of 3 m" increasing from 30.4% before the intervention to 40.1% after the intervention. There was no statistically significant difference in the control group before and after intervention (χ2=3.89, 2.50, P>0.05).

Conclusions

The smoking control intervention at vocational colleges based on social network theory improve the correct tobacco knowledge, attitudes and practice of vocational college students, and reduce the smoking rates.

Tobacco  /  Helath knowledge, attitudes, practice  /  Intervention studies  /  Students
罗敏红, 孙爱, 邓韵卿, 李慧敏, 何文雅, 陈建伟. 基于社会网络理论的高等职业院校学生控烟干预效果评价. 中国学校卫生, 2025 , 46 (2) : 196 -199 . DOI: 10.16835/j.cnki.1000-9817.2025062
Minhong LUO, Ai SUN, Yunqing DENG, Huimin LI, Wenya HE, Jianwei CHEN. Effectiveness evaluation of smoking control intervention based on social network theory among vocational college students[J]. Chinese Journal of School Health, 2025 , 46 (2) : 196 -199 . DOI: 10.16835/j.cnki.1000-9817.2025062
正文
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青少年吸烟是社会关注的公共卫生问题，职业院校学生的吸烟情况比其他类型学校大学生更为严重[1-2]。大学生吸烟影响身心健康[3-4]，且未来成为规律吸烟者的可能性也更高[5]。社会网络理论认为，特定人群中人与人之间形成的复杂网络影响网络成员行为的产生和结果，吸烟在社会网络中是可以互相影响的[6]。同学是在校大学生群体中最重要的亲密社会网络成员[7]，拥有健康规范的社会网络可促进健康行为的形成[8]。本研究基于社会网络理论，开展以学校为基础的高等职业(简称“高职”)院校学生控烟干预实践，为今后学生控烟工作提供参考。
1　对象与方法
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1.1　对象
参考实验流行病学中非连续性变量样本量的估计公式[9]，计算所需样本为775名学生。2023年4—5月，采用方便抽样与整群随机抽样相结合的方法，先从广州市某高职院校6个校区方便抽取4个校区，再从4个校区中不同学院一、二年级采用随机数字表法抽取24个班级，以全班学生为研究对象，共825名。根据排除标准和脱落标准，最终纳入781名学生作为研究对象。以班级为单位，按照随机数字表法分为干预组(12个班级359名)、对照组(12个班级422名)，两组研究对象在性别、户籍、年级分布上差异均无统计学意义(χ2值分别为3.12，3.37，2.37，P值均>0.05); 干预后干预组329名，对照组399名。排除标准：不愿意参与本项干预活动，不能坚持完成整个项目者; 脱落标准：学生中途退学，暑假参加实习，中途退出。本研究经广州市卫生健康宣传教育中心伦理委员会审批，并取得学生和学校的知情同意。
1.2　调查工具
参考《2015年中国成人烟草调查》问卷[10]以及专家咨询的方式，初步制定基线调查问卷和终末调查问卷，并对2份问卷进行预调查，根据预调查的结果对问卷进行微调后确定内容。问卷内容包括基本情况、卷烟使用情况、同伴卷烟使用情况、烟草知识以及学校吸烟者所持态度及在学校遇到吸烟者保持距离的情况等。其中，烟草知识共14题，具体包括标明低焦油含量卷烟、过滤嘴卷烟、淡味卷烟、高档卷烟与一般卷烟的危害比较，开窗通风能否避免二手烟危害; 吸烟是否会引起中风、心肌梗死、阳痿，吸二手烟是否会引起乳腺癌、流产、冠心病，电子烟是否会成瘾，电子烟是否会产生二手烟问题，电子烟对青少年智力发育有无不良影响等。以正确回答项目记1分，错选记0分，总计14分。其中现在吸卷烟者指调查前30 d内吸烟的人。该问卷Cronbach α系数为0.879。
1.3　干预方法
1.3.1　明确核心干预信息
根据基线调查结果制作控烟课件，并收集整理相关控烟科普文章、视频等。
1.3.2　实施干预
见表1。
于2023年6月20日—12月20日在干预组开展为期6个月的干预活动，干预模式以社会网络理论为基础，建立新的控烟社会网络，培训网络中的中心人物——同伴教育者，对网络提供控烟社会支持，提高个体控烟自我效能和自我管理技能; 同时，学校加大控烟力度创造控烟氛围，以此巩固建立控烟社会网络。另外，项目组成员监督控烟社会网络发展，发现和解决问题，单独提供戒烟技术支持，加强控烟网络建设。暑假期间，项目组人员不定期在同伴教育者群发布同伴教育任务，提供相应控烟线上材料，不定时在群里提醒同伴教育者，在社交活动下保护自己免受二手烟暴露，建议选择无烟场所进行聚会，要求传达到各同伴教育者各自控烟干预小群中，并做好监督管理。对照组只接受学校大环境的控烟教育。
1.4　质量控制
以班级为单位，采用问卷星线上无记名自填方式，全部选项需填写完整方可提交，对误填、填写时长过短的问卷以作废处理。基线调查由各班班长组织完成; 终末调查干预组由同伴教育者组织完成，对照组由各班班长组织完成。基线和终末调查前，调查组织者均接受统一的调查培训。
1.5　统计学分析使用SPSS
22.0软件对数据进行统计分析。计量资料采用(x±s)描述，并使用两独立样本t检验对两组间差异进行分析; 计数资料用频数或百分率描述，采用χ2检验对不同组间差异进行分析，当出现1≤任意一个格子的理论频数 < 5时，采用Continuity Correction χ2检验进行连续性校正。当出现任意一个格子的理论频数 < 1时，采用Fisher确切概率法。检验水准α=0.05。
2　结果
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2.1　干预前后两组研究对象烟草知识得分变化
干预前，干预组和对照组烟草知识得分[(7.0±5.0)(7.3±4.9)]差异无统计学意义(t=0.71，P=0.48)。干预后，干预组的知识得分(8.9±4.8)高于对照组(7.6±5.0)和干预前(t值分别为3.30，4.91，P值均 < 0.01); 对照组干预前后差异无统计学意义(t=-1.08，P=0.28)。
2.2　干预前后两组研究对象吸烟行为改变
干预前，干预组现在吸卷烟率(8.1%，29/359)高于对照组(4.0%，17/422)(χ2=6.14，P=0.01)。干预后，干预组现在吸卷烟率(4.0%，13/329)和对照组(2.5%，10/399)差异无统计学意义(χ2=1.23，P=0.27); 干预后干预组现在吸卷烟率低于干预前(χ2=5.10，P=0.02)，而对照组干预前后差异无统计学意义(χ2=1.49，P=0.22)。干预前，对照组17名现在吸卷烟者中15名一年内无戒烟想法; 干预组29名吸卷烟者中23名一年内无戒烟想法。干预后对照组10名现在吸卷烟者中一年内均无戒烟想法，干预组13名现在吸卷烟者中有5名一年内无戒烟想法。干预组干预后无戒烟想法的人数比例低于干预前，Continuity Correction χ2检验结果显示，差异有统计学意义(χ2=5.03，P=0.03)。Fisher确切概率检验结果显示，对照组干预前后无戒烟想法的人数比例差异无统计学意义(P=0.52)。
2.3　干预前后两组研究对象同伴吸卷烟人数变化
干预前，干预组同伴≥50%吸卷烟人数比例(16.7%，60/359)和对照组(10.9%，46/422)差异有统计学意义(χ2=5.59，P=0.02); 干预后，干预组(11.2%，37/329)和对照组(11.8%，47/399)差异无统计学意义(χ2=0.05，P=0.82)。干预组在干预后同伴≥50%吸卷烟人数比例低于干预前(χ2=4.24，P=0.04)，而对照组干预前后差异无统计学意义(χ2=0.16，P=0.69)。
2.4　干预前后两组研究对象吸烟态度及行为变化
干预前，两组研究对象对学校吸烟者态度构成差异有统计学意义(χ2=10.04，P < 0.01)，干预后两组差异无统计学意义(χ2=2.15，P>0.05)。干预组学生在干预后对学校吸烟者持反感态度比例高于干预前(χ2=12.34，P=0.01)，而对照组在干预前后差异无统计学意义(χ2=3.89，P=0.27)。见表2。
干预前，两组研究对象对在学校遇到吸烟者保持距离构成差异有统计学意义(χ2=14.18，P < 0.01); 干预后，两组研究对象间差异无统计学意义(χ2=0.47，P>0.05)。干预组学生在干预后遇到吸烟者保持距离的比例高于干预前(χ2=18.21，P < 0.01)，而对照组差异无统计学意义(χ2=2.50，P=0.64)。见表3。
3　讨论
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经过控烟干预后，干预组学生控烟知识提高，现在吸卷烟率下降，吸卷烟学生一年内无戒烟意愿人数减少，同伴吸卷烟人数减少，对吸烟者持反感态度和遇到吸烟者保持一定距离的人数均有提高，而对照组干预前后差异均无统计学意义。本次干预组吸烟率的下降程度高于白承续等[11]对北京市高职生控烟干预后吸烟率的下降程度，以及李嘉慧等[5]对上海4所中职学校学生控烟干预后吸烟率下降程度。提示基于社会网络理论的控烟干预有效提高了高职院校学生的烟草知信行。
社会网络主要包括社会影响、伙伴关系、社会损害、社会资本和社会支持五大功能，社会网络对健康有双重作用，伙伴关系、社会资本和社会支持对健康具有促进作用，但社会影响和社会损害可能会有负面作用[6]。若周围的朋友都是吸烟者，则个体吸烟的可能性也会增加; 而与控烟相关的社会支持则可以提高吸烟青少年的戒烟意愿[8]。因此，建立健康的控烟社会网络，增强网络中伙伴关系的联结，提高网络中社会支持的互帮互助，是开展学校青少年控烟工作的重要着力点。
相近年龄群体的大学生社会网络成员之间存在相互影响和模仿的效应[12]。吸烟大学生倾向于与持有相似吸烟态度和行为的同伴交友，使得网络中吸烟行为的相似性越来越高[13]。在吸烟者的社会网络中，不吸烟者可能出于社交压力，为获得和维持网络地位而选择吸烟行为[14]。而在不吸烟者的社会网络中，因为所在网络规范的影响，网络成员吸烟易感性较低，但游离在网络外的孤立者吸烟率最高[15]。本研究基于社会网络理论，通过建立不吸烟者的社会网络，围绕社会网络功能中的伙伴关系和和社会支持，加强不吸烟者的社会网络来开展控烟干预。
本研究通过对控烟社会网络中的中心人物(同伴教育者)进行控烟培训，确定1名同伴教育者关联8~10名同学，建立新的控烟社会网络。由于成员较少，每个同伴教育者可针对本网络开展形式多样的活动，做到个体化的精准控烟教育，掌握每个成员烟草情况，及时对成员控烟态度和行为提供情感和评价支持并及时反馈，提高网络中控烟社会支持的提供。项目组成员实时监督控烟社会网络的发展，及时维护并提供相应技术支持，加强巩固控烟网络建设。干预策略由点到面，辐射状改善周围同学的烟草知识态度行为，达到了较好的由个体到群体的控烟效益。
社会网络中的成员受所在网络的规范约束，吸烟行为很大程度上关联着错误的社会规范信息，纠正这种错误认知的核心思想是提供精准的科学数据和让人信服的事实案例[8]，形成正确的群体规范。本次干预中均引用权威机构公布的具体数据、科普文章以及科普视频，以全面的控烟信息深入揭露吸烟与疾病的关联性、烟草营销真相和烟草的成瘾性等，同时培养学生拒吸二手烟技能，结合学校范围内禁烟行动多方面共同营造不吸烟网络氛围，建立不吸烟网络规范。
本研究也存在一定的局限性：干预时间为6个月，青少年吸烟行为容易受社会环境影响，维持干预效果需要更长时间巩固。
基金
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  • 广东省医学科学技术研究基金项目(A2022219)
文献
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2025年第46卷第2期
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文章信息
doi: 10.16835/j.cnki.1000-9817.2025062
  • 接收时间：2024-05-09
  • 首发时间：2026-11-06
  • 出版时间：2025-02-25
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  • 收稿日期：2024-05-09
  • 修回日期：2024-12-20
基金
广东省医学科学技术研究基金项目(A2022219)
作者信息
    1广州市卫生健康宣传教育中心健康指导部，广东 510630
    2广东省外语艺术职业学院小学教育系

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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
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species		 占总种数比例
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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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