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目的系统评价以学校为基础的预防青少年吸烟干预研究,探讨不同干预研究实施时间和1偏倚风险对控烟有效性的影响。方法 16篇对照研究文献被纳入研究,包括以吸烟率为指标的11篇文献(干预/对照:16 057/18 289)和以尝试吸烟为指标的7篇文献(干预/对照:15 786/14 701),并根据干预实施时间和偏倚风险程度进行亚组分析。结果吸烟组中,吸烟率总RR值(95%CI)值为0.42(0.31~0.57),≤半年、半年~一年和﹥一年亚组的合并RR(95%CI)值分别为0.74(0.63~0.88)、0.31(0.14~0.68)和0.30(0.18~0.52);尝试吸烟组中,尝试吸烟率总RR(95%CI)值为0.61(0.48-0.77),≤半年、半年~一年和﹥一年亚组的合并RR(95%CI)值分别为0.86(0.75~0.99)、0.54(0.37~0.78)和0.50(0.36-0.71)。结论控烟干预总体效果和稳定性均较好,但具有较高的异质性和发表偏倚。经亚组分析后,部分亚组异质性降低或消失,且干预实施时间越长的亚组干预效果越好。
Objective To systematically evaluate the school-based prevention of smoking among young people and explore the impact of different interventions and the risk of bias on the effectiveness of tobacco control. Methods Sixteen controlled studies were included in the study, including 11 articles (intervention / control: 16 057/18 289) with smoking prevalence as an indicator and 7 articles (intervention / control: 15 786/14 701) and a subgroup analysis based on the timing of interventions and the degree of risk of bias. Results In the smoking group, the total RR (95% CI) of smoking prevalence was 0.42 (0.31-0.57), and the combined RR (95% CI) of the patients who were less than 6 months, 6 months to 1 year and> 1 year were 0.74 0.63-0.88), 0.31 (0.14-0.68) and 0.30 (0.18-0.52) respectively. In the trial smoking group, the overall RR of smoking prevalence was 0.61 (0.48-0.77), ≤ six months, six months to one year (> 95% CI) for the one-year subgroup were 0.86 (0.75-0.99), 0.54 (0.37-0.78) and 0.50 (0.36-0.71), respectively. Conclusion The overall effect and stability of tobacco control interventions are good, but with high heterogeneity and publication bias. After subgroup analysis, the heterogeneity of some subgroups decreased or disappeared, and the longer the intervention, the better the subgroup intervention effect.