Abstract：
Tobacco use among young people still remains a major public health problem. Thus, the aim of this study was to perform a cross-country comparison for the factors associated with susceptibility to tobacco use among youth from five central and eastern European countries.
The data used in the current analysis, focusing on youth (aged 11-17 years), who have never tried or experimented with cigarette smoking, was available from the recent Global Youth Tobacco Survey (Czech Republic (2016), n = 1997; Slovakia (2016), n = 1998; Slovenia (2017), n = 1765; Romania (2017), n = 3718; Lithuania (2018), n = 1305). Simple, multiple logistic regression analyses and random-effect meta-analysis were conducted to identify factors associated with tobacco use susceptibility as the lack of a firm commitment not to smoke.
Nearly a quarter of the students were susceptible to tobacco use in 4 of 5 countries. The following factors were identified, consistently across countries, as correlates of tobacco use susceptibility: exposure to passive smoking in public places (AOR from 1.3; p = 0.05 in Slovakia to 1.6; p < 0.01 in Czech Republic and Romania), peers smoking status (AOR from 1.8 p < 0.01 in Slovakia to 2.5; p < 0.01 Lithuania), opinion that smoking helped people feel more comfortable at celebrations (AOR from 1.3; p = 0.01 in Czech Republic to 1.9; p < 0.01 in Lithuania), noticing people using tobacco in mass media (AOR 1.5; p < 0.01 in Slovenia and 1.6; p < 0.01 in Lithuania), lack of knowledge on harmful effects of passive smoking (AOR 1.8; p < 0.01 in Slovakia and 2.4; p < 0.01 in Slovenia), lack of antismoking education provided by school (AOR 1.3; p < 0.05 in Czech Republic, Slovakia and Slovenia; 1.9; p < 0.01 in Lithuania), and family (AOR 1.5; p < 0.01 in Slovenia and Romania). Moreover those who believed that smoking makes young people look less attractive (AOR from 0.5; p < 0.01 in Romania to 0.7; p = 0.05 in Lithuania) and that people who smoke have less friends (AOR 0.7; p ≤ 0.06) turned out to be less susceptible to tobacco use initiation. In Czech Republic and Slovenia significantly higher susceptibility to tobacco use was observed among females as compared to males (AOR 1.4; p < 0.01), whereas in Romania opposite pattern, although not significant, was observed (p = 0.3). Having more money available for own expenses, positively correlated with smoking suitability in all countries (AOR > 1.5; p < 0.01) except Lithuania where youth with more money available tend to be less susceptible to tobacco use (p > 0.05). Youth who share the opinion that people who smoke have more friends were more susceptible to smoking in Romania (AOR 1.4; p = 0.04) but tend to be less susceptible in other countries. Exposure to advertisements at points of sale was significant correlate of tobacco use susceptibility in Slovakia and Slovenia (AOR 1.4 and 1.5 respectively; p < 0.05), with moderate heterogeneity between the countries.
A high proportion of youth from central and eastern European countries was susceptible to tobacco use. Social factors, and those related to educational and policy issues as well as to attitudes regarding tobacco use were strongly, and consistently across countries, correlated with tobacco use susceptibility. Slight differences in susceptibility to tobacco use between the countries were related to: sex, money available for own expenses, exposure to advertisements at points of sale and opinion that people who smoke have more friends. These factors should be considered when designing and implementing anti-tobacco activities among young people.
The data used in the current analysis, focusing on youth (aged 11-17 years), who have never tried or experimented with cigarette smoking, was available from the recent Global Youth Tobacco Survey (Czech Republic (2016), n = 1997; Slovakia (2016), n = 1998; Slovenia (2017), n = 1765; Romania (2017), n = 3718; Lithuania (2018), n = 1305). Simple, multiple logistic regression analyses and random-effect meta-analysis were conducted to identify factors associated with tobacco use susceptibility as the lack of a firm commitment not to smoke.
Nearly a quarter of the students were susceptible to tobacco use in 4 of 5 countries. The following factors were identified, consistently across countries, as correlates of tobacco use susceptibility: exposure to passive smoking in public places (AOR from 1.3; p = 0.05 in Slovakia to 1.6; p < 0.01 in Czech Republic and Romania), peers smoking status (AOR from 1.8 p < 0.01 in Slovakia to 2.5; p < 0.01 Lithuania), opinion that smoking helped people feel more comfortable at celebrations (AOR from 1.3; p = 0.01 in Czech Republic to 1.9; p < 0.01 in Lithuania), noticing people using tobacco in mass media (AOR 1.5; p < 0.01 in Slovenia and 1.6; p < 0.01 in Lithuania), lack of knowledge on harmful effects of passive smoking (AOR 1.8; p < 0.01 in Slovakia and 2.4; p < 0.01 in Slovenia), lack of antismoking education provided by school (AOR 1.3; p < 0.05 in Czech Republic, Slovakia and Slovenia; 1.9; p < 0.01 in Lithuania), and family (AOR 1.5; p < 0.01 in Slovenia and Romania). Moreover those who believed that smoking makes young people look less attractive (AOR from 0.5; p < 0.01 in Romania to 0.7; p = 0.05 in Lithuania) and that people who smoke have less friends (AOR 0.7; p ≤ 0.06) turned out to be less susceptible to tobacco use initiation. In Czech Republic and Slovenia significantly higher susceptibility to tobacco use was observed among females as compared to males (AOR 1.4; p < 0.01), whereas in Romania opposite pattern, although not significant, was observed (p = 0.3). Having more money available for own expenses, positively correlated with smoking suitability in all countries (AOR > 1.5; p < 0.01) except Lithuania where youth with more money available tend to be less susceptible to tobacco use (p > 0.05). Youth who share the opinion that people who smoke have more friends were more susceptible to smoking in Romania (AOR 1.4; p = 0.04) but tend to be less susceptible in other countries. Exposure to advertisements at points of sale was significant correlate of tobacco use susceptibility in Slovakia and Slovenia (AOR 1.4 and 1.5 respectively; p < 0.05), with moderate heterogeneity between the countries.
A high proportion of youth from central and eastern European countries was susceptible to tobacco use. Social factors, and those related to educational and policy issues as well as to attitudes regarding tobacco use were strongly, and consistently across countries, correlated with tobacco use susceptibility. Slight differences in susceptibility to tobacco use between the countries were related to: sex, money available for own expenses, exposure to advertisements at points of sale and opinion that people who smoke have more friends. These factors should be considered when designing and implementing anti-tobacco activities among young people.
摘要：
年轻人的烟草使用仍然是一个主要的公共卫生问题。因此，这项研究的目的是对来自5个中欧和东欧国家的青少年的烟草使用易感性相关因素进行跨国比较.
当前分析中使用的数据，专注于青年（11-17岁），从未尝试或尝试过吸烟的人，来自最近的全球青年烟草调查(捷克共和国(2016)，n=1997；斯洛伐克(2016)，n=1998；斯洛文尼亚（2017），n=1765；罗马尼亚（2017年），n=3718；立陶宛（2018年），n=1305)。简单，我们进行了多项logistic回归分析和随机效应荟萃分析,以确定与烟草使用易感性相关的因素,即缺乏不吸烟的坚定承诺.
在5个国家中的4个国家中，近四分之一的学生易受烟草使用的影响。确定了以下因素，在各国之间始终如一，作为烟草使用敏感性的相关因素：暴露于公共场所的被动吸烟（AOR从1.3；斯洛伐克的p=0.05到1.6；捷克共和国和罗马尼亚的p<0.01），同龄人吸烟状况(AOR从斯洛伐克的1.8p<0.01到2.5；立陶宛的p<0.01)，认为吸烟有助于人们在庆祝活动中感到更舒适（AOR从1.3；捷克共和国的p=0.01到1.9；立陶宛的p<0.01），注意到人们在大众媒体中使用烟草（AOR1.5；斯洛文尼亚的p<0.01；立陶宛的p<0.01），缺乏对被动吸烟有害影响的知识（AOR1.8；斯洛伐克和2.4的p<0.01；斯洛文尼亚的p<0.01），缺乏学校提供的反吸烟教育(AOR1.3；捷克共和国的p<0.05，斯洛伐克和斯洛文尼亚；1.9；立陶宛p<0.01)，和家庭(AOR为1.5；斯洛文尼亚和罗马尼亚的p<0.01)。此外，那些认为吸烟会使年轻人看起来不那么有吸引力的人（AOR从0.5；罗马尼亚的p<0.01到0.7；立陶宛的p=0.05），并且吸烟的人的朋友较少（AOR0.7；p≤0.06）被证明是较不容易开始吸烟。在捷克共和国和斯洛文尼亚，女性对烟草使用的易感性明显高于男性（AOR1.4；p<0.01），而在罗马尼亚则相反，虽然不重要，观察到（p=0.3）。有更多的钱可用于自费，所有国家的吸烟适宜性呈正相关(AOR>1.5;p<0.01),立陶宛除外,那里有更多钱可用的年轻人往往不太容易吸烟(p>0.05)。认为吸烟的人有更多朋友的年轻人在罗马尼亚更容易吸烟（AOR1.4；p=0.04），但在其他国家往往不太容易吸烟。在斯洛伐克和斯洛文尼亚，在销售点接触广告与烟草使用敏感性显着相关（AOR分别为1.4和1.5；p<0.05），国家之间具有中等异质性。
来自中欧和东欧国家的年轻人中很高比例容易吸烟。社会因素,与教育和政策问题以及对烟草使用的态度有关的问题强烈，并且在各个国家都始终如一，与烟草使用敏感性相关。各国对烟草使用的易感性的微小差异与：性别，可用于自费的钱，在销售点接触广告，并认为吸烟的人有更多的朋友。在年轻人中设计和实施反烟草活动时应考虑这些因素。
当前分析中使用的数据，专注于青年（11-17岁），从未尝试或尝试过吸烟的人，来自最近的全球青年烟草调查(捷克共和国(2016)，n=1997；斯洛伐克(2016)，n=1998；斯洛文尼亚（2017），n=1765；罗马尼亚（2017年），n=3718；立陶宛（2018年），n=1305)。简单，我们进行了多项logistic回归分析和随机效应荟萃分析,以确定与烟草使用易感性相关的因素,即缺乏不吸烟的坚定承诺.
在5个国家中的4个国家中，近四分之一的学生易受烟草使用的影响。确定了以下因素，在各国之间始终如一，作为烟草使用敏感性的相关因素：暴露于公共场所的被动吸烟（AOR从1.3；斯洛伐克的p=0.05到1.6；捷克共和国和罗马尼亚的p<0.01），同龄人吸烟状况(AOR从斯洛伐克的1.8p<0.01到2.5；立陶宛的p<0.01)，认为吸烟有助于人们在庆祝活动中感到更舒适（AOR从1.3；捷克共和国的p=0.01到1.9；立陶宛的p<0.01），注意到人们在大众媒体中使用烟草（AOR1.5；斯洛文尼亚的p<0.01；立陶宛的p<0.01），缺乏对被动吸烟有害影响的知识（AOR1.8；斯洛伐克和2.4的p<0.01；斯洛文尼亚的p<0.01），缺乏学校提供的反吸烟教育(AOR1.3；捷克共和国的p<0.05，斯洛伐克和斯洛文尼亚；1.9；立陶宛p<0.01)，和家庭(AOR为1.5；斯洛文尼亚和罗马尼亚的p<0.01)。此外，那些认为吸烟会使年轻人看起来不那么有吸引力的人（AOR从0.5；罗马尼亚的p<0.01到0.7；立陶宛的p=0.05），并且吸烟的人的朋友较少（AOR0.7；p≤0.06）被证明是较不容易开始吸烟。在捷克共和国和斯洛文尼亚，女性对烟草使用的易感性明显高于男性（AOR1.4；p<0.01），而在罗马尼亚则相反，虽然不重要，观察到（p=0.3）。有更多的钱可用于自费，所有国家的吸烟适宜性呈正相关(AOR>1.5;p<0.01),立陶宛除外,那里有更多钱可用的年轻人往往不太容易吸烟(p>0.05)。认为吸烟的人有更多朋友的年轻人在罗马尼亚更容易吸烟（AOR1.4；p=0.04），但在其他国家往往不太容易吸烟。在斯洛伐克和斯洛文尼亚，在销售点接触广告与烟草使用敏感性显着相关（AOR分别为1.4和1.5；p<0.05），国家之间具有中等异质性。
来自中欧和东欧国家的年轻人中很高比例容易吸烟。社会因素,与教育和政策问题以及对烟草使用的态度有关的问题强烈，并且在各个国家都始终如一，与烟草使用敏感性相关。各国对烟草使用的易感性的微小差异与：性别，可用于自费的钱，在销售点接触广告，并认为吸烟的人有更多的朋友。在年轻人中设计和实施反烟草活动时应考虑这些因素。
