Public mobilisation in implementation of smoke-free Beijing: a social media complaint platform.

In November 2014, Beijing People's Congress adopted the Beijing Smoking Control Ordinance and a key provision bans smoking in all indoor public places, workplaces and on public transport. To ensure effective implementation of the ordinance, the government calls on the whole society to take part. In response, Beijing Tobacco Control Association, with the support of a local technology company, developed the Beijing Tobacco Control Map, a digital system that enables comprehensive tobacco control information collection, data visualisation and mapping. A key component of the Beijing Tobacco Control Map is the Complaint Map which is generated by the data of reported violations of the smoke-free provisions by the general public through a social media platform. The Complaint Map visually displays the reported violations on a map of Beijing in real time. The general public can access the Complaint Map at any time to see which venues and locations have been reported. It is used by tobacco control volunteers, who are recruited and trained to address complaints and promote compliance. It is also used by the government's enforcement team for targeted inspections. The Complaint Map has effectively engaged the public and promoted a smoke-free Beijing. Beijing's innovative and systematic approach that involves the Complaint Map, volunteer management, coordination with the enforcement team, and media exposure can be replicated or adapted in other cities in China and abroad that are implementing smoke-free laws or tobacco control laws in general.

Work stress, life stress, and smoking among rural-urban migrant workers in China.

BACKGROUND: Stimulated by rapid modernization and industrialization, there is massive rural-urban migration in China. The migrants are highly susceptible to smoking and mental health problems. This study examined the association between both perceived work stress and perceived life stress with smoking behavior among this group during the period of migration. METHODS: Participants (n = 1,595) were identified through stratified, multi-stage, systematic sampling. Smoking status separated non-smokers from daily and occasional smokers, and migration history, work stress, and life stress were also measured. Analyses were conducted using the Chi-square test and multiple logistic regression. Two models were utilized. The first was the full model that comprised sociodemographic and migration-related characteristics, as well as the two stress variables. In addressing potential overlap between life and work stress, the second model eliminated one of the two stress variables as appropriate. RESULTS: Overall smoking prevalence was 64.9% (95% CI: 62.4-67.2%). In the regression analysis, under the full model, migrants with high perceived life stress showed a 45% excess likelihood to be current smokers relative to low-stress counterparts (OR: 1.45; 95% CI: 1.05 - 2.06). Applying the second model, which excluded the life stress variable, migrants with high perceived work stress had a 75% excess likelihood to be current smokers relative to opposites (OR: 1.75; 95% CI: 1.26-2.45). CONCLUSIONS: Rural-urban migrant workers manifested a high prevalence of both life stress and work stress. While both forms of stress showed associations with current smoking, life stress appeared to outweigh the impact of work stress. Our findings could inform the design of tobacco control programs that would target Chinese rural-urban migrant workers as a special population.

Nicotine dependence among Chinese city dwellers: a population-based cross-sectional study.

INTRODUCTION: Although nicotine addiction is thought to be the primary driver of tobacco smoking, few studies have examined nicotine dependence among Chinese mainland smokers. METHODS: A population-based cross-sectional study was designed. Subjects (4735) aged 15 years and older residents were drawn from six cities in China through a multistage systematic sampling procedure. Nicotine dependence of respondents was assessed in a face-to-face interview using the 6-item Mandarin Chinese version of the Fagerström Test for Nicotine Dependence (FTND). A multilevel regression model, accounting for cluster sampling, was used to identify correlates of dependence. RESULTS: Among females, only 4.2% (n = 115) were smokers (2.5% daily, 1.7% occasional). Subsequent analysis focused on males, of whom 50.8% (n = 1477) were smokers (38.9% daily, 11.9% occasional). The average FTND score was 2.89 (95% CI: 2.77-3.01) among all current smokers. Daily smokers had a significantly higher FTND score (3.49, 95% CI: 3.35-3.63) than occasional smokers (1.12, 95% CI: 0.98-1.26) (p < .01). Of all smokers, 27.1% were considered dependent based on FTND ≥ 4. Among daily smokers, FTND scores were negatively associated with age at smoking initiation, education, and self-efficacy for quitting smoking. FTND was associated (negatively) with income among occasional smokers only. There were regional differences in FTND scores among daily smokers. CONCLUSIONS: Cigarette smoking is highly prevalent among Chinese males but rare among Chinese females. Occasional smoking is also common among males. Only 3.3% of occasional male smokers appear dependent by FTND criteria. Dependence varies by smoking history and demographics. These findings have implications for design and implementation of smoking cessation interventions.

[Confirmative factor analysis in the health literacy questionnaire and its applications in Chinese residents].

OBJECTIVE: To evaluate construct validity of China residents health literacy questionnaire and explore the application of confirmative factor analysis (CFA) in health literacy measurements. METHODS: CFA was performed on dimension of basic healthy skills in the questionnaire. Latent variable scores and comprehensive score based on factor variance weight were calculated. Comparison among the latent variable scores, comprehensive scores and proportion of knowing was conducted via GLM or Logistic model. RESULTS: Two factors named general capacity and emergency capacity were well fitted (chi(2)=12.12, P=0.356, IFI=0.998, TLI=0.996, RMSEA=0.007). According to comprehensive score the sample qualification rate of basic health literacy was 38.5%(785/2 040), much similar to 38.2% (780/2 040) which is calculated by original item scores. Latent variable score or comprehensive score has more statistical power than that of proportion of knowing in multivariate analysis. CONCLUSION: CFA is a useful tool and valuable for applying in the field of health literacy measurement and analysis.

[Study on the trend of obesity prevalence among primary and middle school students in Beijing, from 1985 to 2005].

OBJECTIVE: To study the prevalence and trend of obesity among primary and middle school students in Beijing from 1985 to 2005. METHODS: Morphological data of students aged 7-18 from the National Physical Fitness and Health Surveillance of Chinese School Students in Beijing in 1985, 1995, 2000 and 2005 was analyzed with methods of cross-sectional study. The prevalence of obesity was calculated, and its secular trends was characterized. RESULTS: The prevalence of obesity among students aged 7-18 in Beijing were 0.65%, 3.40%, 5.23% and 8.53% respectively in the four surveillance programs with obvious rising trend which had an increase. In 2005, it was indicated that the obesity prevalence of subgroups were significantly different from each other. It was higher for males (11.11%) than females (5.98%), also for students aged 10-12 (11.63%). In rural schools (6.60%) it was much lower than in urban (10.38%), but the areas with high SES was deemed to have a lower prevalence. CONCLUSION: In the last two decades, among primary and middle school students in Beijing, obesity had changed its characteristics from sporadic to epidemic with the features of both developed and developing countries.

[Validation of lipids on body mass index reference recommended by Obesity Working Group, International Life Science Association of China].

OBJECTIVE: To assess the relationship between overweight, obesity and blood lipid profiles of children and adolescents and to validate body mass index (BMI) cutoff points for overweight and obesity screening to Chinese children and adolescents, recommended by Working Group of Obesity, China (WGOC), International Life Science Association. METHODS: 2293 children and adolescents (1124 males and 1169 females), aged between 10 and 18 years, were randomly selected as samples from 6 schools in Beijing area. Fasting serum lipids including total cholesterol (TC), total triglycerides (TG), high density lipoprotein cholesterol (HDLC), thropometrical index as weight and height were measured. BMI equals to weight in kilograms were then divided by the square of height in meters. RESULTS: According to BMI cutoff points recommended by WGOC, samples fell into 3 groups including normal group (BMI < 85 percentiles), overweight group (BMI >or= 85 and < 95 percentiles) and obesity group (BMI >or= 95 percentiles). Results clearly showed an increase of both serum TC and TG and a decrease of HDLC when BMI was increasing, among most age groups regardless of sex difference and the difference among BMI groups was statistically significant (P < 0.05 or P < 0.01). CONCLUSIONS: Results of this study indicated that there was an obvious dose-effect relationship between BMI and lipid profiles which accounted for some rationality of the BMI cutoff points recommended by WGOC. The authors reckoned the findings important to managing relevant adult diseases during childhood, in China.

[The study on relationship of body mass index and blood pressure in children and adolescents of Beijing].

OBJECTIVE: To identify the relationship of body mass index (BMI) and blood pressure in 7 - 15 years children and adolescents of Beijing so as to provide scientific basis for early prevention of hypertension and to provide evidence for verification on the category criterion of overweight and obesity in children and adolescents of China, recommended by the Working Group on Obesity in China (WGOC) to sensitively distinguish the blood pressure in normal weight, overweight and obesity populations. METHODS: A cross-sectional survey on epidemiological characteristics of obesity with stratified cluster sampling method carried out in Beijing in April and May, 2000. 5155 students aged 6 - 15 years were selecte das research subjects. The category criterion of overweight and obesity in children and adolescents of China was recommended by WGOC, the diagnostic criterion of hypertension in children was recommended by CDC in the USA. Statistics analysis system (SAS 8.1) including partial person correlation analysis, t-test, chi(2) test and logistic multi-factors regression analysis was used to analyses the data from 4982 subjects aged 7 - 15 years. RESULTS: (1) after the age and gender were adjusted, the BMI positive correlation with systolic blood pressure (SBP) and diastolic blood pressure (DBP) was found independent in 7 - 15 years children and adolescents (P < 0.0001) and the partial relation coefficients(r) between BMI and SBP and DBP were 0.323 87 and 0.245 88 respectively. (2) the means of SBP and DBP in obesity group were significantly higher then overweight, while overweight was significantly higher then normal weight group (P < 0.0001). (3) the prevalence rates of hyper-SBP, hyper-DBP and hypertension were significantly different (P < 0.0001). When compared with the normal weight group, the relation risk (RR) for hypertension in overweight group and obesity group were 2.96 and 4.85 respectively. The prevalence rates of hypertension in overweight and obesity group were 19.70% and 24.22% respectively. (4) the results of logistic multi-factors regression analysis showed that both age and weight were effecting on hyper-SBP, hyper-DBP and hypertension (P < 0.0001). After age was adjusted, the RR for hypertension was 2.62, and their confidence interval (CI) was 2.36 - 2.91 in obesity or overweight, between overweight and normal weight. CONCLUSION: (1) the BMI positive correlation with SBP and DBP was found independent in 7 - 15 years children and adolescents of Beijing, and the risk for hypertension maybe increased when these people with overweight and obesity, it is very important for hypertension prevention and control that overweight and obesity prevention and control in children and adolescents. (2) the sensitivity of the category criterion of overweight and obesity in children and adolescents of China, recommended by WGOC have been verified on distinguish the blood pressure in normal weight, overweight and obesity populations.