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バヌアツの思春期前期の子どもにおける喫煙・飲酒に関連する要因:子どもと両親を対象とした横断的研究

Nakaseko, Emi 中世古, 恵美 ナカセコ, エミ 神戸大学

2021.03.25

概要

【目的】
思春期前期の子どもの喫煙・飲酒には、両親の喫煙・飲酒行動や養育態度、兄弟・仲間の喫煙・飲酒行動が影響することが先行研究において明らになっている。しかし、それらの報告の多くは高・中所得国からの報告であり、バヌアツ共和国をはじめとする低・中所得国からの報告,は限られている。本研究は、両親の知識・態度・行動、兄弟・仲間の行動などの様々な要因と子どもの喫煙・飲酒との関連について検討をおこない、バヌアツの思春期前期の子どもにおける喫煙・飲酒に関連する要因について明らかにすることを目的とした。

【方法】
バヌアツの3つの公立校に所属する7•8年生の子どもとその両親/保護者を対象に自記式質問紙調査を実施した。336名の子どもとその保護者に質問紙を配付し、すべての子どもと221人の保護者(回答率65.8%)から回答が得られ、221組の子どもとその保護者から成るデータセットが得られた。うち、有効回答の得られた157組の子ども(平均年齢13.3歳;52.2%女子)とその保護者を分析対象とした(有効回答率71.0%)。
本研究は姫路獨協大学生命倫理委員会(承認番号:18-11)とバヌアツ保健省執行委員会(承認番号:DPH02/2-LT/mt)の承認を得て実施した。
解析には統計解析ソフトSPSSF or Windows.Ver20(IBM,Armonk,NY)を用い、有意水準はp<0.05とした。分析は、両親、兄弟、仲間の要因と子どもの喫煙・飲酒との関連について単変量解析を用いて検討をおこなった。さらに多変量解析として単変量解析において有意差を認めた変数を独立変数、子どもの喫煙・飲酒を従属変数とするロジステイック回帰分析(変数増加式ステップワイズ法)を行い、oddsratio(OR)と95%confidence intervals(95%CI)を算出した。

【結果】
子どものうち、喫煙・飲酒経験のある者の割合はそれぞれ12.7%であり、・子どもの約半数が喫煙・飲酒習慣のある友人を有していた。また、大部分の保護者が未成年での喫煙・飲酒を「容認しない」と回答した。ロジスティック回帰分析の結果、子どもの喫煙経験には、仲間からの喫煙・飲酒の誘い(OR=37.54;95%CI,7.81-180.46;p<0.001)、仲間の飲酒習慣(OR=8.41;95%CI,1.55-45.54;p<0.05)が、子どもの飲酒経験には、仲間からの喫煙・飲酒の誘い(OR=6.19;95%CI,1.49-25.78;p<0.05)、仲間の喫煙習慣(OR=5.91;95%CI,1.26-27.71;p<0.05)が有意に関連していた。一方、両親と兄弟の要因は子どもの喫煙・飲酒との有意な関連を認めなかった。

【考察】
本研究の結果、仲間から喫煙・飲酒の誘いを受けることが思春期前期の子どもの喫煙・飲酒経験に最も強く関連していることが明らかとなった。したがって、今後のバヌアツにおける学校を拠点とした喫煙・飲酒予防教育においては、子ども自身が仲間からの喫煙・飲酒の誘いに対し建設的、効果的に対処することができるライフスキルを高めていくことの重要性が示唆された。

【結論】
本研究は、低・中所得国の1つであるバヌアツにおいても仲間の要因が思春期前期の子どもの喫煙・飲酒の開始に関連していることを示した。本研究結果は低・中所得国における未成年での喫煙・飲酒予防教育の推進に貢献するものと考える。

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