摘要目的:了解浙江省中学生烟草广告/促销及影视吸烟镜头暴露现况及对其认知行为的影响。方法:本研究为横断面调查。于2021年9—10月，采用多阶段分层整群随机抽样方法抽取浙江省60所中学共7 692名在校学生进行现场问卷调查，内容包括人口学特征、烟草广告/促销暴露情况、影视吸烟镜头暴露情况以及烟草相关的认知、态度和行为等。对数据加权后，采用SPSS 21.0软件进行数据分析。结果:中学生的烟草广告/促销暴露率为24.8%，影视吸烟镜头暴露率为63.8%。过去30 d内，去过烟草零售点的学生中，46.1%看到过烟草广告/促销，用过互联网的学生中，23.4%看到过烟草广告/视频。所有学生中，2.4%接受过免费烟草产品。有烟草广告/促销暴露的初中、普通高中、职业高中学生认为社交场合吸烟令人更舒服的比例（5.6%、6.7%、8.8%）、认为年轻人吸烟更有吸引力的比例（9.1%、8.4%、8.8%）以及尝试吸烟率（12.5%、16.9%、20.5%）均高于非暴露者（初中学生分别为：2.3%、5.5%、4.8%；普通高中学生分别为2.9%、2.9%、9.8%；职业高中学生分别为：4.0%、4.0%、15.3%）（均 P<0.05）；有影视吸烟镜头暴露的初中学生（8.1%）、普通高中学生（14.7%）、职业高中学生（20.0%）的尝试吸烟率均高于非暴露者（5.4%、8.0%、10.6%）（均 P<0.05）。 结论:浙江省中学生烟草广告/促销和影视吸烟镜头暴露情况仍较严峻，可能使中学生对烟草使用持支持态度，并促进尝试和使用烟草。

abstractsObjective:To investigate the exposure to tobacco advertisement/promotion and smoking scenes from television/movie/video among middle school students in Zhejiang Province in 2021, and the influence on the knowledge and behavior about smoking of the students.Methods:Total 7 692 students were selected from 60 middle schools with the proportional probability sampling (PPS) method in Zhejiang Province. The investigation was performed with self-administered questionnaire survey which consisted of tobacco use, exposure to tobacco advertisement/promotion, et. The collected data was weighted and analyzed using the complex survey module of SPSS 21.0 software.Results:The prevalence of exposure to tobacco advertisement/promotion and smoking scenes from television/movie/video among the middle school students were 24.8% and 63.8% respectively. In recent 30 d, among those who had been exposed to the tobacco retail point, the proportion of those exposed to tobacco advertisement/promotion was 46.1%, and among those who surfed the internet, the proportion of those exposed to tobacco advertisement/video was 23.4%. Among the whole students, the proportion of those exposed to free tobacco product was 2.4%. The junior middle school students, regular high school students, and vocational school students who had been exposed to tobacco advertisement/promotion were more likely to feel smoking more comfortable in social occasions (5.6%, 6.7%, 8.8%), to feel smoking attractive for the young (9.1%, 8.4%, 8.8%), and also had higher rate of attempted smoking (12.5%, 16.9%, 20.5%) than non-exposed ones (junior middle school students: 2.3%, 5.5%, 4.8%; regular high school students: 2.9%, 2.9%, 9.8%; vocational school students: 4.0%, 4.0%, 15.3%) (all P<0.05). Among the students who had seen television/movie/video within 30 days, the junior middle school students, regular high school students, and vocational school students who had been exposed to smoking-related scenes had higher rate of attempted smoking (8.1%, 14.7%, 20.0%) than non-exposed ones (5.4%, 8.0%, 10.6%) (all P<0.05). Conclusion:The prevalence of exposure to tobacco advertisement/promotion and smoking scenes from television/movie/video are relatively high among the middle school students in Zhejiang province, which make exposed students more likely to report positive attitude to tobacco use, and more likely to smoke, to attempt to smoke.