目的研究社区综合干预对北京市郊区人群吸烟、慢性支气管炎和哮喘流行情况的影响。方法1992年,将北京市房山区23个自然村整群随机分为13个干预村和10个对照村,对干预村进行以戒烟、改善居住环境为主的社区人群综合干预,对照村未施加干预。2000年4月,对干预区和对照区34436名15岁以上人群进行吸烟、慢性支气管炎和哮喘流行情况普查。同期,对1658名慢性阻塞性肺疾病(COPD)高危人群进行卫生知识水平、居住环境和吸烟状况的基线调查和复查。结果干预区男女高危人群卫生知识水平得分改善幅度和居住环境好转率显著大于对照区(P<0.001)。干预区全人群中男性吸烟率、现吸烟率下降幅度显著大于对照区(0.4%vs-0.8%,P<0.001;2.4%vs1.3%,P<0.001),女性差异无显著性(P>0.05)。无论男女,干预区15～24岁人群1993～2000年累积新吸烟率显著低于对照区(男:18.9%vs23.7%,P=0.005;女:0%vs0.7%,P=0.005)。干预区吸烟者日吸烟支数低于对照区男:(14.8±7.0)支/dvs(17.2±8.2)支/d,P<0.001;女:(12.8±6.9)支/dvs(13.4±7.2)支/d,P=0.088。由于人群老龄化,慢性支气管炎患病率呈上升趋势,干预村上升幅度低于对照村(男:0.9%vs1.3%,P=0.012;女:0.1%vs0.3%,P=0.003)。控制年龄因素后,干预村慢性支气管炎1993～2000年累积发病率低于对? Objective To study the effects of community-based interventions on the prevalence of smoking, chronic bronchitis and asthma in suburban areas of Beijing. Methods In 1992, the cluster of 23 natural villages in Fangshan District of Beijing was randomly divided into 13 intervention villages and 10 control villages. The interventions were conducted in community groups with cessation of smoking and improvement of living environment in intervention villages without intervention . In April 2000, a total of 34,436 people aged 15 and over in the intervention and control areas were surveyed for smoking, chronic bronchitis and asthma prevalence. Over the same period, a baseline survey and review of health knowledge, living environment and smoking status among 1658 high-risk COPD patients were conducted. Results The rate of improvement of health knowledge and the improvement rate of living environment were significantly higher in the intervention group than in the control group (P <0.001). In the intervention group, the male smoking rate and the current smoking rate in the whole population were significantly lower than those in the control group (0.4% vs-0.8%, P <0.001; 2.4% vs 1.3%, P <0.001) 0.05). The accumulative new smoking rates of the 15-24-year-old population in the intervention area between 1993 and 2000 were significantly lower than those in the control area (male: 18.9% vs 23.7%, P = 0.005; female: 0% vs0.7%, P = 0.005) . The number of smokers per day in the intervention area was lower than that in the control group (14.8 ± 7.0) /dvs(17.2 ± 8.2) /d,P<0.001; female: (12.8 ± 6.9) /dvs(13.4 ± 7.2) Branch / d, P = 0.088. Due to the aging population, the prevalence of chronic bronchitis was on the rise, and the rate of increase in intervention villages was lower than that in control villages (male: 0.9% vs 1.3%, P = 0.012; women: 0.1% vs 0.3%, P = 0.003) . After controlling for age, the cumulative incidence of chronic bronchitis in the village from 1993 to 2000 was lower than that of the control group