Objective:It aims to investigate the impact of tobacco use on Catastrophic Health Expenditure(CHE),providing a ba-sis for government investment in tobacco control and the formulation of effective anti-smoking policies.Methods:Based on the 2018 National Health Service Survey data from Shandong Province,the incidence rate,average overshoot gap,and relative overshoot gap of CHE under different thresholds for different household were calculated to analyze the distribution of tobacco-related diseases for smoking households.Results:In 2018,the overall incidence rate of CHE for current smoking households in Shandong Province was 13.56%(at a 40%threshold),with average overshoot gap and relative overshoot gap of 4.61%and 34.02%,respectively.As income levels decreased,the overall incidence rate of CHE increased.Rural current smoking households had higher overall incidence rates of CHE,average overshoot gap,and relative overshoot gap than urban households.Smoking households that experienced CHE were pri-marily afflicted with chronic diseases.Conclusion:The CHE risk is significantly higher in smoking households,particularly in rural and low-income households.It is recommend implementing a diverse range of promotional methods to strengthen anti-smoking health education,with a specific focus on intensifying awareness of the dangers of tobacco use in rural areas.Additionally,it is suggested to further increase tobacco taxes so as to reduce the motivation for smoking among low-income populations.

Objective:To develop the children′s postoperative health-related quality of life scale for thyroid cancer and to test its reliability and validity.Methods:The first draft of the scale was developed through literature search, focus group meetings, and a pre-survey, and 116 children (76 for testing and 40 for external validation) with thyroid cancer attending Beijing Children′s Hospital of Capital Medical University were selected to answer the scale, to screen and categorize the questions and to form the final scale with multiple dimensions.Results:The children′s postoperative health-related quality of life scale for thyroid cancer contained 5 dimensions and 29 questions. Exploratory factor analysis showed that the cumulative variance explained by the 5 factors was 64.343%. Confirmatory factor analysis showed correlations between the questions and dimensions of this scale, fair convergent validity for the scale, and good discriminant validity. The validity of the validity scale showed that there was a existing correlation between the questions and the validity scale of this scale. The item-dimension correlation coefficients showed that the questions in each dimension were well differentiated. The total Cronbach′s α coefficient of the scale was 0.930, the folded half reliability was 0.843, and retest reliabilities at 2 weeks, 1 month, and 3 months after the initial test were respectively 0.936, 0.922, and 0.910.Conclusion:The developed children′s postoperative health-related quality of life scale for thyroid cancer has good reliability and validity and can be used to assess the health-related quality of life of children after thyroid cancer surgery.