目標:探討南台灣地區2009年菸害防制新法實施前後,國小學童家庭二手菸暴露狀況與迴避家庭二手菸自我效能影響因素。 方法:研究對象收集南台灣地區就讀於國小3-6年級的學童,以集束抽樣方式於2008及2009年個別選取26所國小進行問卷調查,取得有效樣本4,450份,回覆率為92.85%。最後使用階層複迴歸模式分析新法實施前後學童迴避家庭二手菸自我效能及其影響因素。 結果:結果發現菸害防制新法實施前後,學童的迴避家庭二手菸自我效能得分有顯著差異(P<0.05)。兩次調查資料皆顯示超過60%同住家人會在學童面前吸菸;換言之,有半數以上的國小學童暴露於家庭二手菸環境當中,其中高達35%於一週內至少有4天暴露於家庭二手菸。影響學童迴避家庭二手菸自我效能因素有學童吸菸態度(B=-0.05~-0.06,P<0.001)與家庭二手菸暴露天數(B=-0.34~-0.47,P<0.05)。男學童菸害知識得分顯著低於女學童。迴歸模式亦証實菸害知識與男性學童迴避家庭二手菸自我效能有顯著相關(B =0.13~0.14,P<0.001),但是在2008年女性學童並未呈現顯著性(B=0.05,P>0.05)。其他影響因素為學童吸菸行為 (B =-0.37,P=0.05)與年級。 結論:2009年新法實施之後,仍有相當高比例的國小學童暴露於家庭二手菸環境中,其暴露天數及傾向吸菸的態度未因政策短期實施而有所顯著的改變。2008年及2009年影響因素不同建議學校宜提供適切性的衛生教育活動,以強化學童的反菸態度與避免家庭二手菸自我效能,特別應針對男性學童提供菸害知識教育,以減低學童暴露於家庭二手菸危害中。
Objective: To analyze children’s household SHS (Second Hand Smoke) and factors related to self-efficacy to avoid SHS in southern Taiwan after 2009 Tobacco Hazards Prevention Act. Method: Two cross-sectional surveys were conducted on the schoolchildren enrolled in the third to sixth grades selected respective 26 elementary schools in 2008 and 2009 academic years. A total of 4450 valid questionnaires were obtained, with a response rate of 92.85%. Hierarchical regression models were therefore to analyze the related factors of children’s self-efficacy to avoid household SHS. Results: Higher mean score of self-efficacy of avoid SHS was found after new act (P<0.05). More than 60% of children were living with a family smoked in front of them and 35 % of them were exposed to household SHS more than 4 days a week. Schoolchildren’s positive attitude toward smoking (β=-0.05~-0.06,P<0.001) and household SHS exposure (β=-0.34~-0.47,P<0.05) were associated with children’s self-efficacy of avoid SHS. Compared to girl students, boys had lower score in the knowledge of tobacco hazards and that was related to self-efficacy of avoid SHS(β=0.13~0.14,P<0.001). Other observed significant factors were ever-smoking and grade. Conclusion: After the law implemented in 2009, yet high percentages of schoolchildren exposed to household SHS. The exposure days and attitude toward smoking were not changed by the short-term policy. The influential factors for 2008 differed from those for 2009. The findings suggested that intervention program should enhance positive attitude toward anti-smoking and self-efficacy to avoid SHS, more particularly, to provide tobacco hazards knowledge in the boy students in order to reduce SHS exposure at home.
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