菸害防制法新制實施前後吸菸行為之影響因子：以平鎮世代資料為例

目的：新制菸害防制法於2009年1月實施，開始有明確的罰則及相關配套措施。本研究欲了解此法在鄉鎮型社區的介入成效，同時分析社區世代吸菸與戒菸族群的特性，以做為社區提升戒菸效果的實證依據及未來戒菸策略制定的參考。方法：回溯性收集2008與2009兩年間均有參與壢新世代研究計畫之個案為分析樣本，共計有2,945位年齡為30歲以上的平鎮市民被納入後續分析；探討新制菸害防制法實施後，與個案戒菸相關之因子，並進一步瞭解戒菸個案在追蹤期間各項生理數值與未戒菸個案之差異。結果：菸害防制法新制實施後，民眾吸菸率有顯著下降，吸菸率自實施前之14.1%下降至實施後之13.0%（p ＜ 0.001）。在分析影響個案戒菸相關因子部分，發現新制菸害防制法實施後與戒菸有關之因子為年齡（45-64歲戒菸OR = 3.21,95% CI = 1.13-9.13; 65歲以上OR = 4.87, 95% CI = 1.50-15.28）及教育程度（大學以上OR = 2.89, 95% CI = 1.37-6.12），同時戒菸個案在追蹤期間其各項生理數值差異與未戒菸個案相較並無顯著差異。結論：菸害防制法新制實施後，年齡較大及教育程度較高者確實較可能在平鎮地區有吸菸行為的改變。建議政策上應思考如何運用策略讓年輕人與低教育程度者及早戒菸。同時不健康的生活型態有群聚現象，建議未來應將健康促進資源整合，以提升社區民眾的整體健康。

關鍵字

世代資料分析；社區研究；菸害防制法；吸菸行為；戒菸

並列摘要

Aim: The amended Tobacco Hazards Prevention Act, promulgated in January 2009, stipulates specific penalty provisions reinforced by comprehensive supplmentary measures. Aiming to assess the effectiveness of the amended act in rural communities in Taiwan, the study analyzed the characteristics of tobacco smokers and quitters in Pingzhen District of Tayouan City. Empirical findings of the study can be expected to assist the development of more effective smoking cessation strategies in the future.Methods: The study retrospectively collected the data of people participating the Lishin Outreaching Neighborhood Screening (LIONS) project in 2008-2009. A total of 2,945 subjects aged over 30 years were recruited for analysis of factors associated with smoking cessation after the promulgation of the amended Tobacco Hazards Prevention Act. The differences in biochemical indicators between tobacco quitters and smokers during the study period were also evaluated.Results: The smoking rate of the examined subjects showed a significant decrease from 14.1% to 13.0% (p ＜ 0.001) after the promulgation of the amended Act. Results of multivariate analysis indicated that older age (compared to 30-39 years, 40-45 years: OR = 3.21, 95% CI = 1.13-9.13; 65 years and older: OR = 4.87, 95% CI = 1.50-15.28) and higher education (college and above: OR = 2.89, 95% CI = 1.37-6.12) were significantly associated with smoking cessation. However, the differences in biochemical indicators between tobacco quitters and smokers did not reach the statistical significance.Conclusions: The smoking behavior of the older and higher educated residents in Pingzhen District of Tayouan City underwent a positive change after the promulgation of the amended Tobacco Hazards Prevention Act. More efforts should accordingly be invested to develop effective smoking-cessation strategies for younger and lower educated people. In addition, as unhealthy behaviors tend to cluster, health promotion resources should be better integrated to improve the overall health and well-being of community dwellers.

並列關鍵字

cohort data analysis ； community-based study ； quit smoking ； smoking behavior ； Tobacco Hazards Prevention Act

參考文獻

World Health Organization. Factsheet on Tobacco. http://www.who.int/mediacentre/factsheets/fs339/en/. Accessed 25 November, 2014.

Google Scholar

溫啟邦、鄭秋汶、鄭丁元(2009)。國人嚼檳榔的現況與變化－探討嚼檳榔與吸菸之關係。台灣衛誌。5，407-19。

Chang, F. C.,Sung, H. Y.,Zhu, S. H.,Chiou, S. T.(2014).Impact of the 2009 Taiwan tobacco hazards prevention act on smoking cessation.Addiction.109,140-6.