嘉義市成人嚼食檳榔行為、吸菸行為與檳榔危害健康意識相關性之探討

Investigation of Areca Quid Chewing and Cigarette Smoking Prevalence Rates and the Health Conscience of Betel Quid to Health for Adults in Chiayi City

謝金蕊(Chin-Jui Hsieh)

指導教授 ： 楊奕馨

高雄醫學大學/口腔醫學院/口腔衛生科學研究所碩士在職專班/碩士(2003年)

摘要

中文摘要
為瞭解嘉義市檳榔嚼食和吸菸行為之現況以及蒐集一般民眾對檳榔之認知與態度。本研究於民國九十年，針對嘉義市地區進行家庭訪視，完成問卷調查。研究設計乃以抽樣調查方式，採分層多階段集束抽樣調查法(stratified multi-stage cluster sampling)，抽樣機率以等比隨機抽樣(probability proportional to size, PPS design)方式，針對嘉義市東、西區，調查年滿十八歲以上成年人相關資料，其項目包括：嚼食檳榔及抽菸狀況；民眾對檳榔危害健康之認知程度及對嚼檳榔的態度、行為現況。研究結果共回收446份問卷，完成資料建檔後，以SAS統計軟體進行資料整理及SUDAAN進行統計分析。
結果發現，嘉義市18歲以上嚼食檳榔盛行率方面曾有嚼食習慣者為13.2%（男性26.3%，女性0.4%），而目前仍有嚼食習慣者為9.8%，由此推估嘉義市成年人口約有2萬4千人左右曾有嚼食檳榔習慣者，且以技術性工人為最高26.4%，檳榔嚼食者中達嚼食濫用者為52.5％，其嚼食濫用的行為與性別、年齡層及婚姻狀態都有相關，男性年齡為50歲以上較容易成為嚼食濫用高危險群，而職業與教育程度則與此無關。
吸菸盛行率方面，曾有吸菸習慣者為27.1%（男性51.1%，女性3.6%），目前仍有吸菸習慣者為24.6%（約4萬人），在曾有吸菸習慣者中以技術性工人為最高41.3％。教育程度對吸菸狀態均有影響，而抽菸行為並不會因工作種類而有不同。一旦吸菸後戒者少，維持者多。在抽菸方面，需針對18-34歲間男性，職業類別以半技術、非技術、無業等高危險群做推廣戒菸教育。
一般民眾在檳榔/菸物質使用上，以同時使用檳榔/菸為11.7％，單獨使用檳榔為1.6％，單獨使用菸為15.5％；由此發現不良習慣由抽菸開始，接著有嚼食檳榔習慣。在嚼食檳榔習慣的比例，隨著教育程度的升高，從曾嚼食者變為習慣者的比例下降幅度更為明顯。而戒食檳榔後有一半以上（57.7％）無任何症狀，有戒斷症狀者以口乾舌燥為最高19.7％，其次為精神不集中16.5％。在嚼食檳榔方面，應針對男性（98.3％），年齡層35-49歲（42.4％），婚姻為已婚（62.7％），教育程度為國初中畢業（32.2％），職業類別以半技術、非技術、無業（57.7％）等高危險群作檳榔戒食教育。
在口腔癌前病變黏膜顏色的認知方面（回答白色）僅為12.8％，有一半以上民眾回答不清楚為62.5％。在嚼食檳榔的認知平均分數為49.9分（滿分為100分），在嚼食檳榔的態度平均得分為3分（總分為5分）。
本研究顯示嘉義市地區民眾對於檳榔認知明顯不足，所以應加強健康意識宣導，並針對高危險群作篩檢與找出嚼食檳榔者達濫用及阻礙戒斷成功之原因，提供有效戒食檳榔計畫，以達協助大多數已習慣且持續嚼食者戒食檳榔成功之目標。

關鍵字

嚼食檳榔 ； 吸菸 ； 盛行率 ； 嚼食檳榔認知與態度

並列摘要

Abstract
In order to understand the prevalence rates of chewing betel quids and smoking cigarettes in Chiayi City, and to collect the recognition and attitude of population to betel quids, a stratified multi-stage cluster sampling was designed with sampling probability proportional to size (PPS design) to investigate the related data for adults above 18 years old in east and west areas of Chiayi City. Each participant received a personal interview, and questions included: the status of chewing betel quids and smoking cigarettes; the recognition degree of population to danger caused from betel quids, and their attitude and behavior to betel quid chewing. There were totally 446 questionnaires. The data was organized by SAS and analyzed by SUDAAN.
From the results, the prevalence rate of having chewing betel quids habit in their lifetime was 13.2% (men 26.3%, women 0.4%), and 9.8% were current chewers. It was estimated that about 24,000 adults in Chiayi City ever had the habit of betel quid chewing. Among them, most were technical workers(26.4%). For those who had the habit of betel quid chewing, there were 52.5% abusers. Such behavior was related to sex, age groups and martial status. For men above 50 years old, they more easily became abusers. Occupation and education were not related to abuse.
In prevalence rates of smoking cigarettes, 27.1% had cigarette smoking habit in their lifetime (men 51.1%, women 3.6%), and 24.6% were current smokers (about 40,000 persons). Among them, most were technical workers(41.3%). Education was associated with cigarette smoking behavior, but this behavior was not different in various kinds of jobs.
In terms of the betel quid chewing and cigarette smoking behavior, 11.7% used them at the same time, 1.6% only used the betel quids and 15.5% only used the cigarettes. It was found that bad habit started from smoking cigarettes, following was chewing betel quids. Considering stopping the chewing habit, half (57.7%) of the chewers didn’t have any syndrome after they stopped betel quid chewing. For those who had syndromes, most were thirty(19.7%) and lost concentration(16.5%) was second.
For the recognition of membrane color in oral precancerous lesion, only 12.8% answered white color, more than half answered unclear(62.5%). The average score of recognition to chewing betel quids was 49.9 (total 100), and the average score of attitude to chewing betel quids was 3 (total 5).
This study showed that population in Chiayi City didn’t have enough recognition to the hazard effect of betel quids; hence, the oral health education should be promoted. Besides, we can screen the high-risk population and find the reasons for which they abused and failed to stop chewing. Furthermore, one can develop effective program for cessation of betel quid chewing and smoking.

並列關鍵字

chewing betel quids ； smoking cigarettes ； prevalence recognition and attitude to chewing betel quids

參考文獻

參考文獻

1. 黃萬傳、潘潻進、鐘鎮東。台灣地區檳榔產業之經濟研究。屏東農業學報1991；32：213-229。

2. 李蘭。台灣地區成人對慢性疾病之知識態度及保健行為研究。民國八十三年。

3. 黃萬傳、潘添進、鍾震東。台灣地區檳榔產業之經濟研究。行政院農業委員會研究報告1990。

4. 陳少卿。嚼食檳榔、抽菸及喝酒對口腔癌病變自然病史之流行病學研究。疾病管制局流行病學專業人員訓練班結業論文2000；9-10。