青少年吸菸及戒菸之探討-- 以高雄市八所國中高中職學校學生為例

The Study of Adolescent Smoking and Cessation of High School Students in Kaohsiung City

邱鈺雯(Yu-Wen Chiu)

指導教授 ： 劉宏文 ； 莊弘毅

高雄醫學大學/健康科學院/公共衛生學研究所/碩士(2005年)

摘要

研究目的：(1)探討高雄市青少年吸菸之盛行率。(2)青少年抽菸學生之人口學特徵、抽菸行為探討、影響抽菸行為之因素探討。(3)評值菸害教育課程對青少年之菸害認知及吸菸相關資訊的成效。(4)青少年戒菸班的研究，包括與抽菸有關的生理、心理的檢查。(5)評值戒菸介入計畫的成效。
研究對象及方法：選取高雄市4所國中及4所高中高職的學生，進行吸菸盛行率及菸害認知的調查，並為學生安排加強菸害認知的課程，同時以問卷方式評估宣導前及宣導後的菸害認知差異。另外為吸菸的青少年成立戒菸班，以認知改變的教學方法(課程式戒菸班)或認知行為改變團體(團體行為治療)兩種不同模式之戒菸班來幫助吸菸學生戒菸，並在戒菸教育前後，進行生理(包括吹氣一氧化碳、肺功能、及血清尼古丁代謝物濃度分析)、心理(簡式症狀量表)、及吸菸相關資訊的分析，並評估戒菸之成效。
研究結果：有固定吸菸行為的國中男性吸菸率為2.4%，國中女性吸菸率3.0%；高中職生有固定吸菸行為的男性吸菸率15.1%；女性1.0%。青少年之父親吸菸率為48.2%，母親吸菸率為2.6%，父母親都不吸菸的比率為48.7%。青少年吸菸學生的戒菸意願偏低，有戒菸意願者佔18.7%。菸害認知的調查方面，在菸害教育前和菸害教育後，菸的成分(包括尼古丁、焦油、及一氧化碳)、以及吸菸會造成心血管疾病這幾個題目，宣導後的正確答題率顯著高於宣導前。吸菸學生的研究方面：血型研究顯示，A型與B型血型之青少年比例與一般人口(以高雄縣市、屏東縣市及澎湖縣人口的ABO血型盛行率)之血型分佈明顯不同，A型比例偏低，而B型比例偏高。簡式症狀量表評估結果顯示，吸菸學生與一般學生在焦慮指標與憂鬱指標都有顯著差異。吸菸國中生在焦慮指標及精神指數總合明顯比吸菸之高中職生嚴重。戒菸班之前的生理評估顯示，肺功能與吸菸學生的年紀有相關，年齡越大肺功能越好，而與吸菸年數無關。由吹氣一氧化碳前後差以及血清尼古丁及其代謝物濃度分析之前後差的結果顯示，高中生之戒菸成效比國中生好。比較不同模式戒菸班之戒菸成效，在調整家人抽菸與否、以及情緒等因素後，顯示認知行為改變團體(團體行為治療)之戒菸成效較好，為課程式戒菸班戒菸成效的將近4倍。本研究結果期望能提供國內學者對於青少年吸菸行為及戒菸方法有更深入的了解，並在未來預防吸菸及戒菸教育的規劃上，能達到事半功倍的效果。

關鍵字

青少年 ； 吸菸率 ； 菸害認知 ； 戒菸班 ； 肺功能 ； 尼古丁 ； 戒菸成效

並列摘要

Purpose: (1) To evaluate the smoking prevalence of adolescents in Kaohsiung. (2) To search the demographic data, smoking behavior and the influence factors to smoking behavior of adolescent smokers. (3) To evaluate the effects of against-smoking program for adolescents. (4) To evaluate the physical and psychological aspects of adolescents who involved in the smoking-cessation program. (5) To evaluate the effects of smoking-cessation program.
Materials and Methods: The subjects of this study were consisted of students from 4 senior high school and 4 junior schools in Kaohsiung. Students were assessed smoking prevalence and knowledge of cigarette hazard by the questionnaires before and after the intervention. Then the knowledge of cigarette hazard and education programs was arranged for all of the students. The second stage was to plan smoking-cessation programs or classes for the smoking students. The intervention for the experimental group included 4 weeks structured courses and counseling. Two models of programs were arranged including course model and cognitive-behavior groups. The physical and psychological aspects were evaluated including explored CO exam, lung function exam, nicotine metabolism examination (from serum), and BSRS (brief symptoms rating scale) examination before and after the intervention.
Results: The smoking prevalence of junior high school male students in our study is 2.4%, and the prevalence of junior high school female students is 3.0%. The smoking prevalence of senior high school male students is 15.1%, and the prevalence of senior high school female students is 1.0%. The fathers' smoking rate of the students is 46.8%, and the mothers' smoking rate is 1.0%. The parents' smoking incidence is 51.3%. The desire for smoking students to quit cigarette smoking is low in our study. Just 18.7% of the smokers has desire to quit smoking. Besides, the quit smoking desire of senior high school smoking students is lower than which of junior high school students. The evaluation for adolescent students about the knowledge of smoking hazard revealed that there is significant difference before and after the education programs. The results after programs are better than the exam before programs in some aspects like cigarette components (nicotine, tar, CO) and cardio-vascular disease results from smoking. According to the evaluation from BSRS, the anxiety scales and depression scales of smoking students are different from that of non-smoking students. Anxiety scales and total psychological scales of junior high school students are higher than those of senior high school students. The physical evaluation before smoking cessation programs revealed that there are correlations between lung function and ages of smoking students. The larger the ages, the better the lung functions. There is no correlation between lung function and smoking-years. The difference in explored CO and in serum nicotine metabolism exam before and after the smoking-cessation program revealed that the cessation outcomes of senior high school students are better than junior high school students. To compare the cessation outcomes between two different models of classes, it revealed that the outcome of cognitive-behavior groups is better than that of course models after modifying the smoking condition of parents and mood problems. The cessation outcome of cognitive-behavior groups is four times of that of course models. Our study hopes that we can provide for adolescent educator our experience about knowledge of adolescent smoking behavior and cessation programs. We hope that we can yield twice the result with half the effort on smoking hazard prevention in the future.

並列關鍵字

smoking prevalence ； Adolescent ； knowledge of smoking hazard ； lung function ； smoking-cessation program ； effects of smoking-cessation program. ； nicotine

參考文獻

參考文獻

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