學生戒菸教育計畫成效之研究-以台北市立某高級中學為例

The Effects of Smoking Cessation Program for High School Students In Taipei

林宜蕙(Yi-Hui Lin)

指導教授 ： 李景美

國立臺灣師範大學/教育學院/衛生教育學系/碩士(2004年)

摘要

本研究的主要目的在於評價一套以跨理論模式為基礎的高中學生戒菸教育計畫，探討學校實施吸菸學生戒菸教育計畫對吸菸學生菸害知識、拒菸技巧、拒菸自我效能、戒菸決定平衡、戒菸改變過程、戒菸行為改變階段、尼古丁依賴程度、一氧化碳值、及日吸菸量的影響，並瞭解本研究的吸菸學生與輔導教師對於戒菸教育計畫的評價。
本研究設計採用「實驗組對照組前、後測實驗設計」。立意取樣台北市立某兩所完全中學之高一、高二吸菸學生為研究對象。實驗組學生接受連續六週、共十四小時的團體戒菸班課程，並於課餘時間由學校輔導老師提供三次個別化戒菸輔導；而對照組未接受任何介入，僅於問卷後後測完成後，發予菸害防制相關之衛教宣導資料。
實驗組與對照組於戒菸教育計畫介入進行之前、之後及六個月後進行問卷前測、後測、及後後測，藉此瞭解戒菸教育計畫介入之立即成效與延宕效果。資料處理與分析以費雪正確機率考驗、魏氏曼惠特尼考驗、及魏氏帶符號等級考驗進行統計檢定。
本研究主要結果敘述如下：
一、戒菸教育計畫介入，能使實驗組學生「戒菸知識」分數顯著地優於對照組，但「吸菸危害知識」分數則與對照組沒有顯著差異。
二、戒菸教育計畫介入，能顯著提升實驗組學生「拒菸技巧」分數，且進步分數顯著地高於對照組。
三、戒菸教育計畫介入，能顯著提升實驗組學生「拒菸自我效能」分數，進步分數顯著地高於對照組，且有延宕效果。
四、戒菸教育計畫介入，能顯著提升實驗組學生「戒菸改變過程」分數，進步分數顯著地高於對照組，且有延宕效果。
五、戒菸教育計畫介入，能顯著降低實驗組學生「尼古丁依賴程度」，且進步分數顯著地高於對照組。
六、戒菸教育計畫介入，能使實驗組學生在「戒菸行為改變階段」間有正向的移動。
七、戒菸教育計畫介入，能減少實驗組學生的「日吸菸量」。
八、實驗組學生與輔導教師對整體戒菸教育計畫多持正向的評價。
本研究結果可作為未來高中學校進行學生戒菸教育計畫、及衛生與教育主管機關推動學校戒菸教育之參考。未來相關研究可在本研究基礎下，進一步發展適宜台灣本土且具成效的青少年戒菸教育計畫，並探討其成效。

關鍵字

戒菸 ； 吸菸 ； 教育 ； 跨理論模式 ； 青少年 ； 學生

並列摘要

This study aimed at evaluating a transtheoretical model (TTM)-based smoking cessation program for high school students. It explored the impact of setting up smoking cessation program at school on the smoking students’ knowledge of smoking harm, cigarette-refusing skills, self-efficacy in refusing cigarette, decisional balance for giving up smoking, processes of change in giving up smoking, the stage of change in giving up smoking, the score of Fagerstrom test for nicotine dependence, the level of carbon monoxide (CO), and the daily smoking quantity, and tried to understand the smoking students’ and counseling teachers’ evaluation on this smoking cessation educational program.
Experimental design of the study adopted an “experimental group/control group, pre-test and post-test design.” First- and second-year students from two Taipei municipal comprehensive junior-senior high schools were chosen through purposive sampling as the subjects. The students in the experimental group received a 14-hour group smoking cessation course in six consecutive weeks and three sessions of individual smoking cessation counseling by counseling teachers during break time. In contrast, the control group received no intervention except the health education materials about prevention of smoking harm after finishing the post-posttest questionnaire.
Experimental group and control group were given pre-test, post-test and post-posttest questionnaires before, after and six months after the educational intervention of the smoking cessation program, in order to understand the immediate effect and delayed effect of the intervention of the smoking cessation program. The data were processed and analyzed by using the Fisher’s exact probability test, Wilcoxon-Mann-Whitney test, and Wilcoxon signed ranks test for statistical examination.
The main results of this study were as following:
1. The smoking cessation intervention program made a significant difference on the “smoking knowledge” of the experimental group students as contrast to the control group, but there was no significant difference between the groups in the scores of “knowledge of smoking harm.”
2. The smoking cessation intervention program significantly increased the scores of “cigarette-refusing skills” among the students in the experimental group, and their improvement in scores was also significantly higher than the control group.
3. The smoking cessation intervention program significantly increased the scores of “self-efficacy in refusing cigarette” among the students in the experimental group; their improvement in scores was also significantly higher than the control group, and a delayed effect was seen.
4. The smoking cessation intervention program significantly increased the scores of “processes of change in giving up smoking” among the students in the experimental group; their improvement in scores was also significantly higher than the control group, and a delayed effect was seen.
5. The smoking cessation intervention program significantly reduced “the scores of Fagerstrom test for nicotine dependence” among the students in the experimental group, and their improvement in scores was also significantly higher than the control group.
6. The smoking cessation intervention program brought about a positive tendency during “the stage of change in giving up smoking” among students in the experimental group.
7. The smoking cessation intervention program reduced the “daily smoking quantity” among the students in the experimental group.
8. The students in the experimental group and the counseling teachers mostly held a positive evaluation of the overall smoking cessation program.
Results of this study may be used as reference for senior high schools in conducting student smoking cessation programs, and for the health and education authorities in pushing forward school smoking cessation education. In the future, researchers may build on the basis of this study to develop an effective smoking cessation program which is suitable for adolescents in Taiwan, and to explore the effects of the program.

並列關鍵字

cessation ； smoking ； education ； Transtheoretical Model ； adolescent ； students

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