青少年吸菸之個人、社區及環境相關因素研究

Individual, community and environmental factors associated with tobacco use among adolescents in Taiwan

梁育群(Liang Yu-Chun)

指導教授 ： 李子奇

國立臺灣師範大學/教育學院/健康促進與衛生教育學系/碩士(2019年)

https://doi.org/10.6345/NTNU201900465

摘要

研究目的
本研究主要目的為了解國內青少年目前吸菸行為及戒菸意圖之相關因素，以探討青少年目前吸菸行為與有戒菸意圖之預測因子。
研究方法
本研究納入101年台灣青少年吸菸行為調查的34,552位學生為分析樣本，解釋變項包含六大類變項(父母與同儕之影響、吸菸相關知識與態度、學校菸害課程與禁菸規定、二手菸暴露、菸商促銷與媒體廣告、菸品可近性)；兩個結果變項(目前吸菸行為及戒菸意圖)分別進行分析。以卡方檢定分析解釋變項與目前吸菸行為及戒菸意圖之雙變數相關性；以邏輯斯迴歸分析探討各個解釋變項相互控制後對青少年目前吸菸行為及戒菸意圖之預測力;以路徑分析探討預測因子對青少年目前吸菸行為之關係網絡。
研究結果
邏輯斯迴歸分析顯示性別、零用錢、父母及朋友抽菸、吸菸知識與態度、學校菸害課程、二手菸暴露、菸商廣告與促銷以及原住民人口數是青少年目前吸菸的預測因子。
以邏輯斯迴歸分析青少年戒菸意圖，在15歲以下的男女生當中，菸品可近性、戒菸原因與戒菸自信是戒菸意圖的預測因子；在15歲以上的男女生當中，菸品可近性、菸癮強度及戒菸原因是戒菸意圖之預測因子。
路徑分析顯示零用錢、二手菸暴露、父母及朋友抽菸、菸商免費提供菸品、原住民人口數，以及覺得在社交場合吸菸對於感覺自不自在沒有影響對青少年目前吸菸行為有顯著正向的影響；女性、學校菸害課程、覺得戒菸很難、認為吸菸之後再戒菸對身體有害，以及在社交場合吸菸感覺較不自在對青少年目前吸菸行為有顯著負向的影響。
結論
本研究採用PRECEDE 模式架構分析青少年目前吸菸行為及戒菸意圖之預測因子，在青少年目前吸菸行為的分析中發現，社會因素(原住民人口數)、行為及環境因素(菸商廣告與促銷、二手菸暴露)、及教育、生態因素(吸菸知識與態度、學校菸害課程、家庭與同儕)均是青少年目前吸菸行為之預測因子；在青少年戒菸意圖之分析中發現，社會因素(原住民人口數)、行為及環境因素(菸商廣告與促銷、二手菸暴露、菸癮強度)、及教育、生態因素(吸菸知識與態度、戒菸自信、學校菸害課程、菸品可近性、家庭與同儕、戒菸原因)均是青少年戒菸意圖之預測因子。
本研究結果可做為未來規劃青少年菸害防制策略及教育之參考，以預防及降低我國青少年吸菸問題。

關鍵字

青少年 ； 吸菸 ； 戒菸 ； 戒菸意圖 ； 邏輯斯迴歸 ； 路徑分析

並列摘要

Objectives:
The main purpose of this study was to understand the factors related to adolescent current smoking and smoking cessation intention in order to explore the smoking behavior of young people and the predictors of smoking cessation intention.
Methods:
The study included 34,552 students surveyed in the 2012 Taiwan Youth Tobacco Survey. The explanatory variables included six categories of variables (the influence of parents and peers, smoking-related knowledge and attitudes, school smoke courses, second-hand smoke exposure, smoker promotion and media advertising, smoking product proximity); two outcome variables (adolescents’ current smoking and smoking cessation intention) were analyzed separately. The chi-square test was used to analyze and explain the correlation between variables and adolescents’ current smoking and smoking cessation intention. Logistic regression analysis was used to explore the adjusted effect of explanatory variables on adolescents’ current smoking and smoking cessation intention after mutual controlling. Subsequently, path analysis was conducted to examine the pathway from predictors to current smokers.
Results:
Logistic regression analysis showed that adolescents’ current smoking was associated with gender, pocket money, parental and friends’ smoking, knowledge and attitude toward smoking, school anti-smoking education, second-hand smoke exposure, tobacco advertising, promotion and sponsorship, and indigenous population.
As for quitting smoking intention, Among 15 year-old or younger male and female adolescents, access and availability, quitting reasons and self-confidence of quitting were significantly associated with quitting smoking intention. Among over 15 year-old male and female adolescents, access and availability, level of cigarette addiction, and quitting reasons indicated significant associations with quitting smoking intention.
Path analysis illustrated second-hand smoke exposure, friends smoked, not feeling uncomfortable with smoking at social occasions, cigarettes free offering by tobacco company, parents smoked, indigenous population, and pocket money had strong positive direct effects on adolescents’ current smoking. Female adolescents, considering smoking then quit harmful, feel less comfortable with smoking at social events, school anti-smoking education, and feeling quitting smoking hard had strong negative direct effects on adolescents’ current smoking.
Conclusion:
This study adopted PRECEDE model to analyze adolescents’ current smoking and quitting smoking intention. With respect to adolescents’ current smoking, social factor (indigenous population), behavioral and environmental factors (tobacco advertising, promotion and sponsorship and second hand smoke exposure) and educational and organizational factors (knowledge and attitude toward smoking, family and peers and school anti-smoking education) were the predictors of adolescents’ current smoking. With respect of adolescents’ quitting smoking intention, social factor (indigenous population), behavioral and environmental factors (tobacco advertising, promotion and sponsorship, second hand smoke exposure and level of cigarette addiction) and educational and organizational factors (knowledge and attitude toward smoking, self-confidence of quitting, reasons of quitting, access and availability, family and peers and school anti-smoking education) were the predictors of adolescents’ quitting smoking intention.
The results of this study can be used for future planning strategies and education for juvenile smoke prevention to prevent and reduce the problem of smoking among young people in Taiwan.

並列關鍵字

adolescent ； smoking ； quit smoking ； quitting smoking intention ； logistic regression ； path analysis

參考文獻

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