國際醫事人員戒菸訓練課程回顧

Review of International Medical Staff Smoking Cessation Training Courses

詹欣隆(Hsin-Lung Chan) ； 黃偉新(Wei-Hsin Huang) ； 張家禎(Betty Chia-Chen Chang) ； 黃麗卿(Lee-Ching Hwang)

《健康促進研究與實務》 2卷1期 (2019/01) Pp. 11-23

https://doi.org/10.29442/HPRP.201901_2(1).0002

摘要

世界衛生組織（Would Health Organization, WHO）2018全球菸草流行報告指出，菸害每年導致全球720萬人死亡（包括接觸二手菸引起的死亡），每五個死亡的人，就有一人和菸害有關，菸害是造成人類提早死亡及失能的主要原因，卻也是最能夠被有效預防的危險因子。在臺灣，每年約有2萬7,000名吸菸者死於吸菸及近2,600名非吸菸者死於二手菸害。因此我國透過菸害防制法的實施，提高菸稅，立法禁止，加強教育宣導，增強吸菸者戒菸意願，推廣戒菸服務政策，以期邁向WHO非傳染性疾病（Noncommunicable diseases, NCDs）2013-2020年減少30% 吸菸率之目標。我國自2002年起逐年推動醫事人員戒菸訓練，歷年合格受證的戒菸治療醫師近1萬四千人約占執業醫師數30.87％，超過兩千位牙醫師參與戒菸門診，藥事人員戒菸培訓人數計2,299人，戒菸衛教人員培訓人數計5,000人。至2018年總計有超過四千家各級醫療院所、牙醫診所及藥局投入戒菸服務。有鑑於我國醫師、牙醫師、藥師、衛教人員等戒菸訓練課程已施行多年，需檢視現行訓練課程及繼續教育課程內容，以提升戒菸訓練課程之品質及醫事人員參與戒菸服務意願。本研究回顧國際醫療相關人員戒菸訓練課程方式與內容，我們搜尋亞洲地區、歐洲地區、英國、美國各國網站，包含政府組織、醫院、學會或是學校網頁，關鍵字為戒菸訓練課程，共整理22個網站，依據課程名稱、實體課程、影音實境模擬、個案討論、網站e化課程、初階進階分類，以及是否頒給證書或是收費機制等做探討。比較國際戒菸訓練課程現況，其中e化課程規劃，重視個案討論、實境模擬教學最值得我國參考。建議積極做e化課程規劃，亦須重視個案模擬教學、新興菸品、戒菸服務體系、特殊對象（孕婦、青少年）議題。執行網路課程規畫與設計應採取互動式、實用性規畫，避免網路教學缺失而失去教育訓練目的，建議實體課程與e化課程相互搭配設計，以期更符合學員期望、有效率、普及全國的戒菸課程規劃。

關鍵字

教育 ； 戒菸訓練課程 ； 醫事人員

並列摘要

The World Health Organization (WHO) report on the global tobacco epidemic estimated that 7,200,000 deaths worldwide were caused by tobacco hazards (including exposure to second-hand smoke), and that one in five deaths was related to tobacco hazards. Tobacco hazard is one of the major causes of premature death, but is also the most preventable risk factor. In Taiwan, 27,000 smokers died from tobacco use and nearly 2,600 died from exposure to second-hand smoking. The Tobacco Hazard Prevention Act in Taiwan was implemented to fulfill the 2013-2020 WHO Noncommunicable diseases goal of decreasing tobacco use rate by 30% via efforts such as raising tobacco tax, prohibiting tobacco use, promoting public education, enhancing smoker's will to quit smoking, and promoting smoking cessation services. Since 2002, promotion of smoking cessation training course for healthcare professionals in Taiwan led to participation by nearly 14,000 certified physicians (30.87% of physicians in practice), 2,000 dentists, 5,000 pharmacists, and 5,000 smoking cessation educators. In 2018, over 4,000 medical facilities, dental clinics, and pharmacies were involved in providing smoking cessation services. In regard to the long-term participation from many healthcare professionals, smoking cessation training courses should be reviewed and revised in order to improve the quality of the services and increase the will of healthcare professionals to engage in smoking cessation. This paper reviewed international smoking cessation training courses for healthcare professionals by searching websites from Asia, Europe, the United Kingdom, and the United States using the keyword smoking cessation training course, and focuing on topics including the course title, actual classroom courses, visual reality simulation, case discussion, e-classes, level classification, certificate process, payment system; a total of 22 websites were used for comparison. E-classes, case discussion, visual reality simulation were aspects of the smoking cessation training courses most worthy of reference. Recommendations for revising the training courses in Taiwan include active planning of e-classes, use of visual reality simulation, and focusing on topics such as new tobacco products, smoking cessation services, and special populations including pregnant women and young adults. Online courses should be interactive and practical, so not lose their main teaching purposes. Actual classroom courses and e-classes should both be used in order for the program to be efficient and also meet the expectations of the participants.

並列關鍵字

Education ； Smoking Cessation Training Courses ； Healthcare Professionals