台灣地區20歲以上民眾二手菸暴露社經地位差異分析

Thesis of Master, Department of Public Health, Chung Shan Medical University

陳詩婷(Shih-Ting Chen)

指導教授 ： 陸玓玲

中山醫學大學/健康管理學院/公共衛生學系碩士班/碩士(2013年)

摘要

目的：透過分層分析，探討台灣地區20歲以上民眾二手菸暴露之社經地位差異。
方法：以2004-2008年國民營養健康狀況變遷調查中20歲以上非學生民眾（4510人）進行次級資料分析，依變項為受訪者自述過去二手菸暴露狀況（分為「有/無」及「暴露時數」），社經地位係以受訪者自述之教育程度、個人及家庭收入為指標，以整體及分層方式進行邏輯斯迴歸分析，並以多變項迴歸分析探討暴露時數與社經地位之關係。
結果：控制人口學變項後，整體二手菸暴露與教育程度（不識字、小學、國中及高中職之二手菸暴露率皆顯著高於大專及以上）、工作（有工作之暴露率高於無工作者）有關。分層分析發現：非吸菸者及非吸菸女姓之整體二手菸暴露仍與年齡層、教育程度及工作狀況呈現相同之關聯性，再以工作狀況分層，非吸菸無工作之女性，二手菸暴露在控制年齡層之後仍與其教育程度有關。針對有二手菸暴露者之多變項分析結果同樣發現二手菸暴露量與教育程度有關。
結論：台灣地區成人之二手菸暴露比率及暴露量呈現顯著之教育程度差異，建議未來應瞭解教育程度較低族群之相關環境（包括工作、活動空間與家庭）的菸害暴露狀況，並進行相對之預防保護政策與措施，以減少此種社會地位之健康危害差異。

關鍵字

性別 ； 社經地位 ； 二手菸暴露

並列摘要

Study purpose: The study purpose was to evaluate the differences of socioeconomic status among Taiwanese with more than 20 years old by using the stratified analysis.
Methods: Study subjects with more than 20 years old, whose were not students, were recruited from Nutrition and Health Survey in Taiwan (NAHSIT), 2004-2008 (n = 4510) to conduct the secondary analyses. The dependent variables was exposure to second-hand smoke (null/non-null and hour of exposure of second-hand smoke). Socioeconomic status was defined according to individual education, personal income, and household income. Using the logistic regression among the total subjects and stratified method, and multiple logistic regression was used to evaluate the relationship of hour of exposure of second-hand smoke and socioeconomic status.
Results: After adjusting the effects of demographics, exposure to second-hand smoke was related to individual education (subjects with individual education as non-education, elementary, junior high school, and senior high school had the significantly increased risk of second-hand smoke exposure than those with individual education as high college) and working status (subjects with working had the significantly increased risk of second-hand smoke exposure than those without work). In stratified analyses, exposure to second-hand smoke was related to age, individual education, and working status among the subjects without smoking and females without smoking. Further, after adjusting the effect of age, exposure to second-hand smoke was related to individual education among the females without smoking and working. This relationship was also observed among the subjects with exposure to second-hand smoke.
Conclusion: the differences of proportion and hours of exposure to second-hand smoke were significant in the different individual education among Taiwanese. We suggested to understand the environment of exposure to second-hand smoke (including working, living space, and family space) in the subjects with lower education status. Further, using the preventive and protective polices to reduce the difference of healthy risk of socioeconomic status.

並列關鍵字

gender ； socioeconomic status ； exposure to second-hand smoke

參考文獻

1. WHO Report on the Global Tobacco Epidemic, 2009:Implementing

Somke-Free Environments:World Health Organization;2009.

2. Morbidity and Mortality Weekly Report ,Women and Smoking: A

Report of the Surgeon General: CDC;2002.

3. Mattias O, Maritta SF, Alistair W, Amando P, Annette , Pruss U. Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries, The Lancet 2011;377:139-346.