台北市某完全中學拒菸宣導活動對學生吸菸行為及其相關因素之影響研究

Effect Evaluation of Antitobacco Campaign on Youth Smoking Behavior and Related Factors

顏麗娟(Li-Jiuan Yen)

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評價校園拒菸宣導活動對學生吸菸危險因子、保護因子和吸菸行為之影響。採用準實驗研究法，選擇台北市二所市立完全中學，一為實驗組並自2003年進行一系列校園拒菸宣導活動，是台北市無菸校園輔導計畫之示範學校。而另一所學校為對照組且非為台北市無菸校園輔導之實驗示範學校。
隨機選取四個實驗學校班級和七個對照學校班級進行問卷施測。前測於九十二年十月進行，後測為九十三年五月進行，以二次皆填答完整個案才納入統計分析，總計國中實驗組63人，國中對照組90人，高中實驗組68人，高中對照組133人。
問卷內容包含三個層面，1.危險因子：（1）個人層面：未來一個月、六個月、一年、五年、二十年吸菸意圖。（2）家庭層面：父親、母親、兄弟、姐妹的吸菸情況（3）學校層面：老師吸菸情況和校園無菸環境知覺。（4）同儕層面：好友吸菸情況、同學吸菸、同學邀約吸菸情況。2.保護因子：（1）個人層面：吸菸態度、拒菸行為、拒菸自我效能、拒菸活動認同度。（2）家庭層面：父親、母親、兄弟、姐妹的吸菸態度。（3）學校層面：老師吸菸態度、校園無菸環境、訊息暴露程度。（4）同儕層面：好友吸菸態度、同儕參加拒菸活動比率。3.吸菸行為：過去一年吸菸行為、過去三十天吸菸行為。
本研究有以下發現:
一、受測學生具有良好保護因子包括：1.高度拒菸自我效能。2.不贊成的吸菸態度。3.重要他人的吸菸態度為不贊成。4.六成的校園無菸環境的項目被實施
二、受測對象危險因子分佈頻次不高：1.家人的吸菸情況以父親最嚴重（國中為62.8％，高中54.7％），其次為母親（國中為11.8％，高中11.5％），在其次兄弟、姐妹吸菸情況在5％以下。2. 吸菸意圖方面，國中和高中組皆有八成回答未來一個月、六個月、一年、五年、二十年不可能吸菸。
三、吸菸行為：國中組曾經吸菸盛行率為9.2％，高中為11.5％。過去一年吸菸率國中組為4％，高中組5％。過去三十天吸菸率國中組為2.7％，高中組3％。
四、高中實驗組於拒菸宣導活動後，控制前測的情況下，學校保護因子「拒菸訊息暴露」、「校園無菸環境知覺」和同儕保護因子「同儕參與拒菸活動比例」，皆顯著高於對照組。
五、國中組實驗組於拒菸宣導活動後，控制前測的情況下，學校保護因子「校園無菸環境知覺」和同儕保護因子「同儕參與拒菸活動比例」顯著高於對照組。
六、拒菸宣導活動後，控制前測的情況下，國中的實驗組和對照組以
及高中的實驗組和對照組，其危險因子（重要他人吸菸情況和吸
菸意圖）皆不因組別不同而有不同。
七、拒菸宣導活動後，控制前測的情況下，國中的實驗組和對照組以及高中的實驗組和對照組，其過去一年吸菸行為和過去三十天吸菸行為不因組別不同而有不同。

綜合上述，本研究校園拒菸宣導活動雖可有效增加學校和同儕的保護因子，但危險因子和吸菸行為並未因拒菸宣導活動介入而有所改變。建議未來實務和研究上可參考健康促進學校模式和危險和保護因子模式來設計拒菸宣導活動，持續推動宣導活動並輔以質性研究探求影響宣導活動成效因素。

關鍵字

學生 ； 拒菸 ； 宣導活動 ； 危險因子 ； 保護因子 ； 吸菸行為

並列摘要

The purpose of this study was to evaluate the effects of the antitobacco campaign on the smoking risk factors, protective factors,and smoking behavior among the youth. The research method was designed quasi-experiment and two composite high schools in Taipei City were selected. The experiment school had proceeded a series of campus antitobacco campaign during 2003-2004 school years.
Four classes in the experiment school and seven classes in control school were randomly selected for the research. The pre-test was administed in October, 2003 and the post-test was administed in May, 2004. Only the study cases that completed both tests were included in the statistics analysis. The subjects included: 63 students in the junior high experiment group, 90 students in the junior high control group, 68 students in the senior high experiment group and 133 students in the senior control group.
The questionnaire included three sections: The risk factors included: (1) individual factors: the smoking intention in the future one month, six months, one year, five years, and twenty years; (2)family factors: the smoking conditions
of father, mother, brothers ,and sisters; (3) school factors: smoking condition of the teachers; (4) peer factors: smoking condition of the peers and condition of the peer invitation to smoking.The protective factors included: (1) individual factors: the attitudes toward smoking , anti-tobacco behavior , self-efficacy of refusing tobacco use and identification of anti-tobacco campaign: (2) family factors: the smoking attitudes of the father, mother, brothers, and sisters；(3) school factors: teacher’s smoking attitudes ,the awareness of tobacco-free environment, and the degree of exposure to antitobacco information: (4) peer factors: peer’s smoking attitude and the rate of participation of antitobacco campaigns among peers.smoking behavior included: (1) smoking behavior in the past year, and (2)smoking behavior during the past thirty days.
The finds of the study were as follows:
1. The examined students had following the protective factors: (1) high self-efficacy of refusing tobacco use, (2) positive attitudes toward smoking,(3) important others with antismoking attitudes, and(4)The tobacco free activitives was to carry out well.
2. The students had the following risk factors: (1) The smoking prevalences of the family were in the following order: 62.8% fathers in the junior high group, 54.7% fathers in the senior high group, 11.8% mothers in the junior high group, and 11.5% mothers in the senior high group. Besides, the rates of brothers and sisters who smoked were below 5%. (2)There were 80% students reported they wouldn’t smoke in the future one month, six months, one year, five years, and twenty years.
3. In terms of smoking behavior, the results showed：(1) The lifetime smoking prevalence of the junior high group was 9.2%, and the senior high group was 11.5%. (2) The past year smoking prevalence of the junior high group was 4%, and the senior high group was 5%. (3) The past 30 days smoking prevalence of the junior high group was 2.7%, and the senior high group was 3%.
4. After the antitobacco campaign , the experimental senion high group were significantly higher then the control group in the following variables in the post-test under the control of pre-test condition: (1) The school protective factor “the awareness of tobacco-free environment”,and“ the degree of exposure to antitobacco information” ; (2) the peer protective factor “the rate of participation of antitobacco campaigns among peers”.
5. After the antitobacco campaign , the experimental junior high group were significantly higher then the control group in the following variables in the post-test under the control of pre-test condition; (1) The school protective factor “the awareness of tobacco-free environment”,and（2）the peer protective factor “the rate of participation of antitobacco campaigns among peers.
6. After the antitobacco campaign ,there were not diffrenent between experiment group and control group in the following variables in the post-test under the control of pre-test condition; the risk factors “the smoking condition of importan others”, “ the smoking intention in the future”,both in junior high group and senion high group.
7. After the antitobacco campaign, there were not diffrenent between experiment group and control group in the following variables in the post-test under the control of pre-test condition; “ the smoking behavior in the past year”,and “smoking behavior during the past thirty days”, both in junior high group and senion high group.
According to the study, after the antitobacco campaign some protective factors significantly diffrenent between experiment group and control group,However the risk factors and the smoking behavior did not show the same results. The future antitobacco campaign is suggested to be promoted and monitored. Additionally, the antitobacco campaign should be designed base on the risk factors and the protective factors of smoking behavior.

並列關鍵字

student ； antitobacco campaign ； risk factors ； protective factors ； smoking behavior

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