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  • 學位論文

影響戒菸國中生持續戒菸行為之相關因素探討

Determinants of smoking cessation sustainability among formerly smoking junior high school students in Taiwan.

指導教授 : 廖宏恩
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摘要


背景與目的:現今吸菸的健康危害已經由許多研究證實,各國的菸害防制措施也持續增加,然而全球菸癮人口比例仍居高不下,吸菸族群年輕化與一定比例的青少年仍持續吸菸的現象更是令人憂心。依據行政院衛生署國民健康局於民國93、95年針對國中生吸菸行為調查研究發現:吸菸國中生盛行率,在民國95年為7.5%(男性9.64%,女性4.69%)較民國93年6.53%(男性8.5%;女性4.2%)有增高的現象;民國95年27.18%的國中生表示曾有吸菸的經驗 (男生31.39%,女生21.96%),相較於民國93年27.04%(男生31.49%,女生22.01%)也略有小幅上升的趨勢,且兩年調查皆有超過三成以上的吸菸者始於10歲前開始吸第一根菸(95年36.57%,93年38.94%)。鄭秀月(2009)研究指出國內成人菸害防制透過門診、以尼古丁替代療法進行,戒菸成功率85.7%,持續戒菸行為者為47.3%;許多針對青少年菸害防制研究則多偏重於如何預防青少年吸菸,或如何提高吸菸青少年開始戒菸的動機,然而對於正在戒菸中的青少年如何持續戒菸的研究卻所知不多。因此,本研究將探討影響戒菸國中生持續戒菸行為相關因素。 方法:以行政院衛生署國民健康局「民國95年國中學生吸菸行為調查」次級資料庫中3489名正在戒菸國中生為分析對象,引用「三元影響理論」為分析架構,利用統計軟體SPSS 12.0進行卡方檢定與階層邏輯斯迴歸分析,探討個人、家庭朋友、學校社區等層次對正戒菸中國中生戒菸持續度的相關影響。 結果:影響戒菸國中生持續戒菸行為超過一年的因素,個人層次有「高自我效能」(OR=2.007)、「低菸癮程度」(OR=1.962)、「贊同校規禁菸態度」(OR=1.693)、「自覺吸菸者朋友較少」(OR=1.649);家庭朋友層次有「拒絕好友給菸同儕壓力」(OR=3.838)、「父母都無吸菸」(OR=1.308);學校社區層次則為「未暴露於校園二手菸環境」(OR=1.228)。本研究預測戒菸國中生戒菸持續一年以上的準確率為75.0%。 討論與結論:推廣戒菸國中生持續戒菸行為的應用上,個人層次方面,我們建議增強戒菸國中生自我效能與降低尼古丁依賴;家庭好友層次,建議注意其與吸菸好友互動情形、加強身旁不吸菸好友的支持,並呼籲無菸家庭的持續宣導;學校社區環境政策層面,期待國中校方更加落實校園完全禁菸政策,與提供師生多元戒菸諮商服務。

並列摘要


Background and purpose: Nowadays the health hazards of smoking has been confirmed in many studies. Various tobacco control measures have continued to increase worldwide. However, the proportion of the world's smoking population still remains high. Smoking population becomes younger in average age and a certain proportion of younger teenagers continue to smoke make us worry. According to the junior high school students smoking behavior survey conducted by Bureau of Health Promotion, the smoking prevalence rate of this population had increased from 6.53%(males 8.5%, females 4.2%) in 2004 to 7.5%(male 9.64%,female 4.69%) in 2006. When it comes to the experience of smoking initiation among junior high school students, 27.18% in 2006(male 31.39%, female 21.96%) also edged slightly upward trend, compared to 27.04% in 2004 (male 31.49%, female 22.01%).Furthermore, more than 30% smokers ignited their first cigarettes before the age of 10 in both years (36.57% in 2006, 38.94% in 2004).At present, the research of Hsiu-Yueh Cheng indicates that tobacco control for adult smokers is through clinic nicotine replacement therapy which leads to the smoking cessation success rate of 85.7% and sustainable rate of 47.3%. For youth tobacco control, researches have emphasized more on how to prevent the youth from smoking and how to motivate young smokers to quit. Nevertheless, how to maintain the smoking cessation behavior of the youth is not well known. Therefore, this study will examine the determinants of smoking cessation sustainability among formerly smoking junior high school students in Taiwan. Methods: Derived from the database of the junior high school students smoking behavior survey in 2006 conducted by Bureau of Health Promotion, 3489 junior high school students are analyzed. Referencing to "Theory of triadic Influence" as the analytical framework, this study used statistical software SPSS12.0 for chi-square test and hierarchical logistic regression analysis to explain continuous abstinence behavior of junior-high-school smokers on the individual level, family and friend levels, school and community levels. The results: For formerly smoking junior high school students whose smoking cessation sustainability more than one year, influencing factors in individual perspectives were "high self-efficacy" (OR =2.007), "low addiction level" (OR = 1.962), "attitude toward smoking free policy in campus " (OR = 1.693), "high conscious of social relations" (OR = 1.649), "self-perceived fewer friends for smokers" (OR = 1.309). Factors in friends and family perspective were "refusing cigarettes from good friends" (OR = 3.838), "parents do not smoke" (OR = 1.308). Factors in the school and community perspective was "No exposure to second-hand smoke in campus" (OR = 1.228). Conclusions and recommendations: Based on our findings, the strategies that Encourage formerly smoking junior high school students to maintain smoking free are as follows: At individual level, we recommend students to reinforce their self-efficacy capability and find ways to decrease the dependency of nicotine addiction. At family and friend level, we recommend students to manage the relationship with smoking peers as well as win the support of non-smoking peers. Meanwhile, it is necessary to propagandize "Smoking free in Family" as a campaign issue. At school and community level, we are looking forward the proper implementation on anti-smoking policy on campus, and multiple services of smoking cessation counseling.

參考文獻


行政院衛生署國民健康局(2004)•國中生吸菸行為調查•行政院署國民健康局,台北。
行政院衛生署國民健康局(2006)•國中生吸菸行為調查•行政院署國民健康局,台北。
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行政院衛生署國民健康局(2008)•台灣菸害防制年報•行政院署國民健康局,台北。

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