成年吸菸者戒菸行為因素探討

Associated Factors of Quitting Behavior among Adult Smokers

張博雅(Po-Ya Chang)

指導教授 ： 陳品玲

臺北醫學大學/護理學院/護理學研究所/碩士(2011年)

摘要

戒菸是種行為改變的方式，達到戒菸的成效，必須找出影響戒菸行為的因素，許多研究發現透過禁菸規定、戒菸服務及避免暴露於環境吸菸氛圍可以有效減少菸品之使用，但其大多是針對少數樣本或特定的個案進行介入研究，較難得知臺灣地區的全貌，基於調查單位、研究方法及研究指標不一致，要進行趨勢變化分析有其困難性，因此，國民健康局自2004年起進行系列電話訪問調查我國成年人吸菸相關行為。
　　本研究經由國民健康局授權取得2004年至2007年「成年人吸菸行為調查」資料庫，透過以SAS9.2套裝軟體進行描述性統計、Chi-Square test、Logistic Regression分析2004年至2007年「成年人吸菸行為資料庫」，依照分析樣本條件「自述一生吸菸超過五包（約100支）之吸菸者」，探討菸品使用行為相關變項、自覺環境吸菸氛圍、禁菸規定及戒菸服務與戒菸經驗之關聯。
　　本研究發現，吸菸者的戒菸行為及戒菸嚐試呈現逐年上升的趨勢，戒菸行為由2004年（20.97%）提升至2006年26.06%，戒菸嚐試由2005年的40.73%提升至2007年的43.86%。不同性別、年齡、婚姻狀況、教育程度、家庭收入及工作狀況與區域別之戒菸行為與戒菸嚐試達統計上顯著差異。環境吸菸氛圍方面，不論是家庭或工作場所，自覺有暴露者其戒菸行為及戒菸嚐試顯著高於自覺無暴露者，隨著暴露天數越多，戒菸行為與戒菸嚐試越低。實習禁菸規定的工作場所隨著年代變化逐年增加，實施全面禁菸的工作場所，其吸菸者的戒菸率顯著高於工作場所沒有任何吸菸相關規定者（OR:1.76，95%CI：1.54-2.00）。吸菸者曾接受戒菸服務的比例逐年上升，且戒菸服務會顯著影響吸菸者之戒菸行為及戒菸嚐試。
　　本研究建議菸害防制策略應有性別差異，針對不同性別之吸菸者提供專門之戒菸服務，對於有戒菸嚐試之吸菸者，除了透過戒菸技巧訓練及戒菸協助外，應避免暴露於二手菸之環境誘惑。此外，應加強專業人士菸害防制教育，增強戒菸諮商之技巧，透過獎勵制度鼓勵醫護人員主動提供戒菸服務。政策方面，政府應擴大禁菸範圍至騎樓或整個社區，甚至將菸害防制法推行至家庭，減少家庭吸菸氛圍及環境二手菸之暴露。

關鍵字

戒菸 ； 環境吸菸氛圍 ； 禁菸規定

並列摘要

The primary of effectiveness of smoking cessation is the identification of the associated for smoking cessation. In order to achieve the effectiveness of smoking cessation, finding factors related to it is essential. Smoking ban, cessation program from health service and avoidance of smoking climate have been proved to be effective in reducing cigarette consumption. However, past studies were limited at small sample size or lack of population-based data. Inconsistency in investigating institution, study method and outcome indicators among studies made it difficult in further analysis of the trend. Therefore, the Bureau of Health Promotion has entrusted scholars to develop a comprehensive study of“Survey on the Smoking Behaviors of Adults”, and set up the database since 2004.
　　“Survey on the Smoking Behaviors of Adults”is a cross-sectional study, adults aged 18 and above were surveyed by telephone through the whole country of Taiwan. This study used “Survey on the Smoking Behaviors of Adults”database authorized by Bureau of Health Promotion to explore factors associated with cessation behavior. Adults who reported cigarette consumption more than 100 in life time were recruited in analysis. Data related to tobacco use, perceived social climate of smoking, smoking ban, cessation program use and cessation experience were mined. Descriptive statistics, Chi-Square test, logistic regression were performed using SAS version 9.2 to analyze data.
　　The trend of increasing cessation behavior and attempt of were found in the study, smoking behavior from 2004 (20.97%) increased to 26.06% in 2006, attempt in 2005 to 40.73% increased to 43.86% in 2007 .A significant difference in cessation behavior and attempt was also existed among different gender, age, marital status, education, household income and working conditions and the area. Adults who perceived exposure from smoking climate demonstrated higher rate of cessation behavior and attempt. Smoking prohibition in working place increased by year, and was associated with higher rate of cessation behavior (OR: 1.76,95% CI: 1.54-2.00). The proportion of accepted smoking cessation services was increased recently and was significantly associated with quit behavior and cessation attempt.
　　In conclusion, this study suggest gender-specified a smoking prevention program need to be developed, and the assistance to smokers who intend to quit in avoiding temptation from secondhand smoke exposure. Improving health providers’ tobacco prevention training and counseling skill in smoking cessation, and promoting health providers to contribute to cessation service also need to be emphasized. We also suggest the government to expand tobacco regulation to the arcades, the community, and even to home environment.

並列關鍵字

Cessation ； Social climate ； Smoking ban

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