比較不同菸品健康福利捐對目前吸菸者的戒菸意圖 及吸菸行為變化之差異—以台北市萬華區為例

To Compare Difference of Smoking Cessation Intension and Smoking Behavior After Raising Tobacco Health Welfare Tax in Wanhwa,Taipai,Taiwan

江曉惠(Shiau-Huei Jiang)

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)

https://doi.org/10.6831/TMU.2011.00042

摘要

世界衛生組織(WHO)指出「落實無菸環境」與「大幅提高菸價」是促成癮君子戒菸、減少菸品消耗量及降低青少年吸菸率最有效的方式。是故國內自98年1月11日起擴大施行禁菸場所，包含公共場所及三人以上共用之室內工作場所全面禁菸外；並於同年6月1日起，立法院三讀通過菸品健康捐第三次調漲，亦即目前國外進口或國內製造的菸所課徵的健康福利捐均由每包菸10元調漲為20元，以呼應WHO的控菸政策。本研究採橫斷式研究設計(cross-sectional study design)，以自擬之結構式問卷調查方式，採配額選樣(quota sampling)方式，收集718名台北市萬華區吸菸里民，對於菸品健康福利捐再度調漲，是否會改變其戒菸意圖及吸菸行為。除分析98年菸品健康福利捐調漲20元後，基本屬性、健康福利福捐之認知、公共場所禁菸規定之主觀認知對吸菸者戒菸意圖與吸菸行為之關聯外，亦比較95年、98年菸品健康福利捐兩次調漲對吸菸者戒菸意圖與吸菸行為變化的差異。本研究結果顯示：
一、年齡18~44歲、過去一個月沒有每天吸菸者及平均吸菸在10支以內者嘗試戒菸的比例顯著較高。
二、教育程度低者、無工作者、個人平均月收入小於40,000元、家庭月收入小於80,000元、購買每包菸品價格在65元以下者之吸菸行為改變比例顯著較高。
三、有三成七之目前吸菸者同意政府為了民眾的健康繼續調漲菸價，且同意者之戒菸意圖比例顯著高於不同意者。
四、2009年菸品健康福利捐調漲20元後之吸菸行為變化比例顯著高於2006年菸品健康福利捐調漲為10元，其中以購菸習慣改變最顯著。
五、「三人以上公共場所全面禁菸規定」實施後，目前吸菸者約九成以上願意配合規定。另外，願意配合規定者之戒菸意圖比例顯著高於不配合規定者。
根據本研究結果建議：
臨床實務方面，除了增加菸捐外，應視低社經之社區特色，推動各種戒菸宣導及增加吸菸者接觸有關戒菸訊息，以促使吸菸者妥善利用戒菸服務。在政策方面，建議持續調漲菸稅價格並定期檢討調漲後預期性或非預期性的影響外，相關配套措施亦能落實，如查緝私菸及禁菸規定。此外；運用與基層醫療合作如診所、藥局，以提供需要戒菸之家庭，提供政府相關單位在制定菸害防制政策時之參考用。未來研究除了持續監測菸品健康福利捐的課徵對戒菸意圖及吸菸行為變化間的關連外，建議探討吸菸者的成癮程度，比較不同程度之菸癮者，於提高菸稅後其戒菸意圖及吸菸行為之變化。以及後續研究者可以區分不同性質的行業，深入探討「三人以上室內公共場所全面禁菸規定」對其戒菸意圖與吸菸行為變化為何。對於低社經女性吸菸動機與其背後社會脈絡尚進一步研究。

關鍵字

戒菸意圖；吸菸行為變化；菸品健康福利捐；禁菸規定

並列摘要

The WHO pointed out that “Constructing no smoking environment” and “Increasing tobacco sale price” were two effective ways of quitting smoking, reducing teenager smoking and tobacco consuming rate. Since 11, Jan. 2009 Taiwan government has extended the restricted area of no-smoking . Six months later, the government signed the third enhancement of tobacco consuming tax in echoing the advocacy of WTO to restrict smoking. A cross-sectional study design was conducted by using self-developed questionnaire and quota sampling for collecting 718 smokers in WAN-HUA district. The purpose of the research was to determine defining the influence of the higher tobacco consuming tax to the smoking behavior and quitting smoking intention of the smokers. Two independent variables of the enhancement the tobacco consuming tax and prohibition smoking in public area were explored for their correlations between dependent variables of smokers’ quitting intention and the smoking behavior. Also, a comparison between two enhancements of tobacco consuming tax in 2006 and 2009 were used to determine define the influence toward these two dependent variables. The results of the study were shown as：
1.The proportion of attempting to quit smoking among people between 18~44 and not smoking everyday in the past month, and less than 10 tobaccos, is significantly high.
2.The change of smoking behavior among people who are lower educated, workless, and with monthly income less than NT 40000, family monthly income less than NT 80000, and smoking tobacco in price lower than NT 65, is significant high.
3.37% current smokers agreeing with price increment policy based on publics health, who had significantly higher attempt to quit smoking than those who disagree.
4.The price increment of NT 20 in 2009 has significant impact to changing smoking behaivors and tobacco purchasing than the price increment of NT 10 in 2006.
5.More than 90% current smokers are willing to follow the policy of “none smoking in public area”, and their quitting smoking attempts are significant higher than those unwilling to follow.
Suggestions：
1.Not only use the tobacco price increment to decrease the smoking rate, but also advertise for those lower income communities.
2.Promote and circulate the message of quitting smoking facilitates.
3.Keep increasing the tobacco price, and follow through the policy of prohibition of smoking and tobacco smuggling.
4.Cooperate with local clinics and drug stores to provide aids for quitting person and family.
5.Compare the quitting attempts and behaviors of different addiction degree smokers after the tobacco price increment.
6.Suggest investigating different industry branches about the “None smoking in public area” over the quitting behaviors.
7.Depict the motivation and context of woman smoking.
Keyword：Quitting smoking attempt, Smoking behavior change, Tobacco-Health tax, Smoking prohibit policy.

並列關鍵字

Quitting smoking attempt；Smoking behavior change；Tobacco-Health tax； Smoking prohibit policy.

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