| 摘要: | 根據世界衛生組織統計，每年全球平均有540萬人死於菸害，在台灣每年有超過18000人死於吸菸相關疾病，世界衛生組織（WHO）早於2003年5月通過國際「菸草控制框架公約」（簡稱FCTC）開放各國簽署，促進各國認知菸草對健康的危害，並積極推動菸害防制相關工作，保護當代與後代免於因菸草消費和接觸菸草煙霧而造成健康、社會、環境、經濟極具破壞性的影響。戒菸成效普遍不盡理想。本研究的目的是希望藉由第一線之戒菸諮詢服務參與觀點，嘗試探討戒菸諮詢服務之徵結或關鍵或困難點，亦提供戒菸政策上之建議。本案從不同戒菸諮詢服務環境下之戒菸衛教師與個案之互動關係、戒菸諮詢所面臨的阻力、當下戒菸計畫執行瓶頸，求教於包括高雄市醫療院所之戒菸諮詢服務之醫師、藥師、護理師及高雄市社區藥局之社區藥局藥事人員等各十位之戒菸衛教師。研究結果發現：1.戒菸衛教師的戒菸環境不同與資源不等導致輔導戒菸成效落差；2.戒菸衛教師的諮詢費用不足以引發從事該諮詢意願；3.菸品購得容易，宣導戒菸與.執行取締卻不易著力；4.戒菸個案因戒菸時間長，負擔相對較高，導致戒菸不易持續。當然，戒菸衛教師年資經驗、專業知識、諮詢態度、宣導海報…等，皆屬輔導戒菸成功與否之關鍵，其次戒菸衛教師人力不夠普及、戒菸經費受侷限、以及菸害專業教育的不一定落實強化等，均值得重視。因此，本研究建議酌增戒菸者藥品補助與戒菸衛教師之諮詢費用，取消戒菸者的部份負擔，以增加戒菸者及衛教師之投入誘因。
According to World Health Organization statistics, the annual global average amount of 540 million people die from tobacco, and at the same time there is more than 18,000 people die of smoking-related diseases in Taiwan. To protect present and future generation from consumption and exposure to the tobacco smoke which cause health, social , environmental and economic devastating impact, World Health Organization ( WHO ) has work through the international ‘’Framework Convention on Tobacco Control ’’ ( abbreviated as FCTC ) opened for signature to promote awareness on the health effect of tobacco and aggressively promote tobacco-control related work.But the effectiveness of smoking cessation is not that well in general.The purpose of this study is to learn the point of view from those who participate in the first-line smoking cessation consulting service to find out the keypoint, problem, difficulty and provide suggestion on smoking cessation policy. This paper learn three major thing from twenty smoking cessation educator who dedicate themselves in Kaohsiung medical institute, including doctor, pharmacist and nurse:1.The relationship between smoking cessation educator and cases in different circumstance. 2.The obstacle faced in smoking consulting service. 3.The difficulty when running the smoking cessation project. As the result, we can know things as follows: 1.The difference circumstance where smoking educator invole in and unequal resource can lead to the effectiveness gap between one another. 2.Not enough consulting fee can’t arouse interest of smoking cessation educator to invole themselves in. 3. The easily of tobacco purchase, but on the contrary, the advocacy in quit smoking and enforcement of restrictions are ineffective and poor. 4.The smoking needs time to get rid of, but at the same time ,long-period treatment also means cost more, this moften makes cases want to quit as the consequence.Of course, the ability and tools of somking educator,such as experience, expertise, consulting attitude and propaganda posters …etc, are all the key whether counseling cessation success or not. Secondly, the shortage of cessation educator, fund restriction, and the tobacco harm education enhancement is worth attention. Therefore, this study suggest that the increase fee of those wants to quit smoking medicine subsidy and smoking cessation counseling fee will reduce smokers’ co-payment and meanwhile will encourage more medical personnel to join the smoking cessation educator. |
