| 摘要: | 近年來台灣成年人的吸菸率已逐漸下降，但青少年的吸菸情況反趨上升。多數吸菸者表示第一次吸菸始於青少年時期。為了有效降低吸菸比率，我國自98年1月11日開始推行新的菸害防制法。國民健康局曾針對一般民眾進行菸害防制法認知調查，結果顯示民眾對於修正後之菸害防制法認知已達九成，但青少年族群對此健康政策的認知情況卻不明。故本研究以就讀於新營市學生為對象，調查青少年對於菸害防制法的認知情況、吸菸行為、二手菸暴露情況、吸菸態度以及對於菸品危害認知態度等相關議題。本研究參考相關文獻、吸菸態度量表及菸害防制法之條文內容改編成結構性問卷，研究母體為新營市國、高中生，抽選3所國中與2所高中，於各年級隨機抽選1~3班發出問卷，回收共計1,137份，有效回收率為97.89%。
研究結果顯示如下：（一）吸菸行為：曾吸菸的青少年有16.8%，吸菸的原因以好奇居多。男生有吸菸經驗者為23.8%，女生則為5.8%，性別與吸菸經驗已達顯著差異（p<0.001）。國中有吸菸經驗者為14.6%，高中則為20.3%，在不同學習階段也具有顯著差異（p<0.01）。進一步分析得知，吸菸者開始吸菸的平均年齡為11.4歲，而在少年福利法界定青少年之年齡間（12~18歲）第一次吸菸的情況高達56.6%。不同吸菸經驗在自覺成績上也具有顯著差異（p<0.01），以未吸菸者自覺成績較好。（二）二手菸暴露情況：家中同住親友吸菸比例高達58.3%，以父親居多，其次為爺爺或外公。和從未吸菸者比較起來，有吸菸經驗之青少年在家中暴露於二手菸的頻率較高（p<0.01）。(三)菸害防制法的認知：從未吸菸者對於菸害防制法的認知良好，但不同性別與學習階段對菸害防制認知並無明顯差別。(四) 吸菸態度：女生、國中生和從未吸菸的青少年對吸菸的態度比較正向。(五)菸品危害認知態度：男生和有吸菸經驗的青少年認知較低，國、高中生之間則無顯著差異。（六）菸害防制相關調查：青少年取得菸害防制法相關資訊的方式以電視居多，其次為學校教育。對於新推行的菸害防制法之成效多數青少年認為普通，僅有20.2 %認為成效良好。（七）影響吸菸行為的因素：整體模式以性別、吸菸態度、以吸菸舒緩壓力的意向、是否有同住吸菸親友以及在校內是否看過同學吸菸可以顯著的解釋新營市青少年吸菸行為。針對上述結果，本研究提出相關建議，以作為未來推動菸害防制活動的參考依據。
The numbers of smoker in Taiwan declined gradually in recent years; however, adolescent smoking is increasing. Most smokers admitted that for the first time they tried smoking was in their adolescence. To suppress smoking effectively, a new law was launched on January 11, 2009 by Bureau of Health Promotion (BHP) namely Tobacco Hazards Prevention Act (THPA). A national survey of THPA Cognitive for adults in Taiwan by BHP showed that 90% people were well aware while the cognition in adolescence remains unknown. The objective of this study is to investigate the adolescent, who enrolled in Junior/Senior High Schools in Sinying City, for their smoking behavior, cognition and understanding of THPA, smoking attitude, tobacco hazards cognitive attitudes, and related issues about tobacco control.
Cross-sectional study was carried out by a structured questionnaire which was designed according to reviewing relevant literature references, Attitudes Towards Smoking Scale (ATS-18) and the Provisions of THPA. Three junior and two senior high schools in Sinying City were selected, and 1 to 3 classes of each grade were randomly selected. 1,137 questionnaires were issued and the valid ones were 1,113 (97.89%).
The results showed that: (1) Smoking behavior：16.8% adolescents had tried smoking. The main reason for smoking was curiosity. Boys (23.8 %) had significantly higher smoking rate than girls (5.8 %, p<0.001). Smoking rate of senior high school students (20.3 %) was higher than junior high school students (14.6 %, p<0.01). The initiation age of smoking was 3-18 years, and the average was 11.4 year-old. Students with better academic achievement had lower smoking rate. (2) Secondhand smoke exposure： More than fifty percent students were lived with smoking relatives, who were mostly their father, secondly, grandfather and the third, grandfather in law. Adolescents with smoking experience had more secondhand smoke exposure than nonsmokers at home. (3) Cognition of THPA： Nonsmokers had better cognition on THPA, and there were no gender or learning phase difference. (4) Smoking Attitude： Girls, Junior high school students, or non smokers were more positive in Smoking Attitude. (5) Cognition of Tobacco Hazards： Boys or smokers had lower cognition (p<0.01), however, there was no significant difference between senior and junior high students. (6) THPA related issues： Students received major THPA information from TV, followed by school education. Most students agreed that the implementation and effect of new THPA were fair, only 20.2% recognized as good. (7) Effective factors on smoking behavior： Logistic regression showed that gender, smoking attitude, intention of smoking for relieving stress, living with smoking relatives and a glimpse of schoolmates smoking in school significantly affect the adolescents’ smoking behaviors. According to these results, discussion and commends were made for the reference of BHP in promoting future activities of tobacco control. |
