以名義團體技術探討高中職學生戒菸困難與支持需求之看法

Abstract

背景：高中職學生戒菸成功率偏低，因此，必須找出戒菸的困難與需求支持，提供未來相關策略擬定之參考，增加戒菸率。 目的：本研究為探討高中職學生戒菸困難的看法及需求支持之影響因素。 方法：本研究研究對象為臺北市某三所高中職學校在學且過去六個月內有吸菸行為的學生，共計50名，採取自填式問卷，透過名義團體的方式了解參與者對於戒菸困難與需求支持的看法；同時採用斯皮爾曼等級相關係數分析參與者的學制（高中vs 高職 ）、開始吸菸年齡（高中職以前vs 高中職之後 ）、每日吸菸量（每日吸菸量≦10支vs每日吸菸量≧11支）、尼古丁成癮程度（輕度 vs 中度以上）在戒菸困難與需求支持之看法的相關性。 結果：名義團體技術重要性排序顯示，學制組、開始吸菸年齡組、每日吸菸量組及尼古丁成癮程度組皆覺得「面臨壓力」是抗拒吸菸誘惑項目最困難的部分，其壓力源來自課業學習挫折、考試成績低落及長期不被家人與師長信任；「我的家人反對高中職學生吸菸，但是自己卻吸菸」是家人同儕的態度項目最困難的部分，原因為吸菸青少年對「家長要求孩子戒菸，自己吸菸卻不願意戒菸」之言行不一致的態度感到反感而不願意戒菸；「一起吸菸作樂」是同儕團體壓力項目最困難的部分，原因為吸菸青少年為了維持與吸菸同伴的友誼而不願意戒菸；「聽我訴說戒菸的困難」是最重要的情緒性支持，原因為吸菸青少年認為家人朋友能傾聽自己戒菸的困難，可以增強自己持續戒菸意願；「提供口香糖嚼食」是最重要的工具性支持，原因為吸菸青少年認為嚼食口香糖是最有效的戒菸工具；「信任的人給我建議」是最重要的訊息性支持，原因為吸菸青少年認為透過醫療專業人員的協助就能成功戒菸；「尼古丁戒斷症狀是暫時，而且是可以克服的」是最重要的評價性支持，原因為吸菸青少年認為只要克服尼古丁戒菸症狀就不會想抽菸；此外，不論是以學制、開始吸菸年齡及每日吸菸量來看，這些參與者皆覺得防止復抽項目最困難的部分是「出現想吸菸的念頭」；而尼古丁成癮輕度與中度以上參與者則表示，防止復抽項目最困難的部分是「出現煩躁易怒、注意力不集中｣，原因為戒菸會讓吸菸青少年出現焦慮不安的戒斷症狀，因此想以吸菸方式來緩解。斯皮爾曼等級相關係數分析結果顯示，不論是高中或高職學制、開始吸菸年齡先後、每日吸菸量多寡及尼古丁成癮輕中度來看，其團體壓力與訊息性支持皆達到顯著相關。 結論：結果發現，即使參與者之學制、開始吸菸年齡、每日吸菸量、尼古丁成癮程度不同，但在同儕團體壓力及訊息性支持之看法是相似的，本研究之結果建議可作為未來推動高中職菸害防制計畫之參考。Background: The rate of smoking cessation is low among senior and vocational high school students with smoking behavior, identifying cessation difficulties and finding need of supports among these students is critical. This study explored factors associated with the smoking cessation difficulties perceived by senior and vocational high school students and their need of cessation supports. Methods: Self-report questionnaire was administered to 50 students recruited from three senior and vocational high schools in Taipei City, Taiwan, who had smoked in the past 6 months before the research initiation. Nominal Group Technique was used to explore smoking cessation difficulties faced with the participants and their need of cessation supports. Spearman’s rank correlation coefficients were used to analyze the correlations between perceived cessation difficulties, need of supports by the grouping of different levels of educational system (i.e., senior high school or vocational high school), 2) time of smoking initiation (i.e., prior to or after admission to senior or vocational high school), 3) daily smoking quantity (≦ 10 cigarettes or ≧ 11 cigarettes), 4) degree of nicotine dependence (mild or moderate–severe). Results: The findings indicated that all participants rated “facing pressure” as the most difficult challenge in term of smoking temptation resistance regardless of the grouping based on the educational system, time of smoking initiation, daily smoking quantity, and degree of nicotine dependence. Such pressure came from academic frustration, low exam scores, and long-term distrust by parents and teachers. In term of family attitudes, the participants rated “My parents disagree with smoking of high and vocational school students, but they smoke” as the most faced difficult. The participants felt uncomfortable when their parents’ words do not match their behaviors, therefore resulting in the difficulties to quit smoking. The participants rated “smoking together for fun” as the most faced difficult in term of peer attitudes. The smokers hesitated to quit smoking to maintain their friendship. The most critical emotional support of participants was “listening to me about difficulties of quitting smoking” because the participants believed that listening of families and friends helped them strengthened willingness of smoking cessation. “Providing chewing gum” was the most critical instrumental support because the participants used chewing gum instead of smoking. . “Someone I trust giving me advices” was the most critical informational support.” For example, the participants mentioned that they believed that they could quit smoking with the assistance of medical professionals. The highest-ranked appraisal support was “Nicotine withdrawal is temporary and can be overcome” because the participants pointed out that they will not have cigarette cravings as long as they survive from nicotine withdrawal symptoms. Furthermore, students from the different levels of groups by educational system, smoking initiation time, and daily smoking quantity all reported that “smoking craving” was the most difficulty of smoking relapse prevention. However, “being irritable and unconcentrated” was the most difficulty perceived by the group of nicotine dependence regardless of different levels. The participants mentioned that whenever they felt anxious (a typical symptom of smoking cessation), they used to smoking cigarettes to alleviate such anxiety. The findings of Spearman’s rank correlation coefficient demonstrated that peer pressure and informational support were statistically significant in all groups regardless of different levels. Conclusion: The findings suggested that regardless of the educational system, time of smoking initiation, daily smoking quantity, and nicotine dependence degree, the participants had similar perspectives on peer pressure and informational support. The findings might contribute to the development of effective smoking cessation program among senior and vocational high schools.