台中縣太平市國中學生拒絕吸菸行為相關因素之研究

Abstract

本研究主要目的在於瞭解台中縣太平市國中學生拒絕吸菸行為的現況，並進一步探討影響國中生拒絕吸菸行為之修正因素與認知知覺因素，以及彼此間的相互關係。以台中縣太平市太平國民中學、新光國民中學兩所學校之學生為母群體，採用立意取樣的抽樣方式，共抽取842位學生為樣本。根據健康促進模式，以自編自填式結構性問卷進行調查研究，主要結果如下： 一、研究對象的生活環境中，普遍存在著二手菸的危害，尤其以撞球館、電動玩具店、MTV、KTV、卡拉OK與網路咖啡店為最；而可以獲得或購買菸的地點以檳榔攤、便利商店與撞球館為主。當他人在身邊吸菸時，近八成的研究對象會感到身體不適，症狀多數是嗆鼻、咳嗽與呼吸困難；四成的研究對象過去有拒絕吸菸的經驗。 二、研究對象普遍對於他人遞菸時，能夠有自信地採取拒絕吸菸行為。最有自信的拒絕吸菸方法是採取「直接說不」，其次是「找藉口推辭」、「不去有人聚集吸菸的地方」、「不想惹很在意的人不高興」、「回請對方食物以取代吸菸」、「轉移話題」與「立即走開」等。 三、修正因素中分別以女性、從未吸菸、班上同學沒有吸菸、父親完全沒有吸菸、同住者低吸菸率、暴露二手菸環境高可能性、對菸害有身體不適、開始吸菸的年齡越小與拒菸社會支持越高者，其拒絕吸菸行為可能性較高。 四、認知知覺因素中以健康責任越能歸屬於自己、越能將健康當成人生重要事、拒菸自我效能越高、吸菸罹病性越高、吸菸嚴重性越高、拒菸利益性越高、拒菸障礙性越低與菸害知識程度越高者，其拒絕吸菸行為可能性較高。 五、修正因素、認知知覺因素對拒絕吸菸行為之解釋力達31.8%。也就是說，若要預測台中縣太平市國中生的拒絕吸菸行為，可經由本人吸菸狀況、吸菸罹病性、拒菸利益性、拒菸障礙性與菸害知識等變項加以預測，其解釋力達總變異量的31.8%，而且依序以「拒菸障礙性」、「本人吸菸狀況」與「吸菸罹病性」最具影響力。若只對有吸菸經驗者進行解釋力的分析，則可達40.0%。

The purpose of this study was to identify and to describe the relationships between the behavior of the anti-smoking and its influential determinants. The predictive variables in this study included modifying and cognitive& perceptual factors. By the determined sampling method, 842 subjects were selected, and surveyed with self-administrated structured questionnaires, which were based on the health promotion model, from a population of Tai-Ping and Hsin-Kung junior high school students in Taichung. The major findings of the study were as follows: 1.The subjects usually lived in the surrounding environment with the tobacco smoke, especially in billiard stores and electric-game arcade, MTV, KTV, Kara-OK, internet cafe. They usually could get or buy the cigarette in betel-nut stands, convenience stores and billiard stores. When someone smoked, 78.3% of the subjects felt physical-indisposed. Their symptom was usually the choke, the cough and the difficulties of breath. The forty percentage of subjects had had the experience of the behavior of the anti-smoking. 2.The subjects usually had positive self-efficacy toward rejecting others’ offer of cigarettes. The subjects refused cigarettes by “saying no directly” with the most confidence, by “declining on the pretext”, by “not going where others smoke”, by “not making someone I care upset”, by ”inviting him or her to have some food instead of smoking”, by “switching the topic of conversation”, and by ”going away quickly”. 3.Within modifying factors, the higher possibility of the behavior of the anti-smoking existed in those who were females, never smoke, classmates were non-smokers, father was a non-smoker, family had low rate of smoking, exposed to environmental tobacco smoke with higher possibilities, felt uncomfortable because of the harm caused by smoking,stared to smoke at the earlier age, had higher social support of no-smoking. 4.Within cognitive& perceptual factors, there were significant relationship between the behavior of the anti-smoking and the variables of self-responsibility of health, the importance of health, self-efficacy to reject smoking, perceived susceptibility, perceived severity, perceive benefits, perceive barriers of anti-smoking, and the knowledge of smoking danger. 5.The modifying and cognitive & perceptual factors explained the 31.8% of the total amount of the variance of the behavior of the anti-smoking, especially for the subjects with smoking experience. In other words, the predictor variables in the study of the behavior of the anti-smoking of junior high school students in Tai-Ping city, Taichung, included smoking status, perceived susceptibility, perceive benefits, perceive barriers of anti-smoking, and the knowledge of smoking danger. The sequence of the most significant influences toward the behavior of anti-smoking was perceive barriers of anti-smoking, smoking status, and perceived susceptibility of smoking.