青少年電子煙使用行為與吸紙菸意圖及其相關因素之研究

Abstract

紙菸是目前全球人的一大公共衛生威脅，青少年吸紙菸對身心及社會發展有嚴重影響。近年來電子煙興起，一開始被認為是紙菸的一種更安全的替代品，但根據研究指出，電子煙存在有毒物質，也可能造成尼古丁上癮，且目前證據顯示，電子煙無法幫助戒菸。然而菸害防制法直到今年才修正公布，導致青少年電子煙的使用比率按年增加。研究也發現，青少年使用電子煙會增加其吸紙菸意圖，之後更有可能吸紙菸。因此，本研究旨在從理性行動論的觀點，探討青少年使用電子煙的現況，以及與吸紙菸意圖之間的相關因素。本研究以臺北市某高中的學生作為研究對象，在2022年6月進行問卷調查，收集研究對象電子煙使用現況等相關資料，共取得534份有效樣本。使用的統計方法為：描述性統計、卡方檢定和二元邏輯斯迴歸。研究結果發現如下：一、有使用電子煙的青少年占5.1%，沒有使用的青少年占94.9%。二、青少年電子煙的使用情況會因「性別」、「年級」及「母親教育程度」不同而有顯著差異。三、青少年使用電子煙的情況會因社會環境之「家人使用電子煙」的不同而有顯著差異。四、青少年使用電子煙與吸紙菸意圖有顯著正相關。本研究結果發現，青少年使用電子煙與吸紙菸意圖有顯著相關，代表青少年使用電子煙，未來更有可能吸紙菸。然而，本研究為橫斷性的量性研究，建議未來可以進行縱貫性研究或質性研究，以深入探討青少年使用電子煙與吸紙菸意圖之間的因果關係，以及了解青少年使用電子煙的原因。此外，建議在教學中採小組討論，透過情境設置讓學生討論家人或同儕使用電子煙時，該如何面對及做出健康的決定。同時，對於青少年的電子煙使用者，利用小組分組方式，讓學生集思廣益，每堂課最後分享討論的結果，藉以提升學生的學習動機及課程參與度；建議未來可以邀請家長參與戒電子煙的課程，以促進學校與家庭之間的合作，共同建立積極的健康環境。

Cigarette smoking is a major public health threat worldwide, and adolescent smoking has serious implications for physical, mental, and social development. In recent years, the emergence of electronic cigarettes (e-cigarettes) was initially seen as a safer alternative to traditional cigarettes. However, studies have indicated that e-cigarettes contain toxic substances and may lead to nicotine addiction, and current evidence suggests that they are not effective in smoking cessation. Despite this, the amendment of the Tobacco Hazards Prevention Act was only announced this year, resulting in an increasing prevalence of e-cigarette use among adolescents. Research has also found that e-cigarette use among adolescents increases their intention to smoke traditional cigarettes, which subsequently leads to actual cigarette smoking. Therefore, this study aims to explore the current status of e-cigarette use among adolescents and the associated factors influencing their intention to smoke traditional cigarettes from the perspective of the Theory of Reasoned Action.The study was conducted with students from a high school in Taipei City as the research participants. A questionnaire survey was carried out in June 2022 to gather data on the participants' e-cigarette usage and related information. A total of 534 valid samples were obtained. Descriptive statistics, chi-square tests, and binary logistic regression were utilized as the statistical methods. The research findings were as follows: 1.The prevalence of e-cigarette use among adolescents was 5.1%, while 94.9% reported no e-cigarette use. 2.E-cigarette use among adolescents varied significantly by "gender," "grade," and "mother's educational level." 3.The use of e-cigarettes among adolescents differed significantly depending on the social environment, particularly the"family members' use of e-cigarettes." 4.There was a significant positive correlation between e-cigarette use and intention to smoke traditional cigarettes among adolescents. The findings of this study revealed a significant correlation between adolescent e-cigarette use and intention to smoke traditional cigarettes, indicating that adolescents who use e-cigarettes are more likely to engage in cigarette smoking in the future. However, it is important to note that this study employed a cross-sectional quantitative research design. Therefore, future research is recommended to employ longitudinal studies or qualitative research methods to further investigate the causal relationship between adolescent e-cigarette use and intention to smoke traditional cigarettes, as well as to understand the underlying reasons for adolescent e-cigarette use.In addition, it is recommended to incorporate small group discussions in teaching, where students can engage in scenario-based discussions on how to confront and make healthy decisions when faced with family or peer e-cigarette use. Furthermore, for adolescent e-cigarette users, utilizing small group assignments can encourage students to brainstorm ideas and share their discussion outcomes at the end of each class, aiming to enhance students' motivation and engagement in the curriculum. We also suggest involving parents in smoking cessation programs to foster collaboration between schools and families, thereby establishing a positive and healthy environment together.