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系統識別號 U0007-0107201100480500
論文名稱(中文) 成年吸菸者戒菸行為因素探討
論文名稱(英文) Associated Factors of Quitting Behavior among Adult Smokers
校院名稱 臺北醫學大學
系所名稱(中) 護理學研究所
系所名稱(英) Graduate Institute of Nursing
學年度 99
學期 2
出版年 100
研究生(中文) 張博雅
研究生(英文) Po-Ya Chang
學號 M406098018
學位類別 碩士
語文別 中文
口試日期 2011-06-28
論文頁數 104頁
口試委員 指導教授-陳品玲
委員-洪百薰
委員-白其卉
中文關鍵字 戒菸  環境吸菸氛圍  禁菸規定 
英文關鍵字 Cessation  Social climate  Smoking ban 
學科別分類
中文摘要   戒菸是種行為改變的方式,達到戒菸的成效,必須找出影響戒菸行為的因素,許多研究發現透過禁菸規定、戒菸服務及避免暴露於環境吸菸氛圍可以有效減少菸品之使用,但其大多是針對少數樣本或特定的個案進行介入研究,較難得知臺灣地區的全貌,基於調查單位、研究方法及研究指標不一致,要進行趨勢變化分析有其困難性,因此,國民健康局自2004年起進行系列電話訪問調查我國成年人吸菸相關行為。
  本研究經由國民健康局授權取得2004年至2007年「成年人吸菸行為調查」資料庫,透過以SAS9.2套裝軟體進行描述性統計、Chi-Square test、Logistic Regression分析2004年至2007年「成年人吸菸行為資料庫」,依照分析樣本條件「自述一生吸菸超過五包(約100支)之吸菸者」,探討菸品使用行為相關變項、自覺環境吸菸氛圍、禁菸規定及戒菸服務與戒菸經驗之關聯。
  本研究發現,吸菸者的戒菸行為及戒菸嚐試呈現逐年上升的趨勢,戒菸行為由2004年(20.97%)提升至2006年26.06%,戒菸嚐試由2005年的40.73%提升至2007年的43.86%。不同性別、年齡、婚姻狀況、教育程度、家庭收入及工作狀況與區域別之戒菸行為與戒菸嚐試達統計上顯著差異。環境吸菸氛圍方面,不論是家庭或工作場所,自覺有暴露者其戒菸行為及戒菸嚐試顯著高於自覺無暴露者,隨著暴露天數越多,戒菸行為與戒菸嚐試越低。實習禁菸規定的工作場所隨著年代變化逐年增加,實施全面禁菸的工作場所,其吸菸者的戒菸率顯著高於工作場所沒有任何吸菸相關規定者(OR:1.76,95%CI:1.54-2.00)。吸菸者曾接受戒菸服務的比例逐年上升,且戒菸服務會顯著影響吸菸者之戒菸行為及戒菸嚐試。
  本研究建議菸害防制策略應有性別差異,針對不同性別之吸菸者提供專門之戒菸服務,對於有戒菸嚐試之吸菸者,除了透過戒菸技巧訓練及戒菸協助外,應避免暴露於二手菸之環境誘惑。此外,應加強專業人士菸害防制教育,增強戒菸諮商之技巧,透過獎勵制度鼓勵醫護人員主動提供戒菸服務。政策方面,政府應擴大禁菸範圍至騎樓或整個社區,甚至將菸害防制法推行至家庭,減少家庭吸菸氛圍及環境二手菸之暴露。
英文摘要   The primary of effectiveness of smoking cessation is the identification of the associated for smoking cessation. In order to achieve the effectiveness of smoking cessation, finding factors related to it is essential. Smoking ban, cessation program from health service and avoidance of smoking climate have been proved to be effective in reducing cigarette consumption. However, past studies were limited at small sample size or lack of population-based data. Inconsistency in investigating institution, study method and outcome indicators among studies made it difficult in further analysis of the trend. Therefore, the Bureau of Health Promotion has entrusted scholars to develop a comprehensive study of“Survey on the Smoking Behaviors of Adults”, and set up the database since 2004.
  “Survey on the Smoking Behaviors of Adults”is a cross-sectional study, adults aged 18 and above were surveyed by telephone through the whole country of Taiwan. This study used “Survey on the Smoking Behaviors of Adults”database authorized by Bureau of Health Promotion to explore factors associated with cessation behavior. Adults who reported cigarette consumption more than 100 in life time were recruited in analysis. Data related to tobacco use, perceived social climate of smoking, smoking ban, cessation program use and cessation experience were mined. Descriptive statistics, Chi-Square test, logistic regression were performed using SAS version 9.2 to analyze data.
  The trend of increasing cessation behavior and attempt of were found in the study, smoking behavior from 2004 (20.97%) increased to 26.06% in 2006, attempt in 2005 to 40.73% increased to 43.86% in 2007 .A significant difference in cessation behavior and attempt was also existed among different gender, age, marital status, education, household income and working conditions and the area. Adults who perceived exposure from smoking climate demonstrated higher rate of cessation behavior and attempt. Smoking prohibition in working place increased by year, and was associated with higher rate of cessation behavior (OR: 1.76,95% CI: 1.54-2.00). The proportion of accepted smoking cessation services was increased recently and was significantly associated with quit behavior and cessation attempt.
  In conclusion, this study suggest gender-specified a smoking prevention program need to be developed, and the assistance to smokers who intend to quit in avoiding temptation from secondhand smoke exposure. Improving health providers’ tobacco prevention training and counseling skill in smoking cessation, and promoting health providers to contribute to cessation service also need to be emphasized. We also suggest the government to expand tobacco regulation to the arcades, the community, and even to home environment.
論文目次 致 謝Ⅰ
中文摘要Ⅱ
英文摘要Ⅳ
目 錄Ⅵ
圖表目次Ⅸ
第一章緒論1
第一節研究動機及重要性1
第二節研究目的4
第二章文獻查證5
第一節成年人吸菸現況與趨勢5
第二節影響戒菸之因素19
第三節研究架構27
第四節研究假設29
第三章研究方法30
第一節研究設計30
第二節資料庫變項結構31
第三節資料處理與分析38
第四章研究結果46
第一節人口學特質、菸品使用相關變項、環境吸菸氛圍、禁菸規定、戒菸服務與戒菸經驗之分佈46
第二節人口學特質、菸品使用相關變項、環境吸菸氛圍、禁菸規定、戒菸服務之戒菸行為的差異比較55
第三節人口學特質、菸品使用相關變項、環境吸菸氛圍、禁菸規定、戒菸服務之戒菸嚐試的差異比較63
第四節校正年代、年齡及性別後吸菸年齡、環境吸菸氛圍、禁菸規定及戒菸服務之戒菸率分析71
第五章討論76
第一節成年吸菸者戒菸經驗、環境吸菸氛圍、禁菸規定及戒菸服務76
第二節影響成年吸菸者戒菸經驗之相關因素79
第六章結論與建83
第一節結論83
第二節建議85
參考文獻88
中文部分88
英文部分91
附錄「民國93至96年成人吸菸行為調查資料庫」審合公文103

圖表目次
頁數
圖 一 美國菸品消費趨勢7
圖 二 美國成年人吸菸率趨勢7
圖 三 美國男女性吸菸率趨勢7
圖 四 英國成年人吸菸率趨勢9
圖 五 澳洲成年人吸菸率趨勢11
圖 六 日本男女性吸菸率趨勢13
圖 七 新加坡成年人吸菸率趨勢13
圖 八 香港成年人吸菸率趨勢13
圖 九 臺灣成年人吸菸率趨勢18
圖 十 臺灣成年人戒菸經驗18
圖 十一「成年吸菸者戒菸行為因素探討」之研究架構28
表 一 研究變項之操作性定義 33
圖 十二「成年吸菸者戒菸行為因素探討」之分析架構41
表二 研究變項之描述性統計42
表三 研究變項之推論性統計43
表三 研究變項之推論性統計(續)44
表三 研究變項之推論性統計(續)45
表四 2004-2007年人口學特質分佈50
表五 2004-2007年菸品使用相關變項分佈51
表六 2004-2007年環境吸菸氛圍分佈52
表七 2004-2007年禁菸規定與戒菸服務分佈53
表八 2004-2007年戒菸經驗分佈54
表九 不同人口學特質之戒菸行為的差異比較58
表十 不同吸菸年齡者之戒菸行為的差異比較60
表十一 不同環境吸菸氛圍之戒菸行為的差異比較61
表十二 不同禁菸規定、戒菸服務之戒菸行為的差異比較62
表十三 不同人口學特質之戒菸嚐試的差異比較66
表十四 不同吸菸天數、吸菸量、吸菸年齡者之戒菸嚐試的差異比68
表十五 不同環境吸菸氛圍之戒菸嚐試的差異比較69
表十六 不同禁菸規定、戒菸服務之戒菸嚐試的差異比較70
表十七 校正年代、年齡及性別後不同吸菸年齡之戒菸率分析73
表十八 校正年代、年齡及性別後不同環境吸菸氛圍之戒菸率分析74
表十九 校正年代、年齡及性別後不同禁菸規定、戒菸服務之戒菸率分析75

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