| 摘要: | 現今青少年吸菸的問題日益嚴重，而卻未見有效的方案能改善此一情形，因此本研究設計一套實驗性質多元介入方案和採用傳統衛教介入方案同時對吸菸青少年進行戒菸介入課程來看介入後對吸菸行為改變的成效，並比較兩方案之間在介入後對青少年吸菸行為的改變效果。 以立意取樣的方式，選擇台中縣一所國中59位和一所高中61位由學校提供名單的吸菸同學為研究對象，且研究對象全部為男性。而本研究以問卷蒐集可能影響改變青少年吸菸行為之因素，並採集尿液樣本以檢驗尿中可丁尼含量，以尿中可丁尼含量之變化用來評估青少年吸菸行為之改變。 本研究的結果發現：1). 傳統衛教戒菸介入方案具有改變國中生吸菸行為的效果，2). 實驗多元戒菸介入方案具有改變高中生吸菸行為的效果，3).實驗多元戒菸介入方案並未比傳統衛教介入方案較具改變吸菸行為的效果，而且不論是哪一個介入方案，方案的內容與執行過程是否能使吸菸同學的行為改變階段跨越至「採取戒菸行動且正維持中」的階段才是改善青少年吸菸行為最重要的因素。; The prevalence of youth smoking has been estimated in the range of 10.8% and 15.4%. Among them, 20% to 30% become habitual smokers. The health authority, non-profit organizations and researchers have made a lot of efforts to reduce the smoking rates since Taiwan Tobacco Control Act was implemented in 1997. However, the need for an effective intervention program for youth smoking cessation remains. In this study, I experimentally developed a multi-component intervention program of smoking cessation for young smokers at schools. Participants recruited were 120 young smokers from two high schools in Taichung County with 59 students at junior high school and 61 at senior high school. These students were randomly assigned into two groups, one was for multi-component intervention and the other was for conventional intervention. A questionnaire was used to collected baseline information on family backgrounds, family and social dynamics factors, and individuals’ physical, psychological and behavior factors. The multi-component intervention activities consisted of small-group interaction courses and group racing in “quit and win” for money, while the conventional intervention activities consisted of lecturing and broadcasting video programs with “question and answer” for gifts. Postintervention evaluation was conducted in 2 months after the intervention activities. In addition, urine samples were collected to determine cotinine levels and the changes in tobacco use. Nonparametric statistical methods such as Mann-Whitney U test, Wilcoxon sign rank test, and Fisher’s exact test were used to examine the bivariate relationships, and multiple regression analysis was used to examine the multivariate relationships. The results showed that for senior high school participants, within multi-component intervention group, the number of smokers who decreased cotinine levels was significantly greater than that of smokers who increased (20 vs. 8, Z=-2.915, P=0.004). On the other hand, for junior high school participants, within conventional intervention group, the number of smokers who decreased cotinine levels was significantly greater than that of smokers who increased (21 vs. 9, Z=-2.910, P=0.004 ). However, while taking possible changes in the individuals’ physical, psychological and social factors into consideration, no differences in the effectiveness existed between the two programs. Among the possible influencing factors on the changes in continine levels, only individual changes of behavior stage had a significant effect. In conclusion, young smoking-cessation intervention can change the amount of tobacco use for young smokers no matter whether it was a conventional or an experimental multi-component approach. Its effectiveness depends on young smokers’ characteristics, especially the stages of behavior change. |
