國中學生吸菸行為與健康信念及自我效能之相關探討

本研究目的主要在瞭解台南縣市國中階段青少年之吸菸盛行率，並探討學生個人屬性與健康信念及拒菸自我效能之關係及其影響因素。研究採橫斷式相關性研究設計，使用「健康信念量表」、「拒菸自我效能量表」進行資料收集。以台南地區國民中學的學生為母群體，採分層隨機取樣方式抽取6校，合計36班，總計1056位學生參與本研究。資料以SPSS 10.0軟體進行統計分析，統計方法包括描述性統計、t檢定、相關分析、變異數分析、Scheffes事後比較及複迴歸。 研究結果顯示：（1）台南縣市國中學生的吸菸盛行率10.3％，曾經吸煙（包括已戒菸者）15.6％。（2）最早養成吸菸行為年齡為11歲，隨著年級愈高，吸菸比例越高；男生吸菸顯著高於女生（3）不吸菸學生的自覺嚴重性、自覺利益性、自覺健康狀況、自我效能、菸害知識和知識來源其得分顯著高於吸菸學生；吸菸學生的自覺障礙性、有家人吸菸及同儕吸菸得分顯著高於不吸菸學生，且具有統計學上顯著差異。（4）自我效能、同儕吸菸、自覺障礙性及性別是吸菸行為的有效預測因子。 本研究結果，建議學校、臨床及社區護理人員形成整合的反菸行動網絡，以便對吸菸學生進行個案管理；國民小學能及早在一年級開始菸害教育；加強老師反菸的模範角色功能，以深入學生生活教育；並對吸菸高危險群對象，設計發展適合青少年需求、長期、階段式有效課程，以加強信念及自我效能，並強化拒絕技巧訓練，以達到有效拒菸、無菸家園及健康促進之目的。

The main purpose of this study is to work out junior high school smoking rate in Tainan region and to discuss the relations and influencing factors between student’s personality and his health belief and anti-smoking self-efficacy. Taking cross-sectional correlation design and plan as the research method, this study collected data by “Health Belief Scales” and “Smoking Self-efficacy Survey”. And taking the students in junior high schools of Tainan region as the research objects, we picked 6 schools by stratified random sampling to participate in this study, totaling 36 classes and 1056 students. The data were analyzed by SPSS 10.0 Software and the statistic methods we used were descriptive statistics, t-test, correlation analysis, analysis of variance, Scheffe’s test and regression analysis. The results of this study show: (1) Junior high school smoking rate in Tainan region is 10.3% and 15.6% of all the junior high school students have ever smoked (including those who have quitted smoking). (2) The youngest student starts to smoke at age of 11. The smoking rate increases with the rise of grades and the boy smokers are much more than the girl smokers. (3) Non-smoker students’ scores on perceived seriousness, perceived benefits, perceived health status, self-efficacy, and knowledge about the dangers of smoking and knowledge resources are much higher than that of the smoker students; and smoker students’ scores on perceived barriers, family smokers and peer smokers are much higher than that of the non-smoker students. This phenomenon shows statistical differences. (4) Self-efficacy, peer smokers, perceived barriers and gender are the effective factors to forecast smoking behavior. The results of this study suggests that schools and clinical and community paramedics should form integrated anti-smoking union to promote the individual management for smoker students; primary schools should start anti-smoking education for grade-one students as soon as possible; teachers should act as anti-smoking pioneers to efficiently promote the life education for students; we should develop progressive and efficient courses which can meet students’ needs for high risk population to strengthen faith and self-efficacy and we should consolidate the training for anti-smoking skills to carry out long-term anti-smoking program efficiently and build a smokeless home and promote health.