都會原住民戒菸衛教成效之初探

Preliminary Findings on Education for Quitting Smoking Among Urban Aborigines

都會原住民吸菸率高，應積極戒菸。本論文報導某健康營造中心2007年對都會原住民提供戒菸衛教之成效。受試者為接受高血壓個案管理，有吸菸習慣，且自願參加此衛教活動的都會原住民，共20位。由個管師家訪時，以一對一方式勸導戒菸，並使用衛教單張進行內容的解說與宣導。前後進行兩次（相隔3週）戒菸衛教，並於衛教前（前測）、2次衛教結束後（後測）、以及5個月後（後後測）作問卷調查、並測量呼出一氧化碳濃度（以下簡稱 CO）。得到的結果如下：（1）菸害認知於後測提升13.3%，達顯著意義（p=.0004）；（2）反菸態度的前、後測沒有顯著改變；（3）尼古丁依賴程度的前測 2.3、後測 1.3、後後測 1.6，下降幅度均達顯著意義；（4）CO的前測值 11.6ppm、後測值 7.3ppm、後後測值 8.9 ppm，呈現的下降幅度均達顯著意義（p=.0010與p=.0156）。尼古丁的依賴程度與CO值，於衛教3個月後下降後卻又上升，因此建議設計持續性的戒菸同儕支持團體活動，以營造少菸甚至無菸的原住民社區環境。以便協助原住民克服其生活中，生理上與心理上的壓力，而使戒除菸癮終能成功。

There is a high smoking rate among urban aborigines who should be actively trying to quit. This study reports the effectiveness of our programs designed to help urban aborigines quit smoking. The subjects of this study were urban aborigines who had hypertension, smoked and were willing to participate in the smoking cessation education program. A total of 20 urban aborigines participated. The case manager made three home visits for each participant, and explained the advantages and method of stopping smoking at the first two visits. The first two home visits were made three weeks apart and the third was made five months later. Questions about awareness, attitude towards not smoking, nicotine dependence (ND) and measure of expiratory carbon monoxide (CO) were taken. (1) There was a 13.3% increase in the understanding of not smoking (p=.0004) after the second visit. (2) There was no significant change in the attitude towards not smoking after the second visit. (3) ND significantly decreased with time while the ND was 2.3, 1.3, 1.6, for the first, second, and last visit, respectively. (4) CO also decreased significantly with time while the values were 11.6, 7.3, 8.9 ppm for the first, second, and last visit, respectively. Although ND and CO values decreased on the second visit, they increased 5 months later. We highly recommend setting up an ongoing peer support group, building a restricted smoking area or a non-smoking community, assisting in overcoming daily, physiological, and psychological stress, so urban aborigines can successfully overcome their smoking addiction.