國中學生戒菸課程發展及介入效果之初探

Development and Evaluation of a Smoking Cessation Program for Junior High School Students: A Pilot Study

雖然國中生吸菸人口日益增加，有關戒菸課程及介入效果的研究尚不多見。而且當學生違反菸害防治法時，學校需要有效的戒菸課程來管教吸菸的學生，而不是只用懲罰的方式。本研究之目的在發展適合青少年的戒菸課程，並初步評價此介入教育的效果。戒菸課程共有六個單元，每週上課2小時，內容包含戒菸相關的健康知識、引發吸菸的情況、拒絕技巧訓練、戒菸的優缺點、個人的價值觀和戒菸的方法，活動設計以遊戲及分組討論方式進行，並由受過訓練的大學護理系學生帶領，乃特別為國中學生設計。本研究採取單組前後測設計，立意取樣23名吸菸的國中生，評價研究對象在戒菸知識、戒菸態度、戒菸自我效能、戒菸行為意向的介入效果和課程的滿意度。統計分析使用成對t-test、Pearson's correlation、獨立t-test、one-way ANOVA和描述性統計法。研究結果顯示介入課程後能增加研究對象的菸害知識及戒菸自我效能，但無法促進正向的戒菸態度。參與的國中生對於每一個單元的滿意度表示尚可，然而參與者一個月內戒菸的行為意向可能性只有中等程度。未來需有長期的戒菸課程加強促進正向的戒菸態度，而且課程中可設計個人會談活動以了解青少年戒菸過程，追蹤研究也應探討學生行為意向的改變。

Despite the increase in smoking among junior high school students, few smoking cessation programs have been developed and evaluated. Effective adolescent tobacco cessation programs are needed, especially in school, as an alternative to punishing students in violation of the Tobacco Hazard Control Act. The present study described the curriculum development of a smoking cessation program and evaluated the effects of the program implementation. Six weekly sessions, each of two hours, covered the content of the consequences of smoking, “triggers”to smoking, refusal skills training, expected pitfalls during and after quitting, individual motivation, and a cessation methodology. Designed for the adolescent population, the program activities consisted of fun games and small group discussion and were conducted by trained university nursing students. The purpose sample was 23 smoking adolescents from a rural junior high school. Pretest and posttest were conducted to evaluate attendants’ health awareness of tobacco use, attitudes toward smoking cessation, and self-efficacy in various smoking situations. The posttest was also designed to examine behavior intention and program satisfaction. Paired t-test, Pearson’s correlation, Independent t-test, one-way ANOVA, and descriptive statistics were employed to analyze data. Results showed that the program increased health awareness and self-efficacy, but did not develop positive attitudes. The participants fairly agreed to quit smoking within one month and showed fair satisfaction with the program. Therefore, future long-term programs must aim at reinforcing positive attitudes toward smoking cessation. Individual interviews should also be added to the programs to explore the cessation process of young adolescents. Follow-up research should focus on exploring the improvement in behavior intention.