戒菸門診個案持續戒菸行為與自我效能之研究

Smoking Cessation Behavior and Self-Efficacy in Subjects of a Smoking Cessation Clinic

我國每年死亡人口中，有五分之一的罹病死因與菸害疾病有關，而戒菸是降低菸害疾病死亡率的重要方法。本研究設計探討參加門診戒菸計畫的個案之戒菸行為及其自我效能，以花蓮某醫院門診74位戒菸個案為研究對象，在門診戒菸計畫及尼古丁替代藥物治療程序下，於戒菸第一天以結構式問卷收集戒菸個案的背景資料、吸菸及戒菸經驗、戒菸健康信念及戒菸自我效能，並於戒菸過程中每週電話追蹤其戒菸情形及戒斷症狀。戒菸治療第三週時由個案自我報告戒菸行為是否持續了三週，對於自我報告有持續戒菸行為者測量呼氣一氧化碳（CO），以CO值＜10 ppm做為戒菸成功與否之判定。結果發現：門診戒菸治療後三週有持續戒菸行為者為47.3％（N=35），這些持續戒菸行為者中經CO檢測戒菸成功率為85.7％（N=30）。而年齡較輕、開始吸菸年齡較早、戒菸障礙性認知較高、戒菸自我效能較低者的持續戒菸行為較差。對於持續戒菸行為有顯著預測力的變項，包括年齡（Odds ratio=1.48）、每日的吸菸量（Odds ratio=0.85）、戒菸利益性認知（Odds ratio=2.10）及戒菸自我效能（Odds ratio=1.25）。根據研究結果建議醫護人員於門診戒菸治療計畫時，對於傾向持續戒菸行為較差者，可藉由戒菸自我效能的提升，增加其持續戒菸行為的維持，達成戒菸行為改變。

In Taiwan, annually, one fifth of death is accounted by smoking-related diseases. Smoking abstinence is important to prevent such death. The correlational study was conducted to investigate the effects of smoking cessation clinic on smoking cessation behavior in an outpatient department. Seventy-four subjects in Hualien who participated in a smoking cessation clinic were recruited in this study. Data on demographic characteristics, smoking history information, health belief of abstinence from smoking, self-efficacy of abstinence from smoking were collected at the first day when subjects participated in smoking cessation clinic and received nicotine replacement therapy. Smoking cessation behavior was defied as self-reported at the third week since subjects started the program. The success of smoking abstinence was confirmed by the value of the breath carbon monoxide (CO) level of less than 10 ppm. The results indicated that the rate of the smoking cessation behavior was 47.3%（N=35）at 3rd week, the success rate of smoking abstinence indicated by the value of the CO levels was 85.7%（N=30/35）. Subjects who are younger in age, start to smoke at early age, have higher perceived barriers to quit, and have lower self-efficacy of abstinence from smoking were more likely to have worse smoking cessation behavior. The subject’s age (odds ratio=1.48), amount of daily smoking (odds ratio=0.85), perceived benefits of quitting smoking (odds ratio=2.10) predicted smoking cessation behavior. Based on the findings of this study, health care providers need to identify the persons who are more likely to have the worse smoking cessation behavior, therefore increase their self-efficacy, and increase their abstinence of smoking.