青少年電子煙網路暴露、素養與電子煙及紙菸使用之相關研究

Association between online exposure, literacy, and adolescent e-cigarette use and cigarette smoking

目標：本研究目的為探討青少年電子煙網路暴露、媒體素養、電子健康素養與電子煙及紙菸使用意圖與行為之關係。方法：在2020年共計完成調查六個縣市30所學校的問卷調查，計2,595名國中一年級學生完成問卷填寫。結果：研究結果發現2.39%國中一年級學生有使用電子煙經驗，0.88%學生在一年內有使用電子煙，2.20%國中一年級學生有使用紙菸經驗，0.8%學生一年內有使用紙菸。以廣義估計方程式（Generalized Estimating Equations, GEE）分析，結果顯示學生電子煙網路暴露愈頻繁、電子煙情感媒體素養愈低者愈易在過去一年有使用電子煙行為。另在未曾使用電子煙學生中，GEE分析結果顯示學生電子煙網路暴露愈頻繁、電子健康素養愈低、電子煙情感媒體素養愈低者其電子煙使用意圖愈高。此外，GEE分析結果顯示學生電子煙網路暴露愈高、電子煙認知媒體素養愈低、有電子煙使用經驗者，愈易在過去一年有使用紙菸的行為。另在未曾使用紙菸學生，其電子煙網路暴露愈高、電子煙情感媒體素養愈低、有電子煙使用經驗者其紙菸使用的意圖愈高。結論：青少年電子煙網路暴露增加其電子煙使用行為與使用意圖，電子煙使用經驗增加其紙菸使用的風險，而電子煙情感媒體素養可降低其電子煙與紙菸使用行為及使用意圖。

Objectives: This study examined the relationship between online exposure, media literacy, eHealth literacy, electronic cigarette (e-cigarette) use, cigarette smoking, and intentions to use e-cigarettes and cigarettes. among adolescents. Methods: The study included 2595 seventh-grade students from 30 middle schools in Taiwan to complete a self-administered survey in 2020. Results: Among the participants, 2.4% reported ever using e-cigarettes, with 0.88% using e-cigarettes within the past year. Additionally, 2.2% reported ever smoking cigarettes, and 0.8% reported smoking within the past year. Generalized estimating equations revealed that adolescents’exposure to online e-cigarette marketing and lower levels of attitudinal media literacy were associated with e-cigarette use. Among nonusers, exposure to online e-cigarette marketing and lower conceptual media literacy were associated with greater e-cigarette use intentions. Furthermore, adolescent e-cigarette use was associated with cigarette smoking and cigarette use intentions. Conclusions: Online exposure to e-cigarette marketing was identified as a risk factor for e-cigarette use and e-cigarette use intention, and e-cigarette use was linked to cigarette smoking and intention to smoke. Attitudinal media literacy was a protective factor against e-cigarette use and cigarette smoking.