青少年族群的二手酒害：危險因子與生活品質影響

Alcohol’s harm to others in adolescents: risk factors and consequences

目標：飲酒造成的傷害不僅限於飲酒者，也會影響周遭或社區他人。本研究旨在了解台灣青少年二手酒害之盛行率、風險因子與其對生活品質之影響。方法：利用107年全國物質使用調查計畫，樣本為具全國代表性之3,598名12-17歲青少年，調查其家庭與個人社經背景、終生所受過之八種二手酒害，並以EQ-5D-5L分析其多面向之生活品質。研究使用複雜問卷分析、羅吉斯迴歸與Tobit迴歸進行分析。結果：在12至17歲的受訪者中，二手酒害的終生盛行率為0.92%。在各風險因子中，父母皆有飲酒與遭受二手酒害的關聯性最為顯著（調整後勝算比為14.1）。在個人因素方面，有逃家經驗及每月飲酒者，其遭受二手酒害的調整後勝算比分別為5.78與5.75。值得注意的是，二手酒害顯著降低青少年族群生活品質分數（調整後β= -0.17），在焦慮/沮喪面向尤為嚴重。在遭受二手酒害的青少年中，僅有16.3%曾向外求助。結論：二手酒害是台灣社會評估飲酒傷害不可忽視的角度。對於未成年族群，家庭飲酒環境是極為重要的危險因子。針對二手酒害對青少年心理健康及生活品質的傷害，後續的酒害防治政策須將家戶內酒害納入標的，辨識出社區中隱藏的酒害，以減少酒精對年輕世代的短期與長期傷害。

Objectives: The study aimed to investigate the prevalence of alcohol’s harm to others (AHTO), its risk factors, and its relationship with quality of life in adolescents in Taiwan. Methods: Data came from the 2018 National Survey of Substance Use in Taiwan. A total of 3,598 respondents aged 12–17 with national representativeness were included. Sociodemographic characteristics at both family and individual levels, eight forms of AHTO, and five-dimensional quality of life (as assessed by the EQ-5D-5L) were obtained in the survey. Logistic and Tobit regressions with complex survey analyses were used. Results: The lifetime prevalence of AHTO in adolescents was estimated at 0.92%. Parents’drinking emerged as the strongest risk factor for AHTO experience (adjusted odds ratio [aOR] = 14.1). Running away from home and monthly drinking were found to increase the odds of AHTO by 478% and 475%, respectively. Having AHTO experience appeared to be a significant predictor for deteriorated quality of life (adjustedβ= -0.17), with that deterioration manifested primarily in the dimension of anxiety/depression. Among all AHTO victims, fewer than one in six ever reached out for help. Conclusions: AHTO provides a vital perspective to help tackle alcohol harm in Taiwan, particularly in the vulnerable underage population. To prevent AHTO-related deterioration in mental health and quality of life among young people in the community, policies and interventions should involve strategies targeting harm to young children in families.