探討大一學生的吸菸行為－－跨理論模式的應用

Application of the Transtheoretical Model to smoking behavior among freshmen

本研究目的乃是應用跨理論模式，探討北縣某大學大一學生的吸菸行為，以瞭解 大一學生的吸菸階段分期及不同吸菸階段與自我效能以及決策權衡的相關。以北縣某大學之全體大一學生為對象，採隨機集束抽樣方法進行抽樣，最後取得有效樣本1216人。樣本平均年齡19.3歲，在吸菸階段的分類上有84.9％為無意圖嘗試期、2.2％為意圖嘗試期、0.7％為準備嘗試期、4.4％為無意圖戒除期，1.4％分別為意圖戒除期與準備戒除期，1.2％為戒除行動期，3.7％為戒除維持期。在吸菸自我效能／誘惑（正向情感／社交情境狀況、負向情感／情緒狀況以及好奇／嘗試狀況或菸癮／習慣等狀況）、吸菸好處同意度及吸菸決策權衡方面，在無意圖嘗試期的T分數最低，隨著意圖／準備嘗試期而陸續增加，在無意圖戒除期時達到最高，隨著意圖／準備戒除期、戒除行動／維持期而逐漸降低。在吸菸壞處同意度方面，呈現反向的線性關係。吸菸自我效能／誘惑及決策權衡在不同的吸菸階段皆有顯著差異存在(p< .001)，其解釋變異量從13％〜51％。研究結果支持跨理論模式的有用性，並提供教育者作為發展不同吸菸階段介入以促進菸害防制的參考。

The purpose of this study was to assess the relationships of the stages of change with self-efficacy / temptation and decisional balance, and to examine the utility of the transtheoretical model in understanding smoking behavior. A random clustered sample of 1216 freshmen was recruited from a college in Taipei county. The average age of the sample was 19.3 years. On the basis of participants, responses to the stage of smoking measure, 84.9% were in acquisition precontemplation, 2.2% in acquisition contemplation, 0.7% in acquisition preparation, 4.4% in cessation precontemplation, both 1.4% in cessation contemplation and cessation preparation, 1.2% in cessation action and 3.7% in cessation maintenance. Participants in acquisition precontemplation scored the lowest and those in cessation precontemplation scored the highest on the self-efficacy / temptation, benefit and decisional balance indices, with the trend reversed on the cons (disadvantages) scale. Significant differences between stages were found for self-efficacy / temptation and decisional balance (p< .001), the proportion of variance accounted for these variables range from 13%~51%. These findings offer support for the transtheoretical model to apply in the antismoking programs, and implications for use of the findings by educator in developing stage-based interventions.