高職全校無菸策略和班級預防吸菸教學介入之成效－－以臺灣北部某縣市為例

The effectiveness of school-wide no smoking strategies and a classroom-based smoking prevention curriculum in vocational schools of one northern county in Taiwan

學校長久以來都是預防青少年吸菸的重要據點，主要從政策、環境和課程等方面 著手。本研究旨在探討全校無菸策略和班級預防吸菸教學對高職學生菸害相關知識、態度、行為和技能的影響。研究採不等組前、後測準實驗設計，選取台灣北部某縣市三所高職一至三年級18班515名學生為對象，並依班級分為三組。實驗組一接受全校無菸策略和六節預防吸菸教學介入；實驗組二只接受全校無菸策略介入；對照組則不接受任何處理。在介入前後，分別進行調查，再以單因子共變數分析和卡方檢定來評估介入成效。研究主要發現如下：1.在全校無菸策略和班級預防吸菸教學兩層面的介入後，實驗組一的菸害知識、反菸態度、吸菸行為、拒絕技巧和替代方案都顯著高於對照組。2.在全校無菸策略介入後，實驗組二的反菸態度、拒菸自我效能和採用替代方案可能性均比對照組高。3.菸害知識較差、拒絕技巧不足和採用替代方案可能性較低的學生，在接受了班級預防吸菸教學介入後，其菸害知識、拒絕技巧和採用替代方案的可能性均變佳。建議高職在執行全校無菸策略之外，仍需強化預防吸菸教學，以求降低學生之吸菸行為。未來可加強與家長、社區建立反菸夥伴關係，再評估其成效。

Schools have long been a priority setting for adolescent smoking prevention. The main focuses of schools included policy, climate change, and curriculum. The purpose of this study was to evaluate the impacts of school-wide no smoking strategies and classroom-based prevention curriculum on smoking related knowledge, attitudes, behavior and skills. A cohort pre-post quasi-experimental design was chosen. Five hundred fifteen students selected from three vocational schools were divided into three groups by class unit. Experiment group 1 (El) received school-wide strategies and a six-session teaching. Experiment group 2 only received school-wide strategies. There was no treatment for the control group. Analysis of covariate was used to examine the effectiveness of the intervention. The major results of this study were as follows. 1. After the treatment of school-wide strategies and classroom-based education, smoking-related knowledge, attitudes, behavior, refusal skill and the possibility of taking alternatives of El were higher than those of the control group. 2. After the treatment of school-wide strategies, smoking-related attitude, self-efficacy and the possible of taking alternatives of E2 nere higher than those of the control group. 3. Classroom-based smoking prevention education had significant impacts on those who have lower knowledge, less refusal skill, and less likely to take alternatives.