臺灣青少年檳榔使用與搖頭丸使用之比較流行病學：全國調查結果

Abstract

目的：探討與青少年使用檳榔及搖頭丸相關之社會人口特徵、使用其他精神作用性物質、行為問題是否有差異性存在。 方法：將2004年至2006年以多階段隨機群集抽樣收集的全國青少年在校樣本，依照使用檳榔及搖頭丸之經驗，區分成四組使用者：無檳榔及搖頭丸使用經驗者 (51,009人)、只使用檳榔者 (1965人)、只使用搖頭丸者 (196人)、使用過檳榔及搖頭丸者(152人)。利用自我陳報問卷來蒐集青少年的社會人口特徵、其他精神成癮性物質使用經驗，並且使用中文版青少年自陳量表 (Youth Self Report)來測量行為問題。 結果：工作經驗、較多零用錢、翹課經驗、性行為經驗、外化行為問題為檳榔及搖頭丸使用的相關因子。與使用搖頭丸者相比，檳榔使用者較傾向為男性、居住於臺灣東部地區、受家人或朋友的影響而開始使用、有較高焦慮、憂鬱、思考問題、注意力問題。相較而言，搖頭丸使用者較傾向為女性、使用其他精神作用性物質、因娛樂助興而開始使用、在娛樂場所使用居多。 結論：青少年檳榔使用者與搖頭丸使用者在社會人口特徵、使用其他精神作用性物質、行為問題上有異質性存在。對此異質性的了解，可以幫助青少年特定物質使用之防制工作。

Aims: To investigate whether variation may exist in betel nut- and ecstasy-involved adolescents in terms of sociobehavioral characteristics, the experience of psychoactive substance use, and behavioral/emotional problems. Methods: Students (n = 53,528) aged 12 to 18 sampled via stratified, multistage, random cluster sampling in 2004, 2005, and 2006 throughout Taiwan were categorized into four groups: betel nut- and ecstasy-naive (n = 51,009), betel nut use only (n = 1965), ecstasy use only (n = 196), and use of both (n = 152). Participants completed a questionnaire with information on sociodemographic features, substance-use experiences, and the Chinese adaptation of the Youth Self Report. Results: Having a job, a larger weekly allowance, truancy, sexual experience, and externalizing behaviors were all in strong association with the involvement of either betel nut or ecstasy use. Compared with ecstasy-only users, betel nut-only users were more likely to be male, from the Eastern region of Taiwan, with initiation motivated by family members or friends, and having excess risks for Anxiety/Depression, Thought Problems, and Attention Problems. In contrast, ecstasy-only users were more likely to be female and involved in using other illegal drugs, with their initiation motivated by entertainment and with the drug-use taking place in such settings. Conclusions: The variation in the experience of psychoactive substance-use and behavioral problems for betel nut and ecstasy users suggests the existence of subgroups of drug-using adolescents in Taiwan. The identification of such heterogeneity may guide the efforts to reduce substance use and develop subgroup-tailored preventive programs.