大學生菸害防制法新制之認知對於其採取戒菸措施 行為意圖之影響：計劃行為理論之應用

Abstract

研究背景：吸菸對全球公共健康和經濟造成了深遠的影響，根據世界衛生組織的統計結果顯示，吸菸造成的相關疾病每年導致超過800萬人死亡，其中包括因暴露於二手菸而致命的人群。面對這一嚴峻的狀況，全球各國政府不斷強化控菸政策，以減少吸菸率並保護公共健康。臺灣於民國112年推動實施了新的菸害防制法修正案，旨在進一步加強對菸草產品的管制，尤其是針對年輕人群體的吸菸行為。這些政策措施包括提高菸草稅、擴大無菸區域、加強對菸草廣告的限制以及規範新型菸草產品如電子煙的使用。然而，該政策在年輕族群中的實際成效，特別是對大學生戒菸行為意圖之影響，尚需進一步研究和驗證。本研究結果提供本土化的實證資料，填補對菸害防制法新制實施效果研究的知識缺口，並為政府單位及相關機構在未來菸害防制成效提升與後續戒菸相關活動與策略訂定之參考依據。 研究目的：本研究以計劃行為理論(TPB)為基礎，旨在探討大學生對菸害防制法新制之認知與態度，如何透過行為態度、主觀規範及自覺行為控制等路徑，影響其戒菸意圖。本研究目的包括：瞭解受測大學生之背景特徵分佈與各研究變項之現況；分析不同背景特徵之大學生在法規認知、法規態度及TPB各構念上之差異情形；探究大學生對新法規之認知與態度與TPB三大核心構念間之關聯；探討戒菸行為態度、主觀規範及自覺行為控制對戒菸行為意圖之關聯性。 研究方法：本研究採用橫斷面調查設計，對大學生進行問卷調查。問卷包括背景資料、菸害防制法新制認知量表、菸害防制法新制態度量表，以及計劃行為理論變項問卷等部分。數據將使用信效度分析、描述性統計分析、雙變項分析、迴歸分析、路徑分析進行統計，以檢驗各潛在變項之間的關聯性。 研究結果：本研究共納入536位有效樣本進行分析。在雙變項分析方面，受試大學生對菸害防制法新制資訊的充足度，與新制認知、新制態度、戒菸行為態度、戒菸自覺行為控制及戒菸行為意圖均呈現顯著差異，惟在戒菸主觀規範未達顯著差異；此外，性別與學科類別在戒菸行為意圖上呈現顯著差異。迴歸分析結果指出，在控制相關干擾變項後，新制態度、戒菸行為態度、戒菸自覺控制，皆對戒菸行為意圖呈現顯著影響；而壓力指數與菸品依賴程度則為顯著之負向預測因子。路徑分析進一步證實本研究架構之適用性，顯示新制認知與新制態度能透過戒菸行為態度、主觀規範及自覺行為控制等三大核心構念的路徑，進而影響大學生的戒菸行為意圖。 結論：透過計劃行為理論（TPB）的路徑架構，幫助我們瞭解大學生的戒菸行為意圖。其中，新制認知與新制態度在大學生採取戒菸措施決策歷程中扮演關鍵角色。因此，建議可從新制認知以及新制態度等方面著手，制定相關健康行為衛生教育策略。

Background: Smoking poses profound challenges to global public health and economic stability. According to statistics from the World Health Organization (WHO), tobacco-related diseases account for over eight million deaths annually, a figure that encompasses fatalities resulting from exposure to secondhand smoke. In response to this critical issue, governments worldwide have consistently intensified tobacco control policies aimed at reducing smoking prevalence and safeguarding public health. In 2023, Taiwan implemented significant amendments to the Tobacco Hazards Prevention Act. These amendments aim to further tighten regulations on tobacco products, with a specific focus on curbing smoking behaviors among the youth population. Key policy measures include increasing tobacco taxes, expanding smoke-free environments, imposing stricter restrictions on tobacco advertising, and regulating emerging tobacco products, such as electronic cigarettes. However, the actual effectiveness of these policies among the younger demographic in Taiwan—specifically their impact on college students' behavioral intention to quit smoking—requires further empirical investigation and verification. The findings of this study provide localized empirical evidence, bridging the knowledge gap regarding the effectiveness of the Revised Tobacco Hazards Prevention Act. Furthermore, they serve as a critical reference for government agencies and relevant institutions to enhance tobacco control efforts and formulate future smoking cessation strategies and initiatives. Purpose: Grounded in the Theory of Planned Behavior (TPB), this study aims to investigate how college students' knowledge of and attitudes toward the Revised Tobacco Hazards Prevention Act influence their behavioral intention to quit smoking, specifically as mediated through the pathways of attitude toward the behavior, subjective norm, and perceived behavioral control. The specific objectives of this study include: (1) to understand the distribution of demographic characteristics among the participating college students and the current status of the research variables; (2) to analyze the differences in knowledge of the regulations, attitudes toward the regulations, and the various TPB constructs among college students with different demographic characteristics; (3) to explore the relationship between students' knowledge of and attitudes toward the Revised Tobacco Hazards Prevention Act and the three core constructs of the TPB; and (4) to investigate the association of attitude toward smoking cessation behavior, subjective norm, and perceived behavioral control with the behavioral intention to quit smoking. Methods: This study employed a cross-sectional survey design administered to college students in Taiwan. The research instrument consisted of several sections: demographic information, the Scale on Knowledge of the Revised Tobacco Hazards Prevention Act, the Scale on Attitude toward the Revised Tobacco Hazards Prevention Act, and the Theory of Planned Behavior (TPB) inventory. Data analyses included reliability and validity assessment, descriptive statistics, bivariate analysis, regression analysis, and path analysis, which were adapted to examine the relationships among the latent variables. Results: A total of 536 valid samples were included in the analysis. Regarding bivariate analysis, significant differences were found in the knowledge of and attitude toward the new regulations, attitude toward smoking cessation, perceived behavioral control, and behavioral intention to quit smoking based on the participants' perceived sufficiency of information regarding the new regulations; however, no significant difference was observed for subjective norm. Furthermore, gender and academic major showed significant differences in the behavioral intention to quit smoking. Regression analysis indicated that after controlling for relevant confounding variables, attitude toward the new regulations, attitude toward smoking cessation, and perceived behavioral control significantly predicted the behavioral intention to quit smoking. Conversely, stress index and the level of nicotine dependence were identified as significant negative predictors. Path analysis further confirmed the applicability of the research framework, demonstrating that knowledge of and attitude toward the Revised Tobacco Hazards Prevention Act influenced college students' behavioral intention to quit smoking through the mediating pathways of attitude toward smoking cessation, subjective norm, and perceived behavioral control. Conclusion: By adapting the path structure of the Theory of Planned Behavior (TPB), this study elucidates college students’ intentions to engage in smoking cessation behaviors. In particular, awareness of the revised tobacco control policy and attitudes toward the revised policy play pivotal roles in the decision-making process underlying students’ adoption of smoking cessation measures. Accordingly, it is recommended that health education and behavior-change interventions be designed with a focus on enhancing policy awareness and fostering positive policy-related attitudes.