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標題: | 職場無菸政策執行成效研究 The effectiveness of smoking-free policy in workplace |
作者: | Su-Chen Hung 洪素真 |
指導教授: | 詹長權(Chang-Chuan Chan) |
關鍵字: | 職場,無菸政策,呼氣中一氧化碳,戒菸,距離, workplace,smoking-free policy,exhaled carbon monoxide,smoking cessation,distance, |
出版年 : | 2007 |
學位: | 碩士 |
摘要: | 目的:戒菸計劃以呼氣中一氧化碳濃度檢測普遍為醫院或診所採用,為一種
快速、有效、便利且低成本評估吸菸的方法,但應用此方法於社區和工作場所仍然有限。以呼氣中一氧化碳濃度為吸菸狀態的評估,目前尚無一定的標準。因此本研究以兩部份來探討,第一部份以呼氣中一氧化碳濃度為評估職場勞工戒菸計劃呼吸狀態指標的可行性。第二部份運用上述研究結果評估不同禁菸政策對職場勞工戒菸成效的影響。 方法:本研究在2002年4月至2006年12月間進行。第一部份,以簡稱A廠之某化學品製造廠員工150人為研究對象,包括吸菸的員工123人與不吸菸的員工27人,研究內容包含受測員工的問卷調查,由受測者自行填寫問卷調查表包括個人基本資料:身高、體重、性別、年齡、每日吸菸量、吸菸行為、尼古丁依賴評估,以及使用一氧化碳偵測器(Micro Medical Limited; UK)量測呼氣中一氧化碳濃度。所取得的資料以Microsoft Excel 2003及Minitab軟體作Descriptive Statistics、Pearson Correlation,、Simple Linear Regression、Two-by Two Table等執行相關之統計運算與分析。第二部份,選擇三家不同禁菸政策之化學品製造廠為無菸政策研究對象。參與調查的吸菸員工為A廠118人,B廠47人與C廠11人。A廠實施禁菸規定,除特定區域外在工作場所及室內禁止吸菸;B廠實施的禁菸規定與A廠相同,而C廠則在廠區範圍內實施全面禁菸規定。研究內容為收集以上三廠無菸政策實施前、後員工之吸菸量、吸菸率及吸菸狀況、呼氣中一氧化碳濃度,比較前後的差異。 結果:第一部份顯示於表1與圖3。非吸菸者呼氣中一氧化碳濃度平均值4.2 ppm (95% CI:3.3~5.1),吸菸者呼氣中一氧化碳濃度與每日菸量有正相關性,r=+0.73 (P<0.01),迴歸模式為呼氣中一氧化碳濃度值(ppm)等於4.43加0.70乘每日菸量(支) (Adjusted R-square: 0.44),{Regression equation: CO(in ppm)=4.43+0.70 x cigarette consumed /stick/day}。以呼氣中一氧化碳濃度大於6ppm判定為有吸菸 (敏感性84%, 特異性:85%)。第二部份評估職場實施無菸政策之成效,由於各廠施行之禁菸規定不同,員工的吸菸狀況亦有所差異。結果員工在吸菸率與平均每日吸菸量方面顯示各廠不同的成效。在A廠(1)全廠員工吸菸率降低14.9%,戒菸率34.7%(2)吸菸量降低54.4%,仍在吸菸的員工平均每人每日可減少菸量4.3支。(3)員工參與戒菸班戒菸成功率為34.7%。(4) A廠於2004/1/1達成無菸政策目標並在政府主管機關登記核備。(5)員工遵守公司禁菸規定迄今無違反案件。在B廠(1) 全廠員工吸菸率降低2.8%,戒菸率8.5%(2) 吸菸量降低11%,仍在吸菸的員工平均每人每日可減少吸菸量0.4支。(3) B廠於2005/7/1達成無菸政策目標並視同公司安全規定處理。(4)員工遵守公司禁菸規定迄今無違反案件。在C廠(1)員工吸菸狀況無顯著差異(2) C廠仍如以往依據安全規定實施無菸政策。 結論:本研究發現呼氣中一氧化碳濃度6ppm可以做為評估職場勞工戒菸計劃吸菸狀態的追蹤指標。我們的研究證明工廠執行的禁菸政策,可以對員工的吸菸行為帶來關鍵性的影響。A廠與B廠以不同的方式實施無菸政策,結果在降低吸菸率與吸菸量上有明顯的差異,分別為A廠14.9%與54.4%,B廠為2.8%與11%。 結果相較之下,A廠減少的吸菸率與吸菸量,分別比B廠各高出5倍。本研究實施過程發現,僅配合政府實施禁煙規定但無任何介入措施,對於減少員工吸菸率或吸菸量毫無幫助。其次,雖實施無菸政策並規劃戒菸課程,但若實施過程未落實或敷衍了事,不但消耗資源與時間,也無法達到良好的成效。工作場所的菸害防制工作,除長期投注的努力外,還要依據好的規劃方法確實執行,落實無菸政策以確保職場的菸害防制工作能順利推展,達成減少菸害保護員工健康的最終目標。 Objective: Exhaled carbon monoxide (CO) concentration is an effective indicator of smoking cessation program in clinics and hospitals. Its application in the community and workplace, however, remains limited. The first section, this study was established that exhaled CO concentration can be used as an objective indicator of the amount of daily cigarette consumption among smokers in the workplace. The second section, for the reason to verify the effectiveness smoking-free policy in workplace. Methods:This research is divided into 2 sections, which had been completed during April 2002 to December 2006. The first section, samples were taken from plant A, a chemical production site, for 150 workers, which included 123 non-smokers and 27 smokers.The conduct of the research are included the analysis of population data, personal information fill out on height, weight, sex, age, cigarette consumption, smoking behavior and the exhaled carbon monoxide level were measured using Micro CO meter (Micro Medical Limited; UK). Microsoft office excel 2003, Minitab software were applied to data analysis by descriptive statistics, pearson correlation, simple linear regression, two-by-two table。The second section, we selected 3 different smoking policy of chemical factories as policies study. Smoker participants included A plant 118, B plant 47 and C plant 11, At that time plant A and plant B implemented prohibitive smoking policy, plant C implemented smoking-free policy. The study were collect the numbers of daily cigarette consumption and smoking behaviors report and the exhaled carbon monoxide level were measured, comparison difference between smoking policy implemented before and after. Results: First section presents as Table.1& Fig.3. The mean exhaled carbon monoxide level of nonsmokers is 4.2 ppm (95% CI: 3.3~5.1).The exhaled CO levels and the numbers of daily cigarette consumption are closely related with the correlation coefficient being +0.73(p<0.01), Adjusted R-square 0.44(simple linear regression model) . A reading > 6 ppm suggests that the worker might be a smoker (Sensitivity: 0.84, Specificity: 0.85). The second section research is the result on the evaluation of non-smoking policy. According to different policies in different plant site did come out with distinct results. Smoking rate and cigarette consumption decrease displayed different effect on each plant. On plant A, (1)14.9% of smoking rate reduction, 34.7% of quit smoking rate. (2)54.4% of cigarette consumed reduction ., 4.3sticks(person/day) of current smoker’s cigarette consumed decreased.(3)34.7% of smoking-free program participants succeeded.(4)achieved smoking-free policy workplace on 2004/01/01 , company registered smoking-free policy to local government.(5)Employees totally complied with legal and plant regulation, non violation case so far. On plant B, (1) 2.8% of smoking rate reduction, 8.5% of quit smoking rate. (2)11% of cigarette consumed reduction, 0.4 sticks (person/day) of current smoker’s cigarette consumed decreased. (3)Plant B achieved smoking-free policy workplace on 2005/07/01 as legal safety regulation.(4)Employees totally complied with legal and plant regulation, non violation case so far. On Plant C (1) Plant C had not been detected difference of smoking status between policies before and after. (2) Plant C keep smoking-free policy as legal safety regulation as past years. Conclusions: We suggest that a cut-point 6ppm of exhaled CO level can be a useful and objective indictor to distinguish smokers from non- smokers in the workplace in Taiwan. The study found that comprehensive achieved tobacco control program in workplace plays a critical or role setting up regulations, even for smokers. Our study proves that the smoking free policy can efficiently affect the worker’s smoking behavior. Plant A and Plant B implement the smoking-free policy with different programs so there are significant difference in the reduction of smoking rate and cigarette consumption between the two plants. The reduction of smoking rate and cigarette consumption for plant A are14.9% and 54.4% while they are 2.8% and 11% for plant B. Based on this study, only complying with government regulations does not help the reduction of smoking rate and cigarette consumption. Although there are smoking-free program and related quit-smoking course in place, it is hard to achieve the goals and probably will waste resource and time if the execution plan is not well performed. In order to maintain a smoking harm-free work place and provide employees with healthy working environment, the following steps should be taken place. Set up smoking-free policy to help the develop smoking-free program and detailed implementation plan. Well execute the plan to keep monitoring the sustainability of tobacco control. Overall, the reduced smoking rate and smoking amount in A plant are both of 5 times higher than those in B plant. It is found not only the long-term effort in manpower and time but also strong commitment the program so that we can establish and sustain the smoking free policy in the workplace. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/27902 |
全文授權: | 有償授權 |
顯示於系所單位: | 職業醫學與工業衛生研究所 |
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