"臺灣吸菸行為與社經地位關係之變化,2004-2013"

Abstract

目的：本研究欲探討2004至2013年臺灣18歲以上民眾吸菸行為趨勢變化，及不同社經地位吸菸行為的差異，並探討2009年菸害防制政策實施後，對不同社經地位吸菸行為的影響。 方法：以衛生福利部國民健康署於2004至2013年間，每年進行之「成人吸菸行為」橫斷性電話調查(完訪樣本數約為16,500人/年) 共計10次之次級資料分析。以教育程度、家戶月收入為社經地位指標，以描述性統計分析吸菸行為分佈，以邏輯斯迴歸探討不同社經地位對吸菸行為之影響，及以年分、菸害防制政策實施對教育程度及家戶月收入之吸菸行為之交互作用分析。資料分析為以臺灣2000年人口之性別、年齡與地理區域進行加權後之推估結果。 結果: 2004至2013年間，臺灣成人從未吸菸、過去吸菸率逐年上升，目前吸菸率逐年下降趨勢。目前吸菸率的變化男性由39.05%降至23.37%，女性則由3.97%降至2.64%。不論男女都以25~44歲之目前吸菸的可能性最高。教育程度較低族群之從未吸菸率較低，目前吸菸率較高。此外，男性家戶月收入較高族群之從未吸菸率較高、目前吸菸率較低，但女性不同家戶月收入之吸菸行為較無規則性。10年間男性不同社經地位為之目前吸菸行為並未隨著年度不同而有改變，而女性則有擴大趨勢。而菸害防制政策實施對男女性不同社經地位之目前吸菸行為的影響有限。 結論:臺灣在2004至2013年之從未吸菸率及目前吸菸率逐年下降，但不同教育程度間存在吸菸行為的不平等。建議未來菸害防制政應著重在以健康平等為導向，找出改善社經地位較低族群之吸菸行為的最適當的方法。

Aim: This study aims to examine the change of smoking behavior and to examine the effect of tobacco control policies implementation among Taiwanese adults by socioeconomic status from 2004 to 2013. Methods: This study used 「adult smoking behavior telephone survey」, repeated cross-sectional from 2004 to 2013, for second hand data analysis which collected from Health Promotion Administration, Ministry of Health and Welfare. This study (sample around16,500 per year) examine the trends in never smoking, former smoking and current smoking among 18 years old and above. Education level and home income level were used as indicators of socioeconomic status (SES) and results were reported separately for men and women. Using logistic regression to examine the relationship between smoking behaviors and SES, and the interaction between ‘years’ and education/income level, and between‘ tobacco control policies implementation’ and education/income level.Using weighted and sex, age, and living area standardized according to the population of 2000 year of Taiwan. Results: The trends in never smoking, former smoking prevalence increased and current smoking decreased in Taiwanese adults from 2004 to 2013. Between 2004and 2013, the prevalence of current smoking decreased from 39.05% to 23.3% for men and from 3.97% to 2.64% for women. There were more current smokers for the 25~44years old in both men and women. Lower educated male respondents were significantly less likely to be never smokers , and more likely to be current smokers than higher educated male respondents, but not for female. During this 10 years, different SES in current smoking behavior didn’t change for male, while it was enlarge for female. The tobacco control policies implementation had a limited impact in different SES in current smokers both male and female. Conclusions: Although the prevalence of smoking decreased and never smoking increased from 2004 to 2013, the inequalities in smoking behavior in different SES. This result suggested interventions specifically designed for those of lower SES and should be addressed in equity-oriented tobacco control policies.