以計劃行為理論探討國中生電子煙使用之行為意圖與其相關因素：臺北市某國中之調查研究

Abstract

背景：電子煙使用率在近幾年迅速增加，在青少年和青年族群中更是明顯，加上目前研究已發現的危害，電子煙已經成為新一代重要的公共衛生議題。首先，青少年的大腦尚在發育階段，如果接觸到電子煙裡的尼古丁，可能造成大腦受損，甚至有尼古丁依賴而難以戒除；其次，目前研究皆指出電子煙無法有效幫助戒菸，反而會增加青少年使用紙菸的可能性，造成更多健康危害；最後，使用電子煙會造成入門效應，進而使用紙菸、酒、藥物等其他成癮物質，甚至與許多危險行為有顯著相關。根據國民健康署的調查，青少年吸菸比例有明顯下降，但電子煙使用比例卻有明顯增加的趨勢，尤其高中生的使用比例更是國中生使用比例的兩倍，表示青少年如未在較早的年紀認知到電子煙的危害，則隨著青少年年紀增長，會更有可能接觸且使用電子煙，因此更加凸顯從國中開始實施電子煙防制的重要性。 目的：本研究期望透過計劃行為理論，了解國中生的電子煙使用意圖，及影響其使用的相關因素，以提供政府單位、教學單位，方便於未來制定政策、發展適性的教學相關策略時能夠做為實證參考。 方法：本研究以立意取樣，招募臺北市某國中七年級全體學生，於該校健康教育課時請學生填寫網路匿名自填式問卷。經篩檢過濾，共納入531位研究參與者進行分析。並透過描述性分析、雙變項分析、羅吉斯回歸分析，探討計劃行為理論、背景變項與電子煙使用意圖之關係。 結果：當性別為男性、學業表現位於班排後段者、平均每月零用錢為1,500元 (含) 以上及家人有吸菸之學生，其成為高意圖電子煙使用者的勝算比較高。在計劃行為理論直接測量方面，行為態度越正向、主觀規範越支持、自覺行為控制越容易，其成為高意圖使用者的勝算比較高。間接測量方面則發現，樣本之主觀規範相對正向組、有利及阻礙情境之自覺行為控制相對正向組，其成為高意圖使用者的勝算比較高。 結論：計劃行為理論可有效檢測國中生電子煙使用意圖，未來對國中生進行電子煙防制宣導時，可以針對電子煙之正向行為態度以及自覺行為控制，以降低其意圖。

Background: E-cigarette use has increased substantially, especially among adolescents, and e-cigarette prevention has become a new crucial public health issue due to its harmful effects. First, e-cigarettes contain nicotine which has detrimental effects on the developing brain of adolescents, and can cause nicotine dependence. Second, e-cigarette use is associated with decreased likelihood of smoking cessation among smokers, and increased the possibility to smoke. Lastly, due to the Gateway Drug Theory, e-cigarette use is associated with the use of tobacco, alcohol, drug, and other substances, as well as engagement in risky behaviors. According to the 2019 Taiwan Health Promotion Administration survey, the prevalence of smoking among Taiwanese adolescents has declined, but the prevalence of e-cigarette use among Taiwanese adolescents have increased. Particularly, the prevalence of e-cigarette use jumped from 1.9% among junior high school students to 3.4% among senior high school students. This survey finding highlight the importance of e-cigarette prevention for junior high school students. Objectives: Based on the Theory of Planned Behavior (TPB), the aim of this study is to examine the e-cigarette using intention (ECUI) among junior high school students. Methods: Using convenience sampling, a total of 531 seventh grade students from junior high school in Taipei City completed the anonymous online self-reported questionnaire. Exploratory factor analysis, descriptive analysis, chi-square tests and logistic regression analysis were applied to examine the associations of the TPB constructs and the background variables with ECUI. Results: This study found that several individual characteristics were associated with ECUI, namely sex, academic performance, pocket money, and smoking statues of family members. In addition, the results show that the significant associations of TPB constructs with ECUI. Participants who had more positive attitude, more supportive subjective norms, and higher perceived behavioral control were associated with increased odds of ECUI. Conclusion: TPB can examine ECUI among junior high school students. Decreasing positive attitude toward behavior and perceived behavioral control could be the mean to reduce ECUI among students in e-cigarette prevention curriculum.