第五章 結論與建議
第二節 建議
根據本研究結果、討論與結論，分別針對戒菸教育、介菸宣導、課 程規劃及未來研究方向提出建議如下：
一、根據本研究結果，吸菸學生在菸害知識方面明顯不足，其中戒菸知 識及菸害防制法規答對率偏低，建議未來除了固定要有一定時間的 菸害法令課程外，也請校長、教官及老師都能以身作則，從生活中 教導學生，才有事半功倍的效果。
二、戒菸相關的因素，如拒菸態度、吸菸危險知覺、戒菸技巧及戒菸自 我效能皆與戒菸行為改變階段有關，可依照上述各因素，有系統的 將其融入教材內。
三、戒菸宣導要靠大家一起來，學校與教育及衛生單位應密切配合，透 過平面及電子媒體，廣泛的向大眾宣導吸菸的害處及戒菸的必要性 及可行性；學校也可辦理各類以戒菸為題的演講、舞蹈、繪畫及歌
四、本研究發現，在戒菸自我效能方面，研究對象在面臨壓力、挫折及 寂寞時，可能誘發吸菸的行為，此時有把握戒菸的信心最低，因此，
真正要青少年戒菸要有成效，可增加情緒調適及壓力管理的課程，
建立輔導機制，協助學生在面對各種可能誘發吸菸的情境時，能夠 勇敢拒菸，進而達到戒菸的成效。
五、由於本研究屬橫斷式研究，無法得知行為改變是否確已發生，且因 果關係不易確認，因此，未來應可針對「戒菸」進行長期研究，可 深入了解戒菸行為階段之改變及會影響其改變的因素。
六、國內目前對吸菸議題的研究已很普遍，而針對青少年戒菸行為改變 的研究卻不多，未來可將對此議題的研究擴大至全國，可建立更客 觀而完整的資料。
七、未來研究除了探討個人、家庭及同儕因素如何影響戒菸行為改變階 段外，更可擴大範圍至社區及社會層面，將可獲得更有價值的資料，
對青少年戒菸行為的改變有更具體、完整的資料。
文獻探討
中文部份
黃淑貞(1982)。國中男生開始抽菸之誘因及其仿效對象之研究。國立台灣 師範大學衛生教育學系碩士論文，臺北。
陳錫琦(1985)。從態度與主觀規範的因素探討國中生之抽菸意向。國立台 灣師範大學衛生教育學系碩士論文，臺北。
黃松元、余玉眉、江永盛、陳政友、賴香如、何瑞琴(1991)。台灣地區青 少年吸菸行為調查研究。衛生教育論文集刊，5，45-66。
黃淑貞(1997)。大學生健康信念、自我效能、：社會支持與吸菸行為研究。
學校衛生，31，30-43。
李景美、林秀霞、劉雅馨(1998)。中學生藥物濫用認知、態度、行為及教 育需求調查研究。衛生教育學報，11，59-76。
李燕鳴(1998)。花蓮市高中生之性知識、態度和行為調查。慈濟醫學，10，
211-219。
周碧瑟、劉美媛、賴明芸、萧美玲、張鴻仁(1999)。Time Trend of Substance Use Among Adolescent Students in Taiwan, 1991-1996. 台灣醫學會雜 誌，98，827-831。
李蘭、陳秀熙、潘怜燕(1999)。民國八十八年台灣地區成人及青少年之吸 菸率及吸菸行為調查：菸害防治法實施一年後之初評。台北：行政 院衛生署八十八年度委託研究計畫成果報告(DOH88-HP-Tobac03)。
游育苓(1999)。以健康信念模式探討某高職吸菸學生之戒菸意向。國立台 灣大學護理學研究所碩士論文，臺北。
李杰炫(2000)。青少年戒菸意向之研究：計畫行為理論之應用—以台中 縣、市專科吸菸學生為例。靜宜大學青少年兒童福利學系碩士論文，
臺中。
郭柏秀(2001)。青少年吸菸與喝酒之雙胞胎追蹤研究。國立台灣大學衛生 政策與管理研究所碩士論文，臺北。
陳怡如（2001）。香菸廣告之接觸、認同與吸菸行為之關係—以北縣高職 學生為例。國立台灣大學衛生政策與管理研究所碩士論文，臺北。
陳秀娟（2001）。桃園縣高中職學生吸菸行為之相關探討---跨理論模式之 應用。中山醫學大學醫學研究所碩士論文，臺中。
李景美、張鳳琴、賴香如、李碧霞、陳雯昭（2002）。台北縣市高職一年 級學生成癮物質濫用之危險與保護因子之研究。衛生教育學報，17，
73-88。
柯姍如(2002)。家人及好友對高中生吸菸行為的影響。國立台灣大學衛生 政策與管理研究所碩士論文，臺北。
葉美玲、陳興夏、張惠芬(2002)。網路網路輔助戒菸課程於青少年之成效。
台灣醫學，6(5)，648-660。
李景美(2003)。青少年菸害預防—策略層面之探討。醫護科技學刊，5(4)，
307-329。
李淑卿(2003)。戒菸教育計畫介入成效之研究—以台北縣某技術學院學生 為例。國立台灣師範大學衛生教育學系碩士論文，臺北。
余致力、黃東益、田玉玨 (2004)。台灣地區青少年菸害媒體識讀能力探 討。載於：輕鬆識讀、菸害消除：菸害媒體識讀教學手冊。臺中：
行政院衛生署國民健康局。
張明惠(2004)。青少年戒菸教育課程介入成效之探討—以台北市某公立高 職院學生為例。國立台灣師範大學衛生教育學系在職進修碩士論 文，臺北。
方美蘭(2005)。 某技術學院學生戒菸教育介入成效之研究。國立台灣師 範大學衛生教育學系碩士論文，臺北。
劉美媛(2005)。 台北市某高職學生吸菸行為之探討—跨理論模式之應 用。國立台灣師範大學衛生教育學系碩士論文，臺北。
林子惠(2006)。「走出菸霧」介入模式對國中生吸菸行為改變之成效。國 立成功大學護理學系碩士論文，臺南。
行政院衛生署國民健康局(2007)。台灣菸害防制年報 2007。臺北。
邱柔蒲(2008)。高職學生吸菸行為及其相關因素之研究—以新竹市某高中 進修學校為例。國立台灣師範大學健康促進與衛生教育學系碩士論 文，臺北。
賴鐘璇(2008)。台北市高中職學生菸品訊息接觸與菸害知識、拒菸態度及 吸菸行為之相關研究。國立台灣師範大學健康促進與衛生教育學系 碩士論文，臺北。
李景美、黃松元、陳政友、苗迺芳、李淑卿、鄭其嘉、羅惠丹、龍芝寧、
黃秀媚、廖信榮、康杏如、業純瑜、林雅婷 (2008)。青少年戒菸教 育實施之先驅計畫。行政院衛生署國民健康局委託之專題研究成果 報告，臺北。
行政院衛生署國民健康局(2008)。台灣菸害防制年報 2008。臺北。
行政院衛生署國民健康局(2009)。台灣菸害防制年報 2009。臺北。
教育部（2011）。各級學校縣市別學生資料。教育部。
英文部份
Aaro, L., Hauknes, A.,& Berglund, E. (1981). Smoking among Norwegian schoolchildren 1975-1980.2. The influence of the social environment.
Social Psychology. 22,297-309.
Adams, PF., Schoenborn, CA., Moss, AJ., Warren, CW., ＆ Kann, L.(1992). :Health risk Behaviors among Our Nation’s Youth: United States, 1992” Vital Health Statistics 10(192):7-8. DHHS Publication No.
95-1520. Hyattsville, MD: U.S Department of Health and Human Services, Public health Service, Centers for Disease Control and Prevention, National center for Health Statistics.
Ahn,O.H.,Yeun, E.J.,Kwon,S.B.,Chung,H.K.,&Ryu,E.J(2005). Predictive factors of aspects of the transtheoretical model on smoking cessation in a rural community. Taehan kanho Hakhoe Chi, 35(7),1285-94.
Ajzen, I. (1988). Attitudes, personality, and Behavior. Chicago Dorsey Press,.
Akers, RL., Krohn,MD., ＆ Lanza-kaduce,L.(1979). Social Learning and deviant behavior:A specific test of a general theory. American Sociological Reviews,44,636-55.
Ary, DV.,＆Biglan, A.(1988). Longitudinal changes in adolescent cigarette smoking behavior: onset and cessation. Journal of Behavior Medicine, 11,361-82.
Backinger, CL.,＆Leischow, SJ.(2001). Advancing the science of adolescent tobacco use cessation. American Journal of Health Behavior, May-Jun,25(3),183-90
Bagot, KS., Heishman, SJ.,＆Moolchan, ET.(2007). Tobacco craving predicts
Nicotine Tobacco Research, 9,647-652.
Bakermeier, RF.(1995).The International challenges of anti-smoking education. Journal of cancer Education, 41(7),219-24.
Bandura, A.(1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Reviews, 84(2),191-215.
Bandura, A.(1986). A Social foundations of thought and action: A social cognitive theory. New York: Prentice Hall.
Bauman, KE.,＆Fisher, LA.(1986). On the measurement of friend behavior in research on friend influence and selection: findings from longitudinal studies of adolescent smoking and drinking. Journal of Youth Adolescence,15(4),345-53.
Baumrind, D. (1991). The influence of parenting style on adolescent competence and substance use. Journal of Early dolescence,11(1),56-95.
Becker, M.H. (1974). The health belief model and sick role behavior. Health Education Monographs,2,409-19.
Becker, M.H.,＆Rosenstock, IM.(1987). Comparing social learning theory and the health belief model. Advanced Health Education Promotion, 2(1),245-9.
Breslau, N.,＆Peterson, EL.(1996). Smoking cessation in young adults: age at initiation of cigarette smoking and other suspended influences. American Journal of Public health,86,214-20.
Bridges, L.,＆Moore, K.(2002). Religion and spirituality in childhood and adolescence. Washington DC:Child Trends..
Brownson, RC., DiLorenzo, TM., Van Tuinen, M.,＆Finger, WW. (1990).
adolescents. Preventive Medicine, 19,170-80.
Brownson, RC.(1992). Demographic and Socioeconomic Differences in Beliefs About the health Effects of Smoking. American Journal of Public Health,. 82(1),99-103.
Burt, RD.,＆Peterson, AV. (1998). “Smoking Cessation among High School Seniors” Preventive Medicine, 27,319-27.
Buttross, LS., ＆ Kastner JW.(2003). A brief review of adolescents and tobacco:what we know and don’t know. American .Journal of Medical Science,326,235-237.
Carvajal, SC.,＆Granillo TM.(2006). A prospective test of distal and proximal determinants of smoking initiation in early adolescents. Addictive Behaviors,31,649-660.
Cattell, RB.,＆Krug S.(1967). Personality factors profile peculiar to the student smoker. Journal of Counseling Psychology,14(2),116-21.
Center of Substance Abuse Research.(1999). Alcohol and Cigarette use remains high among students: illicit drug use increasesCESAR FAX. Vol 4. Available at: http://www.cesar.umd.edu. Accessed April 18,1999.
Centers of disease control(1991). Cigarette smoking among youth,1989.
Journal of Americal Medical Association, 264(19),2493-4.
Center for Disease Control.(2004). Targeting Tobacco Use:The Nation’s Leading Cause of Death.
Center for Disease Control.(2009). Smoking and Tobacco Use: Fact Sheet.
www.cdc.gov/tobacco/data=statistics/fact-sheetw/health-effects/effects-c ig-smoking/index.htm.
influence factors in adolescent smoking cessation. Addictive Behavior, 9,383-90.
Chassin, L.L., ＆ DeLucia. C.(1996).Drinking during adolescence. Public Health Reports,20,175-180.
Chen, C.J., Wen, C.P., Tsai, S.P., Liaw, K.M., Cheng, T.Y.,＆Tsai, MC.(2002).
Smoking attributable mortality in Taiwan 1990-2020. Collection of Research Papers on Tobacco or Health in Taiwan,379-399.
Chen, X., Li, Y., Unger, JB., Gong, J.,＆Johnson, CA. (2001). Hazard of smoking initiation by age among adolescents in Wuhan, China.
Preventive medicine, 32,437-445.
Chou, P., Liou, M.Y., Lai, M.Y., Hsiao, M.L.,＆Chang, H.J. (1999). Time trend of substance use among adolescent students in Taiwan, 1991-1996.
Journal of Formosa Medical Association, 98(12),927-31.
Clark, P.I., Scarisbrick-Hauser, A., & Gautam, S.P.(1999). Wirk SI.
Anto-tobacco socialization in homes of African-American and white parents, and smoking and nonsmoking parents. Journal of Adolescent Health, 329-339.
Cochran,W.G..(1977). Sampling Techniques. 3rd ed., John Wiley and Sons Inc.
448p.
Collins, W.A., Maccoby, E.E., Steinberg, L., ＆ Hetherington,E.M.(2000).
Contemporary research on parenting: The case for nature and nurture.
American Psychologist, 5,218-32.
Darling-Hammond, L.(1997). The right to learn: A blueprint for creating schools that work. San Francisco, CA: Jossey Bass.
Denham, S.A., Meyer, MG.,＆Toborg, M.A. (2004). Tobacco cessation in adolescent females in Appalachian communities, Family Community Health,2,170-81.
Denise, E., Delorme, Peggy J, Kreshel,＆Leonard N, Reid.(2003). Lighting up. Young Adult’s Autobiographical Accounts of Their First Smoking Experiences. Youth & Society, 34(4), 468-496.
Dent, C.W., Sussman, S.,＆Flay, B.R. (1993). The use of archival data to select and assign schools in a drug prevention trial. Evalation Reviews,17,159-181.
DiClemente, C.C., Prochaska,J.O., Fairhurst, S., Velicer,W.F.,Rossi, J.S.,
&Velasquez, M.(1991). The process of smoking cessation:an analysis pf precontemplation, contemplation, and preparation stages of change.
Journal of Consulting and Clinical Psychology, 59, 295-304.
Difranza, JR. (2002). It is time to abandon bad science「Electronic letter to the editor of Tobacco Control」. Retrieved July 1. available from: http;//
tc.bmjjournals.com.
Difranza, J.R.,Savageau, J.A.,Rigotti, N.A.,Fletcher, K.,Ockene, J.K.,McNeill A.D., Coleman M.,＆Wood C.(2002a). Development of symptoms of tobacco dependence in youths: 30-minutes follow up data from theDANDY study. Tobacco Control, 11,228-235.
Dube, M., Green, C.R.(1982). Methods of collection of smoke for analytical purposes. In Recent Advanced Tobacco Science, 8,42-102.
Dubos, R.(1965). Man Adapting. New Haven Conn:Yale University Press.
Dwyer, J.H., Rieger-Ndakorerwa, G.E., Seamer, N.K., Fuchs, R.,＆Lippert, P.
cholesterol among adolescents. Journal of American Medical Association, 259,2857-62.
Engles, R.C., Knibbe, R.A., Drop, M.J.,＆Hann, Y. (1997). Homogeneity of cigarette smoking within peer groups:influence or selection. Journal of Health and Human Behavior, 24,801-11.
Ennett, S.,＆Bauman, K.E.(1994). The contribution of influence and selection to adolescent peer group homogeneity: the case of adolescent cigarette smoking. Journal of Personality and Social psychology, 67(4),653-63.
Ershler, J., Leventhal, H., Fleming, R.,＆Glynn, K. (1989). The quitting experience for smokers in sixth through twelfth grades. Addictive Behavior, 14,365-78.
Falomir, J.M., & Invernizzi, F. (1999). The role of social influence and smoker identity in resistence to smoking cessation. Swiss Journal of Psychology, 58:73-84.
Farkas, A.J., Distefan, J.M., Choi, W.S., Gilpin, E.A.,＆Pierce, J.P.(1999).
Does parental smoking cessation discourage adolescent smoking?
Preventive Medicine, 28,213-18.
Faucher, M.A., ＆ Carter, S.(2001). Why girls smoke:a proposed community-based prevention program. Journal of Obstetics &
Gynecology, 30,463-471.
Fick, AC. (1992). The development of adolescent’s health beliefs and their relationship in intentions to smoke cigarettes「Dissertation」. University of New Orleans.
Frieden, T.R.,& Bloomberg, M.R. How to prevent 100 million deaths from
Glanz, K., Lewis, FM.,＆Rimer, BK.(2002). Health Behavior and Health Education. Theory,Research and Practice. 2nd ed. San Francisco:
Jossey-Bass, 41-59.:
Gottfredson, GD.,＆Daiger, DC.(1979). Disruption in 600 schools. Baltimore, MD:Center for Social Organization of Schools, Johns Hopkins University.
Green, D.E.(1979). Teenage smoking. Immediate and long-term patterns.
Washington; National Inst itute of Education.
Ham, O.K., & Lee, Y.J.(2007). Use of the transtheoretical model to predict stage of smoking cessation in Korean adolescent. Journal of school health, 77(6),319-326.
Hansen, W.B.(1983). Behavioral predictors of abstinence: early indicators of a dependence on tobacco among adolescents. International Journal of Addiction, 18,913-20.
Harrison, J.A., Mullen, P.D.,＆Green, L.W. (1992). A meta-analysis of studies of the Health Belief Model with adults. Health Education Research, 7(1),107-16.
Haveman, R., Wolfe, B., ＆ Spaulding, J.(1991). Childhood events and circumstances influencing high school completion. Demography, 28(1),133-57.
Hebert, R. (2003). What’s new in nicotine and tobacco research? Nicotine and Tobacco Research,4,135-38.
Henningfield, J.E.(1994). Smoking and the Workplace:Realities and Solutions.
Journal of Smoking Related Disease,5(1),261-270.
sociopsychological study. Public Health Service Publication, 572.
Hu,T.W.,Lin,Z.,&Keeler,T.E.(1998). Teenage smoking, attempts to quit, and school performance. American Journal of Public Health, 88(6),940-943.
Iscoe, I., William, M., ＆ Harvey, J. (1963). Modifications of children’s judgments by a simulated group technique. Child Development, 34,963-78
James, D.,＆Madeline Dalton. (2001). Does parental Disapproval of Smoking Prevent Adolescents from Becoming Established Smokers? Pediatrics,
James, D.,＆Madeline Dalton. (2001). Does parental Disapproval of Smoking Prevent Adolescents from Becoming Established Smokers? Pediatrics,