台灣地區不同縣市人口特質與都市化程度之成人吸菸率差異比較
中文摘要
吸菸率受到個人社會人口學特質如性別、年齡、社經地位之教育程度、收入與職業等影響，普遍看 來低社經地位者其吸菸率較高，健康狀態亦顯著較差。台灣地區由於快速都市化的發展，使得城鄉 經濟發展差距愈加顯著，其健康狀況分佈呈現不平等的現象。檢視吸菸相關文獻，多以個人角度闡 述其不同行政區域或戶籍所在地區之吸菸率分佈，鮮少研究以縣市為單位，探討縣市人口特質與吸 菸率之關聯，因此本研究欲探討縣市人口特質與吸菸率之關聯，並透過都市化程度，以找出不同都 市化程度間成人吸菸率之差異性。
本研究為次級資料分析，進行橫斷性研究（ cross-sectional study ），以台灣地區 25 個縣市為分析 單位。研究分析結果如下：
一、民國 93 年、 94 年縣市（男性）成人吸菸率與人口密度達顯著負相關， 94 年縣市男性成人吸 菸率亦與服務業就業比率達顯著負相關。 93 年縣市女性成人吸菸率與國中及以下教育程度比率、農林漁牧業就業比率達顯著負相關， 94 年與平均每戶全年經常性收入呈現臨界顯著正相關。
二、民國 94 年縣市成人吸菸率與腦血管疾病、支氣管炎、肺氣腫及氣喘死亡率達顯著正相關；兩 年縣市男性成人吸菸率皆與腦血管疾病死亡率達顯著正相關， 94 年縣市男性成人吸菸率亦與缺血 性心臟病、支氣管炎、肺氣腫及氣喘、慢性肝病肝硬化死亡率達顯著正相關。
三、僅 94 年縣市男性成人吸菸率與鼻咽癌發生率達臨界顯著正相關，縣市女性成人吸菸率與子宮 頸癌發生率達統計顯著負相關。
四、縣市成人吸菸率、縣市男性成人吸菸率解釋因子主要為人口密度、失業率、農林漁牧業就業比 率、平均每戶全年經常性收入，縣市女性成人吸菸率則為國中及以下教育程度比率、失業率。
五、不同都市化程度之成人吸菸率有差異。
相關衛政單位應持續監測吸菸率及二手菸暴露情形，改善二手菸的危害，以提升國人健康。從事公 共衛生領域之相關人員應瞭解地方特性分佈，以地方區域為導向進行相關介入措施，並帶動社區參 與防制菸害工作，以降低吸菸行為所帶來的健康危害。The Association of Demographic Characteristics, the Level of Urbanization and Adult Smoking Prevalence
英文摘要
Title of Thesis: The Association of Demographic Characteristics, the Level of Urbanization and Adult Smoking Prevalence
Institution: Graduate Institute of Nursing, Taipei Medical University Author: Yu-YinWei
Thesis directed by: Ping-Ling Chen PhD, MPH, Associate Professor Most studies had shown that smoking prevalence was related with individual social economic status. Only few researches were conducted to explore the association between demographic characteristics and smoking prevalence by county-level. The purposes of this study were to determine the association between county-specific demographic characteristics, tobaccorelated mortality, tobacco-related cancer incidence rate, and adult smoking
prevalence by county-level. In addition, the association between levels of urbanization and individual smoking behaviors were also determine in this study. Secondary data analyses were conducted.
Results:
1. In 2004 and 2005, county (male) adult smoking prevalence was significantly negative correlated with population density. In 2005, county male adult smoking prevalence was significantly negative correlated with service employment ratio. County female adult smoking prevalence was significantly negative correlated with junior college and below education ratio and agriculture, forestry, fishing and animal husbandry employment ratio in 2004, and borderline significantly positive correlated with average income per household in 2005.
2. In 2005, county adult smoking prevalence was significantly positive VIcorrelated with crude mortality of cerebrovascular disease, bronchitis, emphysema and asthma. In 2004 and 2005, county male adult smoking prevalence was significantly positive correlated with crude mortality of cerebrovascular disease. In 2005, county male adult smoking prevalence was significantly positive correlated with crude mortality of ischaemic heart disease, bronchitis, emphysema and asthma, chronic liver disease and cirrhosis.
3. In 2005, county male adult smoking prevalence was borderline significantly positive correlated with crude nasopharyngeal cancer incidence rate. For female was significantly negative correlated with crude cervical cancer incidence rate.
4. By using county demographic characteristics to explain the variance of county/male adult smoking prevalence, it revealed that population density, unemployment rate, agriculture, forestry, fishing and animal husbandry employment ratio, average income per household could be explained 47.70% and 42.89%, respectively. For female, junior college and below education ratio, unemployment rate explained 37.51% of variance.
5. Adult smoking prevalence among population of lower level of urbanization was higher than population of higher level of urbanization.
Public health professionals should be aware of importance of the regional-oriented interventions and promote community participation in tobacco control activities to reduce the hazards of smoking behavior.
KeyWords: adult smoking prevalence, level of urbanization, demographic characteristics.
