以Pender健康促進模式探討新北市國小高年級學童拒菸行為之研究

As the prevalence of smokers in Taiwanese youth steadily increase year by year, the prevention of smoking behavior should start with upper-grade elementary students who may attempt to smoke. However, academic knowledge of the anti-smoking behaviors of students at this age is scarce in Taiwan. This study used 5th and 6th grade students of New Taipei City elementary schools in the 2009 academic years as the population and Pender Health Promotion Model as basis to study the various contributing factors of anti-smoking behavior in upper-grade elementary students in an effort to provide more information to the promotion of the ongoing anti-smoking behavior efforts.This study utilized stratified random sampling to select 37 schools from New Taipei City, with 118 classes of 5th graders and 6th graders each. The effective sample size was 6,886 for a return rate of 98.1%. The results were as follows:1. Smoking awareness of the target group remained to be strengthened. Most students held positive anti-smoking attitudes, had low accessibility of tobacco products, and had positive experience in anti-smoking courses. However, while nearly 80% of students chose anti-smoking behavior, 20.6% seldom or never executed anti-smoking behavior.2. The results of ANOVA test demonstrated that anti-smoking behavior was strongly correlated to gender, education level of father, smoking experience, and whether parents and friends were smokers. According to Pearson's correlation coefficient analysis, anti-smoking behavior was positively correlated to the knowledge of the harmful effects of smoking, anti-smoking attitudes, and experience in anti-smoking courses, and negatively correlated to accessibility of tobacco products.3. According to hierarchical regression analysis of the sample, factors such as individual characteristics and experiences, behavior-specific cognitive and affect could account for 10% of anti-smoking behavior, with anti-smoking attitudes being the most decisive factor. In association, standard regression coefficient (β) demonstrated that of all factors, anti-smoking behavior was positively correlated to the knowledge of the harmful effects of smoking, anti-smoking behavior, and anti-tobacco course experience. Meanwhile, anti-smoking behavior was negatively correlated to gender, smoking experience, whether friends smoked, accessibility to tobacco products. In other words, the students who were females, had no smoking experience, had more knowledge of the harmful effects of smoking, had anti-smoking attitudes, had more anti-tobacco learning experience, had limited smoking friends, and had little accessibility to tobacco products would most likely be able to execute anti-smoking behavior.In conclusion, the findings of the research suggests:1. In order to establish a smoking-free environment and reduce children's access to the tobacco products, the government should emphasize the harms of the second-hand smoking to children and strengthen the advocacy and execution of the Tobacco Hazards Prevention Act in the anti-smoking educational campaigns.2. Educational institutions need to provide solid anti-smoking education programs and curriculum for upper-grade elementary students to raise their knowledge of the harmful effects of smoking and anti-smoking attitudes, which further enhance to execute anti-smoking behavior.