背景與目的：吸菸是青少年常出現的成癮行為之一。一旦開始吸菸，則易養成吸菸習慣，長期使用則有害健康，並造成家庭與社會成本的浪費，是一個不管是學界或政府都不可輕忽的重要議題。因此本研究目的除探討青少年的菸害知識、態度及拒菸自我效能行為地影響因素外，也建構菸害防治課程，並檢測其在菸害知識、態度及拒菸自我效能的成效。
研究方法：本研究採前後測設計，選取中部某兩所完全中學之7、8、10、11年級學生為研究對象，共取得1073份有效問卷，自填式結構問卷包括背景資料、同住家人吸菸情形、父母對於小孩吸菸態度、吸菸知識、吸菸態度及拒菸自我效能。
結果與臨床應用：課程介入為實驗組接受上下學期的「菸害防治課程」，每次約50分鐘，總共5次；對照組則沒有接受介入。在介入前1週進行吸菸知識、態度及自我效能之問卷調查，課程結束後1週進行問卷後測。經複迴歸發現，吸菸知識、態度及拒菸自我效能會因為年級、性別、成績排名、校內外運動、自覺家境、自覺健康、父母對子女吸菸態度影響。另課程介入後發現，高中在知識及拒菸自我效能極具顯著成效，但在國中沒有成效。建議此課程可以用於一般高中學校，至於國中，菸害課程設計宜活潑化或遊戲化，或結合活動與反菸並寓教於樂，讓知識、態度與自我效能在潛移默化中得以深耕。

Background and objectives: Smoking is a common addictive behavior in teenagers. Once teenagers start to smoke, it is easy to develop a smoking habit. Long-term smoking is hazardous to health, causes family and social expenditure, and is an important topic that should not be overlooked by academia or the government. Therefore, the aims of this study are to investigate the knowledge and attitudes of teenagers towards the hazards of smoking and self-efficacy behavior in rejecting smoking as influencing factors, to create smoking prevention courses, and examine the effectiveness of these courses in terms of teenagers’ knowledge and attitudes towards the hazards of smoking and the effectiveness of their self-efficacy in rejecting smoking.
Methods: This study adopted a pre-test post-test design and selected 7th, 8th, 10th, and 11th graders from two junior high schools. A total of 1073 valid questionnaires were received. The self-completed questionnaire included background information, smoking status of relatives staying with the subject, attitudes of parents towards child smoking, knowledge and attitudes towards smoking, and self-efficacy in rejecting smoking.
Results and clinical applications: Subjects in the experimental group underwent course interventions, which are “smoking prevention courses,” in the semester. Each class lasted about 50 minutes and there were 5 classes in total. The control group was not given the intervention. Knowledge and attitudes towards smoking and self-efficacy in rejecting smoking were tested using questionnaires 1 week before the intervention and post-testing was carried out 1 week after the course ended. A review of the results found that knowledge and attitudes towards smoking and self-efficacy in rejecting smoking were affected by age, sex, academic result ranking, extra-curricular and intra-curricular exercises, self-perceived family status, self-perceived health, and parents’ attitudes towards child smoking. After course intervention, it was found that the intervention showed significant efficacy in terms of knowledge and self-efficacy in rejecting smoking in senior high school students but no efficacy in junior high school. We recommend that this course can be used in normal senior high schools. With regards to junior high schools, smoking prevention courses should be designed to be interactive or gamified, or combined with activities with both anti-smoking messages and entertainment at the same time, so that knowledge, attitudes, and self-efficacy can be subconsciously cultivated.

誌謝 I
摘要 II
ABSTRACT III
目次 V
表目次 VII
圖目次 VIII
第一章 緒論 1
第一節 前言 1
第二節 研究目的 2
第三節 研究假設 2
第四節 名詞界定 2
第二章 文獻查證 4
第一節 青少年吸菸行為現況 4
第二節 影響青少年吸菸行為之因素 4
第三節 教育課程介入成效之實證研究 6
第四節 計畫行為理論的應用 6
第三章 研究方法 9
第一節 研究設計 9
第二節 研究對象與場所 9
第三節 研究工具 10
第四節 介入課程 11
第五節 研究架構 11
第六節 研究資料處理與分析 12
第七節 研究倫理 13
第八節 預期結果與應用 13
第四章 結果與討論 14
第一節 描述研究對象之背景變項 14
第二節 研究人口學變項與吸菸知識、吸菸態度及拒菸自我效能之複回歸分析 19
第三節 菸害防治課程介入對吸菸知識、吸菸態度及拒菸自我效能分析 31
第四節 討論 39
第五節 結論 42
第六節 研究限制與建議 43
中文文獻 45
英文文獻 47
附錄 51
附錄一 菸害文獻 51
附錄二 吸菸預防介入文獻 56
附錄三 問卷 63

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