臺灣博碩士論文加值系統

研究背景與目的：
「提高菸稅」是菸害防制政策的重要一環，但過去傳統的菸稅評估研究多著重於衡量吸菸率、香菸消費量以及價格彈性的變化來反應菸稅的有效性，卻忽略了吸菸者可以選擇轉換更便宜的香菸品牌而不減少吸菸量，亦能達到控制香菸花費的目的，這種補償行為可能會削弱菸稅以價制量的效果。準此，有必要了解我國吸菸者轉換低價菸品行為的概況及其對吸菸量的影響，故本研究目的有三：(一)了解臺灣吸菸者於2002年菸稅調漲後的轉換低價菸品行為；(二)分析影響轉換低價菸品行為的相關經濟因素；(三)探討轉換低價菸品行為對減量行為的影響。

研究方法：
本研究為回溯性的世代研究，資料來源為國家衛生研究院「2000-2003年臺灣香菸消費行為長期追蹤資料庫」，追蹤443位2001年吸菸的成年男性吸菸者其2002年菸稅調漲後的菸品選擇與吸菸量變化情形，並採用二項式的羅吉斯迴歸模型進行分析。

研究結果：
本研究結果顯示，2002年菸稅調漲後，有82位(18.51%)吸菸者出現轉換低價菸品行為。其中，55位(12.42%)吸菸者只轉換低價菸而未減少吸菸量，其餘27位(6.09%)吸菸者則同時轉換低價菸並減少吸菸量。羅吉斯迴歸分析結果顯示，收入較低的吸菸者相較於收入較高者更傾向於轉換低價菸品，且在中收入族群(OR=3.760, 95%CI=1.482-9.541)、低收入族群(OR=3.838; 95%CI=1.287-11.441)皆有呈現顯著效果。此外，加稅前購買價位較高的菸品者(OR=6.516; 95%CI=2.894-14.668)、以及品牌忠誠度低者(OR=2.183; 95%CI=1.001-4.763)較傾向於轉換低價菸。而在控制其他干擾因素後，吸菸者轉換低價菸品行為對其減少吸菸量的影響並未達統計顯著差異。

結論：
簡言之，臺灣2002年菸稅調漲後確實有部份吸菸者出現轉換低價菸品行為，而且經濟因素確實是影響成年男性吸菸者轉換低價菸的關鍵因素。雖然羅吉斯迴歸分析結果顯示，吸菸者轉換低價菸品的情形對減量行為並沒有顯著的影響，但隨著菸稅政策的發展、香菸價格不斷提高，未來仍有持續關注此議題的必要。

Background and Objectives
In most countries, "Raise taxes on tobacco" has been proved as an effective measure to reduce cigarette consumption and smoking rates. Classic assessment of the effectiveness of higher tobacco tax emphasizes on the change of smoking prevalence, cigarette consumption, and price elasticity. This research approach ignores the fact that smokers may switch to cheaper brand to maintain their smoking amounts while controlling the expenses at an acceptable level. It may weaken the effect of cigarette tax increase on smoking reduction when the majority of smokers adopt such act. There were three objectives in this study: First, examine how Taiwanese male adult smokers responded to 2002 tax increase. Second, explore the important factors influencing the act of switching to cheaper brand. Third, examine the effect of brand-switching on smoking reduction.

Methods
This was a retrospective cohort study, The data were retrieved from a two-year follow-up face-to-face interview survey on cigarette consumption between 2001 and 2002, conducted by the National Health Research Institutes, Taiwan. Cigarette purchasing behavior and change in smoking amounts of 443 adult male smokers defined in 2001 were examined after the 2002 tobacco tax increase. Binomial logistic regression models were used to analyze important factors of switching to cheaper brand and their effects on smoking reduction.

Results
The results showed that 18.5% of adult male smokers switched to cheaper brand after 2002 tax increase. About 70% of these smokers switched brand but did no reduce smoking. The remained smokers switched brand and reduced smoking at the same time.Logistic regression analysis showed that the lower income group inclined to switch to cheaper brand than the higher income group, and the effect occurred in both medium (OR=3.760, 95%CI=1.482-9.541) and low income group (OR=3.838; 95%CI=1.287-11.441). Moreover, smokers who purchased higher priced tobacco products (OR=6.516; 95%CI=2.894-14.668), and with low brand loyalty (OR=2.183; 95%CI=1.001-4.763), were more inclined to switch to cheaper brand. The effect of switching to cheaper brand on smoking reduction did not reach statistical significant difference after controlling for confounding factors in logistic regression analysis.

Conclusion
In conclusion, there were actually part of smokers compensated and switched to cheaper brand after the tax increase. For these smokers, the economic factors were important consideration of this behavior. While switching to cheaper tobacco brand did not show a significant effect on smoking reduction, sustainable attention should be paid on this issue along with the development of tobacco tax policy and the raise of cigarettes price.

總目錄
致謝 i
中文摘要 ii
Abstract iv
目錄 vi
表目錄 viii
圖目錄 ix
第一章 緒論 1
第一節 研究背景與動機 1
第二節 研究目的 4
第三節 研究問題 4
第二章 文獻探討 5
第一節 臺灣菸稅政策調整歷程 5
第二節 菸稅的課稅效果 8
第三節 菸稅調漲與相關補償行為的理論基礎 10
第四節 轉換低價菸品的相關實證研究與影響因素 15
第五節 轉換低價菸品與戒菸、減少吸菸量之間的關係 27
第六節 文獻小結 31
第三章 研究設計與方法 32
第一節 研究設計 32
第二節 研究架構 33
第三節 研究假說 35
第四節 資料來源與研究對象 36
第五節 研究變項定義及測量 38
第六節 統計分析 43
第四章 研究結果 48
第一節 研究樣本對2002年菸稅調漲的行為反應 48
第二節 不可轉價者與可轉價者的基本特質差異 51
第三節 轉換低價菸品行為的描述性分析 57
第四節 影響轉換低價菸品相關因素之羅吉斯迴歸分析 63
第五節 減量行為的描述性分析 66
第六節 轉換低價菸對減量行為影響之羅吉斯迴歸分析 76
第七節 研究結果小結 83
第五章 討論 84
第一節 研究結果討論 84
第二節 研究方法討論 87
第三節 研究限制 89
第六章 結論與建議 91
第一節 結論 91
第二節 未來研究建議 92
第七章 參考文獻 93

表目錄
表 2-1 吸菸者使用各種低價策略之影響因素列表 21
表 2-2 各種低價策略之測量方式整理 24
表 3-1 研究變項說明與操作型定義 40
表 4-1 不可轉價者與可轉價者對2002年菸稅調漲的行為反應概況 48
表 4-2 不同收入水平吸菸者回應菸稅調漲之行為模式 49
表 4-3 可轉價者最常抽香菸品牌加稅前後的使用排名變化 50
表 4-4 不可轉價者與可轉價者樣本基本特質之描述性分析 55
表 4-5 可轉價者轉換低價菸品行為之描述性分析 61
表 4-6 影響可轉價者轉換低價菸品行為相關因素的羅吉斯迴歸分析 64
表 4-7 所有吸菸者與可轉價者減量行為的描述性分析 73
表 4-8 所有吸菸者轉換低價菸品對減量行為影響的羅吉斯迴歸分析 79
表 4-9 可轉價者轉換低價菸品對減量行為影響的羅吉斯迴歸分析 81
表 5-1 各國轉換低價菸品相關行為的盛行率概況 84

圖目錄
圖 2-1 臺灣菸稅政策調整歷程 7
圖 2-2 ITC菸害防制政策評估架構(Fong et al., 2006) 12
圖 2-3 菸價調漲的補償效應模型(Li et al., 2010) 13
圖 2-4 菸價調漲的補償效應模型(Licht et al., 2011a) 14
圖 3-1 研究樣本區分示意圖 32
圖 3-2 轉換低價菸品影響因素之研究架構 33
圖 3-3 轉換低價菸對減少吸菸量影響之研究架構 34
圖 3-4 研究對象篩選流程圖 37

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