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ISSN 2072-2486 97 3-6 26 2416 1249 1167 98% 17.58% 9.14% (Adjusted Odds Ratio (AOR)=1.59) (AOR =1.94) (AOR =3.37) (AOR =3.71) (AOR = 2.69) (AOR = 4.40) (AOR=4.88) (AOR =1.93 2.99 5.86)

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Page 1: 1249 1167 98%web2.kmu.edu.tw/~oralhs/magazine/pdf/v26_2/L2.pdf · 540 (WHO, World Health Organization) 2008 540 1999 11 8 2030 800 96 331 81 16 8.4 96 15 Bandura (Social Learning

ISSN 2072-2486

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97 3-6

26 2416

1249 1167 98%

17.58%

9.14%

(Adjusted Odds Ratio (AOR)=1.59)

(AOR =1.94)

(AOR =3.37)

(AOR =3.71) (AOR =

2.69) (AOR = 4.40)

(AOR=4.88)

(AOR =1.93 2.99 5.86)

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Page 2: 1249 1167 98%web2.kmu.edu.tw/~oralhs/magazine/pdf/v26_2/L2.pdf · 540 (WHO, World Health Organization) 2008 540 1999 11 8 2030 800 96 331 81 16 8.4 96 15 Bandura (Social Learning

540

(WHO, World Health

Organization) 2008

540

1999 11

8

2030 800

96

331

81

���

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���

16 8.4

96 15

Bandura (Social

Learning Theory)

(Observational learning)

Simons-Morton

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(AOR =9.82)

Page 3: 1249 1167 98%web2.kmu.edu.tw/~oralhs/magazine/pdf/v26_2/L2.pdf · 540 (WHO, World Health Organization) 2008 540 1999 11 8 2030 800 96 331 81 16 8.4 96 15 Bandura (Social Learning

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2.746

15

59.42%

44.62%

63.49% 47.67%

15

84.28%

61.49% 20%

81.27% 49.05% 30%

Wen

1.7

2.2 Hill

Scragg

Bauman

Bricker

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97

165

(multistage cluster sampling)

26

8

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Page 4: 1249 1167 98%web2.kmu.edu.tw/~oralhs/magazine/pdf/v26_2/L2.pdf · 540 (WHO, World Health Organization) 2008 540 1999 11 8 2030 800 96 331 81 16 8.4 96 15 Bandura (Social Learning

10

2008 3 6

2416 98%

(1) (2)

(3)

0 1

12 9

3

(1) (2)

(3) (4)

1 0

(1)(2) 1 (3)(4) 0 (1)(2)

0 (3)(4) 1 Cronbach's

0.8246

3

0 1 0 1

(1) (2)

(3)

10 (4) 10

(1) 0 (2)(3)

(4) 1

9

JMP 6.0

(Chi-square tests)

���

Page 5: 1249 1167 98%web2.kmu.edu.tw/~oralhs/magazine/pdf/v26_2/L2.pdf · 540 (WHO, World Health Organization) 2008 540 1999 11 8 2030 800 96 331 81 16 8.4 96 15 Bandura (Social Learning

(Logistic regression

model)

Odds Ratios OR 95%

(95% Confidence interval 95%CI)

(AOR=1.94, 95% CI=

1.01-3.62)

(AOR=3.37,

95% CI=1.34-8.44)

(AOR=3.71, 95% CI=1.56-8.98)

(AOR=2.69, 95% CI=1.60-4.45)

(AOR=4.40, 95%

CI=1.04-16.76)

(AOR=4.88, 95% CI=1.67-13.94)

(AOR=1.93, 95% CI=1.29-2.94)

(AOR=2.99,

95% CI=1.82-5.16)

(AOR=5.86, 95% CI=

4.16-8.32)

(AOR=9.82, 95%

CI=6.28-15.59)

1249 1167 51.70%

48.30%

23.94%

24.58% 26.18% 25.30%

24.85% 25.28% 23.56% 26.31%

17.58%

9.14%

(AOR=1.59, 95% CI=1.02-2.45)

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Page 6: 1249 1167 98%web2.kmu.edu.tw/~oralhs/magazine/pdf/v26_2/L2.pdf · 540 (WHO, World Health Organization) 2008 540 1999 11 8 2030 800 96 331 81 16 8.4 96 15 Bandura (Social Learning

Scragg

����

����

����

����

��� ���

� ��

(social

desirability bias)

NSC-98-2314-B-

037-003-MY2

KMU-Q0980 14

���

Page 7: 1249 1167 98%web2.kmu.edu.tw/~oralhs/magazine/pdf/v26_2/L2.pdf · 540 (WHO, World Health Organization) 2008 540 1999 11 8 2030 800 96 331 81 16 8.4 96 15 Bandura (Social Learning

1.

2.

3.

(2010) 2008

Available at:

http://www.who.int/tobacco/mpower/2008

/zh/index.html.

WHO. New report on global tobacco

control efforts.(2010). Available at: http://

www.who.int/mediacentre/news/releases/

2008/pr04/en/index.html.

(2010) 96

Available at: http://olap.bhp.doh.gov.tw/

search/ShowReport.aspx?mode=9&tarId=

267&year=96&com_year=&ftype=

COUNTY&fvals=%&fpage=0&City

Where=&CityName=&chart=1&addType=

, 2007.

(2010) 96

Available at: http://

olap.bhp.doh.gov.tw/search/ShowReport.

aspx?mode=9&tarId=344&year=96&com

_year=&ftype=AGEGP&fvals=1&fpage=

0&CityWhere=&CityName=&chart=

0&addType=, 2007.

(1999)

Huang HL, Hsu CC, Magnus JH, Chen FL,

Rice J, Lee CH, Yen YY, Chen T.(2008)

Perceived smoking prevalence at school-

level and children's smoking initiation:

a multi-level analysis of a cross-sectional

data in Taiwan Health policy (Amsterdam,

Netherlands);86:213-221.

(2010) 96

Available at: http://olapbhpdohgovtw/

search/ShowReportaspx?mode=9&tarId=

267&year=96&com_year=&ftype=SEX,

AGEGP&fvals=%,%&fpage=0&City

Where=&CityName=&chart=1&addType=

, 2007a.

(2010) 96

Available at: http://olapbhpdohgovtw/

search/ShowReportaspx?mode=9&tarId=

347&year=96&com_year=&ftype=SEX,

AGEGP&fvals=%,1&fpage=0&City

Where=&CityName=&chart=1&addType=

, 2007b.

Bandura A. (1978) Social learning theory

of aggression. J Commun; 28:12-29.

Simons-Morton B, Haynie DL, Crump AD

, Eitel SP, Saylor KE. (2001) Peer and

6.

7.

8.

9.

10.

4.

5.

���

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����� �� ������� ��� ����� �����

Page 8: 1249 1167 98%web2.kmu.edu.tw/~oralhs/magazine/pdf/v26_2/L2.pdf · 540 (WHO, World Health Organization) 2008 540 1999 11 8 2030 800 96 331 81 16 8.4 96 15 Bandura (Social Learning

parent influences on smoking and drinking

among early adolescents. Health Educ

Behav; 28(1):95-107.

(2003)

; 7:128-39

(2010) 96

Available at: http://

olapbhpdohgovtw/search/ShowReportaspx

?mode=9&tarId=284&year=96&com_year

=&ftype=SEX,AGEGP,VAR01_1&fvals=

%,1,%&fpage=0&CityWhere=&City

Name=&chart=1&addType=, 2007c.

(2010) 96

. Available at: http://

olapbhpdohgovtw/search/ShowReportaspx

?mode=9&tarId=286&year=96&com_year

=&ftype=SEX,AGEGP,VAR01_1&fvals=

%,1,%&fpage=0&CityWhere=&City

Name=&chart=1&addType=., 2007d.

Wen, CP, Tsai SP, Cheng TY, Hsu CC,

Chen T, Lin HS. (2005) Role of parents

and peers in influencing the smoking

status of high school students in Taiwan.

Tob Control; 14 Suppl 1:i10-5.

11.

12.

13.

14.

Hill KG, Hawkins JD, Catalano RF, Abbott

RD, Guo J. (2005) Family influences on

the risk of daily smoking initiation. J

Adolesc Health; 37:202-10.

Scragg R, Laugesen M. (2007) Influence

of smoking by family and best friend on

adolescent tobacco smoking: results from

the 2002 New Zealand national survey of

year 10 students. Aust N Z J Public Health;

31:217-23.

Bauman KE, Carver K, Gleiter K. (2001)

Trends in parent and friend influence

during adolescence: the case of adolescent

cigarette smoking. Addict Behav; 26:349-

61.

Bricker JB, Peterson AV, Jr, Andersen MR,

Rajan KB, Leroux BG, Sarason IG. (2006)

Childhood friends who smoke: do they

influence adolescents to make smoking

transitions? Addict Behav; 31:889-900.

(1991)

Huang CM, Yen YY, Chen FL, Hsu CC,

Lee CH, Lin Y, Huang HL. (2010)School-

level policy for tobacco control and

individual-level characteristics in relation

15.

16.

17.

18.

19.

20.

���

Page 9: 1249 1167 98%web2.kmu.edu.tw/~oralhs/magazine/pdf/v26_2/L2.pdf · 540 (WHO, World Health Organization) 2008 540 1999 11 8 2030 800 96 331 81 16 8.4 96 15 Bandura (Social Learning

21.

to cigarette smoking among children:

a multilevel study of elementary schools in

Pingtung County. Taiwan Journal of Public

Health, 29(2):145-158.

Huang HL, Chen FL, Hsu CC, Yen YY,

Chen T, Huang CM, Shi HY, Hu CY, Lee

CH. (2010)A multilevel-based study of

school policy for tobacco control in

relation to cigarette smoking among

children in elementary schools: gender

differences. Health Education Research,

25(3):451-463.

1249

299

307

327

316

218

1022

(51.70)

(23.94)

(24.58)

(26.18)

(25.30)

(17.58)

(82.42)

1167

290

295

275

307

106

1054

(48.30)

(24.85)

(25.28)

(23.56)

(26.31)

(9.14)

(90.86)

2.218

36.583

0.5284

0.0001

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Page 10: 1249 1167 98%web2.kmu.edu.tw/~oralhs/magazine/pdf/v26_2/L2.pdf · 540 (WHO, World Health Organization) 2008 540 1999 11 8 2030 800 96 331 81 16 8.4 96 15 Bandura (Social Learning

1.

2.

3.

4.

5.

6.

7.

8.

9.

���

N % N %AOR(95%CI)

106

105

144

67

138

73

154

55

140

71

158

53

117

92

122

91

160

52

(50.24)

(49.76)

(68.25)

(31.75)

(65.40)

(34.60)

(73.68)

(26.32)

(66.35)

(33.65)

(74.88)

(25.12)

(55.98)

(44.02)

(57.28)

(42.72)

(75.47)

(24.53)

616

386

766

235

772

228

807

197

811

193

857

148

599

402

676

325

861

145

(61.48)

(38.52)

(76.52)

(23.48)

(77.20)

(22.80)

(80.38)

(19.62)

(80.78)

(19.22)

(85.27)

(14.73)

(59.84)

(40.16)

(67.53)

(32.47)

(85.59)

(14.41)

1.00

1.28

1.00

1.03

1.00

1.23

1.00

1.17

1.00

1.59

1.00

1.83

1.00

1.12

1.00

1.27

(0.91,1.81)

(0.69,1.53)

(0.81,1.84)

(0.75,1.81)

(1.02,2.45)

(0.74,1.87)

(0.76,1.63)

(0.80,2.00)

N % N %AOR(95%CI)

62

43

75

30

78

25

80

24

84

19

85

18

55

48

62

43

89

16

(59.05)

(40.95)

(71.43)

(28.57)

(75.73)

(24.27)

(76.92)

(24.08)

(81.55)

(18.45)

(82.52)

(17.48)

(53.40)

(46.60)

(59.05)

(40.95)

(84.76)

(15.24)

675

365

783

253

872

166

847

187

889

150

933

105

598

438

670

364

898

138

(64.90)

(35.10)

(75.58)

(24.42)

(84.01)

(15.99)

(81.91)

(18.09)

(85.56)

(14.44)

(89.88)

(10.12)

(57.72)

(42.28)

(64.80)

(35.20)

(86.68)

(13.32)

1.00

1.65

1.00

1.64

(0.96,2.76)

(0.87,2.94)

��

Page 11: 1249 1167 98%web2.kmu.edu.tw/~oralhs/magazine/pdf/v26_2/L2.pdf · 540 (WHO, World Health Organization) 2008 540 1999 11 8 2030 800 96 331 81 16 8.4 96 15 Bandura (Social Learning

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N % N %AOR(95%CI)

N % N %AOR(95%CI)

186

28

56

159

175

39

200

16

182

31

186

26

186

28

189

24

194

17

62

149

65

145

171

41

(86.92)

(13.08)

(26.05)

(73.95)

(81.78)

(18.22)

(92.59)

(7.41)

(85.45)

(14.55)

(87.74)

(12.26)

(86.92)

(13.08)

(88.73)

(11.27)

(91.94)

(8.06)

(29.38)

(70.62)

(30.95)

(69.05)

(80.66)

(19.34)

987

19

195

802

964

43

981

24

950

59

992

16

993

17

993

17

947

36

158

835

199

799

942

57

(98.11)

(1.89)

(19.56)

(80.44)

(95.73)

(4.27)

(97.61)

(2.39)

(94.15)

(5.85)

(98.41)

(1.59)

(98.32)

(1.68)

(98.32)

(1.68)

(96.34)

(3.66)

(15.91)

(84.09)

(19.94)

(80.06)

(94.29)

(5.71)

1.00

1.79

1.25

1.00

1.00

1.94

1.00

0.75

1.00

0.86

1.00

3.37

1.00

2.55

1.00

3.71

1.00

0.87

1.47

1.00

1.34

1.00

1.00

2.69

(0.73,4.25)

(0.81,1.90)

(1.01,3.62)

(0.24,2.01)

(0.42,1.67)

(1.34,8.44)

(0.97,6.71)

(1.56,8.98)

(0.33,2.10)

(0.90,2.38)

(0.85,2.08)

(1.60,4.45)

97

8

25

78

91

12

98

6

90

13

98

5

92

12

90

13

92

10

20

84

27

75

90

14

(92.38)

(7.62)

(24.27)

(75.73)

(88.35)

(11.65)

(94.23)

(5.77)

(87.38)

(12.62)

(95.15)

(4.85)

(88.46)

(11.54)

(87.38)

(12.62)

(90.20)

(9.80)

(19.23)

(80.77)

(26.47)

(73.53)

(86.54)

(13.46)

1035

10

181

855

992

47

1023

23

987

59

1035

9

1035

12

1027

15

985

38

118

922

167

860

1006

32

(99.04)

(0.96)

(17.47)

(82.53)

(95.48)

(4.52)

(97.80)

(2.20)

(94.36)

(5.64)

(99.14)

(0.86)

(98.85)

(1.15)

(98.56)

(1.44)

(96.29)

(3.71)

(11.35)

(88.65)

(16.26)

(83.74)

(96.92)

(3.08)

1.00

4.40

1.00

0.67

1.00

1.41

1.00

1.24

1.00

2.55

1.00

4.88

1.00

1.10

1.12

1.00

1.63

1.00

1.00

2.19

(1.04,16.76)

(0.22,1.70)

(0.59,3.02)

(0.21,5.89)

(0.67,8.91)

(1.67,13.94)

(0.32,3.15)

(0.55,2.20)

(0.89,2.89)

(0.83,5.19)

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N % N %AOR(95%CI)

N % N %AOR(95%CI)

��

��

��

37

179

19

199

68

149

(17.13)

(82.87)

(8.72)

(91.28)

(31.34)

(68.66)

366

646

383

629

817

195

(36.17)

(63.83)

(37.85)

(62.15)

(80.73)

(19.27)

1.00

1.93

1.00

2.99

1.00

5.86

(1.29,2.94)

(1.82,5.16)

(4.16,8.32)

22

83

17

89

37

69

347

700

342

701

907

143

1.00

1.34

1.00

1.59

1.00

9.82

(0.80,2.30)

(0.92,2.90)

(6.28,15.59)

(20.95)

(79.05)

(16.04)

(83.96)

(34.91)

(65.09)

(33.14)

(66.86)

(32.79)

(67.21)

(86.38)

(13.62)

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Page 13: 1249 1167 98%web2.kmu.edu.tw/~oralhs/magazine/pdf/v26_2/L2.pdf · 540 (WHO, World Health Organization) 2008 540 1999 11 8 2030 800 96 331 81 16 8.4 96 15 Bandura (Social Learning

��������

Knowledge, Attitude, Social Environmental FactorsAssociated with Smoking Behavior among Primary

Schoolchildren in Pin-Tung County

Yuan-Jung Hsu Chen-YuYang Yea-Yin Yen Chih-Chang Chen

Wen-Ling Tsai Pi-Li Lin Ya-Ying Lin Hwei-Ling Ko Hsiao-Ling Huang

� � � � �

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, , , , Fu-Li Chen

, , , ,

1 Department of Oral Hygiene, College of Dental Medicine, Kaohsiung Medical University,Kaohsiung, Taiwan.

2 Department of Public Health, College of Medicine, Fu Jen Catholic University, Taipei, Taiwan.3 Bachelor Program of Biotechnical Cosmetology, Cheng Shiu University, Kaohsiung, Taiwan.4 Department of Nursing, Meiho University, Pin-Tung County, Taiwan.5 Department of Physical Therapy, Shu-Zen College of Medicine and Management, Kaohsiung,

Taiwan.6 Department of Nursing, Min-Hwei College of Health Care Management, Tainan, Taiwan.

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To assess the relationship of tobacco-related knowledge, attitude toward smoking, social

environment factors, and smoking behavior among primary school students in Pin-Tung County.

We used the multistage cluster sampling to obtain a representative sample of third to sixth

grade students in 2008 in Pin-Tung County (n=2416), including 1249 boys and 1167 girls.

Multiple logistic regression analysis was used to explore the related factors on smoking behavior.

The ever-smoking behavior prevalence was higher in boys than girls (17.5% vs. 9.14%).

After adjustment for other variables, logistic regression shows that only one knowledge item was

significant on boys: 'When smoking with fresh air outdoors, we can't worry about harming our

health' (Adjusted Odds Ratio (AOR) =1.59) and no significant variables were observed on girls.

In the part of attitude variables, four items significant on boy's smoking behavior are: 'Loneliness

will relieve by smoking', 'Smoking will make people look handsome', 'Everyone likes to get along

with people who smoke”, and “Parents can smoke in front of children'(AOR =1.94, 3.37, 3.71

and 2.69, respectively) and two items show significant on girls including 'It is happy to smoke',

and 'Everyone likes to get along with people who smoke'(AOR =4.40 and 4.88, respectively).In

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Page 14: 1249 1167 98%web2.kmu.edu.tw/~oralhs/magazine/pdf/v26_2/L2.pdf · 540 (WHO, World Health Organization) 2008 540 1999 11 8 2030 800 96 331 81 16 8.4 96 15 Bandura (Social Learning

���

Keyword: tobacco knowledge; attitude; social environment; smoking behavior; schoolchildren

Correspondence: Hsiao-Ling Huang

Address:Department of Dental Hygiene, Kaohsiung Medical University, 100 Shih-Chuan 1st

Road, San Ming District, Kaohsiung, Taiwan 80756, ROC.

Tel: +011-886-7-3229746 ext.13

E-mail: [email protected]

the social environmental factors, family smoked, people in the school and close friends smoked

were significant factors on boy's ever-smoking behavior(AOR =1.93, 2.99 and 5.86, respectively)

; whereas only close friends show significant on girls(AOR =9.82).

Compare to girls, boys have lower knowledge score, higher positive attitude toward smoking

, were more likely to be influenced by family and close friends who smoke. The finding suggests

the government should implement the tobacco control education on elementary students, in

particularly to strengthen male pupil's knowledge.

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