本研究的主要目的在比較菸害課程結合個案輔導模式與只接受菸害課程介入模式對吸菸國中生吸菸行為之成效差異。採用「實驗組控制組前後測」之實驗設計，立意取樣台南縣市三所國中34位學生為研究對象，以隨機分配分為實驗組（n＝16）及對照組（n=18）。實驗組接受七堂菸害課程與七次個案輔導，對照組僅接受七堂課菸害課程。研究資料以SPSS10.0視窗版套裝軟體進行分析，描述性統計以次數分配、百分比、平均值、標準差分析，推論性統計以卡方檢定、t-檢定進行分析。研究結果顯示，兩種介入皆能顯著提升研究對象之自我效能與戒菸動機。雖兩組學生吸菸行為之頻率皆有降低，但課程合併個案輔導組的同學之吸菸行為降低率有較顯著。整體而言，本研究幫助3位學生持續3個月以上維持不吸菸狀況，且幫助5位學生在過去30天完全沒有吸菸，戒菸率16.12%。本研究結果可提供相關衛生教育單位計劃國中青少年戒菸的一個實證參考。

The study purpose was to identify whether smoking cessation course combined individual counseling had better effect on adolescent smoking behavior than smoking cessation course only. Totally 34 subjects were obtained from 3 junior high schools in Tainan county area. These students were randomly assigned to experimental group (n=16) and control group (n=18). Experimental group received 7-session smoking cessation course and 7 individual counseling sections, whereas control group received 7 smoking cessation course only. Frequency, percentage mean, standard deviation, χ² test, and t-test were used to analyze the data by using SPSS 10.0 for Windows. Results indicated that both program significantly increased subjects’ self-efficacy and motivation to quit. Although the degree of decreasing smoking behavior was no different between groups, subjects in combined course and counseling group had significantly reduced their smoking behavior. Overall, both intervention program helped 3 students remained abstaining from smoking more than 3 months and helped 5 students quit smoking, the past 30-day quit-rate was 16.12%. This study results provide an evidence for health and education professors in planning smoking cessation program for junior high students.

中文部份
行政院衛生署國民健康局：SBOSS吸菸行為線上查詢（2006）‧吸菸行為資料庫‧2006年7月2日取自http://tobacco.bhp.doh.gov.tw:8080/sboss/detailed.php.
行政院衛生署國民健康局（2006）‧門診戒菸作業須知9501-修正950301.1.pdf‧2006年7月25日取自http://www.bhp.doh.gov.tw/BHP/index.jsp
李景美（1990）‧台北市國民中學三年級男生吸菸行為之情境及家庭狀況因素分析研究‧中華民國學校衛生學會雜誌，17，38-47。
李杰炫（2000）‧青少年戒菸意向之研究：計劃行為理論之應用-以台中縣、市專科吸菸學生為例‧未發表的碩士論文‧台中：靜宜大學青少年兒童福利研究所。
李淑卿、郭鐘隆（2005）‧跨理論模式戒菸教育計劃介入應用於大專生之成效評價研究‧衛生教育學報，23，145-160。
陳秀娟（2002）‧桃園縣高中職學生吸菸行為之相關探討-跨理論模式之應用‧未發表的碩士論文‧台中：中山醫學大學醫學研究所。
陳沿瑜（2004）‧校園吸菸青少年之戒菸介入方案研究-傳統式介入和實驗式多元介入方案比較‧未發表的碩士論文‧台中：中國醫藥大學環境醫學研究所。
張明惠（2003）‧青少年戒菸教育課程介入成效之探討-以台北市某公立高職學生為對象‧未發表的碩士論文‧台北：國立臺灣師範大學衛生教育研究所。
葉美玲、陳興夏、張惠芬（2002）‧網際網路輔助戒菸課程於青少年之成效‧台灣醫學，6（5），648-660。
黃松元、余玉眉、江永盛、陳政友、賴香如（1991）‧台灣地區青少年吸菸行為調查研究‧中華民國學校衛生學會雜誌，19，30-47。
黃璉華、左如梅、尹祚芊、楊瑞珍、黃子庭（1996）‧國民中學學生吸菸知識、態度與行為之探討‧護理雜誌，43（2），35-45。
黃芷苓、何夢青（2004）‧台灣南部國中學生戒菸教育成效之探討‧學校衛生護理，15，1-17。
黃秀媚（2005）‧菸害教育對國中生菸害健康信念與戒菸行為意向影響之研究‧學校衛生護理，17，31-49。
廖梨伶、劉潔心（2002）‧運用網際網路於青少年戒菸行為之介入研究‧衛生教育學報，17，109-126。
趙玉蕙（2002）‧「網際網路輔助耳穴戒菸」對青少年戒菸之成效探討‧未發表的碩士論文‧台北：國立台北護理學院中西醫結合護理研究所。
劉潔心、劉貴雲、蔡春美(2000)‧青少年互動式戒菸手冊教材發展及介入效果之初探性研究‧衛生教育學報，13，73-89。
魏美珠、林為森（1999）‧青少年戒菸教育介入成效之評估‧嘉南學報，25（11），43-55。
顏效禹（2001）‧應用跨理論模式在台北國中生的吸菸行為‧未發表的碩士論文‧台北： 國立陽明大學護理研究所。
羅于韻、劉瑞瑤、陳振文、黃信彰（2005）‧戒菸面面觀‧基層醫學，20（10），272-278。

英文部份
Adelman, W. P., Duggan, A. K., Hauptman, P., & Joffe, A. (2001). Effectiveness of a high school smoking cessation program. Pediatrics, 107(4), 1-8.
Aung, A. T., Hickman, N. J., & Moolchan, E. T. (2003). Health and performance related reasons for wanting to quit:Gender differences among teen smokers. Substance Use & Misuse, 38 (8), 1095-1107.
Centers for Disease Control and Prevention (1994a). Guidelines for school health programs to prevent tobacco use and addiction. Morbidity & Mortality Weekly Report, 43(RR-2), 1-19.
Centers for Disease Control and Prevention (1994b). Preventing tobacco use among young people : A report of the surgeon general executive summary. Morbidity & Mortality Weekly Report, 43(RR-4), 1-11.
Centers for Disease Control and Prevention (2003). Tobacco use among middle and high school students -United States, 2002. Morbidity & Mortality Weekly Report, 52(45), 1096-1098.
Centers for Disease Control and Prevention (2004). Cigarette use among high school students -United States, 1991-2003. Morbidity & Mortality Weekly Report, 52(23), 499-502.
Chen, H. S., Homer, S. D., & Percy, M. S. (2002). Validation of the smoking self-efficacy survey for Taiwanese children. Journal of Nursing Scholarship, 34 (1), 33-37.
Chen, H. S., Homer, S. D., & Percy, M. S. (2003). Cross-cultural validation of the stages of the tobacco acquisition questionnaire and the decisional balance scale. Research in Nursing & Health, 26, 233-243.
Chen, H. S., Sheu, J. J., & Chen, W. W., (2006). Psychometric testing of the chinese version of the decisional balance scale (CDBS). Health Education & Behavior, 1-9.
Coleman-Wallace, D., Lee, J. W., Montgomery, S., Blix, G., & Wang, D. T. (1999). Evaluation of developmentally appropriate programs for adolescent tobacco cessation. Journal of School Health, 69 (8), 314-319.
Deveci, S. E., Deveci, F., Acik, Y., & Ozan, A. T. (2004). The measurement of exhaled carbon monoxide in healthy smokers and non-smokers. Respiratory Medicine, 98, 551-556.
Dino, G., Kamal, K., Horn, K., Kalsekar, I., & Fernandes, A. (2004). Stage of change and smoking cessation outcomes among adolescents. Addictive Behaviors, 29, 935-940.
Dozois, D. N., Farrow, J., A., & Miser, A. (1995). Smoking patterns and cessation motivations during adolescence. The International Journal of the Addictions, 30 (11), 1485-1498.
Dolcini, M. M., Adler, N. E., Lee, P., & Bauman, K. E. (2003). An assessment of the validity of adolescent self-reported smoking using three biological indicators. Nicotine & Tobacco Research, 5 (4), 473-483.
Fagan, P., Eisenberga, M., Frazier,L., Stoddard, A. M., Avmnin, J. S., & Sorensen, G. (2003). Employed adolescents and beliefs about self-efficacy to avoid smoking. Addictive Bebaviors, 28, 613-626.
Genuneit, J., Weinmayr, G., Radon, K., Dressel, H., Windstetter, D., Rzehak, P., Vogelberg, C., et al. (2006). Smoking and the incidence of asthma during adolescence: results of a large cohort study in Germany. Thorax, 61, 572-578.
Grimshaw, G., Stanton, A., Blackburn, C., Andrews, K., Grimshaw, C., Vinogradova, Y., et al. (2003). Patterns of smoking, quit attempts and services for a cohort of 15- to 19-year-olds. Child: Care, Health & Development, 29 (6), 457-464.
Holmen, T. L., Barrett-Connor, E., Clausen, J., Langhammer, A., Holmen, J., & Bjermer, L. (2002). Gender differences in the impact of adolescent smoking on lung function and respiratory symptoms.The Nord-Trøndelag Health Study, Norway,1995—1997. Respiratory Medicine, 96, 796-804.
Hollis, J. F., Polen, M. R., Lichtenstein, E., & Whitlock, E. P. (2003). Tobacco use patterns and attitudes among teens being seen for routine primary care. American Journal of Health Promotion, 17 (4), 231-239.
Huang, C. L. (2003). Development and evaluation of a smoking cessation program for junior high school students: A pilot study. 長庚護理，14(2)，121-132。
Hughes, J. R., Stead, L. F., & Lancaster, T. (2004). Antidepressants for smoking cessation (Review). Cochrane Database of Systematic Reviews, 4, 1-56.
Kentala, J., Utriainen, P., Pahkala, K., & Mattila, K. (2004). Verification of adolescent self-reported smoking. Addictive Behaviors, 29, 405-411.
Kim, Y-H. (2006). Adolescents’ smoking behavior and its relationships with psychological constructs based on transtheoretical model: A cross-sectional survey. International Journal of Nursing Studies, 43, 439-446.
McCuller, W., J., Sussman, S., Wapner, M., Dent, C., & Weiss, D. J. (2006). Motivation to quit as a mediator of tobacco cessation among at-risk youth. Addictive Behaviors, 31, 880-888.
Mermelstein, R., Colby, S. M., Patten, C., & Prokhorov, A. (2002). Methodological issues in measuring treatment outcome in adolescent smoking cessation studies. Nicotine & Tobacco Research, 4, 395-403.
Myers, M. G., & MacPherson, L. (2004). Smoking cessation efforts among substance abusing adolescents. Drug and Alcohol Dependence, 73, 209-213.
Nezami, E., Sussman, S., & Pentz, M. A. (2003). Motivation in tobacco use cessation research. Substance Use & Misuse, 38 (1), 25-50.
Pechacek, T. F., Murray, D. M., Luepker, R. V., Mittelmark, M. B., Johnson, C. A., & Shutz, J. M. (1984). Measurement of adolescent smoking behavior rationale and methods. Journal of Behavioral Medicine, 7 (1), 123-140.
Plununer, B. A., Velicer, W. F., Redding, C. A., Prochaska, J. O., Rossi, J. S., Pallonen, U. E., & Meier, K. S. (2001). Stage of change, decisional balance, and temptations for smoking: Measurement and validation in a large, school-based population of adolescents. Addictive Behaviors, 26, 551-571.
Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51 (3), 390-395.
Prochaska, J. O., Redding, C. A., & Evcrs, K. E. (2002). The transtheoretical model and stages of change. In Glanz, K., Rimer, B. K., Lewis, F. M. (3rd ed). Health Behavior and Health Education. (pp.60-80). San Francisco: Jossey Bass.
Precht, D. H., Keiding, L., & Madsen, M. (2003). Smoking patterns among adolescents with asthma attending upper secondary schools: A community-based study. Pediatrics, 111, 562-568.
Riedel, B. W., Robinson, L. A., Klesges, R. C., & McLain-Allen, B. (2002). What motivates adolescent smokers to make a quit attempt? Drug and Alcohol Dependence, 68 (2), 167-174.
Robinson, L. A., Weg, M. W. V., Riedel, B. W., Klesges, R. C., & McLain-Allen, B. (2003). Start to stop :Results of a randomised controlled trial of a smoking cessation programme tor teens. Tobacco Control, 12, 26-33.
Schmid, H. (2001). Predictors of cigarette smoking by young adults and readiness to chang. Substance Use & Misuse, 36 (11), 1519-1542.
Silagy, C., Lancaster, T., Stead, L., Mant, D., & Fowler, G. (2004). Nicotine replacement therapy for smoking cessation (Review). Cochrane Database of Systematic Reviews, 3, 1-104.
Soresi, S., Catalano, F., Spatafora, M., Bonsignore, M. R., & Bellia, V. (2005). ’’Light’’ smoking and dependence symptoms in high-school students. Respiratory Medicine, 99, 996-1003.
Stevens, K. R., & Muñoz L. R. (2004). Cigarette smoking: Evidence to guide measurement. Research in Nursing & Health, 27, 281-292.
Sussman, S. (2002). Effects of sixty six adolescent tobacco use cessation trials and seventeen prospective studies of self-initiated quitting. Tobacco Induced Diseases, 1 (1), 35-81.
Sussman, S., Dent, C. W., Nezami, E., Stacy, A. W., Burton, D., & Flay, B. R. (1998). Reasons for quitting and smoking temptation among adolescent smokers: Gender differences. Substance Use & Misuse, 33 (14), 2703-2720.
Sussman, S., Dent, C. W., & Lichtman, K. (2001a). Project ex: outcomes of a teen smoking cessation program. Addictive Behaviors, 26 (3), 425-438.
Sussman, S., Lichtman, K., & Dent, C. W., (2001b). Case Study 4. Use of focus groups for adolescent tobacco use cessarion. In: S. Sussman (Ed.), Handbook of Program Development for Health Behavior Research & Practice. Thousand Oaks, CA: Sage Publications (Chapter 10).
The Global Youth Tobacco Survey Collaborative Group. (2002). Tobacco use among youth: A cross country comparison. Tobacco Control, 11, 252-270.
Turner, L., R., & Mermelstein, R. (2004). Motivation and reasons to quit: Predictive validity among adolescent smokers. American Journal of Health Behavior, 28 (6), 542-550.
Van der Bijl, J. J., & Shortridge-Baggett L. M. (2002). The theory and measurement of the self-efficacy construct. In Lenz, E. R., Shortridge-Baggett L. M. Self-Efficacy in Nursing：Research and Measurement Perspectives. (pp.9-25). New York: Springer.
World Health Organization. (2006). Prevalence of current tobacco use in
adolescents (13-15 years of age). Retrieved September 4, 2006, from
www.who.int/entity/whosis/whostat2006TobaccoAdolescents.pdf.
Zhu, S. H., Sun, J., Billings, S. C., Choi, W. S., & Malarcher, A. (1999). Predictors of smoking cessation in U.S. adolescents. American Journal of Preventive Medicine, 16 (3), 202-207.
Zheng, H., Sussman, S., Chen,X., Wang, Y., Xia, J., Gong, J., et al. (2004). Projct EX-a teen smoking cessation initial study in Wuhan, China. Addictive Behaviors, 29, 1725-1733.