研究目的：過去文獻已證實ASE模式(Attitude-Social Influence-Efficacy model)可解釋國人檳榔使用的行為，指出檳榔使用結果預期透過自我效能影響嚼檳榔的意圖與行為，社會影響則直接影響意圖與行為。本研究擬修正ASE模式，假設憂鬱可以直接影響嚼檳榔的行為，或透過認知因素間接影響檳榔的使用。
研究方法：利用柯慧貞主持「南區大專院校學生身心健康調查計劃」所收集資料庫進行分析，該研究由南區大學生依分層叢集抽樣出3246名有效樣本，施測檳榔使用意圖與行為量表、檳榔結果預期量表、社會影響量表、拒用檳榔自我效能量表及柯氏憂鬱量表；資料以結構性方程式驗證心理社會因子之模式適配度。
研究結果：指出檳榔使用之高正向結果預期需透過低拒用自我效能影響嚼檳榔的意圖與行為；U高度U社會影響與低拒用自我效能直接影響檳榔使用行為；而憂鬱則透過高正向結果預期和低拒用自我效能，預測嚼檳榔之意圖與行為。
研究結論：本研究建議可透過教育與諮商輔導增加大學生的情緒調控知能，減少檳榔的正向結果預期以及強化拒用自我效能，以預防檳榔的使用。

Purpose：A previous study found that outcome expectancy predicted the intention and behaviors of betel quid chewing via refusal self-efficacy, and social influence directly predicted intention and behaviors, supporting the Attitude Social-Influence Efficacy (ASE) model in explaining betel-quid chewing behaviors. The present study modified the ASE model and explored whether depression would affect the behavior of betel quid chewing directly or indirectly through cognitive factors.
Methods：(1).participants: by stratified and cluster sampling, 3246 university students in southern Taiwan were recruited. (2).Measurements: included demographic data, betel quid outcome expectancy, social influence, betel quid refusal self-efficacy, betel quid chewing intention, betel quid chewing behavior, and Ko Depression Inventory (KDI).U The data verified the goodness of fit through the Structural Equation Model (SEM) which was carried out by AMOS 5.0.
Results：Outcome expectancy predicted behavior by way of refusal self-efficacy. Low refusal self-efficacy and high social influence directly influenced betel chewing intention and behavior. Furthermore, depression, via cognitive variables (low refusal self-efficacy and high positive outcome expectancy), was able to predict intention and behavior. Conclusions：The results of the present study serve educational and counseling purposes to teach university students how to cope with their depression, reduce positive outcome expectancy, and strengthen refusal self-efficacy, in order to prevent the use of betel quid chewing.

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