[ 摘要 ]

本研究之目的旨在了解山地原住民之吸菸行為、二手菸、無菸家庭看法，以及衛生單位人員當初推展無菸家庭計畫之經驗，最後提出實施無菸家庭之策略。

本研究進行係採質性研究之深入訪談與參與觀察法，深入訪談仁愛鄉的九位家中吸菸者及兩位衛生單位人員，並輔以相關檔案文件資料收集佐證。

研究結果發現，在吸菸行為方面：原住民吸菸原因包括心理、生理與社會三個層面，當地婦女有鼓勵孕婦吸菸的情形發生，戒菸的動機與個人意志力以及他人的影響力有強烈的關係。在二手菸方面：吸菸者會因為不喜歡二手菸味道而有吸菸行為產生。在無菸家庭方面：多數人不了解無菸家庭的內涵，但是已有部份家庭實施吸菸限制，主因於吸菸者在乎孩子吸入二手菸造成的健康傷害，若建議在他們家中貼無菸家庭貼紙，有的人認為應該有提醒的效果，但有的人反而認為有輕視吸菸者的意涵，另外研究對象從無菸家庭概念衍生出家用車禁菸的構想，對於未來宣導單的內容以簡單明瞭為主，至於法律的訂定接受度不高，但可以接受家規的制定。

根據訪談結果提出六項建議：一、二手菸與菸害知識需要再教育；二、孩子、配偶與長輩對家庭成員吸菸者的影響有顯著差異性，所以提高家中其他成員的影響將有助於無菸家庭的推廣；三、家中無菸家庭貼紙應適量；四、家用車禁菸可加入無菸家庭的宣傳中；五、衛教單張有其必要性；六、以家規替代法規為一項溫和且有效的方式。

[ 英文摘要 ]

The purpose of this study was to understand the smoking behavior of aboriginals in mountainous region and their attitudes towards second-hand smoke, smoking and smoking-free homes. The preliminary experiences of public health center professionals involved with promotion and implementation of smoking-free homes programs were collected in order to develop strategies and suggestions for the smoking-free home policies.

The study used qualitative approach, which included the in-depth interview and participant observation methods. In addition to a review of archives, this study interviewed nine subjects with smokers in their homes and two public health center professionals.

The results of this study found the smoking behavior of aboriginals were influenced by psychological, physiological and social aspects. It was found that in some situations, the local pregnant women were encouraged to smoke. The motives and degree of willingness for a person to quit smoking were strongly affected by family and peer influence.Some smokers smoked because they dislike the smell of second-hand smoke. Though most of the subjects did not understand the definition and meaning of smoking-free home, some had limited smoking in their homes in order to reduce the threat to the children’s health due to the inhaling of second-hand smoke. Some believed that smoking-free home stickers could remind people not to smoke in the home; however, some felt the stickers were insulting. The idea of smoking-free vehicles was developed during the interviews. Legal regulation was deemed unacceptable compared to simple and clear health education lists, or the home-set rules.

Six suggestions were summarized: (1)More education about adverse effects of second-hand smoke and the hazards of smoking is needed. (2)Children, spouses, and the elders within a household significantly influence smokers and can help promote the smoking-free homes. (3)Smoking-free home stickers should be used appropriately. (4)Smoking-free home vehicles should be included as part of the smoking-free home environment. (5)Health education propaganda are highly recommended. (6)To substitute legalized regulations with home-set rules can be a mild but effective approach.