本研究旨在了解國、高七後學生菸害知識、態度、行為、拒菸自我效能、拒菸技巧、不吸菸替代活動、暴露二手菸環境與吸菸行為之關係。以自填式結構問卷為工具，由班級導師協助施測。採隨機取樣方式從宜蘭縣市五所高中(職)和四所國中各年級抽出兩班學生為對象，實際回收1946份有效問卷，回收率97.2%。 研究木發現：國、高中生的吸菸比較分別是17.6%、24.4%。無論國、高中學生，吸菸者的拒菸效能、拒菸技巧，以及替代方案均顯著低於無吸菸者(P<.001)，而其家人及朋友的吸菸情形，也顯著高於無吸菸者(P<.001)。國中生吸菸的重要影響因子包括拒菸自我效能、反菸態度、拒菸技巧、替代方案、家人吸菸，以及朋友吸菸，上述變項共可解釋34.5%的變異。高中生吸菸的重要影響因子包括拒菸自我效能、反菸態度、替代方案、在家中吸到二手菸的可能性、家人吸菸，以及朋友吸菸，上述變項共可解釋33.5%的變異量。建議考量吸菸因子發展菸害防制教育、深入探討校園二手菸情境，並營造無菸的優質校園，以及擴大研究對象、進行長期追蹤研究。

The purpose of this study was to examine the relationship between tobacco knowledge, attitudes, self-efficacy, refusal skills, alternatives, exposure to environmental tobacco smoke (ETS) and smoking behavior among high school 52 classes from 5 senior and 4 junior high schools in E-Land County were surveyed. Totally, 1946 students provided data with 97.2% response rate. The results showed that the prevalence rate of smoking among junior and senior high school students were 17.6% and 24.4, respectively. Compare with nonsmokers, smoking students had lower self-efficacy, refusal skills and alternatives for smoking. On the contrary, smoking students were more likely to have family smoking and friend smoking. Junior high school students’ self-efficacy, antismoking attitudes, refusal skills, alternatives, family smoking and friend smoking were associated with smoking status. Moreover, these six variables could explain 34.5% of variance. Related to senior high school students, smoking status was associated with self-efficacy, anti-smoking attitudes, alternatives, and the likelihood of ETS exposure at home, family smoking and friend smoking. Totally, these six variables could explain 33.5% of variance. Developing antismoking programs, exploring ETS in campus and building smoking free school were recommended.