背景 青少年毒品防治是法務部與教育部推行多年的政策。但是高中學生的毒品使用仍然有增無減。目的 探討青少年物質危害知識、物質使用態度與拒毒自信的相關性，及了解預測青少年拒毒自信的重要因子。方法 橫斷式研究設計，調查北部243位高二學生的物質危害知識、物質使用態度與拒毒自信。結果 青少年的對菸的知識最為正確，可達80.2%，其次依序為酒（72.0%）、搖頭丸（56.0%）、大麻（30.0%），最後是對K他命的了解，只達19.3%。青少年對物質使用態度以10分Likert's scale測試，調查發現青少年對酒的使用態度最為贊成為2.18（±3.27）分，其次依序為菸0.66（±2.19）分、搖頭丸0.45（±1.88）分、K他命0.43（±1.93）分，最後是大麻0.38（±1.83）分。青少年對K他命（t=-2.37, p=.018）、大麻（t=-2.33, p=.021）、菸（t=-2.02, p=.044）的物質危害知識正確者，在拒毒自信的得分高於錯誤者。以多元迴歸分析青少年拒毒自信的重要影響因素為性別（β=.26, p<.001）、毒品危害知識（β=.15, p=.028）與物質使用態度（β=-.20, p<.001）三變項。結論／實務應用 青少年物質使用的知識及態度因物質不同而異。女性、有正確的毒品危害知識、愈不贊成物質使用的態度，則拒毒自信愈高。本研究結果有助於提供校護、學校軍訓護理老師協助校方建立及執行青少年物質防制計畫的實證依據。

Background: The Ministries of Justice and Education have implemented adolescent substance abuse prevention programs for many years. Rates of substance abuse among high school students continue to rise in spite of such programs.Purpose: This study investigates adolescents' substance abuse-related knowledge and attitudes and self-confidence to resist substance use in order to identify predictive factors of poor adolescent resistance to substance use.Methods: A cross-sectional study survey gathered data on substance abuse-related knowledge and attitudes and self-confidence to resist substance use from 243 second-year senior high school students studying at two schools in northern Taiwan.Results: Participants were most knowledgeable about tobacco (80.2%), followed by alcohol (72.0%), ecstasy (56.0%), and marijuana (30.0%). Only 19.3% demonstrated an understanding of the harmful effects of using Ketamine. A 10-point Likert scale measured participant substance use attitudes. Alcohol was the substance participants were most willing to use (2.18 ± 3.27), followed by tobacco (0.66 ± 2.19), ecstasy (0.45 ± 1.88), Ketamine (0.43 ± 1.93), and marijuana (0.38 ± 1.83). Participants had higher awareness of the harmful effects of Ketamine (t=-2.37, p=.018), marijuana (t=-2.33, p=.021), and tobacco (t=-2.02, p=.044), with participants reporting greater self-confidence to resist using these three substances. Multiple regression analysis found the three most important factors affecting participant self-confidence to resist substance use to be gender (β=.26, p<.001), knowledge about the substance (β=.15, p=.028), and attitude toward substance use (β=-.20, p<.001).Conclusions/Implications for Practice: Level of harmful effects knowledge and attitudes toward use varied among the various substances considered in this paper. Being female, having strong knowledge about the substance, and negative attitude toward substance use correlated with higher levels of self-confidence to resist substance use. Study results will be used in ongoing research designed to establish an empirical basis for adolescent substance use prevention and research, the results of which may be used directly by school nurses and military training education nurses.