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  5. The Present Status of Human Rights Perception and Behavior and their Relationship to Smoking and Drinking Among Adolescent Students in Taiwan

 
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Human Rights Education in Asian Schools Volume III

The Present Status of Human Rights Perception and Behavior and their Relationship to Smoking and Drinking Among Adolescent Students in Taiwan

PESUS CHOU, MEEI-YUAN LIOU, AND HONG-JEN CHANG

This study has three major goals: 1) to survey the present status of adolescents attending schools in Taiwan about four values associated with human rights, 2) to survey the same population about smoking and drinking habits and possible related factors for smoking and drinking, and 3) to thoroughly analyze both sets of survey data to determine relationships. Multi-stage, stratified cluster sampling with proportional allocation was used to determine the study population, which was equal to approximately 0.5% of all students in that age group in Taiwan. A total of 100 schools throughout Taiwan were chosen (50 junior high schools, 14 high schools, 21 vocational schools, and 15 junior colleges), and the proportions were determined by the percentage of all students attending each type of school. One class from each year level at each school was selected. 12,355 of the 12,557 eligible students participated (97.3%).

The four human rights values were respect, trust, esteem, and privacy, and all questions were related to daily life. Regarding attitudes toward privacy, a number of negative trends were found which warrant concern, but no significant relationships were found between privacy issues and smoking and drinking. Questions on "respect" covered the attitudes of both parents and teachers toward the student as perceived by the student. Questions on "trust" all dealt with the family. Questions on "esteem" dealt with two facets: family members and friends/classmates. Multiple instances were found of statistically significant correlations between student perceptions of respect, trust, and esteem with student smoking and drinking habits. This suggests that there is a significant relationship present and it is hoped that human rights education might decrease drinking and smoking prevalence, which in turn might decrease illicit drug use.


Introduction

Human rights are the idea of our time [1]. They can be defined as the basic rights and fundamental freedoms that every person as a human being is entitled to. Beginning with the Charter of the United Nations adopted in 1946, the Universal Declaration of Human Rights in 1948, and the two international covenants in 1966, as well as some 60 to 70 international agreements, conventions and U. N. General Assembly resolutions, the body of international human rights law is impressive indeed. The implementation of the law, however, is problematic [2]. Many states simply refused to comply, citing sovereignty, cultural values and different stage in economic development. Others were confronted with urgent tasks of feeding the people and keeping the nation together, hardly capable of taking human rights seriously [3].
   Against this background, it was recognized early that human rights education is the key to successful implementation of rights and freedoms. By early 1990s, the goal of human rights education was described as the promotion of the human rights culture, giving emphasis to human dignity, tolerance, and full development of the person. The preservation of peace and a heightened sense of environmental protection plainly were also part of the educational efforts in the United Nations Decade for Human Rights Education (1995-2004) as declared by an U.N. General Assembly resolution in 1994 [4].
   To the extent that human rights education is far from being robust in Taiwan, much need be done. This survey is part of a research project aiming at complying teaching materials for middle and high school students. It seeks to establish a baseline against which to measure future developments in human rights education in the Taiwan area. In order to obtain an understanding of possible effecting factors, in addition to questions on the four human rights values (respect, trust, esteem, and privacy) questions on smoking, drinking, and related factors were included in the survey. Factors considered possibly related to smoking and drinking included cutting into lines, playing video games, working as a student, and gang membership [5,6].


Materials and Methods

Participants in this study were all students attending junior high school, high school, vocational school, or junior college (first three years only) in Taiwan and were ages 12 to 19. A total of 100 schools throughout Taiwan were chosen (50 junior high schools, 14 high schools, 21 vocational schools, and 15 junior colleges), and the proportions were determined by the percentage of all students attending each type of school. Multi-stage, stratified cluster sampling with proportional allocation was used, according to the total number of students attending each of these types of schools in Taiwan, with the goal of surveying 0.5% of all students in the specific grades. The survey was completed in September of 1994. Three classes (one per grade) were randomly selected from each sample school, and all students present in a given class on the day of the survey were asked to complete the questionnaire. Class size was generally 30 to 50 students. 12,355 of the 12,557 eligible students participated (97.3%).
   5th year medical students at the School of Medicine of National Yang-Ming University administered the questionnaires. All survey administrators were also members of Yang- Ming Crusade, a community service group. This group does volunteer work in health education and participates in health-related service and survey projects during school vacation periods. Every effort was made to make it perfectly clear to the students that the questionnaires were completely anonymous and that there was no possibility that the information given could be used against them.
   Basic demographic information included sex, age, and ethnicity. The survey also included questions regarding family situation (use of rewards versus punishment by the parents to influence behavior, calling home if one will be late, and who makes decisions within the family) and lifestyle (smoking, drinking, playing video games, cutting into lines, working while a student, and gang membership) [7-12].
   Central to this study were questions regarding four values associated with human rights. [13-14] These included respect (from parents and teachers), trust (from parents), esteem (by parents and classmates), and privacy (both respect of family members' and classmates' privacy and personal experiences of violation of privacy by others).
   All information was self-reported (therefore, all data was in fact regarding perceived respect, trust, esteem, etc., but this distinction was not of concern to us). We did not use strict definitions, but instead posed simple questions that would be responded by choosing "yes" or "no" (Example: Do you smoke?) or by choosing one of a list of general answers (Example: Do your parents respect your opinion? Pick one of the following: yes, no, depends on circumstances). (Please refer to the tables for further examples.)
   The selection of the four human rights factors and all questions in the survey was based on the goals of this study and a thorough analysis of current research literature. The questionnaires were reviewed by various background experts for expert validity and pretested in nearby school students.
   Statistical analysis began with descriptive analysis using frequency distribution of basic demographic information, family situation, four values associated with human rights (respect, trust, esteem, and privacy) and lifestyle factors (smoking, drinking, cutting into lines, frequenting video arcades, holding a job, and gang membership). Univariate analysis using the Chi-square test was done to determine significant relationships between smoking/drinking and the four human rights values. Stratified analysis according to sex was done to determine how risk factors for smoking and drinking varied between the sexes. Multivariate analysis was performed using divisions of the study population according to both sex and age: a younger group that included all junior high school students and an older group that included all high school, vocational school, and junior college students. In the multivariate analysis, logistic regression analysis was used to determine further relationships between smoking/drinking and the four human rights values. Finally, adjusted odds ratios for risk factors were determined.


Results

12,355 of the 12,557 eligible students participated (97.3%). The percentage difference between males (49.6%) and females (50.4%) was very small. The majority of junior high school students varied in age from 12 to 15. The majority of students at high schools, junior colleges, and vocational schools ranged from 15 to 18 years of age.
   Regarding parenting style, 33.1% of all students responded that their parents used roughly equal amounts of rewarding and punishing, 15.6% said that they used mostly rewarding, and only 4.2% said they used mostly punishing. The largest percentage of parents that used mostly rewarding was among high school students (21.7%), and the smallest percentage that mostly used punishment was among vocational school students (3.5%). The largest segment of all groups (and over half of the junior high school students, 52.2%) responded that their parents used either rewarding or punishing depending upon the situation. Regarding who makes decisions in the family, the percentages were fairly evenly spread between the mother (26%), father (21.3%), and the whole family together (22.3%). For 30.4% there was no specific pattern. The large majority (91.4%) of all students called home when they were not able to return on time, and the reason the majority of these gave for doing so was not to let the people at home worry (88.8%). (Table 1)

TABLE 1. Family situation, survey of school-attending adolescents in Taiwan in 1994.

TotalJunior H.S.High SchoolVoc. SchoolJr. CollegeX2 Test
No.%No.%No.%No.%No.%P-value
Do your parents try to effect your behavior by giving rewards or by punishing?
Mostly by rewarding191215.682814.540821.736413.231216.3<0.001
Mostly by punishing5134.22534.4844.4973.5794.1
Equally through rewarding
and punishing
406533.1165028.972938.795934.972737.9
Depends upon situation577647.1298452.266235.2133248.479841.7
Total12266100.05715100.01883100.02752100.01916100.0
Which person makes most of the decision in the family?
Father261421.3116220.445524.156420.443322.6<0.001
Mother318826.0136824.049926.579828.952327.2
The whole family274022.3136624.038220.256320.442922.3
Uncertain372630.4180531.655129.283530.353527.9
Total12268100.05701100.01887100.02760100.01920100.0
If you are not able to return home on time, do you feel you need to call to say so?
Yes1122791.4519290.9175492.7252191.1176091.70.104
No10608.65189.11387.32458.91598.3
Total12287100.05710100.01892100.02766100.01919100.0
If you feel you need to call home, what is the reason for this?
Required by family members9158.84579.71458.61948.51197.3<0.001
So that family members
would not be worried
918388.8414187.4149989.2205589.6148891.1
Other2452.41382.9
362.2451.9261.6
Total10343100.04636100.01680100.02294100.01633100.0

   Questions on "respect" covered the attitudes of both parents and teachers toward the student as perceived by the student. Regarding parents' respect of the students' opinions, 5.4% did not, 39.6% did, and for 55.0% it depended
   on the situation. High school students were most likely to feel that their opinions were respected (50.4%), followed by junior college students (48. 1%), vocational school (41.7%), and junior high school students (32.3%). Furthermore, junior high school students reported the largest percentage of parents who did not respect their opinions (6.6%). The relative lack of respect for the opinions of junior high school students is probably due to age. Regarding normal, daily feelings of respect from teachers, 4.1% of the students felt a lack of respect and 80.4% felt respect to be average or better. Junior high school students reported the highest number who believed that teachers normally respected them very much (34. 9%), while high school students were most likely to feel a lack of respect from their teachers (4.8%). (Table 2)
   Regarding "trust," 4.0% of the students felt they were not trusted by other family members, 56.9% felt trust levels were average, 28.9% felt they were trusted very much, and for 10.2% it depended on the situation. Of the four groups, junior college students reported the highest amount of trust and junior high school students the lowest. (Table 2)
   Questions on "esteem" dealt with 2 facets: family members and friends/classmates. For 6.2% the amount of esteem showed to them by their parents was low, for 68.4% it was normal, and for 14.7% it was high. Junior high school students were most likely to feel that their parents showed them a low level of esteem (6.7%). For 3.1% the amount of esteem showed to them by their friends was low, for 71.8% it was normal, and for 9.9% it was high. Junior high school students were most likely to feel that their friends showed them a low level of esteem (4. 1%). (Table 2)

TABLE 2. Perceptions of respect, trust, and esteem, survey of school-attending adolescents in Taiwan in 1994.

TotalJunior H.S.High SchoolVoc. SchoolJr. CollegeX2 Test
No.%No.%No.%No.%No.%P-value
Do your parents respect your opinions
Yes484839.6182932.294850.4114941.792248.1<0.001
No6595.43766.6914.81174.3753.9
Depends on circum.673055.0348061.284444.8148754.091948.0
Total12237100.05685100.01883100.02753100.01915100.0
In general, do you feel that teachers respect students?
Yes383631.5197734.959831.874127.152027.4<0.001
Somewhat (average)596248.9251244.492048.9147853.9105255.5
No5014.12534.5904.81104.0482.5
Depends on circum.188015.591916.227314.541115.027714.6
Total12179100.05661100.01881100.02740100.01897100.0
Do the people in your family trust you?
Yes355128.9135923.868536.279928.970836.8<0.001
Somewhat (average)699756.9336558.8100953.4162358.7100052.0
No4934.02173.8834.41174.2764.0
Depends on circum.125710.277913.61136.02278.21387.2
Total12298100.05720100.01890100.02766100.01922100.0
In general, to what extent do your parents esteem you?
High180314.770512.333017.539614.337219.4<0.001
Average841368.4390168.2128167.7194270.2128967.1
Low7616.23816.71115.91656.01045.4
Depends on circum.132210.773512.81698.92639.51558.1
Total12299100.05722100.01891100.02742100.01920100.0
In general, to what extent to your friends and classmate esteem you?
High12019.95089.022111.828610.51869.8<0.001
Average871571.8384268.1136372.7207175.7143976.0
Low3833.12284.1412.2752.7392.1
Depends on circum.184415.2106118.825013.330411.122912.1
Total12143100.05639100.01875100.02736100.01893100.0

   Regarding behaviors toward privacy, a number of negative trends were found. 34.2% said that they had looked through other students' book bags without their permission, 19.0% had read other people's mail, 18.2% had listened to other people's telephone conversations, and 13.0% had read other people's diaries. Family members also often did these things to the students. On at least one occasion 43.8% had had their diaries read, 60.6% their mail read, 65.2% their book bags looked into, and 70.3% their telephone conversations listened to. The students were also asked what their reaction would be to such violations of privacy. Of the four groups, high school students were most likely to be upset and junior high school students were least likely, once again possibly due to age differences. The students were more likely to be very upset if friends/classmates (as opposed to family members) open their mail, look into their book bag, or read their diary. But the students were more likely to be upset by family members listening to telephone conversations than friends doing so. At the same time, friends/classmates opening mail, looking into book bags, and reading diaries happen much often, if only because they have more opportunity to do so. (Table 3)

TABLE 3. Privacy issues, survey of school-attending adolescents in Taiwan in 1994.

TotalJunior H.S.High SchoolVoc. SchoolJr. CollegeX2 Test
No.%No.%No.%No.%No.%P-value
How do you feel when someone in your family opens your mail?
Very unhappy406733.1151226.575239.7103737.676640.0<0.001
Not concemed10958.959410.41337.12167.81527.9
Depends on circumstances228318.6105118.434118.051418.637619.6
Has never occurred483239.4254644.766635.299336.062732.6
Total12276100.05703100.01892100.02760100.01921100.0
How do you feel when someone in your family looks in your book bag?
Very unhappy316425.8117920.766034.975127.357429.9<0.001
Not concemed276822.6142825.036419.256620.541021.3
Depends on circumstances206616.8114020.024012.741715.126914.0
Has never occurred427934.8195834.362933.2102337.166934.8
Total12277100.05705100.01893100.02757100.01922l00.0
How do vou feel when someone in your family listens to your telephone conversations?
Verv unhappy465137.9174730.786545.7119943.584043.8<0.001
Not concerned190615.6114720.121011.129210.625713.4
Depends on circumstances206316.899917.528615.148917.728915.0
Has never occurred364829.7180531.753228.177728.253427.8
Total12268100.05698100.01893100.02757100.01920100.0
How do you feel when someone in your family reads your diary?
Very unhappy370530.3140324.770037.089632.670636.8<0.001
Not concerned9667.963811.2814.31575.7904.7
Depends on circumstances6885.64347.7623.31114.0814.2
Has never occurred687456.232006.4104755.4158757.7104054.3
Total12233100.05675100.01890100.02751100.01917100.0
How do you feel when a friend/classmate opens your mail?
Very unhappy514542.0226639.984644.7111140.392248.0<0.001
Not concemed6725.53315.8804.21666.1954.9
Depends oncircurnstances192015.685915.127514.549618.029015.1
Has neveroccurred451736.9222939.269236.698235.661432.0
Total12254100.05685100.01893100.02755100.01921100.0
How do you feel when a friendlclassmate looks in your book bag?
Very unhappy426134.8217738.358530.982429.967535.2<0.001
Not concemed200316.375813.337419.851318.635818.7
Depends on circumstances350428.6152026.756729.990432.851326.7
Has never occurred248320.3123021.736719.451318.737319.4
Total12251100.05685100.01893100.02754100.01919100.0
How do you feel when a fnend/classmate listens to your telephone conversations?
Very unhappy305725.0125722.256129.666724.257229.8<0.001
Not concemed158713.076013.421911.637713.723112.0
Depends on circumstances189015.483514.725213.347217.133117.3
Has never occurred570046.6281549.786045.5123945.078640.9
Total12234100.05667100.01892100.02755100.01920100.0
How do you feel when a friend/classmate reads your diary?
Very unhappy434335.6190733.871537.994934.677240.3<0.001
Not concemed6375.23846.8462.41375.0703.7
Depends on circumstances10098.35609.91125.92097.61286.7
Has never occurred620150.9279349.5101453.8145052.894449.3
Total12190100.05644100.01887100.02745100.01914100.0
Do you open other people's mail?
Often960.8601.170.4140.5150.8<0.001
Sometimes222218.2110719.530416.148717.732416.9
Have never991281.0450279.4158083.5225081.8158082.3
Total12230100.05669100.01891100.02751100.01919100.0
Do you lcok inside other people's book bags?
Often1421.1841.5180.9190.7211.1<0.008
Sometimes404133.1187333.165734.891533.259631.0
Have never803765.8370265.4121464.3181866.1130367.9
Total12220100.05659100.01889100.02752100.01920100.0
Do you listen to other people's telephone conversations?
Often15613.01101.9140.8130.5191.0<0.001
Sometimes206316.9108219.228415.042415.427314.2
Have never998881.8445578.9159284.2231484.1162784.8
Total12207100.05647100.01890100.02751100.01919100.0
Do you read other people's diaries?
Often1110.9671.2110.6170.6160.8<0.001
Sometimes147812.184415.01759.32679.719210.0
Have never1061087.0473283.8170190.1246689.7171189.2
Total12199100.05643100.01887100.02789100.01919100.0

   When they have been treated unfairly, high school, junior college, and vocational students are more likely to stand up for their rights than junior high school students. But for all groups, the largest number would base their reactions on the circumstances of the situation (total 53.2%). Only 3.2% regularly cut into lines, but 80.8% have done so at least once. The large majority of people are upset by others cutting into line, but only 17.8% would consider confronting such a person. Information was also collected on how often the students go to video arcades, if they have held a job, and if they had ever joined a gang, though this data was much less critical than the data on smoking and drinking. (Table 4)
   1250 of the study participants smoked (10.1%). The highest number was among vocational school students (13.8%), followed by junior college students (12.6%), junior high school students (8.8%) and high school students (6.2%). 1315 of the study participants drank (10.6%). The highest number was among junior college students (13.3%), followed by vocational school students (12.5%), junior high school students (9.8%) and high school students (7.9%). Both smoking and drinking rates increased with age, though the average total decreased from 1991 to 1994 and then increased from 1994 to 1996 (data not shown).

TABLE 4. Lifestyle and habits, survey of school-attending adolescents in Taiwan in 1994.

TotalJunior H.S.High SchoolVoc. SchoolJr. CollegeX2 Test
No.%No.%No.%No.%No.%P-value
When are treated unfairly what do you do?
Fight for your rights391731.9166829.367835.889532.467635.2<0.001
Hide your anger140311.570812.419410.232011.61819.4
Do not care4183.42594.6432.3823.0341.8
Depends on circum.652453.2305753.797951.7146053.0102853.6
Total12262100.05787100.01894100.02757100.01919100.0
When you are waiting in line and someone euts line in front of you, how do you feel?
Am upset and will say something218917.8129822.825813.641314.922011.4<0.001
Am upset, but will not say anything559245.6202535.6107556.6139250.4110057.3
Do not eare10978.965811.6985.22167.81256.5
Depends on circum.339327.7170830.046624.674326.947624.8
Total12271100.05689100.01897100.02764100.01921100.0
Do you ever cut into lines?
Often3833.21953.4452.4672.4764.0<0.001
Sometimes260521.3121121.437719.953619.648125.1
Very seldom684756.3314455.5107556.7159958.4105655.1
Never235419.2111519.739721.053819.630415.9
Total12216100.05665100.01894100.02740100.01917100.0
Do you go to video game parlors'?
Every day1591.3801.4130.7361.3301.6<0.001
Often (2-3 times a week)7045.82905.1975.11565.71618.4
Sometimes (2-3 times a month)203516.686615.233517.748117.435318.4
Rarely (once a month or less)468138.2186532.878441.4124445.278841.2
Never467438.2258945.566535.183830.458230.4
Total12253100.05690100.01894100.02740100.01917100.0
Have you ever held a job?
No617150.8346361.5117162.285531.268235.9<0.001
Only during vacation466938.4169230.059431.6140851.597551.4
Yes131010.84798.51166.247317.324212.7
Total12150100.05634100.01881100.02736100.01899100.0
Have you ever been in a gang?
Yes3102.61612.9331.8642.4522.8<0.001
No1161397.4534897.1183198.2262297.6181297.2
Total11923100.05509100.01864100.02686100.01864100.0

For analysis of the relationship between everyday human rights concepts and smoking and drinking habits, the study population was divided into two groups, a younger group (generally ages 13-15) consisting of all junior high school students and an older group (generally ages 16-19) consisting of students from all other school types. Analysis was also done according to sex. In the following "YM" will stand for younger males, "OM" for older males, "YF" for younger females, and "OF" for older females. Multivariate analysis was then done comparing these four groups regarding smoking (Tables 5) and drinking (Table 6).

TABLE 5. Logistic regression analysis on smoking among school-attending adolescents in Taiwan in 1994.

Younger GroupOlder Group
Male
OR (95% C.I.)
Female
OR (95% C.I.)
Male
OR (95% C.I.)
Female
OR (95% C.I.)
Type of school
Vocational vs. High School--2.9 (2.2~3.7)2.1 (1.3~3.6)
Junior College vs. High School--2.5 (1.9~3.3)1.2 (0.6~2.1)
Respect of teachers
No vs. very much2.2 (1.4~3.5)6.4 (3.1~13.3)1.9 (1.2~2.9)N.S.
Average or uncertain vs. very much1.4 (1.1~1.8)1.8 (1.0~3.1)1.4 (1.1~1.8)N.S.
Trust of family
No vs. very much3.0 (1.7~5.4)7.2 (3.0~17.3)2.2 (1.4~3.5)3.1 (1.4~7.1)
Average or uncertain vs. very much1.7 (1.2~2.3)2.6 (1.3~5.3)1.7 (1.3~2.2)1.5 (0.9~2.5)
Esteem of parents
Low vs. very high1.8 (1.0~3.2)N.S.2.9 (1.8~4.6)N.S.
Average or uncertain vs. very much1.6 (1.0~2.4)N.S.1.4 (1.0~1.9)N.S.
Esteem of friends and classmates
Low vs. very high0.5 (0.3~0.9)N.S.0.5 (0.3~0.8)N.S.
Average or uncertain vs. very much0.6 (0.4~0.9)N.S.0.6 (0.5~0.8)N.S.
Reaction to family members opening mail
Very unhappy vs. never occurredN.S.2.7 (1.6~4.4)1.2 (0.9~1.5)1.5 (0.9~2.6)
Not care vs. never occurredN.S.0.9 (0.5~1.7)0.7 (0.6~0.9)0.5 (0.2~1.0)
Reaction to family members listening to telephone conversations
Very unhappy vs. never occurred1.6 (1.1~2.3)N.S.N.S.N.S.
Not care vs. never occurred1.4 (1.0~1.9)N.S.N.S.N.S.
Reaction to friends or classmates opening mail
Very unhappy vs. never occurredN.S.N.S.1.0 (0.7~1.4)1.2 (0.7~2.1)
Not care vs. never occurredN.S.N.S.1.4 (1.0~1.9)2.1 (1.2~3.7)
Reaction to friends or classmates listening to telephone conversations
Very unhappy vs. never occurred1.7 (1 2~2.3)N.S.1.2 (0.9~1.7)N.S.
Not care vs. never occurred1.3 (1.0~1.8)N.S.1.6(1.2~2.1)N.S.
Reaction to friends or classmates looking inside book bag
Very unhappy vs. never occurred0.7 (0.5~0.9)N.S.N.S.2.7 (1.3~5.8)
Not care vs. never occurred0.8 (0.6~1.1)N.S.N.S.1.9 (1.0~3.9)
Reaction to friends or classmates reading diary
Very unhappy vs. never occurredN.S.1.1 (0.7~1.7)N.S.N.S.
Not care vs. never occurredN.S.2.1 (1.2~3.6)N.S.N.S.
Calling home if late
No vs. yesN.S.2.5 (1.5~4.2)N.S.N.S.
The following were not statisitically significant: respect of parents, reaction to family members looking inside book bag, reaction to family members reading diary, parenting style, and decision making within the family.

TABLE 6. Logistic regression analysis on drinking among school-attending adolescents in Taiwan in 1994.

Younger GroupOlder Group
Male
OR (95% C.I.)
Female
OR (95% C.I.)
Male
OR (95% C.I.)
Female
OR (95% C.I.)
Type of school
Voc. vs. H.S.--1.9 (1.5~2.4)1.5 (1.0~2.2)
Jr. Col. vs. H.S.--2.0 (1.6~2.6)1.2 (0.8~1.9)
Respect of parents
No vs. yesN.S.2.3 (1.2~4.1)N.S.N.S.
Uncertain vs. yesN.S.1.4 (0.9~2.1)N.S.N.S.
Respect of teachers
No vs. very much2.3 (1.5~3.6)2.9(1.6~5.4)2.2 (1.5~3.4)N.S.
Average or uncertain vs. very much1.2 (0.9~1.6)1.3 (0.9~1.9)1.3 (1.1~1.7)N.S.
Trust of family
No vs. very muchN.S.N.S.1.7 (1.1~2.7)3.0 (1.5~6.0)
Average or uncertain vs. very muchN.S.N.S.1.3 (1.0~1.7)1.8 (1.2~2.7)
Esteem of parents
Low vs. very highN.S.7.0 (2.9~16.9)2.5 (1.6~4.0)N.S.
Average or uncertain vs. very muchN.S.2.3 (1.1~4.8)1.4 (1.0~2.0)N.S.
Esteem of friends and classmates
Low vs. very high0.8 (0.5~1.4)0.7 (0.3~1.6)0.5 (0.3~ 0.9)N.S.
Average or uncertain vs. very much0.7 (0.5~0.9)0.5 (0.3~0.8)0.8 (0.6~1.0)N.S.
Reaction to family members opening mail
Very unhappy vs. never occurred1.5 (1.1~2.1)N.S.1.1 (0.9~1.5)1.4 (1.0~1.9)
Not care vs. never occurred1.3 (1.0~1.7)N.S.0.7 (0.6~1.0)0.5 (0.3~0.9)
Reaction to family members looking inside book bag
Very unhappy vs. never occurredN.S.2.2 (1.4~3.4)N.S.N.S.
Not care vs. never occurredN.S.1.1 (0.7~1.7)N.S.N.S.
Reaction to friends or classmates opening mail
Very unhappy vs. never occurredN.S.1.3 (0.9~2.0)1.1 (0.8~1.6)N.S.
Not care vs. never occurredN.S.1.8 (1.2~2.9)1.4 (1.1~2.0)N.S.
Reaction to friends or classmates listening to telephone conversations
Very unhappy vs. never occurred1.4 (1.1~1.9)N.S.1.1 (0.8~1.5)N.S.
Not care vs. never occurred1.2 (0.9~1.6)N.S.1.4 (1.1~1.8)N.S.
Calling home if late
No vs. yes1.8 (1.4~2.5)1.9 (1.2~3.1)1.5 (1.1~1.9)1.8 (1.1~3.1)
The following items were not statistically significant: decision making within the family, parenting style, reaction to friends or classmates looking inside book bag, reaction to friends or classmates reading diary, reaction to family members reading diary, and reaction to family members listing to telephone conversations.

   There were no significant relationships between parental respect and smoking and drinking, except for YF: those who said they were not respected by their parents were 2.3 times more likely to drink. The relationship between respect from teachers and smoking and drinking was significant for YM, OM, and YF, but insignificant for OF. The younger females seemed particularly sensitive in this regard-- those who felt their teachers did not respect them were 6.4 times more likely to smoke.
   Trust was a significant factor for smoking in all groups but was a factor for drinking only for OM and OF. Trust was of particular importance for YF. Young females who do not feel trusted by family members were 7.2 times more likely to smoke than young females who felt they were trusted very much.
   Esteem from the parents was a factor for smoking and drinking among OM and for drinking among YF. Young females whose parents did not esteem them were 7.0 times more likely to drink than young females whose parents esteemed them very much. But the effect of esteem from friends/classmates had the opposite relationship: those who were highly esteemed by friends/classmates were more likely to smoke or drink than those who were esteemed to less or average.
   In summary, the major findings from logistic regression analysis of the four groups in relation to smoking and drinking are the following: 1) Younger females are more likely to be effected by respect from parents and teachers, trust within the family, and esteem from the parents. This sensitivity often reflects itself in higher rates of smoking and drinking. 2) The level of respect from teachers is more likely to be associated with smoking and drinking habits than the level of respect from parents. 3) In every school category but one, students who felt they were not trusted were more likely to smoke and drink. The exception was junior high schools, where a lack of trust did have a significant effect on smoking but not on drinking. 4) A low level of esteem from parents increases the likelihood of smoking and drinking, but low esteem from friend/classmates has the opposite effect. This is true for all male students.


Discussion

   Because of the sampling design of the study, the study population represented very well all adolescents attending schools in Taiwan in 1994. We hope that this study may serve as a base for future studies, and the quality of our data should be at a level that a comparison with data collected in the future would be both valid and useful. The primary weakness of this study is probably the general and inexact nature of many of the questions. This was done in order to avoid making the questionnaire excessively long. A longer questionnaire might have provided more specific information in some areas, but may also have caused the participation rate to be lower.
   Many findings in the logistic regression analysis might be attributable solely to age factors, particularly regarding esteem and respect of privacy. Additional research specific to the effect of age on these factors would be very helpful in interpreting our findings in these areas.
   The most interesting results were in regards to esteem in general (not its relationship to the two age groups). As mentioned above, the effect of esteem from friends/classmates had the opposite relationship of esteem from family: those who were highly esteemed by friends/classmates were more likely to smoke or drink than those who were esteemed to less or average, but low esteem from parents was associated with smoking and drinking. This shows that there is an extreme difference between the way adolescents interpret esteem from parents and esteem from friends/classmates. An understanding of these differences is crucial to successful health and human rights education efforts, and more research in this area is definitely needed.
   Many studies have demonstrated the link between smoking, drinking, and drug use [15- 18], but this is one of the first studies to analyze the connection between these dangerous, unhealthy habits and basic elements of our lifestyles and values. To some extent, attitudes and perceptions that work against human rights values are risk factors for smoking and drinking. On the other hand, it is possible that an opposite relationship is also at play, and perhaps smoking and drinking discourage human rights values. In either case, there is a definite relationship between human rights values and substance use, and this is the most important finding of this study. Because of this relationship, a coordinated education effort probably would be the most effective, especially considering that in at least one area (esteem from parents and teachers and its effect on smoking and drinking), teachers appear to have a larger influence than parents. Be that as it may, both parents and teachers should work to teach children and adolescents not only to lead healthy lifestyles, but also to respect themselves and others as human beings.


Acknowledgements

This study was supported by grants from National Science Council (NSC 86-2417-H-010- 002-F11) and Human Rights Education Foundation in Taiwan. The authors would like to thank Dr. Mab Huang for his valuable opinion in human rights education.


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Reprinted from Chinese Journal of Public Health 17(4)1998:303-16.

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