범이론적 모형에 근거한 고등학생의 흡연시작 관련요인

Related Factors for the Initiation of Smoking in High School Students Based on the Transtheoretical Model

  • 홍지영 (건양대학교 의과대학 예방의학교실) ;
  • 나백주 (건양대학교 의과대학 예방의학교실) ;
  • 김건엽 (건양대학교 의과대학 예방의학교실) ;
  • 이무식 (건양대학교 의과대학 예방의학교실)
  • Hong, Jee-Young (Department of Preventive Medicine, College of Medicine, Konyang University) ;
  • Na, Baeg-Ju (Department of Preventive Medicine, College of Medicine, Konyang University) ;
  • Kim, Keon-Yeop (Department of Preventive Medicine, College of Medicine, Konyang University) ;
  • Lee, Moo-Sik (Department of Preventive Medicine, College of Medicine, Konyang University)
  • 발행 : 2006.01.31

초록

Objective: This study was conducted to investigate the relationship between the intention of smoking and its related factors in high school students. Methods: Our study subjects were 1,203 high school students who resided in one city and in one county region. We conducted a self-administered questionnaire survey from June 7 to June 19, 2004. Both the decisional balance and temptation inventory showed high reliability estimates. We provided good fit for the 12-item decisional balance inventory and the 10-item temptation inventory by using a confirmatory factor analysis. We also used multiple logistic regression analysis to identify the major contributing factors for the intention to start smoking. Results: On the univariate analysis, the subjects who were female, the 2nd and 3rd grade students, the students in vocational high school, the ex-drinkers or current drinkers, and ex-smokers were found to be significantly more distributed in the groups with intention to start smoking. Except for the concept of the cons, the group with intention to start smoking showed significantly higher standardized T scores for the 7 concepts of decisional balance and temptations. On the multiple logistic regression analysis, the females, the 2nd and 3rd grade students, the students in vocational high school, the experience of cigarette smoking and low T score of the cons were significantly related to the intention to start smoking. Conclusions: The intention to start smoking in high school students was affected by various factors such as gender, the school grade and the experience of smoking. Therefore, further research should be conducted for providing the essential data for developing a brief instrument for selecting the groups with intention of starting smoking among adolescents.

키워드

참고문헌

  1. Goldman LK, Glantz SA. Evaluation of antismoking advertising campaigns. JAMA 1998; 279(10): 772-777 https://doi.org/10.1001/jama.279.10.772
  2. Centers for Disease Control and Prevention. Guidelines for school health programs to prevent tobacco use and addiction. Morb Mortal Wkly Rep 1994; 43: 1-18
  3. Korean Association of Smoking & Health. Middle High School Students Smoking Survey: from 1988 to 2000; 2000 (Korean)
  4. U.S. Department of Health and Human Services. Reducing the Health Consequences of Smoking - 25 years of Progress: a Report of the Surgeon general; 1989
  5. U.S. Department of Health and Human Services. Preventing Tobacco use Among Young People: A report of the Surgeon General, 1994
  6. Leventhal H, Cleary PD. The smoking problem: a review of research and theory in behavioral risk modification. Psychol Bull 1980; 88: 370-405 https://doi.org/10.1037/0033-2909.88.2.370
  7. Petraitis J. Flay BR, Miller TO. Reviewing theories of adolescent substance use: organizing pieces in the puzzle. Psychol Bull 1995; 117: 67-86 https://doi.org/10.1037/0033-2909.117.1.67
  8. Lee HS, Kim YS, Suh I. A Comparative study on cigarette smoking of male students in middle and high school in Korea(1988-1989). Korean J Epidemiol 1989; 11(2): 198-208 (Korean)
  9. Korean Association of Smoking & Health. Middle High School Students Smoking Survey,1995 (Korean)
  10. Korean Association of Smoking & Health. Middle High School Students Smoking Survey, 2003 (Korean)
  11. WHO. Tobacco or Health: a Global Status Report, 1997
  12. Kang KA, Jang JD. A survey on smoking of adolescence. J Korean Acad Child Health Nurs 2003; 9(1): 66-73 (Korean)
  13. Kang YJ, Suh SJ. Facotrs related with the adolescent cigarette smoking. J Korean Soc Health Educ 1997; 13(1): 28-44 (Korean)
  14. Prochaska JO, DiClemente CC. Stages and processes of self-change of smoking: toward an integrative model of change. J Consult Clin Psychol 1983; 51: 390-395 https://doi.org/10.1037/0022-006X.51.3.390
  15. Prochaska JO, DiClemnte CC, Norcross JC In search of how people change: applications to addictive behavior. Am Psychol 1992; 47: 1102-1114 https://doi.org/10.1037/0003-066X.47.9.1102
  16. Pallonen UE. Transtheoretical measures for adolescent and adult smokers: Similarities and differences. Prev Med 1998; 27: A29-A38 https://doi.org/10.1006/pmed.1998.0423
  17. Pallonen UE, Prochaska JO, Velicer WF, Prokhorov AV, Smith NF. Stages of acquisition and cessation for adolescent smoking: an empirical integration. Addict Behav 1998; 23: 303-324 https://doi.org/10.1016/S0306-4603(97)00074-9
  18. Elder JP, Demoor C, Young RL, Wildey ME, Molgaard CA, Colbeck AL, Sallis JF, Stem RA. Stages of adolescent tobacco-use acquisition. Addict Behav 1990; 15: 449-454 https://doi.org/10.1016/0306-4603(90)90031-R
  19. Oh HS, King YR. Changing mechanism corresponding to the changing stages of smoking cessation. J Korean Acad Nurs 1995; 26(4) :820-832 (Korean)
  20. Lee MS, Lee YS, Shing HH, Lee KS, Yoon SJ, Jung KH, Kim YY, Chun BC Distribution and interrelationship of smoking, drinking, and physical exercising among some rural adult, an application of the transtheoretical model. Korean J Rural Med 2000; 25(1): 113-131 (Korean)
  21. Park NH, Kim JS, Jeong IS, Chun BC. Predictors of stages of change for smoking cessation among adolescents based on the transtheoretical model. Korean J Prev Med 2003; 36(4): 377-382 (Korean)
  22. Ellickson PL, Tucker JS, Klein D. Sex differences in predictors of adolescent smoking cessation. Health Psychol 2001; 20(3): 186-195 https://doi.org/10.1037/0278-6133.20.3.186
  23. Torabi MR, Bailey WJ, Majd-Jabbari M. Cigarette smoking as a predictor of alcohol and other drug use by children and adolescents: evidence of the 'gateway drug effect'. J Sch Health 1993; 63: 302-306 https://doi.org/10.1111/j.1746-1561.1993.tb06150.x
  24. Banks MH, Bewley MR, Bland JM. Adolescent attitudes to smoking their influence on behavior. Int J Health Educ 1981; 24(1): 39-44
  25. Flay BR, Hu FB, Richardson J. Psychosocial predictors of different stages of cigarette smoking among high school students. Prev Med 1998; 27: 9-18 https://doi.org/10.1006/pmed.1998.0380
  26. Kim JO, Mueller CW. Introduction to Factor Analysis: What it is and How to do it. Newbury Park, CA: Sage; 1978
  27. Velicer WF, DiClemente CC, Prochaska JO, Brandenburg N. Decisional balance measure for assessing and predicting smoking status. J Pers Soc Psychol 1985; 48: 1279-1289 https://doi.org/10.1037/0022-3514.48.5.1279
  28. Badura A. Social Learning Theory. NJ: Prentice-Hall; 1977
  29. Ding L, Pallonen UE, Migneault JP, Velicer WF. Development of a measure to assess adolscents temptation to smoke. Ann Behav Med 1994;16:S175
  30. Plummer BA, Velicer WF, Redding CA, Prochaska JO, Rossi JS, Pallonen UE, Meier KS. Stage of change, decisional balance, and temptation for smoking: measurement and validation in a large, school-based population of adolescents. Addict Behav 2001; 26: 551-571 https://doi.org/10.1016/S0306-4603(00)00144-1
  31. Harlow LL. Behavior of some Elliptical Theory Estimators with Nonnonnal Data in a Covariance Structures Framework: a Monte Carlo Study. Unpublished Doctoral Dissertation, University of California, Los Angeles; 1985
  32. West SG, Finch JF, Curran PJ. Structural Equation Models with Nonnormal Variables: Problems and Remedies In R. H. Hoyle(Ed.), Structural Equation Modeling: Concepts, Issues, and Applications. Newbury Park, CA: Sage, 1995. p. 56-75
  33. Tyc VL, Hadley W, Allen D, Varnell S, Ey S, Rai SN, Lensing S. Predictors of smoking intentions and smoking status among nonsmoking and smoking adolescents. Addict Behav 2004; 29(6): 1143-1147 https://doi.org/10.1016/j.addbeh.2004.03.007
  34. Biltstein JL, Robinson LA, Murray DM, Klesges RC, Zbikowski SM. Rapid progression to regular cigarette smoking among nonsmoking adolescents: interactions with gender and ethnicity. Prev Med 2003; 36(4): 455-463 https://doi.org/10.1016/S0091-7435(02)00041-5
  35. Rundall TG. Bruvold WH. A meta-analysis of school-based smoking and alcohol use prevention programs Health Educ Q 1988; 15: 317-334 https://doi.org/10.1177/109019818801500306
  36. Kim YS, Chung YS. The effects of smoking prevention education on high school students. J Korean Soc Health Educ Promot 2003; 20(2): 81-94 (Korean)
  37. Hwang HS, Chun JH, Kim WJ. Effects of a well-designed program for smoking prevention aplicated on Korean middle school students. J Korean Soc Health Educ Promot 2004; 21(1): 171-182 (Korean)
  38. Weincke JK, Kelsey KT. Teen smoking, field cancerization, and a 'critical period' hypothesis for lung cancer susceptibility. Environ Health Perspect 2002; 110(6): 555-558 https://doi.org/10.1289/ehp.02110555