Factors Associated with the Smoking Cessation Behavior according to the Transtheoretical Model in Korean College Students

범이론적 모델에 근거한 한국 대학생의 금연행위 관련 요인

  • Paek, Kyung-Shin (Department of Nursing, Semyung University) ;
  • Riley, Tracy A. (College of Nursing, Akron University)
  • Received : 2010.08.31
  • Accepted : 2010.12.11
  • Published : 2010.12.30

Abstract

Objectives: The purposes of this study were to examine the contribution of each of the Transtheoretical Model components in explaining stages of smoking cessation and to identify factors associated with the smoking cessation behavior among Korean college students. Methods: The participants for this study were 334 undergraduate students who enrolled in general education courses. Self-report surveys were distributed and returned. The survey variables comprised the stages of change for smoking cessation, self-efficacy, decisional balances and processes of change in smoking cessation. Results: Significant differences were noted in the five stages of change for self-efficacy, decisional balance, and the processes of change. The strongest factor associated with the smoking cessation behavior was self-efficacy. Conclusion: Study findings indicate application of the Transtheoretical Model may be useful to enhance future smoking cessation efforts in college students. The strategies to enhance smoking cessation self-eficacy in college students will be an important intervention component in future studies.

목적: 본 연구는 대학생의 금연행위 변화단계를 설명하는데 있어 범이론적 모델 구성요소들의 기여정도를 조사하고 범이론적 모델에 근거한 대학생의 금연행위와 관련된 요인을 파악하기 위해 시행되었다. 방법: 연구대상자는 일반교양 과목을 수강하는 334명의 대학생으로 자가보고식 설문을 통해 범이론적 모델의 구성요소인 금연행위 변화단계, 자기효능감, 의사결정균형 및 변화과정 등의 자료를 수집하였다. 결과: 금연행위 변화 5단계에 따라 자기효능감, 의사결정균형 및 변화과정에서 유의한 차이가 있었고 자기효능감은 금연행위와 관련된 가장 중요한 요인으로 나타났다. 결론: 대학생의 금연 유도를 높이기 위해 범이론적 모델를 적용하는 것이 유용함을 확인하였고 금연행위 변화단계를 고려한 개별화된 프로그램의 개발이 필요하며 특히 대학생의 금연 자기효능감을 증진시킬 수 있는 전략이 요구된다.

Keywords

References

  1. Ahn, O., Yeun, E., Kwon, S., Chung, H., and Ryu, E. 2005. Predictive factors of aspects of the transtheoretical model on smoking cessation in a rural community. Taehan Kanho Hakhoe Chi 35(7):1285-1294.
  2. Bandura, A. 1997. Self-efficacy: The exercise of control. New York: W. H. Freeman and Company.
  3. Chang, S. O., Kim, E. J., Kil, S. Y., Seomun, G. A., and Lee, S. J. 2005. Influential variables on intention and action to quit smoking between adolescent smokers and adult smokers: Based on the transtheoretical model. Journal of Korean Academy Nursing 35(7):1410-1419. https://doi.org/10.4040/jkan.2005.35.7.1410
  4. Cho, K. S. 2006. Tobacco control policy of the republic of Korea, 2005. Kwachon, South Korea: Ministry of Health and Welfare.
  5. DiClemente, C. C., Prochaska, J. O., Fairhurst, S. K., Velicer, W. F., Velasquez, M. M., and Rossi, J. S. 1991. The process of smoking cessation: An analysis of precontemplation, contemplation, and preparation stages of change. Journal of Consulting and Clinical Psychology 59(2):295-304. https://doi.org/10.1037/0022-006X.59.2.295
  6. Durkin, A. 2007. Promoting smoking cessation among nursing students: How faculty can help. Nursing Education Perspectives 28(3):150-154.
  7. Ha, B. M., Yoon, S. J., Lee, H. Y., Ahn, H. S., Kim, C. Y., and Shin, Y. S. 2003. Measuring the burden of premature death due to smoking in Korea from 1990 to 1999. Public Health 117(5):358-365. https://doi.org/10.1016/S0033-3506(03)00142-2
  8. Habib, S. H., and Saha, S. 2010. Burden of non-communicable disease: Global overview. Diabetes & Metabolic Syndrome: Clinical Research & Review 4(1):41-47. https://doi.org/10.1016/j.dsx.2008.04.005
  9. Haddad, L. G., and Petro-Nustas, W. 2006. Predictors of intention to quit smoking among Jordanian university students. Canadian Journal of Public Health 97(1):9-13.
  10. Ham, O. K. 2007. Stages and processes of smoking cessation among adolescents. Western Journal of Nursing Research 29(3):301-315. https://doi.org/10.1177/0193945906295528
  11. Hayes, E. R., and Plowfield, L. A. 2007. Smoking too young: Students' decisions about tobacco use. MCN: The American Journal of Maternal Child Nursing 32(2):112-116. https://doi.org/10.1097/01.NMC.0000264292.72221.ef
  12. Hoeppner, B. B., Velicer, W. F., Redding, C. A., Rossi, J. S., Prochaska, J. O., Pallonen, U. E., et al. 2006. Psychometric evaluation of the smoking cessation processes of change scale in an adolescent sample. Addictive Behaviors 31(8):1363-1372. https://doi.org/10.1016/j.addbeh.2005.11.002
  13. Horneffer-Ginter, K. 2008. Stages of change and possible selves: 2 tools for promoting college health. Journal of American College Health 56(4):351-358. https://doi.org/10.3200/JACH.56.44.351-358
  14. Khang, Y., and Cho, H. 2006. Socioeconomic inequality in cigarette smoking: Trends by gender, age, and socioeconomic position in South Korea, 1989–2003. Preventive Medicine 42(6):415-422. https://doi.org/10.1016/j.ypmed.2006.02.010
  15. Kim, M. Y., Suh, S. L., and Ham, O. K. 2007. Stages and processes of smoking cessation among high school students in rural community. Journal of Korean Academy Community Health Nursing 18(3):431-440.
  16. Kim, Y. 2006. Adolescents' smoking behavior and its relationships with psychological constructs based on transtheoretical model: A cross-sectional survey. International Journal of Nursing Studies 43(4):439-446. https://doi.org/10.1016/j.ijnurstu.2005.06.008
  17. Korea antismoke research institution. Attitudes survey for tobacco. http://cafe.daum.net/kns11. 2006
  18. Korea antismoke research institution. Smoking rate of young adult. http://cafe.daum.net/kns11/1ohf/777 . 2009.
  19. Korea antismoke research institution. Smoking rate of young adult. http://cafe.daum.net/kns11. 2010.
  20. Kyungwon University Newspaper. Smoking and drinking of college students. http://www.i-kwup.com/news/read.php. 2009.
  21. Lee, Y. M. 2004. Process of change, decisional balance and self efficacy corresponding to stage of change in exercise behaviors in middle aged women. Journal of Korean Academy Nursing 34(2): 362-371. https://doi.org/10.4040/jkan.2004.34.2.362
  22. Lee, C. Y., Kim, H. S., and Lee, T. W. 2001. Evaluation of health promotion services in health centers. Ministry of Health & Welfare. Seoul.
  23. Lee, C. Y., Shin, S., Lee, H. K., and Hong, Y. M. 2009. Validation of self-report on smoking among university students in Korea. American Journal of Health Behavior 33(5):540-549.
  24. Lenz, B. K. 2009. Nursing students' response to tobacco cessation curricula in Minnesota baccalaureate nursing programs. Journal of Nursing Education 48(10):566-573. https://doi.org/10.3928/01484834-20090716-03
  25. Lin, K., Lou, M., and Liu, P. 2004. The experiences of resuming smoking among medical college students [Chinese]. Journal of Nursing 51(6):55-63.
  26. Ministry of Education, Science & Technology. Educational statistics. http://www.mest.go.kr/me_kor/inform/science/science/general/index.html. 2008.
  27. Myers, M. G., Doran, N. M., Trinidad, D. R., Wall, T. L., and Klonoff, E. A. 2009. A prospective study of cigarette smoking initiation during college: Chinese and Korean American students. Health Psychology 28(4):448-456. https://doi.org/10.1037/a0014466
  28. O' Hea, E. L., Wood, K. B., and Brantley, P. J. 2003. The transtheoretical model: Gender differences across 3 health behaviors. American Journal of Health Behavior 27(6):645-656. https://doi.org/10.5993/AJHB.27.6.7
  29. Oh, H. S., and Kim, Y. S. 1996a. Changing mechanisms corresponding to the changing stages of smoking cessation. Journal of Korean Academy Nursing, 26(4):820-832.
  30. Oh, H. S., and Kim, Y. S. 1996b. Factor analysis on behavior change mechanisms in self-help smoking cessation. Journal of Korean Academy Nursing 26(3):678-687.
  31. Oh, H. S., and Kim, Y. S. 1997. Exploratory study on developing model for smoking cessation process. Journal of Korean Academy Nursing 27(1):71-82.
  32. Otsuki, M. 2009. Social connectedness and smoking behaviors among Asian American college students: An electronic diary study. Nicotine & Tobacco Research 11(4):418-426. https://doi.org/10.1093/ntr/ntp028
  33. Otsuki, M., Tinsley, B. J., Chao, R. K., and Unger, J. B. 2008. An ecological perspective on smoking among Asian American college students: The roles of social smoking and smoking motives. Psychology of Addictive Behaviors 22(4):514-523. https://doi.org/10.1037/a0012964
  34. Park, N., Kim, J., and Lee, Y. 2003. Factors associated with the stage of change of smoking cessation behavior in adolescents. Taehan Kanho Hakhoe Chi 33(8):1101-1110.
  35. Pimenta, F., Leal, I., and Maroco, J. 2008. Health beliefs, stages of change and smoking behaviour in Portuguese college students. Journal of Smoking Cessation 3(1):14-22.
  36. Prochaska, J. O., and DiClemente, C. C. 1982. Transtheoretical therapy: Toward a more integrative model of change. Psychotherapy:Theory, Research & Practice 19(3):276-288. https://doi.org/10.1037/h0088437
  37. Prochaska, J. O., and Velicer, W. F. 1997. The transtheoretical model of health behavior change. American Journal of Health Promotion 5(1):38-48.
  38. Prochaska, J. O., Velicer, W. F., DiClemente, C. C., and Fava, J. 1988. Measuring processes of change: Applications to the cessation of smoking. Journal of Consulting and Clinical Psychology 56(4): 520-528 https://doi.org/10.1037/0022-006X.56.4.520
  39. Rasmussen-Cruz, B., Hidalgo-San Martin, A., Nuno-Gutierrez, B., and Hidalgo-Rasmussen, C. 2006. Tobacco consumption and motives for use in Mexican university students. Adolescence 41(162): 355-368.
  40. Ridner, S. L., and Hahn, E. J. 2005. The pros and cons of cessation in college-age smokers. Clinical Excellence for Nurse Practitioner 9(2):81-87.
  41. Rigotti, N. A., Moran, S. E., and Wechsler, H. 2005. US college students' exposure to tobacco promotions: Prevalence and association with tobacco use. American Journal of Public Health 95(1):138-144. https://doi.org/10.2105/AJPH.2003.026054
  42. Sarna, L., Danao, L. L., Chan, S., Shin, S. R., Baldago, L. A., Endo, E., et al. 2006. Tobacco control curricula content in baccalaureate nursing programs in four Asian nations. Nursing Outlook 54(6): 334-344. https://doi.org/10.1016/j.outlook.2006.09.005
  43. Son, H. M. 2005. Differences in processes of change, decisional balance and temptation across the stages of change for smoking cessation. Journal ofKorean Academy Nursing, 35(5):904-913. https://doi.org/10.4040/jkan.2005.35.5.904
  44. Staten, R. R., Noland, M., Rayens, M. K., Hahn, E., Dignan, M., and Ridner, S. L. 2007. Social influences on cigarette initiation among college students. American Journal of Health Behavior 31(4):353-362. https://doi.org/10.5993/AJHB.31.4.2
  45. Staten, R. R., and Ridner, S. L. 2007. College students' perspective on smoking cessation: "if the message doesn't speak to me, I don't hear it". Issues in Mental Health Nursing 28(1):101-115. https://doi.org/10.1080/01612840600997990
  46. Thompson, B., Thompson, L. A., Hymer, J., Zbikowski, S., Halperin, A., andJaffe, R. 2007. A qualitative study of attitudes, beliefs, and practices among 40 undergraduate smokers. Journal of American College Health 56(1):23-28. https://doi.org/10.3200/JACH.56.1.23-28
  47. Velicer, W. F., DiClemente, C. C., Prochaska, J. O., and Brandenburg, N. 1985. Decisional balance measure for assessing and predicting smoking status. Journal of Personality and Social Psychology 48(5):1279-1289. https://doi.org/10.1037/0022-3514.48.5.1279
  48. Velicer, W. F., Redding, C. A., Sun, X., and Prochaska, J. O. 2007. Demographic variables, smoking variables, and outcome across five studies. Health Psychology 26(3):278-287. https://doi.org/10.1037/0278-6133.26.3.278
  49. Viswanath, K., Herbst, R. S., Land, S. R., Leischow, S. J., and Shields, P. G. 2010. Tobacco and cancer: An American association for cancer research policy statement. Cancer Research 70(9):3419-3430. https://doi.org/10.1158/0008-5472.CAN-10-1087
  50. Wang, K., Yang, C., Chu, N., and Wu, D. 2009. Predictors of cigarette smoking behavior among military university students in Taiwan. Journal of Nursing Research 17(3):161-168. https://doi.org/10.1097/JNR.0b013e3181b2553b
  51. Warnecke, R. B., Morera, O., Turner, L., Mermelstein, R., Johnson, T. P., Parsons, J., et al. 2001. Changes in self-efficacy and readiness for smoking cessation among women with high school or less education. Journal of Health and Social Behavior 42(1):97-110. https://doi.org/10.2307/3090229
  52. Waters, K., Harris, K., Hall, S., Nazir, N., and Waigandt, A. 2006. Characteristics of social smoking among college students. Journal of American College Health 55(3):133-139. https://doi.org/10.3200/JACH.55.3.133-139
  53. Yalinkaya-Alkar, z., and Karanci, A. N. 2007. What are the differences in decisional balance and self-efficacy between Turkish smokers in different stages of change? Addictive Behaviors 32(4):836-849. https://doi.org/10.1016/j.addbeh.2006.06.023