Abstract
Objectives: This study examines the situation regarding smoking among high school students in Seoul Province and identifies smoking-related factors. Methods: The study sample consisted of 1,000 high school second-grade students from 6 high schools in Seoul. The PRECEDE model was used to assess the students' needs. We carried out an educational diagnosis on attitudes, outcome expectations and social norms. Date were collected from June. 7 to 21, 2011, and were analyzed using SPSS-15.0 according to the study objectives. Results: Of 906 respondents, 9.4% had experiences to smoking: 12.7% were male and 5.7% were female. Smoking-related factors from among general characteristics were statistically significant depending on the degree of gender($x^2$=14.515, p=.001), school performance($x^2$=40.289, p=.001) and friends 'smoking status($x^2$=88.615, p=.001). Factors concerning attitudes toward smoking were statistically significant depending on the students' perceptions as follows: 'Smoking is fun(t=-14.801, p=.000)', 'Smoking looks cool(t=-10.349, p=.000)', 'People who smoke have more friends(t=-11.295, p=.000)', 'Smoking helps me manage stress(t=-15.059, p=.000)' and 'Smoking is not harmful to the body if you exercise(t=-6.388, p=.000)'. Factors concerning outcome expectations were statistically significant depending on their perceptions as follows: 'Tobacco smells good(t=-8.939, p=.000)' and 'Smoking helps in weight management (t=-7.304, p=.000)'. Factors concerning social norms were statistically significant depending on the following perception: 'My friends will not like it if I smoke(t=4.605, p=.000)'. The following influence high school students attitudes toward smoking: School performance (OR=11.66, 95%CI=1.67~81.37; OR=18.27, 95%CI=2.58~129.24; OR=26.74, 95%CI=3.06~233.79), Friends smoking status(OR=80.05, 95%CI=6.94~922.77), 'Smoking is fun(OR=12.90, 95%CI=3.87~43.04; OR=63.41, 95%CI=10.66~377.09)', 'Smoking looks cool(OR=0.15, 95%CI=0.03~0.64)', 'Smoking is not harmful to the body if you exercise(OR=1.44, 95%CI=0.03~0.62)', 'When there is no work to do, smoking is a good way to pass the time(OR=21.68, 95%CI=4.27~109.90)', 'When you are angry, smoking calms you down.(OR=13.39, 95%CI=3.92~45.65; OR=8.69, 95%CI=1.67~45.13)' and 'My parents consider it important that I do not smoke(OR=10.05, 95%CI=1.00~100.43)'. Conclusions: The study suggests that effective ways to discourage of high school students from smoking are changing their attitudes toward smoking, reducing the motivation to smoke, and controlling the number of cigarettes. Therefore, aiming at preventive education. Schools must provide accurate information about the effects of smoking. Thus, health education should actively involve preventive education not only in schools but also at home, the societal and national levels. Cooperation between various sectors of society is required for this.