• Journal of Korean Academy of Nursing
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• v.26 no.4
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• pp.820-832
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• 1996

The average smoking rate for Adults' in our country is 40.6% : It is 74.2% for men and 5.0% for women. Particularly, the smoking rate for men is reported higher than that of men in U.S.A. or Japan. Since the first report on the association between smoking and cancer appeared, 370 thousand smokers have succeeded in smoking cessation and over 90% of them have responded that they depended on a self-help smoking cessation approach. Despite this positive evidence about self- help approaches for smoking cessation, most studies on smoking cessation have focused on evaluation of formal treatment programs that are provided by clinics. Reports on the smoking cessation process used by smokers in our country could not be found. However, it is believed that the situation in our country would be quite similar to that in U.S.A. as far as approaches to successful smoking cessation are concerned. This study was conducted to classify the smoking stage to which they smoker belong and which changing mechanisms could be included at each changing stage (precontemplation stage, comtemplation stage, action stage) with a sample of 155 college students between 20 and 29 years old. And it also identified which variables related both to smoking pattern and to health, which ones were significantly discriminating in the changing stages. From the results of the data analysis it was found that Self-Determination is the most influential variable as one of the changning mechanisms which can discriminate three changing stages. And as the next significant mechanisms were Reinforcement, Dramatic Relief, Cognitive Restructuring, Helping Relationship, and Information Management in that order. Among variables related to the smoking pattern, years of regular smoking, whether smoking is continued or not even when they are sick, the number of attempts to stop smoking, number of cigarettes smoked per day, and whether they have smoked over 100 cigarettes up to now, but not the time of the first cigarette after waking-up, were the significant factors to descriminate changing stages. It was confirmed that among variables related to health that, perceived control for health, confidence of health maintence ability, and self confidence in smoking cessation, were significant variables in determinating changing stages. The most influential variables among them was self-confidence in smoking cessation. Conclusively, it was shown that smoking cessation is the process of attempting to change smoking habits through the various changing processes. Also it can be shown that a few factors smoking habit, self-confidence of smoking cessation, and belief in self control of his /her health, were influential in discriminating the changing stages of the smoking habit.

• Journal of Korean Academy of Nursing
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• v.27 no.1
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• pp.71-82
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• 1997

In this paper, the study model, which presents the patterns of how the changing mechanisms are adopted to the changing stages of smoking cessation, was developed by modifying the integrative model of Prochaska et al. (1983) with including seven changing mechanisms which were identified by Oh and Kim(1996). Then the developed study model was exploratively tested with 155 University student between 20 and 29 years of age as subjects. According to the study results. among the five mechanisms. which are significant in explaining the differences between stages. DUNCAN post-comparison showed that the least applied ones were Stimulus Control, Self Determinism, Cognitive Restructuring in the precomplation stage, and Reinforcement and Dramatic Relief. in the relapsed stage. In the comtemplation stage. it was observed that Dramatic Relief is used most frequently and that the other two mechanisms, Information Management and Cognitive Restructuring, showed different results from those inferred in the study hypothesis. In the case of Information Management, it was excluded from the analysis it was not included in explaining significant difference among changing stages, but Cognitive Reconstruction turns out to be a more frequently used mechanism in the action stage rather than in the comtemplation stage. Helping Relationship was also excluded in the post-comparison analysis since it was not included in explaining significant difference among changing stages and Reinforcement was a more frequently used mechanisms in the comtemplation stage. Stimulus Control turns out to be the connecting mechanism which was most frequently used in both the contemplation and action stages. Self Determination was most frequently used in the action stage rather than in both the comtemplation stage and action stage, differing from the presumption of the model. Lastly, subjects in the relapsed stage were utilizing Stimulus Control and Self Determination at the same level as subjects in the precontemplation stage. and the utilization of both Reinformcement and Dramatic Relief was lower than that of the precomtemplation stage, that is, at the lowest level. Only Cognitive Restructuring was used of the same level as the comtemplation stage. The relapsed stage in this study did not represent the preparation for action stage as presumed in the model of Prochaska et. al. (1983) but did show a pattern similar to the initial stage of smoking cessation. However, since this interpretation about the relapser was based on only a small number of relapsers(n=5), this conclusion may not be reliable.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.3
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• pp.346-352
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• 2018

This study was conducted to investigate the quality of sleep of university students according to smoking behavior and to generate basic data for use in development of smoking prevention and smoking policies for university students and young adults in their 20s. The quality of sleep of 291 college students was measured based on smoking behavior and the Pittsburgh Sleep Quality Index (PSQI) questionnaire from May 29, 2017 to June 3, 2017. Multiple logistic regression analysis with step-wise analysis revealed that the quality of OR increased from 2.542 to 2.820 times as the grade increased, and that OR was 3.126 times higher than that of non-smokers and stop-smokers. The quality of sleep worsened with OR=12.388 times. Among general smokers, 72.4% of the students had poor sleep quality, but 82.6% of the students who did not have good sleep quality of electronic-cigarette or tobacco smokers had electronic-cigarette or tobacco worse than regular tobacco.Based on these findings, quitting smoking is essential to improve quality of sleep, but this can be difficult. Therefore, it is necessary to develop legal regulations and policies at the national level. Moreover, a system or service that can manage phased smoking cessation is needed.

• Journal of Korean Academy of Nursing
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• v.43 no.4
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• pp.557-567
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• 2013

Purpose: This study was done to identify effects of a smoking cessation program including telephone counseling and text messaging using stages of change for outpatients who have had a myocardial infarction (MI). Methods: This research was a quasi-experimental design with a nonequivalent control group pretest-posttest. The participants were 48 outpatients (experimental group=24, control group=24) recruited from one university hospital. They were randomly assigned to one of two groups: (a) an experimental group with telephone counseling (once a week) and text messaging (five times a week) using stages of change, and (b) a control group with traditional telephone counseling (once a month). Efficacy of the intervention was measured by comparing the two groups on smoking-related variables at 3 weeks and 12 weeks. Results: At the 3-week and 12-week measurements, there were significant differences between the experimental and control groups on smoking cessation self-efficacy (p<.001), nicotine dependence (p<.001), CO levels (p<.001), and smoking cessation rates (p<.001). Conclusion: The results indicate that the smoking cessation program including telephone counseling and text messaging using stages of change is effective for outpatients after a MI. Further attention should be paid to the intensity of the smoking cessation program and periods for long-term follow-up.

• Research in Community and Public Health Nursing
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• v.21 no.1
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• pp.63-70
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• 2010

Purpose: This study was to identify the stages of change in smoking cessation behavior and factors associated with the stages of smoking cessation behavior according to the trans-theoretical model. Methods: The subjects were 154 industrial workers working at H Industry in N City, Chonnam Province who were currently smoking and had smoked in the past. Data were analyzed by descriptive statistics, ANOVA, and Duncan's multiple comparison test using SAS Version 10.0. Results: The subjects were distributed among the stages of change in smoking cessation behavior: there were 28 subjects (18.2%) in the precontemplation stage, 71 (46.1%) in the contemplation stage, 21 (13.6%) in the preparation stage, 8 (5.2%) in the action stage, and 26 (16.9%) in the maintenance stage. The amount of smoking per day, self-efficacy, and advantages (pros) of smoking were significantly associated with the stage of change in smoking cessation behavior. Conclusion: This study suggested that the stage of change in smoking cessation behavior of the subject should be identified prior to the application of intervention programs, nursing intervention strategies should be considered to reduce the amount of smoking per day, and the disadvantages of smoking should be perceived.

• Korean Journal of Adult Nursing
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• v.17 no.4
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• pp.592-601
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• 2005

Purpose: The purpose of this study was to investigate differences in smoking related characteristics and psychological features of coronary artery patients by the stages of change in smoking cessation behaviors. Method: Subjects for this survey were 97 patients who were smoking when doctors diagnosed them to have coronary artery diseases. Result: Subjects were distributed 21.6% in precontemplation stage, 24.7% in contemplation stage, 17.5% in preparation stage, 19.6% in action stage, and 16.5% in maintenance stage respectively. The numbers of previous attempts to quit smoking of subjects in precontemplation stage(mean=3.00, SD=3.71) and contemplation stage(mean=2.63, SD=2.32) were significantly lower than that of subjects in preparation stage(mean=5.82, SD=6.20). Benefit scores of subjects in maintenance stage were significantly greater than those of subjects in precontemplation stage. Self-efficacy, barriers, seriousness, and nicotine dependency were not significantly different by the stages of change. Number of signs and symptoms related to smoking which subjects were experiencing were not significant by the stages of change too. Conclusion: Future intervention programs for smoking cessation should be focused on the strategies to enhance the realization of health benefits that patients might acquire from smoking cessation.

• Research in Community and Public Health Nursing
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• v.18 no.3
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• pp.431-440
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• 2007

Purpose: The purpose of this study was to describe stage distribution of current and former smokers and to analyze significant variables that used by adolescents at each stage using the Transtheoretical Model. Methods: A cross-sectional study was performed with 145 students attended to five high schools in one rural area. The survey instruments included stages and processes of change. decisional balance, self-efficacy, and knowledge related to smoking. Results: Among the participants, 47.6% were in the precontemplation and contemplation stages, 20.7% were in the preparation stage, and the other 31.7% were in the action and maintenance stages. Analysis of variance tests revealed that behavioral processes, pros and cons of smoking, and self-efficacy were significantly associated with the stages of smoking cessation, while among 10 processes of change, self-reevaluation, self-liberation, and reinforcement management were significantly different by the stages. Conclusions: The study results suggest that smoking cessation programs should emphasize behavioral strategies, self-efficacy, and decisional balance to help students adopt and maintain smoking cessation.

• Journal of Korean Academy of Nursing
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• v.36 no.6
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• pp.1023-1032
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• 2006

Purpose: The purpose of this study was to identify nicotine dependence, smoking-related attitude, and subjective norms across the stages of change for smoking cessation among adult smokers in a rural area. Method: The subjects were 276 current smokers (male=243, female=33). There were 3 stages of change for smoking cessation: pre-contemplation, contemplation, and preparation stage. Data was collected by an interview or self-reporting from February 12th to March 5th 2004, and analyzed with frequency, percentage, $X^2-test$, Fisher's exact probability test, ANOVA, and Scheffe test using the SPSS-PC program. Result: According to the stages of change, 114(41.3%) current smokers were in pre-contemplation, 110(39.9%) in contemplation, and 52(18.8%) in the preparation stage. There was a higher percentage of males than females ($X^2-test$=8.99, p=.011) in the preparation stage. The mean score of the smoking-related attitude (F:7.43, p=.001) and subjective norm(F=27.41, p=.001) were both lowest in the pre-contemplation stage and increased positively during the stages of change for smoking cessation. Conclusion: Based on these findings, the authors recommend that community-based smoking cessation programs should be developed by considering the intention or motives of current smokers and should be initiated in the preparation stage and primarily for male groups.

• Korean Journal of Adult Nursing
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• v.15 no.3
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• pp.483-492
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• 2003

Purpose: The study was performed to identify the process of change, decisional balance and self-efficacy corresponding to the stage of smoking cessation behavior based on Transtheoretical Model in industrial workers. Method: A convenience sample of 146 industrial workers except for the never smokers, were recruited at a H industry in Ulsan. Data were collected from February 1 to 28, 2002. The research instruments were Stages of Change of Smoking Cessation Measure(DiClemente et al, 1991), Process of change(Prochaska, 1988), Smoking Abstinence Self Efficacy (SASE: DiClemente et al, 1985) and Decisional balance(SDB; Kim, 1999). Result: The results of this study were as follows; 1. The subjects were distributed in each stage of smoking cessation change: There were 64 subjects (43.0%) in the precontemplation stage, 35 subjects(23.5%) in the contemplation stage, 28 subjects(18.8%) in the preparation stage, 14 subjects(10.1%) in the action stage and 7 subjects(4.7%) in the maintenance stage. 2. Analysis of variance showed that experiental process(F=2.808, p=.042), behavioral process (F=4.567, p=.004) self-efficacy(F=9.809, p=.000), pros(F=11.107, p=.000), cons(F=6.686, p=.000), pros- cons(F=3.446, p=.018) were significantly associated with the stages of smoking cessation change. 3. Through discriminant analysis, it was found that 'PROS' was the most influential variable in discriminating the four stages of change. Conclusion: This study can provide the basis of staged matching smoking cessation program using TTM for more effective and useful intervention.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.8 no.3
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• pp.391-401
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• 2001

Purpose: The purpose of this study was to identify variables that influence smoking cessation based on the transtheoretical model. Methods: Variables that influence the stages of change in smoking cessation were selected based on transtheoretical model. Data were collected from 176 men aged 30-64 who smoked, Data collection was done in community settings in Seoul and vicinity, Korea between December, 1999 and June, 2000. Data were analyzed by descriptive statistics and logistic analysis using the pc-SAS program. Results: According to the logit model, the influence of significant variables on stage of change for smoking cessation suggest that ; When the scores for Pros in decision making for smoking cessation are high, the possibility that the subjects are in the action, precontemplation and contemplation stage of change will be lower than the possibility that the subjects are in the maintenance stage of change. When the scores of habitual craving in smoking temptation is high, the possibility that the subjects are in the precontemplation and contemplation stage of change will be higher than the possibility that the subjects are in the maintenance stage of change. When the scores of smoking temptation in negative affect situations are high, the possibility that the subjects are in the contemplation stage of change will be higher than the possibility that the subjects are in the maintenance stage of change. When the scores of cognitive process in the process of change are high, the possibility that the subjects are in the contemplation stage of change will be higher than the possibility that the subjects are in the maintenance stage of change. Conclusions : The results provide evidence that physical and psychological dependence on smoking are main barriers to smoking cessation. Therefore nursing interventions based on stage that focus on increasing motivation and intention for smoking cessation need to be developed.