Effectiveness of a Smoking Cessation Program for Adolescents

  • Published : 2004.06.01

Abstract

Purpose. The purpose of this study was to test the effectiveness of a comprehensive smoking cessation program for Korean adolescents. Method. The study design was quasi-experimental with one pre and three post-tests. The three posttests were done immediately after, three months later, and six months after the completion of the program. A total of 43 high school students who smoked participated in the study with 22 in the experimental group and 21 in the control group. The smoking cessation program consisted of 9 sessions with content on enhancement of self-efficacy, stress management, correction of distorted thoughts, consciousness raising, and assertiveness training. The study variables were urine cotinine levels, self-efficacy, stress, and stages of changed behavior. Results. Urine cotinine levels significantly decreased in the experimental group after the program (F=3.02, p=.06) but significantly increased in the control group (F=6.32, p=.004). Self-efficacy and the degree of stress did not change in either group. The stages of smoking cessation behavior tended to change when compared with raw data for the experimental group. For most participants, the stages of change had been precontemplation and contemplation, but changed to action and maintenance stage among the experimental group. Conclusion. The program was effective in smoking cessation and influencing stages of change but did not change psychosocial factors such as self-efficacy and stress. It is suggested a program should be developed to change psychosocial variables on a long-term basis. It is also desirable to involve peers and families of adolescents who smoke when planning programs to enhance social support.

Keywords

References

  1. Bandura, A. (1982). Self-efficacy mechanism in human agency. Am Psychology, 37, 122-147 https://doi.org/10.1037/0003-066X.37.2.122
  2. Bolman, C. & De Vries, H. (1998). Psycho-social determinants and motivational phases in smoking behavior of cardiac inpatients. Preventive Medicine, 27, 738-747 https://doi.org/10.1006/pmed.1998.0352
  3. Choi, J. H., Yang, Y. J., & Seo, H. K. (1995). Factors influencing medical students' smoking and nonsmoking. J of Korean Acad Fam Med, 16(2), 157-171
  4. Crump, R. L., Lillie-Blanton, M., & Anthony, J. C. (1993). The influence of self-esteem on smoking among African-American school children. J of Drug Education, 27(3), 277-291
  5. De Vries H. D., & Backbier, E. (1994). Self-efficacy as an important determinant of quitting among pregnant women who smoke: the phi-pattern. Preventive Medicine, 23(2), 167-174
  6. Glanz, K., Patterson, R. E., Krista, A. R., DiClemente, C. C., Heimendinger, J., Linnan, L., & McLerran, D. F. (1994). Stages of change in adopting healthy diets: fat, fiber, and correlates of nutrient intake. Health Education Quarterly, 21(4), 499-519
  7. Grimley, D. M., Riley, G. E., Bellis, J. M., & Prochaska, J. O. (1993). Assessing the stage of change and decision making for contraceptive use for the prevention of pregnancy, sexually transmitted disease, and acquired immunodeficiency syndrome. Health Education Quarterly, 20(4), 455-470
  8. Hurst, D. F., Boswell, D. L., Boogaard, S. E., & Watson, M. W. (1997). The relationship of self-esteem to the health-related behaviors of the patients of a primary care clinic. Archives of Fam Medicine, 6(1), 67-70
  9. Kim, B. J. (2000). Factors associated with the stages of change of smoking cessation behavior in military officers. Unpublished master's thesis, Yonsei Uniersity, Seoul
  10. Kim, D. H., Nam, K. K., Oh, B. H., & Yoo, K. J. (1997). Effectiveness of the Community based drug abuse prevention program for smoking students. J of Neuropsychiatry, 36(1), 177-191
  11. Kim, M. S., & Kim, A. K. (1996). College woman's smoking experience. J of Korean Academy of Nursing, 27(2), 315-324
  12. Kim, S. J. (1999). The effectiveness on the high school boys smoking behavior and psychosocial factors of the smoking cessation program based on trans theoretical model. Unpublished doctoral dissertation, Catholic University, Seoul
  13. Kim, S. Y., Kim, S. A., Kong, S. S., Kim, M. A., & Seo, M. A. (1999). Effectiveness of the prevention program for adolescents substance abuse. J of Korean Academy of Nursing, 29(1), 150-159
  14. Kim, T. M. (1990). Effectiveness of smoking cessation education to high school students. Unpublished masters dissertation, Yonsei University, Seoul
  15. Korean Association of Smoking and Health (2003). Actual condition of Korean adolescent smoking in 2003. Annual report of Korean Association of Smoking and Health
  16. Kwon, Y. H. (2003). The analysis of effects of smoking cessation program applying the cognitive behavior therapy among the soldiers who are cigarette smokers. Unpublished masters dissertation, Yonsei University, Seoul
  17. Lamkin, L., Davis, B., & Kamen, A. (1998). Rational for tobacco cessation interventions for youth. Preventive Medicine, 27, A3-8
  18. Lee, E. Y. (1992). Smoking adolescents' psychosocial characters. Unpublished master's thesis, Yonsei University, Seoul
  19. Lee, J. Y. & Ryu, H. S. (2003). The effect of follow-up support in the adolescent smoking cessation program. J of Korean Community Nurs, 14(1), 39-44
  20. Lee, S. H. (1995). High school students' social support, stress and health according to family living together. Unpublished master's thesis, Kyoungbook University, Daeku
  21. Matheny, K. B., & Weatherman, K. E.(1998). Predictors of smoking cessation and maintenance. J of Clinical Psychology, 54(2), 223-235
  22. McConnaughy, E. N., Prochaska, J. O., & Velicer, W. F. (1983). Stages of change in psychotherapy: Measurement and sample profiles. Psychotherapy: Theory, Research and Practice, 20, 368-375 https://doi.org/10.1037/h0090198
  23. Oh, H. S., & Kim, Y. R. (1996). Change mechanism to change stage of smoking cessation. J of Korean Academy of Nursing, 26(4), 820-832
  24. Ouimette, P. C., Finney, J. W., & Moos, R. H. (1997). Twelve-step and cognitive-behavioral treatment for substance abuser: A comparison of treatment effectiveness. J Consult Clin Psychol, 65(2), 230-240
  25. Park, M. H. (2004). Analysis concluded that 5-day stop smoking program has favorably influenced adolescents to quit smoking. Unpublished master's thesis, Yonsei University, Seoul
  26. Pederson, L. L., Koral, J. J., McGrady, G. A., & Tyas, S. L. (1998). The degree and type of relationship between psychosocial variables and smoking status for students in grade 8 : Is there a dose response relationship? Preventive Medicine, 27(3), 337-347
  27. Prochaska, J. O., Redding, C. A., Harlow, L. L., Rossi, J. S., & Velicer, W. F. (1994). The transtheoretical model of change and HIV prevention: A review. Health Education Quarterly, 21(4), 471-486
  28. Rojas, N. L., Killen, J. D., Haydel, K. F., & Robinson, T. N. (1998). Nicotine dependence among adolescent smokers. Archives of Pediatrics and Adolescent Medicine, 152(2), 151-156
  29. Seo, L., Ji, S. H., Kim, S. Y., Shin, D. C., Ryu, S. Y., & Kim, I. S. (1998). Middle and high school students' smoking pattern change in Korea: 1988-1997. Korean J of Epidemiology, 20(2), 257-266
  30. Velicer, W. F., DiClemente, C. C., Rossi, J. S., & Prochaska, J. O. (1990). Relapse situations and self-efficacy: An integrative model. Addictive Behaviors, 15, 271-283 https://doi.org/10.1016/0306-4603(90)90070-E
  31. Yalom, I, D. (1975). The theory and practice of group psychotherapy, 2nd ed., Basic Books, Inc.