• Journal of Korean Academy of Nursing
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• v.33 no.8
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• pp.1171-1177
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• 2003

Purpose. Despite many smoking cessation programs, many patients with CAD continue to smoke or re-smoke. The processes of change and self-change for smoking cessation is emphasized. The purpose of present study was to investigate decisional balances and processes of change according to stages of change for smoking cessation in the patients with CAD. Methods. This descriptive study was performed using the self-reported questionnaires from 157 male patients with CAD who have smoking experiences. The questionnaires consisted of decisional balances toward smoking (pros/cons) and processes of change including 7 factors. Results. 45.2% of the subjects had myocardial infarction and 54.8% for angina pectoris. Major stages of change were maintenance, contemplation, and precontemplation in 62%, 14%, and 18% respectively. The mean score of pros smoking was 31.07 and cons smoking was 32.52. The mean scores of processes of change were high in all 7 factors, especially in self determination. The pros smoking in precontemplation stage was significantly higher than those in other stages. Between contemplation and precontemplation stages, processes of change showed significant differences in stimulus control, self determination, information management, and dramatic relief. Conclusion. This study suggests that decisional balances and processes of change are stage-specific. As this study, smoking cessation program in the patients with CAD must put priority on the patients group in pre-contemplation and contemplation stages, and stress self determination and dramatic relief.

• Journal of muscle and joint health
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• v.17 no.2
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• pp.113-123
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• 2010

Purpose: The purpose of this study was to identify the effects of a smoking cessation program on processes of change, situational temptation, and decisional balance in male university student smokers. Method: Utilizing a quasi-experimental design, 78 male university students consisted of an experimental group (n=48) and a control group (n=30). A smoking cessation program was applied to the experimental group for a period of 6 months while no program was given to the control group. Study questionnaires were used to measure outcome variables before and after the program. Descriptive analysis, $\chi^2$-test, t-test, and ANCOVA were used with SPSS 18.0 program for data analysis. Results: After treatment with this program, the experimental group showed significantly higher scores for processes of change (experiential and behavioral processes of change) than the control group. The experimental group also showed significantly lower scores for situational temptation (positive social, negative affect, and habit strength). Conclusion: The smoking cessation program may have positive effects on process of change and smoking temptation for male university student smokers.

• 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.

• Korean Journal of Health Education and Promotion
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• v.27 no.5
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• pp.27-39
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• 2010

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.

• Korean Journal of Health Education and Promotion
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• v.23 no.2
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• pp.11-27
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• 2006

Objectives: This study was conducted to evaluate the effects of a tailored program based on the Transtheoretical Model to smoking cessation in high school girls. Methods: A quasi-experimental research design was used in this study. The participants were 35 industrial high school girls who have been smoking. The girls were allocated to an experimental group(18) and a control group(17) by randomization. For intervention, the experimental group received the group smoking cessation program and individual program which tailored according to the stage of change. A common group smoking cessation program was given to the control group. Data were collected before the program, immediately after and 4 weeks after the program was completed and were analyzed with repeated measure ANOVA. Result: In the experimental group, the daily smoking amount, nicotine dependency and decisional balance(Pros) score were significantly decreased and the self-efficacy score were significantly increased at one month after the intervention in comparison with before and immediately after it. The decisional balance(Cons) and processes of change score of the experimental group were significantly increased at immediately after the intervention and one month after it in comparison with before it, and at one month after it in comparison with immediately after it. A significant difference in the daily smoking amount, urine cotinine, nicotine dependency, decisional balance(Pros, Cons) and processes of change score between the both groups was found after one month of intervention. Conclusions: The tailored smoking cessation program was more effective, compared to the common smoking cessation program on smoking behavior, self-efficacy, decisional balance, processes of change. This program can be used for favorable changes in high school girl's smoking behavior.

• Journal of Korean Academy of Nursing
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• v.35 no.5
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• pp.904-913
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• 2005

Purpose: The purpose of this study was to investigate smoking cessation behavior of male taxi drivers in Korea on the basis of the Transtheoretical model(TTM), and to validate the usefulness of TTM. Method: Data were collected using a self-reported questionnaire including smoking history and major factors of TTM from 208 subjects who were current smokers or ex-smokers. Data were analyzed by descriptive statistics and ANOVA. Result: Most subjects ($85.1\%$) were current smokers. Stages of change were precontemplation ($44.7\%$) and contemplation ($27.4\%$). Subjects in precontemplation stages had the lowest mean score in processes of change and the highest mean scores in decisional balance(pros) and temptation(positive affective, habitual/craving). According to stages of change, there were statistically significant differences in processes of change, decisional balance, and temptation. Conclusion: This study supported the generalization of TTM. As this study showed that the subjects didn't have motivation in smoking cessation, applying tailored smoking cessation programs for taxi drivers is needed.

• 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.

• Korean Journal of Adult Nursing
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• v.21 no.4
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• pp.391-402
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• 2009

Purpose: This study was conducted to identify predictors of the stage of change for smoking cessation of male university students on the basis of the Transtheoretical model (TTM). Methods: The 388 current smokers or exsmokers who agreed to participate were recruited from three areas in Korea from August 2 to September 5, 2006. Data was analyzed using a SPSS program for descriptive statistics, ANOVA, and multiple logistic regression. Results: Most subjects (76.8%) were current smokers. According to stages of change, there were statistically significant differences in self efficacy, smoking temptation, decisional balance (cons, pros), and processes of change. The predictors of transition from contemplation to preparation were behavioral and experiential processes. The predictors of transition from preparation to action were pros of smoking and experiential process. The predictors of transition from action to maintenance were cons of smoking and behavioral process. Conclusion: Specific nursing interventions based on stages of change need to be developed for smoking cessation of male university students.

• Journal of Korean Academy of Nursing
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• v.26 no.3
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• pp.678-687
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• 1996

Smoking is considered to be one of the important risk factors associated with various health problems. Thirty seven million people in America quit smoking in the past decade, with 90% quitting on their own(Americal Heart Association, 1986). According to McAlister(1975), 70% of smokers reported that they adopted a self-help smoking cessation approach rather than a formal treatment program. In our country, although, auccessful exsmokers have used, are not available, concerns about smoking cessation have increased, recently, due to changes in social and political attitudes to health promotion. This study was conducted to help smokers who had made a decision to adopt a self-helf smoking cessation approach instead of depending on a formal treatment program. It provided a structurd way for sucessful smoking cessation by identifying change mechanism factors which have been commonly used by smokers. The subjects selected for this study were 155 university students between 20 and 29. Years of age the results from the analysis of the collected data showed that seven factors in the self-help change processes significant, and they are named, Stimulus Control, Self-Determination, Information Management, Reinforcement Management, Helpful Relationships, Dramatic Relief, and Cognitive Restructuring. All of the factors except Self-Determination represent the same change mechanisms which are proposed by Prochaska et at.(1988). Self-Determination uniformly includes items belonging to various change processes. Therefore, it might be an transitional factor including strategies related to both cognitive and behavioral dimensions. In spite of this, noted that one item which gives meaning of Self-Determination shows the highest factor loading, it is named Self-Determination.

• Korean Journal of Health Education and Promotion
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• v.28 no.4
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• pp.79-94
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• 2011

Objectives: The aim of this study was to evaluate the effectiveness of smoking cessation clinics for soldiers in the Korean armed forces. In so doing it attempted to identify the predictors of smoking cessation and positive transition of stages of change. Methods: In a single-group pre-post test study design, 5,362 smokers from Korean armed forces participated in the smoking cessation clinic programs based on both the Transtheoretical model and life skills approaches. Changes in stages of change and related variables were measured before the intervention and at 3-month follow-up after the intervention. Results: The cessation rates was 66.0% at 3-month follow-up. With the positive transition to action/maintain stage, proportion of participants in action/maintain stage increased more than 5 times after the intervention. Cons of smoking, self-efficacy, processes of change, and life skills increased, and pros of smoking decreased after the intervention. Predictors of smoking cessation included nicotine dependency, pros of smoking, high levels of self-efficacy, processes of change and life skills. Positive stage transition was predicted by pros of smoking and high self-efficacy. Conclusions: Application of the Transtheoretical model and life skills approaches provided useful strategies for a smoking cessation program in armed forces.