청소년의 흡연에 영향을 미치는 사회적 요인으로서의 학교 흡연율: 다수준 분석의 적용

School Smoking Rate as a Social Factor Affecting the Adolescent Smoking in Korea: Multilevel Analysis

  • 변진옥 (서울대학교 보건대학원) ;
  • 조영태 (서울대학교 보건대학원)
  • Byeon, Jin-Ok (Dept. of Health Science and Services, Seoul National University Graduate School of Public Health) ;
  • Cho, Young-Tae (Dept. of Health Science and Services, Seoul National University Graduate School of Public Health)
  • 투고 : 2010.10.04
  • 심사 : 2010.12.11
  • 발행 : 2010.12.30

초록

Objectives: To obtain a more intensive understanding smoking behaviors of young adolescent in the contexts of schools which they attend, this study examined the effects of individual and school level factors divided into psychological and social factors respectively. Methods: Multilevel logistic regression analysis was used to test the effects of school smoking rates on 1 year smoking experience of individual pupils in a sample of 3,449 students from 100 middle schools in Korea. Results: The results of multilevel analysis revealed the importance of social factors in three environments. Especially the social factors in school level, which were sense of school membership and school smoking rate, explained the variances between groups dropping the school effect from 0.194 to 0.046. Conclusion: This study suggests that adolescents' smoking behaviors are related to the multi dimensional and multi level factors. To reduce young adults' smoking rate, school level intervention should not be ignored.

키워드

참고문헌

  1. 권수진. 청소년의 건강행위와 사회적 요인간의 상관관계분석, 한국학교보건학회지 1996;9(1):69-75.
  2. 김병희, 조형오, 이건세. 청소년의 흡연동기와 상황적 맥락에 대한 질적연구. 홍보학연구 2001;5(2):81-108.
  3. 김의철, 박영신. 스트레스 경험, 대처와 적응결과: 토착심리학적 접근. 한국심리학회지:건강 1997;2(1):96-126.
  4. 김현숙. 청소년의 건강행위와 비행에 영향을 미치는 요인에 관한 연구. 한국학교보건학회지 1997;10(2):213-239.
  5. 김현옥. 청소년의 흡연관련 사회적 환경, 흡연거절기술 및 금연관련 자기효능감. 아동간호학회지 2003;9(3);237-250.
  6. 김희경 외 8명. 흡연청소년의 신념, 친구교제, 통제력, 흡연의도 및 자기효능에 대한 비교연구. 한국보건교육․건강증진학회지 2004;21(1):197-216.
  7. 민영숙. 남녀고등학교 학생의 건강통제위 성격과 건강지각 건강행위와의 관계연구. 혜전대학 논문집 1989:547-583.
  8. 소희영, 이영란, 손식영. 고등학생의 건강행위 결정요소. 성인간호학회지 1997; 9(1): 44-54.
  9. 신성례, 김애리. 청소년들의 흡연행위에 따른 부모의 흡연 여부 및 지각된 부모의 태도. 성인간호학회지 1998;10(2):302-310.
  10. 양경희, 김영희, 이정란. 중학생의 흡연행위에 영향을 주는 요인. 지역사회간호학회지 2005;16(1):40-48.
  11. 유순화, 정규석. 청소년 음주, 흡연에 관한 사회학습이론적 분석. 한국청소년연구 2003;10(2):195-214
  12. 유지수, 김조자, 박지원. 청소년들의 건강지각, 건강행위, 건강상태와의 상관관계 연구. 연세논총 1985;21(5):169-187.
  13. 이무송. 다수준 분석. 예방의학회지 2004;37(3):212-216.
  14. 이보은 외 4명. 서울시내 일부 초․중․고등학생의 흡연위험요인에 관한 연구. 한국보건교육․건강증진학회지 2004;21(2):167-185.
  15. 이상균. 청소년 흡연행위의 결정요인. 사회복지리뷰 2001;6(1):77-94.
  16. 이성식. 청소년 비행의 원인에 관한 한미 비교연구: 사회통제이론과 차별접촉이론을 중심으로. 한국사회학회 1993:123-128.
  17. 이영란. 비행청소년의 음주, 흡연실태에 관한 조사연구. 형사정책 2002;14(1):105-148.
  18. 이윤수, 이혜리, 강윤주. 청소년의 흡연, 음주 및 기타약물사용 실태. 가정의학회지 1998;19(1):43-58.
  19. 이윤지, 이정애. 광주지역 남자 중․고등학생의 흡연실태와 흡연관련 요인. 예방의학회지 1993;26(3):359-370.
  20. 전경자, 박선희. 중학생의 흡연시작 및 흡연빈도에 영향을 미치는 요인. 한국청소년연구 2007;18(1):5-27.
  21. 조수현. 일부청소년의 건강지각과 건강행위와의 관계연구. 순천청암대학 논문집 1996;20(2):113-136.
  22. 질병관리본부. 국민건강영양조사 제4기 1차년도(2007) 결과 발표회 자료집. 서울: 질병관리본부, 2009.
  23. 질병관리본부. 제4차(2008년) 청소년건강행태온라인조사 통계.서울: 질병관리본부, 2010.
  24. 최은진. 흡연예방을 위한 청소년 교육방. 보건교육․건강증진학회지 2000;17(2):75-86.
  25. 한국금연운동협의회. 우리나라 청소년 흡연실태 일람표
  26. http://www.kash.or.kr/user_new/pds_view.asp
  27. 한국청소년개발원. 한국청소년패널조사(KYPS) II. 서울: 청소년개발원, 2004.
  28. 황성현. 청소년 음주․흡연행위에 관한 사회유대, 자아통제, 사회학습이론적 고찰. 한국청소년연구 2009;20(1):113-139.
  29. Alexander C, Piazza M, Mekos D, Valente T. Peers, schools, and adolescent cigarette smoking. Journal of Adolescent Health 2001;29(1):22-30. https://doi.org/10.1016/S1054-139X(01)00210-5
  30. Anderson C. The search for school climate: A review of the research. American Education Research Journal 1982;52:368-420.
  31. Annie Qu. Comparison of PROC MIXED in SAS and HLM for Hierachical Linear Models http://www.pop.psu.edu/pss-core/papers/Qu97.pdf.
  32. Aveyard P 외 5명. Is inter-school variation in smoking uptake and cession due to differences in pupil composition? A cohort study. Health & Place 2005;11:55-65. https://doi.org/10.1016/j.healthplace.2004.02.001
  33. Bandura A. Social Learning Theory. Englewood Cliffs, NJ: Prentice- Hall, 1977.
  34. Cox CL. An interactional model of client health behavior: theoretical prescription for nursing. Advance in Nursing Science 1982; 5(1):41-56.
  35. Ellickson, PL, Bird CE. Social Context and Adolescent Health Behavior: Does School-level Smoking Prevalence Affect Students' Subsequent Smoking Behavior? Journal of Health and Social Behaviour. 2003;44(4):525-535. https://doi.org/10.2307/1519797
  36. Elizabeth E, Papandonatos G, Kazura A, Stanton C, Niaura R. Differentiating stages of smoking intensity among adolescents: Stage-specific psychological and social influences. Journal of Consulting and Clinical Psychology 2002;70(4):998-1009.
  37. Evans-Whipp T, Bond L, Ukoumunne O, Toumbourou J, Catalano R. The Impact of School Tobacco Policies on Student Smoking in Washington State, United States and Victoria, Australia. International Journal of Environmental Research and Public Health 2010;7:698.
  38. Farrand LL, Cox CL. Determinants of positive health behavior in middle childhood. Nursing Research 1993;42(3):208-213.
  39. Fishbein M, Ajzen I. Belief, Attitude, Intention and behavior: An Introduction to Theory and Research Reading. MA: Addison-Wesley, 1975.
  40. Fray BR 외 7명. Differential Influence of Parental Smoking and Friends' smoking on Adolescent Initiation and Escalation of Smoking. Journal of Health and Social Behavior 1994;35: 248-265. https://doi.org/10.2307/2137279
  41. Glanz K, Lewis FM, Rimer BK. editors. Health Behavior and Health Education. San Francisco: Jossey-Bass, 1990.
  42. Henderson M, Ecob R, Wight D, Abraham C. What explains between-school differences in rates of smoking? BMC Public Health 2008;8:218. https://doi.org/10.1186/1471-2458-8-218
  43. Lau RR, Quadrel MJ, Hartman KA. Development and change of young adults' preventive health beliefs and behavior: Influence from parents and peers. Journal of Health and Social Behaviour 1990;31(3):240-259. https://doi.org/10.2307/2136890
  44. Page RM 외 5명. Perceptions of the prevalence of cigarette smoking by peers: A study of Taiwanese, Filipino, and Thai High School Students. Southeast Asian Journal of Tropical Medicine and Public Health 2005;36(5):1346-1352.
  45. Pentz MA외 5명. The Power of Policy: The relationship of smoking policy to adolescent smoking. American Journal of Public Health 1989;79:857-862. https://doi.org/10.2105/AJPH.79.7.857
  46. Pinilla J, Gonzalez B, Barber P, Santana Y. Smoking in young adolescents: an approach with multilevel discrete choice models. Journal of Epidemiology and Community Health 2002;56:227-232. https://doi.org/10.1136/jech.56.3.227
  47. Raudenbush SW, Bryk AS. Hierachical Linear Model: Applications and Data Analysis Methods. Newbury Park, CA: Sage Publication, 2002.
  48. Sellström E, Bremberg S. Is there a "school effect" on pupil outcomes? A review of multilevel studies. Journal of Epidemiology and Community Health 2006;60(2):149-155. https://doi.org/10.1136/jech.2005.036707
  49. Turner K, West P, Gordon J, Young, R, Sweeting H. Could the peer group explain school differences in pupil smoking rates? An exploratory study. Social Science & Medicine 2006;62:2513- 2525. https://doi.org/10.1016/j.socscimed.2005.11.017
  50. Urberg KA, Degirmencioglu SM, Pilgrim C. Close friend and group influence on adolescent cigarette smoking and alcohol use. Developmental Psychology 1997;33:834-844.
  51. Virtanen M 외 6명. Contribution of parental and school personnel smoking to health risk behaviours among Finnish adolescents. BMC Public Health 2009;9:382. https://doi.org/10.1186/1471-2458-9-382
  52. Wang MQ 외 5명. Prospective social-psychological factors of adolescent smoking progression. Journal of Adolescent Health 1999;24(1):2-9. https://doi.org/10.1016/S1054-139X(98)00080-9
  53. Whitrow M, Harding S, Maynard M. The influence of parental smoking and family type on saliva cotinine in UK ethnic minority children: a cross sectional study. BMC Public Health 2010;10:262. https://doi.org/10.1186/1471-2458-10-262
  54. Zhang L, Wang W, Zhao Q, Varitiainen E. Psychosocial predictors of smoking among secondary school students in Henan, China. Health Education Research 2000;15(4):415-422. https://doi.org/10.1093/her/15.4.415