The Effects of Smoking Cessation Clinics in the Korean Armed Forces: Application of the Transtheoretical Model and Life Skill Approaches

범이론적모형과 생활기술접근법을 통합적용한 군인.전의경 대상 금연클리닉프로그램의 효과

  • Kim, Hye-Kyeong (Health Promotion Research Institute, Korea Association of Health Promotion) ;
  • Kwon, Eun-Joo (Health Promotion Research Institute, Korea Association of Health Promotion) ;
  • Lim, Jae-Ho (Public Relation and Health Education Department, Korea Association of Health Promotion) ;
  • Jung, Hye-In (Public Relation and Health Education Department, Korea Association of Health Promotion) ;
  • Cha, Jae-Ku (Health Promotion Research Institute, Korea Association of Health Promotion) ;
  • Cho, Seon (Health Promotion Research Institute, Korea Association of Health Promotion) ;
  • Kim, Su-Young (Health Promotion Research Institute, Korea Association of Health Promotion) ;
  • Uhm, Soo-Jin (Public Relation and Health Education Department, Korea Association of Health Promotion) ;
  • Park, Ji-Youn (Health Promotion Research Institute, Korea Association of Health Promotion) ;
  • Cho, Han-Ik (Health Promotion Research Institute, Korea Association of Health Promotion)
  • 김혜경 (한국건강관리협회 건강증진연구소) ;
  • 권은주 (한국건강관리협회 건강증진연구소) ;
  • 임재호 (한국건강관리협회 홍보교육본부) ;
  • 정혜인 (한국건강관리협회 홍보교육본부) ;
  • 차재구 (한국건강관리협회 건강증진연구소) ;
  • 조선 (한국건강관리협회 건강증진연구소) ;
  • 김수영 (한국건강관리협회 건강증진연구소) ;
  • 엄수진 (한국건강관리협회 홍보교육본부) ;
  • 박지연 (한국건강관리협회 건강증진연구소) ;
  • 조한익 (한국건강관리협회 건강증진연구소)
  • Received : 2011.12.01
  • Accepted : 2011.12.29
  • Published : 2011.12.31

Abstract

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.

Keywords

References

  1. Baldwin, A. S., Rothman, A. J., Hertel, A. W., Linda, J. A., Jeffy, R. W., Finch, E. A., & Lando, H. A. (2006). Specifying the determinants of the initiation and maintenance of behavior change: an examination of self-efficacy, satisfaction, and smoking cessation. Health Psychology, 25, 626-634. https://doi.org/10.1037/0278-6133.25.5.626
  2. Choi, E. J., Choi, S. E., Seo, M. K., Kim, J. E., & Maeng, K. H. (2010). Establishing basis for mid and long term anti-smoking policy. Final report of National Health Promotion Research Project. Ministry of Health and Social Welfare.Management Center for Health Promotion (Policy 10-10). Available at: http://research.hp.go.kr/. Accessed on 11, 2010.
  3. Condiotte, M. M., & Lichtenstein, E. (1981). Self-efficacy and relapse in smoking cessation programs. Journal of Counseling and Clinical Psychology, 49, 648-658. https://doi.org/10.1037/0022-006X.49.5.648
  4. Erol, S., & Erdogan, S. (2008). Application of a stage based motivational interviewing approach to adolescent smoking cessation: The Transtheoretical Model-based study. Patient Education and Counseling, 72, 42-48. https://doi.org/10.1016/j.pec.2008.01.011
  5. Etter, J. F., Pernerger, T. V., & Ronchi, A. (1997). Distributions of smokers by stage: international comparison and association with smoking prevalence. Preventive Medicine, 26, 580-585. https://doi.org/10.1006/pmed.1997.0179
  6. Heatherton, T. F., Kozlowski, L. T., Frecker, R. C., & Fagerstom, K. O. (1991). The Fagerstom test for nicotine dependence: A revision of the Fagerstom Tolerance Questionnarie. British Journal of Addiction, 86(9), 1119-1127. https://doi.org/10.1111/j.1360-0443.1991.tb01879.x
  7. Kim, Y. H. (2006). Adolescents' smoking behavior and its relationships with psychological constructs based on Transtheoretical model: a cross-sectional survey. International Journal of Nursing Studies, 43, 439-446. https://doi.org/10.1016/j.ijnurstu.2005.06.008
  8. Korea Association of Health Promotion (2010). 2009 Evaluation of smoking cessation program in armed forces. Korea Association of Health Promotion. Available at: http://www.kahp.or.kr/cms/read.php?tkind=3&lkind=10&mkind=&skind=&num=3898. Accessed on 12, 2011.
  9. Kim, B. J., Jeong, A. S., & Lee, J. Y. (2010). Factors associated with health status of male military officers. Korean Journal of Health Education and Promotion, 27(4), 49-62.
  10. Ministry of Health and Welfare press release. (2010) Available at: http://www.mw.go.kr/front/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&CONT_SEQ=238368&page=1&SEARCHKEY=TITLE&SEARCHVALUE=흡연. Accessed on 7, 2010.
  11. Ministry of Health and Welfare press release. (2011) Available at: http://www.mw.go.kr/front/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&CONT_SEQ=247402&page=1&SEARCHKEY=TITLE&SEARCHVALUE=흡연. Accessed on 7, 2010.
  12. National prevention, health promotion and public health council (2010). 2010 Annual status report. Available at: http://www.hhs.gov/news/reports/nationalprevention2010re port.pdf. Accessed on 7, 2010.
  13. Jeong, Y. H., Ko, S. J., Lee, Y. K., Park, S. B., & Lee, J. H. (2010). Lifetime cost of obesity and smoking and long-term effectiveness of health promotion. Final report of National Health Promotion Research Project. Ministry of Health and Social Welfare‧ Management Center for Health Promotion (General 10-37). Available at: http://research.hp.go.kr/. Accessed on 12. 2010.
  14. Otake, K., & Shimai, S. (2001). Adopting the stage model for smoking acquisition in Japanese adolescents. Journal of Health Psychology, 6, 629-6436 https://doi.org/10.1177/135910530100600602
  15. Pallonen, U. E., Prochaska, J. O., Velicer, W. F., Prokhorov, A. V., & Smith, N. F. (1998). Stages of acquisition and cessation for adolescent smoking: an empirical investigation. Addictive Behaviors, 23, 303-324. https://doi.org/10.1016/S0306-4603(97)00074-9
  16. Plummer, B. A., Velicer, W. F., Redding, C. A., Prochaska, J. O., Rossi, J. S., Pallonen, U. E., & Meier, K. S. (2001). Stages of change, decisional balance, and temptations for smoking: measurement and validation in a large, school-based population of adolescents. Addictive Behaviors, 26, 551-571. https://doi.org/10.1016/S0306-4603(00)00144-1
  17. Prochaska, J. O., & Dieclemente, C. C. (1983). Stages and process of self-change in smoking: toward an intergrative model of change. Journal of Consulting and Clinical Psychology, 51, 390-395. https://doi.org/10.1037/0022-006X.51.3.390
  18. Prochaska, J. O., Velicer, W. F., Rossi, J. S., Goldstein M. G., Marcus, B. H., Rakowski, W., ... Rossi, S. R. (1994). Stages of change and decisional balance for 12 problem behaviors. Journal of Health Psychology, 13, 39-46. https://doi.org/10.1037/0278-6133.13.1.39
  19. Prochaska, J. O, & Velicer, W. F. (1997). The Transtheoretical model of health behavior change. American Journal of Health Promotion, 12, 38-48. https://doi.org/10.4278/0890-1171-12.1.38
  20. Seo, M. K., Chio, E. J., Kang, E. J., Lee, Y. M., Park, H. J., Kim, D. H., ... Cho, H. O. (2008). The comprehensive pan for tobacco control and promotion of anti-smoking environment. Report of Korea Institute for Health and Social Affairs. Ministry of Health and Welfare.Korea Institute for Health and Social Affairs. Available at: http://211.252.146.33:8080/handle/201002/1676. Accessed on 10. 2008.
  21. Scholte, R. H. J., & Breteler, M. H. M. (1997). Withdrawal symptoms and previous attempts to quit smoking: associations with self-efficacy. Substance Use & Misuse, 32, 133-148. https://doi.org/10.3109/10826089709027303
  22. Shiffman, S., Kassel, J., Gwaltney, C., & McChargue, D. (2005). Relapse prevention for smoking. In G. A. Marlatt & D. M. Donovan(Eds.), Relapse prevention: maintenance strategies in the treatment of addictive behaviors. New York: The Guilford Press.
  23. Song, T. M. (2011), Changes in smoking rates of male adults in Korea and smoking cessation policy: Focus on smoking cessation clinics. Health and Welfare Policy Forum, 173, 55-63.
  24. The Lewin Group. (2009). Can we reduce health care spending? Available at: http://www.ingenix.com/-/media/Ingenix/Resources/Articles/LewinReportCostDrivers.pdf. Accessed on 10. 2009.
  25. Velicer, W. F., Norman, G. J., Fava, J, L., & Prochaska J. O. (1999). Testing 40 predictions from the Transtheoretical model. Addictive Behavior, 24, 455-469. https://doi.org/10.1016/S0306-4603(98)00100-2
  26. Windsor, R., Clark, N., Boyd, N. R., & Goodman, R. M. (2004). Evaluation of health promotion, health education, and disease prevention programs.
  27. WHO (1999). Tobacco use prevention: An important entry point for the development of health-promoting schools. WHO Information series on school health. document 5. Geneva, Switzerland: WHO, 4-42. Available at: http://collections.infocollections.org/ukedu/en/d/Jh1482e/4.8.html. Accessed on 1999.
  28. WHO. Tobacco Free Initiative (TFI). Tobacco control country profiles. Available at: http://www.who.int/tobacco/global_data/country_profiles/en/index.html. Accessed on August, 2003.
  29. WHO. An international treaty for tobacco control. Available at: http://www.who.int/features/2003/08/en/#. Accessed on 12 August 2003.
  30. Transtheoretical Model. Cancer prevention research center university of Rhode Island. Available at: http://www.uri.edu/research/cprc/Measures/Smoking11.htm. Accessed on September 1, 2006.