• Journal of Preventive Medicine and Public Health
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• v.51 no.1
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• pp.1-5
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• 2018

Smokers keep smoking despite knowing that tobacco claims many lives, including their own and others'. What makes it hard for them to quit smoking nonetheless? Tobacco companies insist that smokers choose to smoke, according to their right to self-determination. Moreover, they insist that with motivation and willpower to quit smoking, smokers can easily stop smoking. Against this backdrop, this paper aims to discuss the addictive disease called tobacco use disorder, with an assessment of the addictiveness of tobacco and the reasons why smoking cessation is challenging, based on neuroscientific research. Nicotine that enters the body via smoking is rapidly transmitted to the central nervous system and causes various effects, including an arousal response. The changes in the nicotine receptors in the brain due to continuous smoking lead to addiction symptoms such as tolerance, craving, and withdrawal. Compared with other addictive substances, including alcohol and opioids, tobacco is more likely to cause dependence in smokers, and smokers are less likely to recover from their dependence. Moreover, the thinning of the cerebral cortex and the decrease in cognitive functions that occur with aging accelerate with smoking. Such changes occur in the structure and functions of the brain in proportion to the amount and period of smoking. In particular, abnormalities in the neural circuits that control cognition and decision-making cause loss of the ability to exert self-control and autonomy. This initiates nicotine dependence and the continuation of addictive behaviors. Therefore, smoking is considered to be a behavior that is repeated due to dependence on an addictive substance, nicotine, instead of one's choice by free will.

• Journal of Korean Academy of Nursing
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• v.30 no.5
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• pp.1265-1278
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• 2000

This study was carried out to assess the perception of decisional balance of Korean subjects about 4 health behaviors and to identify the influencing factor of decisional balance for exercise acquisition, smoking cessation, mammography screening and Kegel's exercise acquisition. All are representative health behaviors nurses can intervene in Korea based on the Transtheoretical model. Convenient samples of 2,484 subjects (191; exercise, 169; smoking cessation, 1903; mammography screening and 221; Kegel's exercise) were selected from cities and counties over 9 provinces throughout Korea, and the data was collected from January 1, 1999 to February 29, 2000. The research instrument were the Decisional Balance Measure for Exercise (Marcus & Owen., 1992), Smoking Cessation (Velicer et al., 1985), Mammography Screening (Rakowski et al.,1992) and Kegel Exercise (Lim, 1999) and Stage of Change Measure for Exercise (Marcus et al, 1992), Smoking Cessation (DiClemente et al., 1991), Mammography Screening (Rakowski et al.,1992) and Kegel's Exercise (Lim, 1999). The data was analyzed by the SAS Program. The results are as follows; 1. According to the stage of change measure, 2,484 subjects were distributed in each stage of change for four health behaviors: 1,233 subjects (49.8%), 745 subjects (30.2%), 113 subjects (4.7%), 156 subjects (6.5%), and 216 (8.7%) belonged to the pre- contemplation stage, contemplation stage, preparation stage, action stage and maintenance stage. They were all series of stages of change in their efforts to do health behavior. 2. Factor analysis identified 3 factors (1 of Pros, 2 of Cons) for the exercise, 4 factors for smoking cessation (2 of Pros, 2 of Cons), 2 factors (1 of Pros, 1 of Cons) for the mammogram screening and 2 factors (1 of Pros, 1 of Cons) for Kegel's exercise of decisional balance. 3. The analysis of variance and multiple comparison analysis showed that for all 4 samples, the Cons of changing the problem behaviors outweighed the Pros for subjects who were in the pre- contemplation stage, The opposite was true for subjects in action and maintenance stage. 4. Through the discriminant analysis, it was found that one factor of Pros for exercise, one factor of Cons for smoking cessation, 1 factor of Cons for mammogram screening and one factor of Cons for Kegel's exercise were the more influencing factors, than others in discriminating the stages of change. Results are consistent with the applications of the Transtheoretical model, which have been used to understand how people change health behaviors. This results provide some evidence that subject's report of his/her health behavior corresponds to beliefs about usefulness of related health behaviors. The results of this study have implications for patients' health education and health intervention strategies. The findings of this study give useful information for nursing educators for 4 health behaviors, especially the factors relating to decision making in the different stages of change.

• Journal of Korean Academy of Nursing
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• v.35 no.1
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• pp.27-36
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• 2005

Purpose: The main purpose of this study was to investigate that the stages of change in smoking cessation behavior among coronary artery disease patients for six months progressed following the stages of change suggested by the transtheoretical model. Method: Subjects for this descriptive survey were 59 coronary disease patients who were smoking or who had stopped smoking for less than six months. Result: In the baseline, the distribution of the subjects’ stages of change was as follows: pre-contemplation stage 25.4%, contemplation stage 25.4%, preparation stage 22%, and action stage 27.1%. After six months, more subjects in the contemplation(33.3%) and preparation stages(30.8%) progressed to the action stage than those of the pre-contemplation stage(0%). Eighty-one percent of the subjects in the action stage at baseline progressed to the maintenance stage. The relationship between the numbers of smoking cessation attempts for six months and stages of change at baseline was significant(p=.001). However, the relationships between self-efficacy and nicotine dependence at baseline and progression in stages of change after six months were not significant. Conclusion: Progression in the stages of change for six months among subjects corresponded to the stages of change suggested by the transtheoretical model. Hence, future development and evaluation of intervention programs should be tailored individually considering each patient's stage of change.

• Journal of the Korean Society of School Health
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• v.29 no.3
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• pp.277-285
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• 2016

Purpose: This study investigated the rate of attempts to quit smoking and related factors in Korean adolescent smokers. Methods: The findings of this study were based on the data obtained from the '2015 $11^{th}$ Korea Youth Risk Behavior Web-based Survey'. The number of subjects was 5,123. Results: 71.7% of adolescent smokers in our study group had made previous attempts to quit smoking. Logistic regression analysis showed that the following significant factors were related to attempts to quit smoking: smoking amount (OR=1.78, 95% CI=1.42~2.23), experience of secondhand smoking in family (OR=1.16, 95% CI=1.02~1.32), experience of smoking cessation education in school (OR=2.05, 95% CI=1.79~2.35) anti-smoking publicity (OR=1.34, 95% CI=1.17~1.55), and close friend's smoking (OR=1.63, 95% CI=1.24~2.17). Conclusion: Smoking cessation policies and programs, especially those targeting adolescent smokers, should consider the factors mentioned above when designing new interventions or campaigns.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.7 no.2
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• pp.164-176
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• 2000

Purpose : This study was done to identify the factors of decisional balance for smoking cessation among middle aged men in Korea. This was composed of a set of variables at the level of decision making when middle aged men decide to stop smoking. It was used to classify and identify the characteristics of the stages of change for smoking cessation to which the middle aged men belong, and was used to identify the variables of decisional balance which influenced the stages of change for smoking cessation in middle aged men. Methods : A convenience sample of 169 men who had smoked and were smoking, were between age 30 and 60 and lived in Seoul(mean age=44), were selected from the community. The data was collected from December 10, 1999 to February 28, 2000. The research instrument was the Decisional Balance Measure for Smoking Cessation (Velicer et al., 1985). and Stage of Change Measure(DiClemente et al., 1991). The data were analyzed using the SAS Program. Results : 1. According to stage of change measure, the 169 subjects were distributed in each stage of change for smoking cessation: in the pre-contemplation stage 63 subjects(32.7%), contemplation stage 60 subjects (35.5%), preparation stage 17 subjects(10.1%), and maintenance stage 29 subjects(17.2%). 2. Factor analysis identified 4 factors of decisional balance as appropriate factors for smoking cessation of middle aged men. There were named by the researchers; 1)'Perceived Burden to Self', 2)'Perceived Benefit to Others' 3)'Perceived Approval to Others', and 4)'Perceived Disapproval to Self'. 3. Analysis of variance showed that the three components, 1)'Perceived Burden to Self(F=8.50, P=.0001)', 2)'Perceived Benefit to Others(F=3.19, P=.025)' and 3)'Perceived DisApproval to Self(F=2.87, P=.038)were significantly associated with stage of change. 4. Through discriminant analysis, it was found that 'Perceived Burden to self' was the most influential variable in discriminating the four stages of change(pre-contemplation, contemplation, preparation, and maintenance). Conclusion : The results are consistent with the application of the Transtheoretical model, which has been used to understand how people change health behavior. Even though this study is a cross-sectional, not a longitudinal study, the findings of this study give useful information for smoking cessation intervention for the middle aged men.

• Research in Community and Public Health Nursing
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• v.29 no.1
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• pp.33-40
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• 2018

Purpose: The purpose of this study was to identify factors associated with intermittent and light smoking among Korean high school students. Methods: In this cross-sectional study, we employed secondary data from the 2015 Korea Youth Risk Behavior Web-Based Survey, and used the biopsychosocial model as a framework. The analysis was performed using the data of 2,851 high school students who smoked. We defined intermittent and light smoking as smoking on 1 to 29 days in a 30-day period and no more than 10 cigarettes per day. A logistic regression analysis using the complex samples procedure was conducted. Results: Among all the participants, 1,231 (43.2%) were intermittent and light smokers. Factors significantly predicting intermittent and light smoking were gender and grade (biological factors); subjective stress (psychological factor); and mother's smoking, sibling's smoking and academic achievement (sociocultural factors). Conclusion: In smoking cessation programs, health care providers both at school and in the community should consider the unique biological, psychological, and sociocultural characteristics of intermittent and light smoking behavior among high school students.

• Journal of agricultural medicine and community health
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• v.45 no.4
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• pp.221-234
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• 2020

Objectives: The purpose of this study is to identify the policy compliance according to the socio-demographic characteristics, stress, satisfaction of relationship, Health Belief Model and characteristics of smoking behaviors and knowledge related smoking of the residents living in the Smoke-free apartment and to investigate the change of the smoking related behavior before and after the implementation of the policy. Methods: The subjects of the survey were 293 residents aged 19 or older who reside in apartments six months after the designation of Smoke-free apartment located in Daejeon. All collected data were analyzed using T-test, ANOVA and Hierarchical multiple regression of SPSS for windows(ver 24.0) program. Results: The policy compliance was higher in women and those who lived for less than two years, and non-smokers were significantly higher. The policy compliance of the whole subjects was related to satisfaction with the surrounding relationship, perceived disability about smoking cessation, frequency of smoking and the amount of smoking. The policy compliance of the whole subjects was related to the satisfaction of the surrounding relationship, the perceived disability about smoking cessation, and the amount of smoking. In addition, after the implementation of the gold research station designation policy, it had a positive impact on smoker's smoking behavior and resulted in reducing the frequency of secondhand smoke among residents. Conclusions: In order to increase the compliance of the non-smoking policy It is necessary to continuously expand the indoor smoking cessation zone policy, develop policies and supplement the health belief model components.

• Journal of Convergence for Information Technology
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• v.11 no.11
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• pp.210-218
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• 2021

This study was conducted to provide a basis for developing strategies to improve the intention to quit smoking by identifying the factors affecting the smoking cessation intention of male smokers living in Seoul who have not tried to quit smoking in the past year. The components of the planned behavioral theory were used to identify the influencing factors. The research data were analysed secondary data used in the study performed by the Korea Centers for Disease Control and Prevention in 2020. As a result of the univariate analysis, the factors affecting the smoking cessation intention rate were the average daily smoking amount and the components of the TPB. As a result of multivariate logistic regression analysis, the subjective norm and the perceived behavior control factor among the components of the TPB had statistically significant differences. Therefore, in order to increase the intention to quit smoking, it would be effective to use strategies that strengthen the strong recommendations from significant others and the smoker's self control.

• Child Health Nursing Research
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• v.4 no.1
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• pp.128-149
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• 1998

Cigarette smoking has been identified as the single most important source of preventable morbidity and mortality. Smoking behavior varies each individual, so individuality & subjectivity of smoking behavior must be specially focused upon to understand smoking behavior. The purpose of this study was to find attitudes of university students in the prediction of smoking behavior. Q-Methodological method was used as a research design and data were collected during the period from Jan.1, 1997 to Feb. 28, 1998. As the research method, Q-statements were collected through in- depth interviews and a literature review. For the study 33 Q-statements were selected. There were 45 university students as subjects for the research. The 45 university students sorted the 33 statements using the principle of Forced Normal Distribution. The principle of Forced Normal Distribution, which has nine scales to measure the individual opinions, Pc Quanl program was used for analysis and Q-factors were analyzed by using principal component analysis. According to the results of this study, there were four categories of opinion about the smoking behavior in university students. The first type is seeking the habitual dependency. The second type is seeking the stress relief : The third type is seeking the active disapproval : The fourth type is seeking the self control. As a result, The meaning of the smoking behavior is affected by perceived subjective experience, so we need to understand each persons meaning of the smoking behavior and to develop appropriate nursing interventions based on the typology of smoking behavior. Finally, The result of the study will provide basic data for smoking prevention and cessation program.

• Research in Community and Public Health Nursing
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• v.19 no.3
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• pp.469-479
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• 2008

Purpose: We reviewed all the articles on effect of smoking cessation intervention to find out the way of improvement of it. Method: 48 researches were published in Korean journals from 1980 to 2007. The research were analyzed according to: major of first author, subjects, application of theoretical framework, contents of intervention, a term of intervention, the time of evaluation on effect of interventions, research design, dependant variables, and effect of interventions. Results: Research on effect of smoking cessation intervention increased rapidly in the 2000's. At this time. 72.9% of research was published. Most of research subject were students. Theoretical framework were applied in 20.8% of articles. The most common intervention was education(39.4%). The effect of combined program on outcome variable was found to be stronger than only education program. Experimental design was used in 29.2% and quasi-experimental design was adapted in 43.8% of articles. 1- 6months intervention was in 35.4%. The long term intervention more than 1month was found to be effective. Health behavior related index was measured as a dependant variable in 62.3%. conclusion: Accordingly, long term program to apply to various subject is needed.