• 보건교육건강증진학회지
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• 제28권4호
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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.

• 보건교육건강증진학회지
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• 제21권4호
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• pp.35-49
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• 2004

The purpose of this study was to analyze variables associated with smoking and selected health behaviors. This study targeted adult men and women over 20 of age. The sample population was drawn from the national sample, and the samples were chosen from the telephone book. A total of 1,500 cases were collected through a telephone based interview survey. As a tool for this study, a structured questionnaire was developed. the variables included self-perceived health status, and selected 7 health behaviors; smoking behavior, physical activities, eating habit, weight control, alcohol consumption, stress management, and cancer exam. The healthy life practice actions of Trans-theoretical model have been classified into five stages. Smokers were more likely than non-smokers to positive attitudes toward smoking and the impact of smoking in this study. This means that smokers's awareness toward the impact of smoking is very week. Smoking behavior was significantly related to other health related behaviors based on the correlation analysis. However, gender, engaging in regular physical activities, moderate consumption of alcoholic beverages, and receiving a cancer examination were the variables that can explain and predict a person's stages of adopting a non-smoking behavior. Self perceived health status was closely related to other health behaviors. Gender, age, and monthly household income were important demographic variables that have significant relationship with the self-perceived health status. Among the health behaviors, regular physical activities and weight control were significant predictable variables. Similar results have been found in the National health and Nutrition examination survey in Korea. As a result of this study, it was found that among the selected health behaviors, engaging in physical activity was an important variable to increase positive sense of health and non-smoking behaviors. Educational and policy level input is needed to increase awareness and provide chances to participate in fitness activities. To those who maintain exercise, the environmental support and diffusion of knowledge information and education data should be strengthened. To change attitudes toward smoking, more in-dept awareness campaign and education should be provided according to people's different behavioral status. In addition, not only diffusing health education data and delivering knowledge information through related programs, but also environmental support system that helps an individual maintain his/her action is required. Such a support system means settlement of the health enhancement base of school, workplace and community should be carried out, and the policy level support and regular programs should be provided and spread to the unit of community.

• 사회복지연구
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• 제49권1호
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• pp.5-28
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• 2018

개인의 건강에 부정적인 영향을 미치고 높은 사회경제적 비용 부담을 초래하는 흡연은 예방이 가능하다는 측면에서 중요한 사회문제로 인식되고 있지만, 성인 흡연자의 금연의도에서 행동으로의 종단적인 변화 패턴을 살펴보는 연구는 매우 제한적이다. 따라서 본 연구는 3~11차의 한국복지패널 자료를 활용하여 한국 성인 흡연자 4,968명의 금연행동의 변화 패턴을 반복측정 잠재계층 모형을 사용하여 확인하였다. 반복측정 잠재계층 분석 결과, 본 연구는 (1) 지속적으로 금연 실행/유지 단계에 있는 집단(33.6%) (2) 금연 숙고/준비 단계에서 금연 실행/유지 단계로 변화하는 집단(14.8%), (3) 지속적으로 숙고/준비 단계에 머무르는 집단(29.6%), (4) 지속적으로 숙고이전 단계에 머무를 집단(22.1%)의 4개의 잠재적 집단을 확인하였다. 또한 다항로지스틱 분석을 통하여 금연행동 변화 패턴과 인구사회학적 요인 및 임상적 특성(우울수준 및 음주행동) 간 연관성을 살펴보았다. 다항로지스틱 회귀분석 결과 높은 우울수준과 음주를 하는 흡연자의 경우 지속적 금연 실행/유지 단계의 집단보다는 지속적 숙고 이전 단계에 속할 가능성이 높은 것으로 나타났다. 본 연구의 결과는 금연을 전혀 고려하지 않고 있는 숙고 이전 단계의 사람들과 지속적으로 숙고/준비 단계에 머무를 사람들에 대한 타켓화된 접근이 필요함을 시사한다.

• 농촌의학ㆍ지역보건
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• 제29권2호
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• pp.287-301
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• 2004

본 연구는 전남 곡성군 주민을 대상으로 지역사회 주민의 흡연율을 감소시키고, 금연 희망자의 금연 의지를 강화시키기 위해 2002년도에 개발된 곡성군 금연 클리닉의 '금연 개인관리 프로그램'을 중심으로 흡연 욕구 및 금연 장애요인에 대처하고, 금연 실천을 독려할 수 있는 금연 강화 프로그램을 개발하였으며, 프로그램의 지속적인 관리를 위해 지역 보건소가 수행의 주체가 되는 금연정보 지원시스템을 구축하는데 그 목적을 두었다. 본 연구의 중심이 된 '금연 개인관리 프로그램'은 지역 주민들에게 금연관련 정보 및 금연 기술을 제공하고, 금연에 관한 자기 통제력을 강화시키기 위해 개발된 인터넷 금연 프로그램이다. 그러나 '금연 개인관리 프로그램'은 참여자의 자발적인 행위를 원칙으로 하기 때문에 금연행위 유도 및 지속적인 금연 유지에 취약성을 지니고 있다. 따라서 이러한 단점을 보완하기 위해 성공적인 금연이 이루어질 수 있도록 개인별 금연실천을 돕기 위한 금연 강화 프로그램인 인터넷 금연 푸쉬 서비스를 개발하였고, 이에 관한 효과평가를 수행함으로써 프로그램의 문제점을 보완하기 위한 단계별 개선방안을 제시하고자 하였다. 연구결과를 요약하면 다음과 같다. 첫째, 금연 푸쉬 서비스를 활용한 금연 강화시스템은 개인별 금연실천을 돕기 위해 회원 가입이 이루어진 당일부터 금연 푸쉬 서비스가 제공되도록 설계하였으며, 모든 금연 푸쉬 서비스는 금연도전 프로그램의 단계에 맞추어 전자메일을 활용하여 제공되도록 고안하였다. 또한 각 단계별로 일정 형식에 따라 하루 1회씩 프로그램 참여 일정에 맞추어 제공하도록 설계하였다. 둘째, 금연 의지를 강화시키기 위해 금연 압력 메시지 및 경고 메시지, 성공 메시지를 개발하였으며, 금연 압력 메시지는 '금연 개인관리 프로그램' 에서 작성된 각 단계별 개인 정보를 활용하였고, 이전 단계에서 수립된 금연전략의 재확인 및 활용수준을 점검할 수 있도록 구성하였다. 셋째, 금연 푸쉬 서비스를 활용한 금연 강화 프로그램 및 운영 시스템을 평가하기 위해 군청 공무원 및 보건의료원의 보건직 공무원 중 흡연자로서 금연 강화 프로그램에 참여를 희망하는 10명으로 평가단을 구성하였으며, 1개월 간 시범 운영을 수행하였다. 넷째, 금연 강화 프로그램에 관한 내용 및 접근형식을 평가한 결과, 참여자의 기록 분량, 내용의 난이도. 시각적 효과의 불충분이 문제점으로 지적되었으며, 이를 개선하기 위해 참여자 중심의 기록방식을 클릭중심의 기록방식으로 전환, 참여자의 이해수준의 고려한 내용수정, 그래픽 요인의 추가 및 시각적 효과의 보완, 추구관리를 모듈 개발 등을 대안으로 제시하였다. 다섯째, 금연 강화 프로그램의 운영 시스템에 관하여 평가한 결과, 금연 압력 메시지를 제공하는 금연 푸쉬 서비스와 홈페이지와의 연계성 및 금연 개인관리 프로그램과의 연계성이 문제점으로 지적되었으며, 이를 보완하기 위해 홈페이지와의 링크 작업 개선 및 금연 개인관리 프로그램과의 링크 작업 새선, 휴대폰의 문자서비스(SMS) 기능 활용 등을 대안으로 제시하였다. 여섯째, 금연 강화 프로그램의 향후 단계별 개선방안을 프로그램의 일부 코드의 수정으로 가능한 즉시 개선방안과 프로그램 흐름의 일부 수정, 가감해야 하는 단기 개선방안, 프로그램 흐름의 대폭 수정 및 추가 모듈 개발이 필요한 중장기 개선방안으로 구분하여 제시하였다. 따라서 향후 금연 강화 프로그램을 지원하기 위한 금연자 추후관리 시스템이 구축되어야 하고, 지역 주민의 금연 실천을 독려하기 위한 다양한 컨텐츠가 개발이 선행되어야 하겠다. 또한 이를 지원하기 위해 지역 보건소 실무 담당자의 지속적인 교육 훈련 및 금연 사업을 위한 예산확보, 표준화된 금연사업 관리 지침서가 개발되어야 하겠다.

• 대한간호학회지
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• 제33권8호
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• pp.1101-1110
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• 2003

Purpose. The purpose of this study was to identify the stage of change of smoking cessation behavior and investigate factors associated with the stage of smoking cessation behavior according to the transtheoretical model. Methods. The participants, 297 smokers & quitters were selected by a stratified random sampling from 127 high school sophomore students in B city. Data were collected from April 6th to 16th, in 2002 using the structured self-report questionnaire. Results. The subjects were distributed in each stage of change of smoking cessation behavior: there were 46 subjects (15.5%) in precontemplation, 73 subjects (24.6%) in contemplation, 67 subjects(22.3%) in preparation, 56 subjects (18.5%) in action, 55 subjects (18.5%) in maintenance. Compared to the precontemplation and contemplation, people in preparation tended to smoke daily more and smoked for a shorter time, and as precontemplation progressed to the maintenance, past 1 year smoking cessation frequency increased and friends smoking decreased. Smoking onset age was the earliest in preparation, and the latest in maintenance. Helping relationships and self relationships are used a lot in precontemplation and also in contemplation. In preparation, self liberation and helping relationships are used a lot, in action, self liberation and helping relationships, and in maintenance, self liberation and environmental reevaluation. At each stage, the score of negative affect situation was the highest, but the one of negative affect situation, positive social situation, habitual strength, weight control decreased as precontemplation progressed to the maintenance. While the score of social pros and coping pros decreased with increasing stage, the one of cons tended to increase. Through stepwise discriminant analysis, it was found that social pros, smoking onset age, delf-libration were the most influencing powers among factors associated with the stages of smoking cessation behavior. Conclusions. This study suggested that, in developing an effective smoking cessation intervention for adolescents, all the stage of a client's cessation had to be assessed prior to applying intervention programs. In addition, the results of this study will become a pillar of smoking cessation program planning and application.

• Asian Pacific Journal of Cancer Prevention
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• 제15권17호
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• pp.7287-7290
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• 2014

Background: Brief physician counselling has been shown to be effective in improving smokers' behaviour. If the counselling sessions can be given at the workplace, this would benefit a larger number of smokers. This study aimed to determine the effectiveness of a ten-minute physician counseling session at the workplace in improving smoking behaviour. Materials and Methods: This prospective randomised control trial was conducted on smokers in a factory. A total of 163 participants were recruited and randomised into control and intervention groups using a table of random numbers. The intervention group received a ten-minute brief physician counselling session to quit smoking. Stages of smoking behaviour were measured in both groups using a translated and validated questionnaire at baseline, one month and three months post intervention. Results: There was a significant improvement in smoking behaviour at one-month post intervention (p=0.024, intention to treat analysis; OR=2.525; CI=1.109-5.747). This was not significant at three-month post intervention (p=0.946, intention to treat analysis; OR=1.026; 95% CI=0.486-2.168). Conclusions: A session of brief physician counselling was effective in improving smokers' behaviour at workplace, but the effect was not sustained.

• 지역사회간호학회지
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• 제32권3호
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• pp.268-280
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• 2021

Purpose: The study is examined the effects of the smoking cessation program of life skills training using flipped learning for male middle school students. Methods: The study was a nonequivalent control group non-synchronized design. The Smoking Cessation Program of life skills training using flipped learning is a Smoking Cessation Program that applied 5 stages of flipped learning such as before class, introductory class, during class, after class, and during work. Participants were 32 male students attending a middle school in D city, with 16 in the control group and 16 in the experiment group. Data collection was conducted from February 26, 2019 to May 14, 2019 for the control group, and from May 28, 2019 to August 19, 2019 for the experiment group. The collected smoking knowledge, smoking attitude, self-efficacy, basic psychological needs, and urine cotinine were analyzed by x² test, independent t-test, two-way repeated measured ANOVA, and Fishers exact test using the SPSS 25.0 program. Results: The experimental group showed higher smoking knowledge, smoking attitude, self-efficacy, basic psychological need, and urine cotinine negative response than the control group, and there were significant differences. Conclusion: These findings indicate that the Smoking Cessation Program of life skill training using flipped learning is an effective intervention for cessation of middle school male students, and it has a positive effect on the increase in urine cotinine, and a physiological indicator of the cessation effect, and is effective in the success of smoking cessation.

• 대한간호학회지
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• 제35권7호
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• pp.1285-1294
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• 2005

Purpose: This study was done to evaluate the predictive value of aspects of the Transtheoretical model (TTM) of behavior change as applied to smoking cessation in a rural population. Method: A convenience sample was recruited from a public health center in a community. A total of 484 participants were recruited, including 319 smokers, 116 ex-smokers and 49 non-smokers. A cross-sectional and descriptive design was used in this study. Data was analyzed using descriptive statistics, frequency statistics, ANOVA and Logistic regression. Result: The major findings were 1) The participants were assessed at baseline for their current Stage of Change resulting in a distribution with $42.1\%$ in Precontemplation, $24.1\%$ in Contemplation, $9.7\%$ in Preparation, $6.2\%$ in Active, and $17.9\%$ in the Maintenance stage. 2) There were statistically significant differences of processes of change, decisional balance and situational temptation across the stages of change. 3) The main factors that affect smoking cessation were age, number of years smoking, age when began smoking, self-liberation and negative/affective situations, which combined explained $33.2\%$ of the smoking cessation. Conclusion: TTM variables measured prior to a smoking cessation program added little predictive value for cessation outcome beyond that explained by demographic and smoking history variables.

• 성인간호학회지
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• 제22권6호
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• pp.582-593
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• 2010

Purpose: Health care professionals represent an immediately available resource to promote smoking cessation. However, the content in smoking cessation intervention courses in most institutions is insufficiently covered due to the limited number of class hours. The purpose of this study was to develop a comprehensive tobacco cessation-web-based, multimedia, educational program for a range of medical professionals. Methods: Based on Jung's Teaching and Learning Structure Plan Model, a development process was proposed comprising four stages: (1) analysis, (2) planning, (3) production, and (4) operation/evaluation. The effectiveness of the program was tested using quasi-experimental design, and the participants in experimental group were required to complete the program. Changes in the level of knowledge and attitude were measured. Results: The educational program developed includes nine topics and 26 sub-topics. A total of 180 storyboards, 15 videos, and 27 pictures were made. After the education, the level of knowledge was significantly increased in the experimental group. Conclusion: This web-based program can be recommended as a potential medium for health care professionals to use in counseling smoking cessation. The study findings also indicated that the program may be either offered as a teaching aid or utilized concurrently with lectures for students studying health care-related topics.

• Journal of Preventive Medicine and Public Health
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• 제36권4호
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• pp.377-382
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• 2003

Objectives : The purpose of this study was to investigate the predictor associated transitions with each stage of smoking cessation based on the Transtheoretical Model, and to provide basic data for smoking cessation programs for adolescents. Methods : The participants were 297 current and former smokers, obtained from stratified random sampling of 2nd graders from 127 high schools in B cities. The data were collected between April 6th and 16th 2002, using a structured self-report questionnaire, and analyzed using a multiple logistic regression, with the SPSS program for Windows (Version 10.0). Results : The predictors of transition from precontemplation to contemplation were consciousness raising (OR=1.22, 95% CI:1.07-1.40), coping pros (OR=.84, 95% CI:.70-1.00) and attitude of parents to smoking (OR=2.97,95% Cl: 94-9.24). The predictors of transition from contemplation to preparation were helping relationships (OR=.83, 95% CI:.72-.96), self-liberation (OR=1.15, 95% CI: 99-1.33) and nicotine dependence (OR=.76, 95% CI: 56-1.03). The only predictor of transition from preparation to action was the social pros (OR=.66, 95% CI:.57-.82). The predictors of transition from action to maintenance were self-reevaluation (OR=.81, 95% CI:.71-.92) and negative affective situation (OR=.85, 95% CI:.72-1.00). Conclusion : Adequate examination on the factors for predicting the transitional stages of change for smoking cessation in Koreans are presented in this study. The results of this study will become the pillar of smoking cessation Planning and application programs.