• Research in Community and Public Health Nursing
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• v.22 no.2
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• pp.173-183
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• 2011

Purpose: This study was to compare the Transtheoretical Model components according to the stage of change in smoking cessation behavior and identify factors associated with preparation to quit smoking among college smokers. Methods: Data were collected from 224 undergraduate students using the self-report questionnaire. The survey variables comprised the stage of change in smoking cessation, self-efficacy, and decisional balance and process of change in smoking cessation. Results: There were significant differences in self-efficacy, cons of smoking, and the process of change according to the stage of change in smoking cessation behavior. Cons of smoking and self liberation were significant factors related to the preparation stage of smoking cessation. Conclusion: Strategies to enhance cons of smoking and self liberation in college smokers will be an important intervention component to prepare and plan smoking cessation in future studies.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.8 no.3
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• pp.391-401
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• 2001

Purpose: The purpose of this study was to identify variables that influence smoking cessation based on the transtheoretical model. Methods: Variables that influence the stages of change in smoking cessation were selected based on transtheoretical model. Data were collected from 176 men aged 30-64 who smoked, Data collection was done in community settings in Seoul and vicinity, Korea between December, 1999 and June, 2000. Data were analyzed by descriptive statistics and logistic analysis using the pc-SAS program. Results: According to the logit model, the influence of significant variables on stage of change for smoking cessation suggest that ; When the scores for Pros in decision making for smoking cessation are high, the possibility that the subjects are in the action, precontemplation and contemplation stage of change will be lower than the possibility that the subjects are in the maintenance stage of change. When the scores of habitual craving in smoking temptation is high, the possibility that the subjects are in the precontemplation and contemplation stage of change will be higher than the possibility that the subjects are in the maintenance stage of change. When the scores of smoking temptation in negative affect situations are high, the possibility that the subjects are in the contemplation stage of change will be higher than the possibility that the subjects are in the maintenance stage of change. When the scores of cognitive process in the process of change are high, the possibility that the subjects are in the contemplation stage of change will be higher than the possibility that the subjects are in the maintenance stage of change. Conclusions : The results provide evidence that physical and psychological dependence on smoking are main barriers to smoking cessation. Therefore nursing interventions based on stage that focus on increasing motivation and intention for smoking cessation need to be developed.

• Research in Community and Public Health Nursing
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• v.21 no.1
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• pp.63-70
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• 2010

Purpose: This study was to identify the stages of change in smoking cessation behavior and factors associated with the stages of smoking cessation behavior according to the trans-theoretical model. Methods: The subjects were 154 industrial workers working at H Industry in N City, Chonnam Province who were currently smoking and had smoked in the past. Data were analyzed by descriptive statistics, ANOVA, and Duncan's multiple comparison test using SAS Version 10.0. Results: The subjects were distributed among the stages of change in smoking cessation behavior: there were 28 subjects (18.2%) in the precontemplation stage, 71 (46.1%) in the contemplation stage, 21 (13.6%) in the preparation stage, 8 (5.2%) in the action stage, and 26 (16.9%) in the maintenance stage. The amount of smoking per day, self-efficacy, and advantages (pros) of smoking were significantly associated with the stage of change in smoking cessation behavior. Conclusion: This study suggested that the stage of change in smoking cessation behavior of the subject should be identified prior to the application of intervention programs, nursing intervention strategies should be considered to reduce the amount of smoking per day, and the disadvantages of smoking should be perceived.

• Korean Journal of Adult Nursing
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• v.17 no.4
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• pp.592-601
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• 2005

Purpose: The purpose of this study was to investigate differences in smoking related characteristics and psychological features of coronary artery patients by the stages of change in smoking cessation behaviors. Method: Subjects for this survey were 97 patients who were smoking when doctors diagnosed them to have coronary artery diseases. Result: Subjects were distributed 21.6% in precontemplation stage, 24.7% in contemplation stage, 17.5% in preparation stage, 19.6% in action stage, and 16.5% in maintenance stage respectively. The numbers of previous attempts to quit smoking of subjects in precontemplation stage(mean=3.00, SD=3.71) and contemplation stage(mean=2.63, SD=2.32) were significantly lower than that of subjects in preparation stage(mean=5.82, SD=6.20). Benefit scores of subjects in maintenance stage were significantly greater than those of subjects in precontemplation stage. Self-efficacy, barriers, seriousness, and nicotine dependency were not significantly different by the stages of change. Number of signs and symptoms related to smoking which subjects were experiencing were not significant by the stages of change too. Conclusion: Future intervention programs for smoking cessation should be focused on the strategies to enhance the realization of health benefits that patients might acquire from smoking cessation.

• Korean Journal of Adult Nursing
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• v.15 no.3
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• pp.483-492
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• 2003

Purpose: The study was performed to identify the process of change, decisional balance and self-efficacy corresponding to the stage of smoking cessation behavior based on Transtheoretical Model in industrial workers. Method: A convenience sample of 146 industrial workers except for the never smokers, were recruited at a H industry in Ulsan. Data were collected from February 1 to 28, 2002. The research instruments were Stages of Change of Smoking Cessation Measure(DiClemente et al, 1991), Process of change(Prochaska, 1988), Smoking Abstinence Self Efficacy (SASE: DiClemente et al, 1985) and Decisional balance(SDB; Kim, 1999). Result: The results of this study were as follows; 1. The subjects were distributed in each stage of smoking cessation change: There were 64 subjects (43.0%) in the precontemplation stage, 35 subjects(23.5%) in the contemplation stage, 28 subjects(18.8%) in the preparation stage, 14 subjects(10.1%) in the action stage and 7 subjects(4.7%) in the maintenance stage. 2. Analysis of variance showed that experiental process(F=2.808, p=.042), behavioral process (F=4.567, p=.004) self-efficacy(F=9.809, p=.000), pros(F=11.107, p=.000), cons(F=6.686, p=.000), pros- cons(F=3.446, p=.018) were significantly associated with the stages of smoking cessation change. 3. Through discriminant analysis, it was found that 'PROS' was the most influential variable in discriminating the four stages of change. Conclusion: This study can provide the basis of staged matching smoking cessation program using TTM for more effective and useful intervention.

• Journal of Korean Academy of Nursing
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• v.33 no.8
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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.

• 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 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 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.

• Korean Journal of Health Education and Promotion
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• v.27 no.2
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• pp.95-108
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• 2010

Objectives: The Purpose was to investigate the effects of the '5&6 smoking cessation program' and '5 days smoking cessation program' on the high school student's perception, urine cotinine, and smoking behaviors. Methods: This study was designed using nonequivalent control group pretest-posttest. The '5&6 smoking cessation program' was applied to the experimental group 1(28 students). The '5 days smoking cessation program' was applied to the experimental group 2(19 students). Control group was 53 students. Data was analyzed using descriptive statistics, $X^2$-test, Fisher's exact test, Independent-sample t-test, Paired t-test, ANOVA, Wilcoxon signed ranks test, Cronbach's coefficient alpha. Results: The '5&6 program' was significantly increased on smoking self-efficacy, stage of smoking cessation behavior change, Cons. for smoking and significantly decreased on daily smoking amount, urine cotinine level than control group. The '5 days program' was significantly decreased on urine cotinine level and Pros. for smoking than control group. The '5&6 program' was significantly increased on stage of smoking cessation behavior change than '5 days program'. Conclusion: This study showed that the '5&6 program and the '5 days program' are effective in adolescent's smoking cessation behaviors.