• Journal of Korean Academy of Nursing
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• v.39 no.3
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• pp.376-385
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• 2009

Purpose: The purposes of this study were(a) to identify smoking behavior by following a cohort representative of the population of 4th grade elementary schoolers in South Korea over a four-year period(2004-2007), and(b) to explore predictors of smoking initiation among non-smokers in Wave 1. Methods: Secondary data, the Korea Youth Panel Study, was analyzed in this study. First, frequencies or percentages were calculated to identify smoking behavior(i.e., smoking initiation, smoking intensity, and smoking duration). Second, binary logistic regression analysis was performed to examine significant factors related to smoking initiation. Results: Smoking initiation and daily smoking were more pronounced when the participants entered middle school. In bivariate analysis, statistically significant predictors of smoking initiation were loneliness at school, self-control, delinquent behavior, depressive symptoms, and stress. However, after controlling for other factors, only a high level of risk-taking tendency and a greater number of delinquent behaviors remained statistically significant. Conclusion: Based on greater involvement in smoking among first-year middle schoolers, smoking prevention strategies should be provided to elementary schoolers rather than middle schoolers. A risk-taking tendency and delinquent behaviors should be considered as proxy measures to detect the high-risk group for smoking initiation.

• Journal of Preventive Medicine and Public Health
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• v.47 no.5
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• pp.266-272
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• 2014

Objectives: The aim of this study was to investigate the relationship between age at cigarette smoking initiation and smoking level among adolescent current smokers. Methods: In 2007, students from one or two classes of the 10th or 11th grade were randomly selected using the probability proportional to size sampling method. In total, 743 current smokers were included. Multiple logistic regression was used to determine the association between age at smoking initiation and smoking level as either frequent, daily, or heavy smokers. Results: The adjusted odds ratios for each smoking level were significantly higher for younger ages of smoking initiation than those for older ages of initiation were (p for trend <0.001). Compared with the students who started smoking in grades 10 to 11, the adjusted odds ratios for frequent, daily, and heavy smokers increased from 2.24 (95% confidence interval [CI], 1.30 to 3.87) to 3.90 (95% CI, 2.02 to 7.56), from 1.56 (95% CI, 0.92 to 2.62) to 3.17 (95% CI, 1.70 to 5.92), and from 2.56 (95% CI, 1.21 to 5.42) to 5.67 (95% CI, 2.61 to 12.30) with younger ages of smoking initiation. Conclusions: Smoking frequency and amount were closely associated with age at smoking initiation. Therefore, smoking prevention programs should be initiated from the young adolescent period.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3341-3355
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• 2016

Background: A recent WHO data report on mortality attributable to tobacco use including cigarette smoking indicated a very high burden of deaths in Asia and that people often initiate smoking as early as young adolescents. The objectives of this study were to systematically review peer-reviewed articles on cigarette smoking initiation among Asian adolescents and to develop a conceptual model of factors influencing smoking initiation by integrating all relevant factors based on existing data. Materials and Methods: Following a PRISMA guideline, a systematic review of articles published between 2005 and June 2015 was conducted using 5 databases on cigarette smoking initiation among adolescents (aged 10-19 years) living in Asia. We summarized the main findings of each study according to our research questions and data that emerged during the data extraction process. Analysis and categorization were based on the TTI and TPB models and classification of factors extracted from the study, were as follows: personal factors, social factors, broader environmental factors, mediators, and intention to initiate smoking and smoking behavior. Results: Of 1,227 identified studies, only 20 were included in this review. Our findings found that the mean age of cigarette smoking initiation ranged from 10 to 14 years and those who are more likely to initiate smoking are male, older adolescents, adolescents with low parental SES, individuals with low parental monitoring, low parental education level and having no discussion on smoking at home, those living in public housing and those exhibiting health-risk behavior. Our study also revealed that the risk of smoking initiation increased when they are exposed to smokers, influenced by peers, exposed to tobacco advertisements, receive pocket money, have lack of knowledge about smoking, have poor school performance, have a family conflict and have psychological problems. The conceptual model developed demonstrated complex networks of factors influencing initiation. Conclusions: This systematic review presents various factors influencing smoking initiation of the Asian adolescents and provides a conceptual framework to further analyze factors. Future studies should have a standard measure of smoking initiation, should analyze interactions and the intensity of relationships between different factors or variables in the conceptual model. This will in turn consolidate the understanding of the different factors affecting smoking initiation and will help to improve interventions in this area.

• Korean Journal of Health Education and Promotion
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• v.29 no.5
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• pp.115-123
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• 2012

Objectives: Students' life changes substantially as grade increases. It implies that risk factors that trigger students' smoking may not be consistent across grades. Most previous studies on student smoking have considered grade simply a control variable. This study examines which and to what extent risk factors are differently associated with smoking initiation according to grade level among high school students in Korea. Methods: Data from the Korean Youth Risk Behavior Web-based Survey (KYRBWS) conducted by the Korea Centers for Disease Control and Prevention (KCDC) in 2007 and 2008 were analyzed in this study. Results: Among boys, school location, school type and pocket money etc. significantly influence smoking initiation in the first grade than in any other grades, but the strength of the association decreased as grade increases except academic performance. Among girls, most independent variables were associated with smoking initiation in the second grade except school location, pocket money per week and academic performance. Conclusions: Our results suggested that the variables related smoking initiation in Korean high school students were notably different by grade and gender. These findings can serve as the basis of policy recommendations with regard to school efforts to prevent student smoking.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.3
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• pp.1747-1753
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• 2013

Background: It is projected that low and middle-income countries will bear a major burden of tobacco related morbidity and mortality, yet, only limited information is available on the determinants of smoking initiation among youth in Africa. This study aimed to assess the determinants of smoking initiation and susceptibility to future smoking among a population of high school school students in Lagos, Nigeria. Materials and Methods: Baseline data from an intervention study designed to assess the effect of an anti-smoking awareness program on the knowledge, attitudes and practices of adolescents was analyzed. The survey was carried out in six randomly selected public and private secondary schools in local government areas in Lagos state, Nigeria. A total of 973 students completed self-administered questionnaires on smoking initiation, health related knowledge and attitudes towards smoking, susceptibility to future smoking and other factors associated with smoking. Results: Of the respondents, 9.7% had initiated smoking tobacco products with the predominant form being cigarettes (7.3%). Males (OR: 2.77, 95%CI: 1.65-4.66) and those with more pro-smoking attitudes (OR: 1.44, 95%CI: 1.34-1.54) were more likely to have initiated smoking. Those with parents and friends who are smokers were 3.47 (95%CI: 1.50-8.05) and 2.26 (95%CI: 1.27-4.01) times more likely to have initiated smoking. Non-smoking students, in privately owned schools (OR: 5.08), with friends who smoke (5.09), with lower knowledge (OR: 0.87) and more pro-smoking attitudes (OR 1.13) were more susceptible to future smoking. In addition, respondents who had been sent to purchase cigarettes by an older adult (OR: 3.68) were also more susceptible to future smoking. Conclusions: Being male and having parents who smoke are predictors of smoking initiation among these students. Consistent with findings in other countries, peers not only influence smoking initiation but also influence smoking susceptibility among youth in this African setting. Prevention programs designed to reduce tobacco use among in-school youth should take these factors into consideration. In line with the recommendations of article 16 of the WHO FCTC, efforts to enforce the ban on the sales of cigarettes to minors should be also emphasised.

• Survey Research
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• v.12 no.2
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• pp.159-173
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• 2011

The goal of this study is to identify and compare predictors of smoking initiation, persistence and smoking status among Hispanics and Whites. The sample includes 1,410 Hispanic and non-Hispanic White adults living in El Paso, TX, USA and Do$\tilde{n}$a Ana and Otero counties, NM, USA from the Paso del Norte 2002 BRFSS. Whites reported higher rates of cigarette smoking and became regular smokers earlier than Hispanics. Males were twice more likely to initiate cigarette smoking and progress to regular smoking than females among Hispanics, but this gender difference among Whites was not significant. Childhood exposure to drinkers or alcoholics was an important predictor of smoking initiation and becoming a regular smoker, but only among Hispanics. Few identified ethnic differences in predictors of smoking were found. The findings underscore the importance of Hispanic norms on smoking behaviors. Prevention efforts need to address the culture as one of the important components relevant to smoking.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.sup1
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• pp.31-36
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• 2016

Scientific evidence on all aspects of smoking amongst youth is very important for designing appropriate interventions to reduce smoking among this vulnerable population. This paper describes current access to anti-smoking information among school children aged 13 to 15 years in Vietnam in 2014 and examines its potential impact on preventing smoking initiation. The data used in this paper were obtained from the 2014 Global Youth Tobacco Survey (GYTS) in Vietnam. Students were asked questions about their level of awareness of anti-smoking information from various sources in the past 30 days and about lessons in school regarding the dangers of tobacco use during the last 12 months. Those who have never smoked were asked "whether or not they thought about avoiding cigarettes because of health warnings on cigarette packages" and answers were analyzed in combination with data on access to anti-smoking information from other sources. The prevalence of exposure to antismoking campaigns was high among school children in Viet Nam: 55.3% of current smokers reported thoughts of smoking cessation because of health warnings on cigarette packages; 60.5% of never smokers avoided initiating smoking because of the same health warnings. The potential impact of graphic health warnings to prevent school-aged children from smoking initiation would be stronger if there was concurrent access to anti-smoking programs on the dangers of tobacco use in schools. However, school education for tobacco prevention and control has not been as strong as expected. A more comprehensive school curriculum on tobacco prevention and control is recommended to reinforce antismoking messages among school children.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3533-3540
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• 2016

Background: Cigarette smoking is one of the leading global causes of premature and preventable death. In Brunei Darussalam, smoking-related diseases have been a primary cause of mortality for the past three decades. Despite the increasing efforts that have been made in recent years to reduce the consumption of tobacco products in Brunei, the prevalence of adolescent smoking cigarette, however has risen alarmingly, from 8.9% in 2013 to 11.4% in 2014, with a higher prevalence found in males (17.8%) than in females (4.8%). In response to the need for more effective smoking prevention programmes in Brunei, this study sought to explore factors that influence Bruneian male adolescents to start and continue smoking. Materials and Methods: A qualitative study using focus group discussions (FGDs) as the data collection method was conducted from October to November 2015. A total of 43 studentss, comprising 31 smokers and 12 non-smokers, aged 13-17 years, from two government secondary schools in Bandar Seri Begawan, participated in six FGDs. Discussions were recorded and translated. Transcripts were entered into NVivo10, before thematic analysis was conducted. Results: We identified three themes under the core construct of 'factors influencing smoking initiation' ('family as teachers', 'overt pressure from peers' and 'perceived smoking has many advantages') and three themes under the core construct of 'factors influencing smoking continuation' ('craving and addiction', 'smoking as a 'social activity' and 'easy accessibility of cigarettes'). Conclusions: Based on the findings, it is recommended that future prevention activities should be embedded in a comprehensive approach, involving all stakeholders within a community, and should be focused towards bringing a change in smoking and parenting behavior of parents, social norms within the culture towards all population levels, and at strengthening the existing non-smoking policies in schools and other public places where young people congregate.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.1209-1214
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• 2016

Background: Cigarette smoking constitutes a major threat to the health and wellbeing of teenagers. While smoking has been on decline in the developed countries, the reverse is the case in developing countries. The aim of this study was to determine the age of initiation, determinants and prevalence of cigarette smoking among teenagers in Mushin Local Government Area of Lagos state, Nigeria. Materials and Methods: This was a descriptive cross-sectional study among 475 teenagers selected by multistage sampling. A pre-tested, structured, interviewer-administered questionnaire was used for data collection. The study was carried out in November, 2014. Results: Response rate was 84.6%. Mean age of the respondents was $16.4{\pm}1.65years$. Range and mean age of initiation of cigarette smoking were 7 to 17 years and $12.0{\pm}3.32years$ respectively. Teenagers who were above 15 years (OR:5.13, 95%CI: 0.87-30.26), males (OR:5.19, 95%CI: 1.57-17.18), married (OR:8.41, 95%CI: 1.04-63.35), had ${\leq}$primary school education(OR:4.31, 95%CI: 1.07-17.33), influenced by friends(OR:308.84, 95%CI:84.87-1123.81), and influenced by advertisements (OR:27.83, 95%CI: 3.92-197.64) were more likely to have initiated cigarette smoking. Furthermore, teenagers who were males (OR:12.77, 95%CI: 2.90-56.28), married (OR:19.24, 95%CI: 2.05-180.45), had ${\leq}$primary school education(OR:7.85, 95%CI: 2.37-26.01), influenced by friends(OR:28.56, 95%CI: 10.86-75.07), and influenced by advertisements (OR:5.95, 95%CI: 1.72-20.61) were more likely to be current cigarette smokers. In addition, 24.9% had initiated cigarette smoking while 14.7% were current smokers of cigarette. Conclusions: Mean age of initiation of cigarette smoking was $12.0{\pm}3.32years$. Determinants of cigarette smoking were age, gender, marital status, educational background, friends and advertisements. Life time prevalence of cigarette smoking was higher than prevalence of current cigarette smokers. Cigarette smoking reduction programs should take these factors into consideration.

• Journal of Korean Public Health Nursing
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• v.20 no.1
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• pp.39-56
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• 2006

Objectives: To investigate the drinking and smoking habits among the community residents of a city. Methods: We surveyed 1.973 adults from October 1, 2005 to November 16, 2005. The data collected on alcohol drinking habits involved frequency, age of initiation, amount of alcohol consumed, number of attempts to reduce consumption and reasons for reducing it. The data collected on smoking habits involved amount, age of initiation, duration, situations, and the number of attempts to quit smoking. These were analyzed with frequency, percentage, mean, standard deviation, $x^2$-test, t-test and ANOVA. Results: The rate of drinking was 67.4%; 83.1% among males, and 52.5%among females. Among all drinkers, the largest group (29.8%) drank once or twice a week. The mean age of initiation was 21.2 years; 19.9 among males, and 22.8 among females. The average consumed amount was 5.8 glasses; males consumed 7.4 glasses, and females 3.3 glasses. The consumption was the highest among those in fifties. The rate of attempts to reduce drinking was 33.4%, mainly for health reasons. The rate of smoking was 38.0%; 72.4% among males, and 5.5% among females. Among all smokers, the largest group (44.1%) smoked between 11 and 20 cigarettes per day. The mean of the age of initiation was 20.7 years; 20.3 among males, 25.6 among females. The mean smoking duration was 20.9 years; 21.3 years among males, and 16.2 years among females. The main reason for the initial attempt was curiosity. The most common situation for smoking was after dinner. The rate of attempts to quit smoking was 77.1%, mainly out of concern for one's health. Alcohol consumption among smokers was higher than among any other group of nonsmokers. Also, the age of drinking initiation among smokers was lower than among any other group of nonsmokers. Conclusion: This study highlighted the actual data on drinking and smoking habits among community residents. The study can be utilized for creating programs aiming at reducing the consumption of alcohol and tobacco or stopping it altogether. Therefore, it is now possible to assess the indicators for interventions in each population group. Finally, the groups of heavy drinkers and smokers are expected to be given priority for intervention program.