Integrative Smoking Cessation Stage Model for Chinese Students Studying in Korea

Hyunsoo Oh,Hyesun Jeong,서화숙 한국간호과학회 2013 Asian Nursing Research Vol.7 No.4

Purpose: The present study aimed at developing an integrative stage model of smoking cessation behavior by combining highly predictable constructs extracted from previously verified health behavior models. The fitness of the hypothetical model was also tested. Methods: The study participants were 214 Chinese students studying in Korea, presenting high smoking rates. Perceived severity, benefit, barrier, self-efficacy, and social support were measured using the modified AttitudeseSocial InfluenceseSelf Efficacy Questionnaire. Demographic and smoking-related characteristics were also evaluated. Results: Results showed that the hypothetical model provides a good fit. Significant psychosocial predictors of smoking cessation stage were perceived benefit (p = .050), barrier (p = .003), and social support (p = .003). Among demographic and smoking-related characteristics, gender (p = .030), duration of smoking (p = .010), and previous smoking cessation experience (p = .020) were found to influence smoking cessation stage. In addition, gender, age, number of cigarettes smoked, previous smoking cessation experience, smoking-related symptoms, and smoking cessation education needs were found to influence psychosocial constructs significantly. Conclusion: The significant psychosocial predictors and demographic and smoking-related characteristics defined in the present study appear to be potent and promising predictors of smoking cessation behavior stages for a cohort of Chinese students studying in Korea. Purpose: The present study aimed at developing an integrative stage model of smoking cessation behavior by combining highly predictable constructs extracted from previously verified health behavior models. The fitness of the hypothetical model was also tested. Methods: The study participants were 214 Chinese students studying in Korea, presenting high smoking rates. Perceived severity, benefit, barrier, self-efficacy, and social support were measured using the modified AttitudeseSocial InfluenceseSelf Efficacy Questionnaire. Demographic and smoking-related characteristics were also evaluated. Results: Results showed that the hypothetical model provides a good fit. Significant psychosocial predictors of smoking cessation stage were perceived benefit (p = .050), barrier (p = .003), and social support (p = .003). Among demographic and smoking-related characteristics, gender (p = .030), duration of smoking (p = .010), and previous smoking cessation experience (p = .020) were found to influence smoking cessation stage. In addition, gender, age, number of cigarettes smoked, previous smoking cessation experience, smoking-related symptoms, and smoking cessation education needs were found to influence psychosocial constructs significantly. Conclusion: The significant psychosocial predictors and demographic and smoking-related characteristics defined in the present study appear to be potent and promising predictors of smoking cessation behavior stages for a cohort of Chinese students studying in Korea.

보건소 금연클리닉 등록자의 금연 성공에 영향을 주는 요인 : 금연상담사의 상담내역 중심

황승숙(Seung-Sook Hwang) 한국생활환경학회 2010 한국생활환경학회지 Vol.17 No.5

The purpose of this study was to identify factors affecting on success of smoking-cessation in the smoking cessation clinic of public health center. The subjects of this study were 187 adult smokers who had registered in smoking-cessation clinic of public health center in I City. Data were analyzed through x²-test, t-test, and logistic regression using the SPSS/WIN 14.0 program. Identified factors affecting the success of smoking-cessation were 'hardly ever', 'sometimes', 'after eating', 'not so strong', 'in anger', and 'right after getting up' in smoking urges. And the elements of withdrawal symptoms were 'nothing', 'irritated' and 'unsound sleep'. Also 'will strengthening' and 'finger-press pen' in behavior guide were identified. 'Age', 'amount of smoking', 'exercise' and 'smoking cessation days' were other elements affecting the success of smoking-cessation. Smoking-cessation program should be based on the careful examination of real smoking urges, practical withdrawal symptoms of the subjects and by the strengthened behavior guides case by case, the ratio of successful smoking cessation will be far more increased.

계획적 행위이론에 근거한 잠재적 흡연 청소년의 금연에 대한 의도

김경미 ( Gyeong Mi Kim ),김미진 ( Mi Jin Kim ) 한국통합교육과정학회 2016 통합교육과정연구 Vol.10 No.2

본 연구는 Ajzen의 계획적 행위이론에 근거하여 잠재적 흡연청소년의 금연에 대한 의도를 파악하고 이에 영향을 미치는 요인을 과학적이고 체계적으로 접근하여 청소년의 금연에 대한 실질적이고 다각적인 활동 방향, 청소년을 위한 효과적인 금연교육프로그램의 기초자료를 제공하고자 하였다. 본 연구는 2012년 7월9일부터 7월 13일까지 서울시에 위치한 특성화계 고등학교 1,2,3학년 총 6학급 중 흡연자, 비흡연자 모든 청소년을 대상으로 132명을 설문 조사하였으며 12명이 탈락되어 최종 120명을 대상으로 질문지를 이용한 전향적 조사연구이다. 본연구의 측정도구는 표준 질문지 구조(Ajzem,2000)와 계획적 행위이론 모델을 검증한 바 있는 지연옥(1994)의 도구를 수정하여 사용한 김태욱(2001)의 설문지를 재수정하여 사용하였다. 연구 결과는 다음과 같다. 1. 일반적 특성가운데 금연의도에 영향을 미치는 요인으로는 담배양(F=4.442 p=.008)으로 담배양이 적으면 적을수록 의도와의 유의한 차이를 보였다. 청소년 흡연자 중 성인이 되어서도 담배를 계속 필 것인가(F=5.873 p=.005)에 대한 여부에는 의도와의 유의한 차이가 있었으며, 이 중 담배를 끊을 것이다. 모르겠다. 계속핀다 순으로 나왔다. 이는 흡연 청소년 중 성인이 되어 담배를 계속 필 것 인가에 대해서는 주관적 규범과 지각된 행위 통제가 아닌 금연의도 차이에서 볼 수 있으므로 학생 스스로에게 담배에 대한 유해성을 강력히 어필하고 금연의도를 부축일 수 있는 환경과 방안이 모색되어야 할 것이다. 학년에 따라서는 주관적 규범 간(F=3.245 p=0.43)의 유의한 차이를 보였으며 중 2학년, 1학년, 3학년 순으로 나타났다. 반면에 성별, 학교성적, 스트레스, 흡연경험, 금연교육 유무는 주요요인과 금연의도에 영향을 주지 않았다. 기존 연구들을 비교해 볼 때 학교성적이 낮을수록 스트레스가 많을수록 흡연가능성이 높다고 하였지만 본 연구에서는 학교성적, 스트레스 유무와 상관없이 흡연가능성과 의도와의 관계는 없는 것으로 나타나 연구 대상자의 표본수를 확대화 한 추후 연구가 필요할 것으로 생각된다. 2.계획적 행위이론 주요요인과 신념요인관의 상관관계에서는 금연행위에 대한 태도와 행위신념(r=.292 p=.063)으로 유의한 상관관계는 없었다. 3.계획적 행위이론 주요요인과 의도간의 상관관계에서는 금연행위에 대한 태도와 의 의도(r=.248 p=.014),주관적 규범과 의도(r=.308 p=.003)간의 유의한 상관관계가 있었다. 그러나 지각된 행위 통제와 의도(r=.120 p=.236)간의 유의한 상관관계는 없었다. 4.계획적 행위이론 주요요인이 금연의도와의 관련성에서 10.3% 금연 의도에 영향을 미쳤다. 이 중 주요요인 3가지 중 주관적 규범만이 의도와의 관련성이 있는 것으로 나타났다. 잠재적 흡연청소년을 대상으로 한 본 연구에서는 주관적 규범만이 유의한 차이를 보여 부분적으로 지지되었음을 보여준다(p=.017). 따라서 주관적 규범을 높이기 위해선 잠재적 흡연청소년들의 규범적 신념에 긍정적인 영향을 줄 수 있는 주위 사람들, 즉 학교에서나 가정에서 교사나 부모 등 성인들이 이들에 대해 금연교육, 상담, 지원 등이 교육적 중재자 역할이 절실히 요구된다고 본다. This study uses Ajzen’s theory of planned behavior to examine lescents’ smoking-cessation behaviors and investigate factors that affect smoking-cessation intention in order to provide basic data for effective anti-smoking education. Smoking volume influenced intention: smoking-cessation intention was likely to increase with decreases in quantity. Significant differences in subjective norms by school year were observed. Regarding relationships between theory of planned behavior components and belief factors, attitude towards smoking-cessation behaviors and behavioral beliefs were significantly correlated, as were subjective norms and normative beliefs. Moreover, attitude towards smoking-cessation behaviors and smoking-cessation intention, as well as subjective norms and smoking-cessation intention were positively correlated. Collectively, the main theory of planned behavior factors influenced smoking-cessation intention, of which, only subjective norms was significantly associated with intention. Based on these results, specific implications for program development and improvement that focus on strengthening subjective norms were discussed.

머신러닝을 이용한 성인흡연자의 금연행동 예측모델 구축 및 평가

최화영 ( Hwa-young Choi ),이광수 ( Kwang-soo Lee ) 대한보건협회 2021 대한보건연구 Vol.47 No.4

연구목적 : 본 연구의 목적은 머신러닝 알고리즘을 통해 흡연자의 금연행동을 예측하는 모델을 구축하고, 금연행동에 미치는 요인의 영향을 평가하는 것이다. 연구방법 : 연구는 2019년 지역사회건강조사 전국 데이터를 사용하였고, 대상자는 흡연경험이 있는 만 19세 이상 성인으로 하였다. 종속변수는 금연시도와 금연성공을 사용하였다. 금연시도의 연구대상자는 무응답을 제외한 후 84,126명이었고, 금연성공의 대상자 수는 금연시도 경험이 있는 61,784명이었다. 연구대상자의 남녀 비율은 9:1이었고 과적합을 방지하기 위해 남녀를 구분하여 예측모델을 구축하였다. 자료 분석은 SAS 9.4를 이용하여 데이터 전처리, 일반적 특성 파악을 진행하였고, SAS Enterprise-Miner 15.2를 이용하여 모델링 및 비교, 스코어 시각화를 진행하였다. 결과 : 연구의 주요 결과는 다음과 같다. 첫째, 랜덤포레스트 알고리즘을 이용하여 구축한 예측모델은 금연시도와 금연성공을 예측할 때 AUC 값이 0.7~0.8이상으로 안정적이었다. 둘째, 남성은 흡연기간이 길수록 금연시도를 할 확률이 줄어들지만 금연을 하게 될 경우 유지할 확률이 높았다. 셋째, 여성은 흡연기간이 길수록 금연시도 확률이 남성에 비해 큰 폭으로 감소하고, 흡연기간이 길수록 금연성공 할 확률도 감소하였다. 결론 : 연구를 통해 머신러닝 알고리즘을 금연연구에 적용할 수 있는 가능성을 확인하였으며, 성별과 흡연기간이 금연지원 시 주요 고려 변수임을 시사하였다. Objectives : The purpose of this study was to formulate a prediction model for smoking cessation behaviors of adult smokers using machine learning algorithms and to evaluate the effects of factors on the smoking behaviors. Methods : Community health survey in 2019 was utilized, and the study subjects were persons over 19 years of age who smoke or have smoked. Dependent variables were smoking cessation behaviors such as smoking cessation attempts and successful smoking cessation. 84,126 persons had experiences of smoking cessation attempts, and 61,784 persons had experiences of successful smoking cessation. Prediction models were formulated by gender to prevent over-fitting. SAS 9.4 was utilized for the descriptive analysis, and SAS Enterprise-Miner 15.2 was utilized for the prediction model building and to visualize the scores. Results : Study results showed that first, the prediction model using a random forest algorithm had an AUC(Area Under the Curve) of 0.7-0.8 in predicting smoking cessation attempts and successful smoking cessation, which indicates a stable result. Second, men who smoked for a longer period were less likely to attempt smoking cessation but were more likely to maintain their smoking cessation once they succeeded. Third, the likelihood for female smokers to quit smoking dropped quicker than their male counterparts as they smoked for a longer period. Female smokers who smoked longer were also less likely to succeed in smoking cessation. Conclusion : This study suggested the possibility for machine learning algorithms to be adapted to smoking cessation program and suggested that sex and length of smoking periods will be major factors for supporting smoking cessation.

대구 소재 금연 시도 학생들의 특성에 대한 탐색적 연구

공나영(Nayeong Kong),김희진(Hee Jin Kim),서완석(Wan Seok Seo) 대한생물치료정신의학회 2021 생물치료정신의학 Vol.27 No.1

Objectives:Adolescents cigarette smoking is a major public health concern, because it is highly associated with physical and mental development of adolescents. This study examines the psychosocial variables affecting smoking behaviors and smoking cessation plan. Methods:A total of 74 (35 smokers and 40 non-smokers) students in Daegu metropolitan city were included in this study. 35 smokers visited smoking cessation center between September 2019 and November 2019. Subjects were asked to complete a self-reported questionnaire evaluating smoking status, self-esteem, parent-adolescent communication, parent and peer attachment, and peer relationship quality. The independent t-test was conducted to determine the difference in psychological variables between smoker and non-smoker. Additionally, logistic regression analysis was done to identify the factors that affect smoking cessation plan and willingness. Results:The majority of adolescent smoker was male (94.3%) and middle school students (82.9%). Twenty-four smokers (68.5%) started smoking at sixth and seventh grade. The smoking amount and smoking days were related to plan and willingness of smoking cessation in logistic regression analysis and the number of friends who smoke was related to smoking cessation plan. The openness of communication in smoking students was significantly higher than that of non-smoking students. Conclusion:Our findings indicate that the environmental factors such as peer or parental smoking is important in adolescents smoking. In addition to individual factors such as smoking amount and days, openness of communication related with impulsivity and susceptibility in peer pressure can affect plan or willingness of smoking cessation.

5&6 금연프로그램이 흡연 고교생의 인지적, 행위적, 생리적 특성에 미치는 효과

임은선(Eun Sun Lim),이정렬(Chung Yul Lee),이영자(Young Ja Lee),김정애(Jung Ae Kim) 한국보건교육건강증진학회 2007 보건교육건강증진학회지 Vol.24 No.4

Purpose: The Purpose of this study was to investigate the effects of the '5&6 smoking cessation program - six classes in five weeks' on the high school students' perception and smoking behavior. Methods: The data collection was done from November to December, 2006. This study was designed using nonequivalent control group pretest - posttest. Experimental group had 24 students, control group had 41 students. The '5&6 smoking cessation program' was applied to the experimental group for two hours per session during five weeks. Data analysis was done using descriptive statistics, X2-test, Fisher's exact test, Independent-samples t-test, Paired t-test, Cronbach's coefficient alpha. Results: The experimental group showed significant increase on smoking self-efficacy, stage of smoking cessation behavior change and significant decrease on daily smoking amount, dependancy of nicotine, urine cotinine level than control group. But the experimental group was not significantly changed at self-awareness, Pros. for smoking and Cons. for smoking. Conclusion: In conclusion, the results of this study showed that the 5&6 smoking cessation program, which focuses on self-awareness, is effective in adolescent's smoking cessation behaviors.

남성 건설근로자의 금연실천단계와 금연행동 영향요인

황선경 ( Hwang Sun-kyung ),김보경 ( Kim Bokyoung ),이윤지 ( Lee Yoon-ji ) 부산대학교 간호과학연구소 2017 글로벌 건강과 간호 Vol.7 No.1

Purpose: This study assessed smoking-cessation stages of change using the Precaution Adoption Process Model (PAPM) and identified smoking cessation-related factors. Methods: Using a cross-sectional descriptive study, a convenience sample of 216 male construction workers answered a self-administered questionnaire including demographics, the Champion`s Health Belief Model Scale, and questions on the smoking-cessation stages of change through the PAPM. Data were analyzed by descriptive statistics, x<sup>2</sup> test, t-test, Fisher`s exact test, and logistic regression. Results: The distribution of the PAPM stages of change in smoking-cessation was as follows: 9.7% unengaged, 32.4% engaged and deciding to quit smoking, 1.9% deciding not to quit smoking, 16.7% deciding to quit smoking, 8.3% acting, and 31.0% maintaining. The health beliefs related to smoking cessation indicated mean scores of susceptibility, seriousness, benefits, barriers, confidence, and health motivation of 2.23±0.88, 3.23±0.86, 3.41±0.88, 2.57±0.72, 3.37±0.77, and 3.45±0.64, respectively. The significant predictors of smoking cessation were smoking banned at home (OR=2.61, 95% CI: 1.37~5.00), susceptibility (OR=0.60, 95% CI: 0.40~0.89), and confidence (OR=2.05, 95% CI: 1.29~3.27). Conclusion: The findings indicated that, to increase the rate of successful smoking cessation, it is necessary to forbid smoking at home and to implement smoking-cessation programs compatible with the smoking-cessation stages of change.

남성 흡연자의 금연에 대한 관심도 및 관련 요인

신택수(Taek-Soo Shin),임영아(Young-A Lim),조영채(Young-Chae Cho) 한국산학기술학회 2018 한국산학기술학회논문지 Vol.19 No.4

본 연구는 남성 흡연자들의 금연에 대한 관심도와 그에 관련된 요인을 규명하고자 시도하였다. 조사대상은 D광역시청에 근무하고 있는 남성 공무원 중 조사시점에서 현재 흡연자인 593명으로 하였다. 조사는 2015년 10월에 구조화된 무기명 자기기입식 설문조사에 의하였다. 연구결과, 조사대상자의 금연에 대한 관심도는 「관심 없음」 28.3%, 「관심이 있으나 6개월 이내에 금연할 생각 없음」 45.7%, 「관심이 있으며 6개월 이내에 금연할 것임」 26.0%로 나타났다. 다중회귀분석 결과, 조사대상자의 금연에 대한 관심도에 영향을 미치는 요인으로는 「고용형태」, 「최초 흡연 연령」, 「1일 흡연량(담배 개피 수)」, 「아침에 일어나서 첫 번째 담배를 피울 때까지 걸리는 시간」, 「폐암 이환 가능성 인지」, 「금연에 대한 행동실천의 인지된 이익」이 유의한 변수로 선정되었다. 로지스틱 회귀분석 결과, 금연에 대한 관심도가 「관심 없음」군보다 「관심이 있으며 6개월 이내에 금연할 것임」군에서 「폐암 이환 가능성 인지」, 「금연에 대한 행동실천의 인지된 이익」 및 「금연에 대한 행동실천의 인지된 장애」가 높게 나타날 위험비가 유의하게 상승하는 것으로 나타났다. 위와 같은 연구결과는 흡연에 의한 건강장애의 심각성의 인식이 금연에 대한 관심을 높이는 주요 요인이 되고 있음을 시사한다. This study was conducted to investigate the relationship between interest in smoking cessation and factors that define this interest. The study subjects were 593 male civil servants who work at D metropolitan city and were smokers at the time of the survey. The research method was a survey using a self-administered questionnaire in October 2015. Interest in smoking cessation of study subjects showed that 28.3% had no interest in smoking cessation, 45.7% were interested in smoking cessation, but had no intention to quit within six months, and 26.0% were interested in smoking cessation and intended to quit within six months. Multiple regression analysis revealed that the factors influencing interest in smoking cessation with explanatory powers of 23.6% were employment type, age when first starting smoking, number of cigarettes smoked per day, time from when you wake up until you smoke your first cigarette, recognition of susceptibility to lung cancer, and benefits to smoking cessation. Logistic regression analysis revealed that the odds ratio of recognition of susceptibility for lung cancer, benefits to smoking cessation, and barriers to smoking cessation were significantly increased in the group with interest in smoking cessation and intention to quit within six months vs. the group with no interest in smoking cessation. Taken together, these results suggest that cancer prevention due to smoking and awareness of the seriousness of health problems caused by smoking were factors increasing interest in smoking cessation.

건강믿음모형(Health Belief Model)을 이용한 남성 흡연자의 금연에 대한 관심도를 규정하는 건강행동요인 분석

신택수(Taek-Soo Shin),조영채(Young-Chae Cho) 한국산학기술학회 2017 한국산학기술학회논문지 Vol.18 No.5

본 연구는 남성 흡연자들의 금연에 대한 관심도와 금연에 대한 관심도를 규정하는 요인 간의 관련성을 규명하고자 시도하였다. 조사대상은 D광역시청 및 그 산하 지청에 근무하고 있는 남성 공무원 중 조사시점에서 현재 흡연자인 593명으로 하였다. 조사방법은 2015년 10월에 구조화된 무기명 자기기입식 설문지를 이용한 설문조사에 의하였다. 연구결과, 조사대상자의 「금연에 대한 관심도」는 「금연에 대한 행동의 계기」, 「폐암에 대한 이환 가능성 인지」, 「폐암에 대한 심각성인지」 및 「금연에 대한 행동실천의 인지된 이익」과 유의한 양의 상관관계를 보였다. 공분산 구조분석 결과, 금연의 관심도를 규정하는 요인들의 「금연에 대한 관심도」를 높이는 요인으로는 「금연에 대한 행동실천의 인지된 이익 및 장애」가 가장 큰 요인이었으며, 다음으로 「폐암 이환 가능성 인지 및 심각성 인지」, 「금연에 대한 행동의 계기」 및 「사회적지지 네트워크」의 순이었다. 위와 같은 연구결과는 금연에 의한 암 예방효과와 흡연에 의한 건강장애의 심각성의 인식은 금연에 대한 관심을 높이는 요인이 되고 있음을 시사한다. 따라서 향후 남성 흡연자들의 금연지도에 있어서는 대상자의 금연의 관심도를 높이는 요인들을 정확하게 파악하여 끈기 있게 지도해 나가는 것이 중요하다고 생각된다. This study examined the relationship between the interest in smoking cessation and factors that define the interest in smoking cessation. The study subjects were 593 male civil servants who worked at D metropolitan city, and were smokers at the time of the survey. The research method was a survey using a self-administered questionnaire in October 2015. As a result, the interest in smoking cessation showed a positive correlation with the cues to action for smoking cessation, recognition of susceptibility for lung cancer, recognition of the seriousness for lung cancer, and benefits to the practice of action on smoking cessation. With the analysis of the covariance structure, the benefits and barriers to the practice of action on smoking cessation were the largest factors increasing the interest of smoking cessation, followed by the order of recognition of susceptibility and seriousness for lung cancer, cues to action for smoking cessation, and social support network. These results suggest that the cancer prevention effect due to smoking and the awareness of the seriousness of the health problems caused by smoking were the factors increasing interest in smoking cessation. Therefore, it is very important that education on quitting smoking for male smokers be continued to better understand the factors leading to an increase in smoking.

니코틴 의존의 정신사회적 치료

조근호(Keun Ho Joe) 한국중독정신의학회 2015 중독정신의학 Vol.19 No.1

There are still debates that the needs of medical advice for smoking cessation. On the contrary, some physicians look down on the addictive characters of nicotine and act as if they can handle it only with some medications easily. However, similar to another addiction problem, the medications for smoking cessation are not the perfect remedy yet. Even though it is possible to reduce the withdrawal and craving some extent through the medication, the risk of recurrence is still present. The psychosocial intervention itself can increase the success rate of for smoking cessation, and when combined with some medications it can improve the cessation rate and reduce the relapse rate. The psychosocial advices for smoking cessation are diverse, for example, from simple way like brief medical advice of the doctors, up to the more complex and systematized program on the basis of the motivation enhancement therapeutic and cognitive behavioral therapeutic approach. The smoking rate is much higher in mentally ill patients compared to the general population, and heavier smoking also leads to more physical problems. Accordingly, psychiatrists in Korea who could effectively apply both psychosocial intervention and pharmacological treatment could practice better smoking cessation programs.