Journal List > Korean J Health Promot > v.15(4) > 1089861

Kim, Choi, and Oak: The Effect of Spiritual Well-Being on Social Nicotine Dependence, Alcohol Consumption, Internet Overuse and Gambling among Medical Students



The purpose of this study is to examine the effect of the spiritual well-being on social nicotine dependence, alcohol consumption, use of internet and gambling among medical students (n=271).


A cross-sectional survey was conducted on 271 medical students using self-administered questionnaires including the spiritual well-being scale, KTSND score, the alcohol use disorder identification test, the internet addiction test, and the Canadian problem gambling index (Korean Version).


: There were significant negative relationships between spiritual well being and addictive behaviors such as social nicotine dependence (r=-0.160, P<0.05), alcohol consumption (r=-0.357, P<0.001), internet overuse (r=-0.156, P<0.01). High social nicotine dependence was related with high alcohol consumption (r= 0.317, P<0.01), as well as internet overuse with gambling (r=0.165, P<0.01). Spiritual well being on was significantly related to alcohol consumption (β=-0.244, P<0.01) and use of internet (β=-0.136, P<0.01). This suggests the higher spiritual well being score the student has, the lower possibility of alcohol or internet overuse he or she tends to have. On the other hand, the impact of spiritual well being on social nicotine dependence or gambling were not significant.


The milestone of the current study is to provide the importance of better understanding of spiritual background of an individual, and to address the necessity of its holistic approach. Moreover, new spiritual counseling model and its healing program should be developed and validated before application.


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Table 1.
Background characteristics of subjects
Characteristics Value
Sex Male 190 (70.1)
Female 81 (29.9)
Marital status Unmarried 268 (98.9)
Married 2 (0.7)
Other 1 (0.4)
Grade Premedical 1st 52 (19.2)
Premedical 2nd 36 (13.3)
Medical 1st 52 (19.2)
Medical 2nd 50 (18.5)
Medical 3rd 39 (14.4)
Medical 4th 42 (15.5)
Smoking status Current smoker 39 (14.4)
Past smoker 26 (9.6)
Never smoker 206 (76.0)
Religion Christian 81 (29.9)
Buddhist 16 (5.9)
Catholicism 17 (6.3)
No religion 153 (56.5)
Others 3 (1.1)
Unkonwn value 1 (0.04)

Values are presented as number (%).

Table 2.
The difference of spiritual well-being, smoking, alcohol consumption, use of Internet and gambling according to demographic characteristics
Spiritual well-being Social Nicotine dependence Alcohol consumption Use of Internet Gambling
Datum score 6 30 40 80 27
Overall average (standard deviation) 3.51±0.89 13.30±5.06 9.61±7.23 40.32±12.22 1.08±2.98
Sex Male 3.41±0.84 14.02±4.94 10.50±7.12 41.47±12.27 1.30±0.54
Female 3.74±0.96 11.60±4.92 7.54±7.10 37.63±11.73 3.22±2.27
T (p-value) -2.868 (0.007)b 3.684 (0.000)c 3.132 (0.002)b 2.432 (0.016)a 1.939 (0.053)
Religion Christian 4.33d±0.87 11.88d±4.87 6.16d±7.39 40.03±12.42 1.04±2.75
Buddhist 3.24d±0.61 12.18±4.21 12.56d±8.72 39.31±15.07 0.68±1.40
Catholicism 3.60d±0.67 15.11±5.91 11.00±6.49 38.11±11.29 1.23±2.88
No religion 3.08d±0.60 13.92d±5.04 11.00d±6.50 40.59±12.03 1.14±3.25
Others 3.38±0.45 14.33±1.52 10.00±4.35 47.00±3.60 0.00±0.00
F (p-value) 42.368 (0.000)c 3.009 (0.019)a 7.511 (0.000)c 0.415 (0.797) 0.197 (0.940)
Smokingstatus Current smoker 3.28±0.64 16.92d±4.17 15.43d±8.35 39.41±11.35 2.15d±3.98
Past smoker 3.50±0.88 16.57d±3.81 12.20±7.76 42.19±13.74 0.53±0.88
Never smoker 3.55±0.92 12.19d±4.85 8.18d±6.25 40.25±12.21 0.94d±0.92
F (p-value) 1.431 (0.241) 23.793 (0.000)c 21.114 (0.000)c 0.414 (0.661) 3.245 (0.041)a
Grade Premedical 1st 3.60±0.86 12.84±5.64 10.98±7.75 38.92±11.18 0.65±1.67
Premedical 2nd 3.33±0.78 13.50±4.69 11.41±6.66 40.58±11.81 1.00±2.17
Medical 1st 3.62±0.92 14.07±4.74 9.05±8.24 41.76±13.90 1.44±3.66
Medical 2nd 3.41±0.99 12.68±5.73 9.02±6.71 42.16±12.68 1.00±3.13
Medical 3rd 3.62±0.94 13.48±4.26 8.71±7.44 37.46±11.97 1.20±3.11
Medical 4th 3.40±0.78 13.28±4.91 8.61±5.82 40.50±11.20 1.19±3.59
F (p-value) 0.936 (0.458) 0.497 (0.778) 1.233 (0.294) 0.940 (0.455) 0.401 (0.848)

a p<0.05.

b p<0.01.

c p<0.001.

d Significant difference on post hoc test.

Table 3.
Correlation analysis of spiritual well-being, smoking, alcohol consumption, use of Internet and gambling
Spiritual well-being Social nicotine dependence Alcohol consumption Use of Internet Gambling
Spiritual well-being 1.00 1.00 1.00 1.00 1.00
Social nicotine dependence -0.160a 0.317a 0.073 0.165a
Addictions of alcohol -0.357b -0.014 0.102
Addictions of internet -0.156a -0.009
Addictions of gamble -0.090

a p<0.01.

b p<0.001.

Table 4.
The hierarchical regression analysis of spiritual well-being, social nicotine dependence, alcohol consumption, use of internet and gambling
Independent variable Dependent variables: Social nicotine dependence
Model 1 Model 2
B SE β t B SE β t
Sex 1.578 0.655 0.143 2.407a 1.529 0.662 0.139 2.310a
Smoking status 3.528 0.854 0.245 4.130c 3.520 0.885 0.245 4.115c
Religion 1 -0.157 0.884 -0.015 -0.178 -0.008 0.896 -0.008 -0.089
Religion 2 -1.422 0.958 -0.129 -1.484 -1.207 1.030 -0.109 -1.173
Spiritual well being -0.239 0.419 -0.042 -0.570
R2=0.129 Corrected R2=0.116 F=9.839c R2=0.130 Corrected R2=0.114 F=7.916c
Independent variable Dependent variables: Addiction of alcohol
Model 1 Model 2
B SE β t B SE β t
Sex 1.501 0.900 0.095 1.667 1.097 0.889 0.070 1.234
Smoking status 5.675 1.173 0.276 4.838c 5.607 1.149 0.273 4.881c
Religion 1 0.546 1.214 0.037 0.450 1.189 1.203 0.082 0.988
Religion 2 -4.782 1.315 -0.303 -3.636c -3.009 1.383 -0.191 -2.176a
Spiritual well being -1.980 0.563 -0.244 -3.51b
R2=0.196 Corrected R2=0.184 F=16.201c R2=0.232 Corrected R2=0.218 F=15.987c
Independent variable Dependent variables: Addiction of internet
Model 1 Model 2
B SE β t B SE β t
Sex 3.839 1.607 0.144 2.388a 3.216 1.620 0.121 1.986a
Spiritual well being -1.858 0.833 -0.136 -2.231a
R2=0.021 Corrected R2=0.017 F=5.704a R2=0.039 Corrected R2=0.031 F=5.383b
Independent variable Dependent variables: Addiction of gamble
Model 1 Model 2
B SE β t B SE β t
Smoking status 1.192 0.510 0.149 2.464a 1.192 0.512 0.141 2.326a
Spiritual well being -0.254 0.202 -0.076 -1.255
R2=0.022 Corrected R2=0.018 F=6.071a R2=0.028 Corrected R2=0.021 F=3.830a

Sex: Male=1, Female=0. Smoking status: Current smoking 1, Others=0. Religion 1: Yes=1, No=0. Religion 2: Christian=1, Others=0. Model 1 is the effect of Demographic characteristics (Selection of significan variables on T-test and Anova anaysis) to dependent variables. Model 2 is the Demographic characteristics (Selection of significan variables on T-test and Anova anaysis) and effect of spiritual well being to dependent variables.

a p<0.05.

b p<0.01.

c p<0.001.

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