Factors associated with Intermittent and Light Smoking among Korean High School Students: Intermittent and Light Smoking among Korean Adolescents

Jin Suk Ra; Hye Sun Kim; Yoon Hee Cho

doi:10.12799/jkachn.2018.29.1.33

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Ra, Kim, and Cho: Factors associated with Intermittent and Light Smoking among Korean High School Students: Intermittent and Light Smoking among Korean Adolescents

Original Article

J Korean Acad Community Health Nurs 2018;29(1):33-40.

Published online: 12 March 2018

DOI: https://doi.org/10.12799/jkachn.2018.29.1.33

Factors associated with Intermittent and Light Smoking among Korean High School Students: Intermittent and Light Smoking among Korean Adolescents

Jin Suk Ra¹, Hye Sun Kim¹, Yoon Hee Cho²

¹College of Nursing, Chungnam National University, Daejeon, Korea

²College of Nursing, Dankook University, Cheonan, Korea

Corresponding author: Cho, Yoon Hee College of Nursing, Dankook University, 119 Dandae-ro, Dongnam-gu, Cheonan 31116, Korea. Tel: +82-41-550-3886, Fax: +82-41-559-7902, E-mail: choyoonhee@dankook.ac.kr

Received 16 August 2017 Revised 26 December 2017 Accepted 26 January 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to identify factors associated with intermittent and light smoking among Korean high school students.

Methods

In this cross-sectional study, we employed secondary data from the 2015 Korea Youth Risk Behavior Web-Based Survey, and used the biopsychosocial model as a framework. The analysis was performed using the data of 2,851 high school students who smoked. We defined intermittent and light smoking as smoking on 1 to 29 days in a 30-day period and no more than 10 cigarettes per day. A logistic regression analysis using the complex samples procedure was conducted.

Results

Among all the participants, 1,231 (43.2%) were intermittent and light smokers. Factors significantly predicting intermittent and light smoking were gender and grade (biological factors); subjective stress (psychological factor); and mother's smoking, sibling's smoking and academic achievement (sociocultural factors).

Conclusion

In smoking cessation programs, health care providers both at school and in the community should consider the unique biological, psychological, and sociocultural characteristics of intermittent and light smoking behavior among high school students.

Keywords: Students, Smoking, Smoking cessation

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Table 1.

Measurement of Biopsychosocial Factors

Variables		Measurement
Biological factors	Gender	Male or Female
	Grade	1^st, 2^nd, or 3^rd
Psychological factors	Perceived health status	Subjects responded to a question on their perceived health status (with possible responses of very healthy, healthy, fair, unhealthy, or very unhealthy). They were reclassified as healthy, fair, or poor
	Subjective stress	Subjects responded to a question on subjective stress (with possible responses of extremely high stress, high stress, low stress, almost none, not at all). They were subsequently classified as having “high stress,” “low stress,” and “no stress”
	Depressive symptoms	Subjects responded to a question asking if they had felt sad or hopeless during the past 12 months (with possible responses of yes or no)
	Alcohol consumption	Subjects responded to a question about whether they had drank alcohol in the past 30 days (with possible responses of yes or no)
Sociocultural factors	Family socioeconomic status	Subjects responded to a question on their perceived household economic status. They were then reclassified as high, middle, and low
	Father's education level	Subjects responded to a question about their father's education level (with possible responses of less than middle school, high school graduation, and above college)
	Mother's education level	Subjects responded to a question about their mother's education status (with possible responses of less than middle school, high school graduation, and above college)
	Father's smoking	Subjects indicated whether their father smoked or not
	Mother's smoking	Subjects indicated whether their mother smoked or not
	Sibling's smoking	Subjects indicated whether a brother or sister smoked or not
	Exposure to secondhand smoking at home	Subjects indicated whether they had been exposed to secondhand smoking related to their family at home during the past 7 days or not
	Close friends' smoking	Subjects indicated how many close friends smoked (with possible responses of all, most, some, or none)
	Observing teachers and other staff smoking at school	Subjects responded whether school employees smoked at school or not.
	Academic achievement	Subjects ranked their academic achievement as high, upper-middle, middle, lower-middle, and low based on their own grade. They were subsequently reclassified as high, middle, or low
	Participation in anti-smoking education	Subjects responded with whether they had received education for smoking prevention and cessation during classes in the last year or not.

Table 2.

Characteristics of Biological, Psychological, and Sociocultural Factors (N=2,851)

Variables	Categories	Intermittent and light smoker (n=1,231)	Intermittent and heavy smokers (n=86)	Daily and light smokers (n=1,109)	Daily and heavy smokers (n=425)
Variables	Categories	n^†(%)^‡	n^†(%)^‡	n^†(%)^‡	n^†(%)^‡
Biological factors
Gender	Male	989 (80.2)	65 (77.1)	931 (84.3)	354 (83.7)
	Female	242 (19.8)	21 (22.9)	178 (15.7)	71 (16.3)
Grade	1^st	355 (29.1)	30 (34.4)	219 (19.1)	96 (22.8)
	2^nd	405 (32.4)	22 (26.1)	395 (35.4)	142 (34.9)
	3^rd	471 (38.5)	34 (39.5)	495 (45.5)	187 (42.3)
Psychological factors
Perceived health status	Healthy	877 (72.3)	58 (68.4)	771 (68.5)	294 (68.7)
	Fair	274 (21.8)	19 (20.7)	263 (24.2)	84 (19.1)
	Poor	80 (5.9)	9 (10.9)	75 (7.3)	47 (12.2)
Subjective stress	High	500 (41.2)	38 (40.3)	480 (43.9)	209 (47.6)
	Low	535 (42.8)	31 (41.0)	438 (39.6)	142 (33.4)
	None	196 (16.0)	17 (18.7)	191 (16.5)	74 (19.0)
Depressive symptoms (in a year)	Yes	401 (33.6)	50 (53.1)	398 (35.9)	186 (44.2)
	No	830 (66.4)	36 (46.9)	711 (64.1)	239 (55.8)
Alcohol consumption (in 30 days)	Yes	807 (64.9)	66 (74.3)	833 (75.0)	366 (84.3)
	No	424 (35.1)	20 (25.7)	276 (25.0)	59 (15.7)
Sociocultural factors
Family socioeconomic status	High	392 (33.0)	34 (42.9)	340 (32.0)	165 (38.9)
	Middle	558 (44.1)	30 (34.5)	511 (45.1)	156 (37.1)
	Low	281 (22.9)	22 (22.6)	258 (22.9)	104 (24.0)
Father's educational level	≤Middle school	59 (4.6)	8 (11.7)	63 (4.8)	29 (7.0)
	High school	558 (42.7)	36 (35.7)	505 (44.5)	208 (45.8)
	≥College	614 (52.7)	42 (52.6)	541 (50.7)	188 (47.2)
Mother's educational level	≤Middle school	36 (2.9)	9 (8.5)	52 (4.3)	23 (6.0)
	High school	687 (55.3)	43 (54.1)	625 (56.3)	240 (52.6)
	≥College	508 (41.8)	34 (37.4)	432 (39.4)	162 (41.4)
Father's smoking	Yes	584 (46.9)	29 (33.9)	575 (51.3)	224 (49.7)
	No	647 (53.1)	57 (66.1)	534 (48.7)	201 (50.3)
Mother's smoking	Yes	54 (4.2)	10 (8.5)	83 (7.2)	50 (10.8)
	No	1,177 (95.8)	76 (91.5)	1,026 (92.8)	375 (89.2)
Sibling's smoking	Yes	160 (12.5)	15 (16.2)	160 (14.6)	91 (19.9)
	No	1,071 (87.5)	71 (83.8)	949 (85.4)	334 (80.1)
Exposure of second handed smoking at home	Yes	478 (38.1)	57 (66.4)	430 (37.0)	210 (48.8)
	No	753 (61.9)	29 (33.6)	679 (63.0)	215 (51.2)
Smoking of close friend	All	43 (3.6)	28 (35.7)	166 (14.7)	153 (37.1)
	Most	468 (38.3)	36 (40.6)	674 (60.8)	221 (49.2)
	Some	671 (54.1)	17 (18.6)	243 (21.8)	41 (10.6)
	None	49 (4.0)	5 (5.1)	26 (2.7)	10 (3.1)
Observing teachers and other staff smoking at school	Yes	674 (55.3)	63 (74.9)	694 (64.4)	293 (67.2)
	No	557 (44.7)	23 (25.1)	415 (35.6)	132 (32.8)
Academic achievement	High	338 (27.8)	25 (29.4)	230 (20.0)	102 (23.2)
	Middle	332 (26.9)	23 (32.7)	281 (26.7)	79 (19.9)
	Low	561 (45.3)	38 (37.9)	598 (53.3)	244 (56.9)
Participation in anti-smoking education (in a year)	Yes	737 (58.6)	34 (39.4)	667 (58.6)	244 (56.9)
	No	494 (41.4)	52 (60.6)	442 (41.4)	181 (43.1)

^† Under weighted;

^‡ Weighted.

Table 3.

Associated Factors on Intermittent and Light Smoking among High School Students (N=2,851)

Variables		Categories	OR	95% CI	p
Biological factors	Gender (Ref.: male)	Female	1.53	1.23~1.90	＜.001
	Grade (Ref.: 3^rd)	2nd	1.09	0.90~1.32	.400
		1st	1.56	1.29~1.90	＜.001
Psychological factors	Perceived health status (Ref.: poor)	Fair	1.39	0.98~1.96	.062
		Healthy	1.21	0.66~2.24	.543
	Subjective stress (Ref.: none)	Low	1.16	0.98~1.37	.088
		High	1.46	1.23~1.72	＜.001
	Depressive symptoms (in a year) (Ref.: no)	Yes	1.15	0.99~1.35	.074
	Alcohol consumption (in 30 days) (Ref.: no)	Yes	0.85	0.32~2.29	.748
Sociocultural factors	Family socioeconomic status (Ref.: low)	Middle	0.89	0.73~1.08	.234
		High	0.48	0.11~2.08	.324
	Father's educational level	High school	1.03	0.72~1.48	.878
	(Ref.: less than middle school)	Above college	1.11	0.77~1.59	.580
	Mother's educational level	High school	1.05	0.87~1.27	.604
	(Ref.: less than middle school)	Above college	0.63	0.39~1.01	.053
	Father's smoking (Ref.: no)	Yes	1.04	0.89~1.21	.633
	Mother's smoking (Ref.: no)	Yes	1.96	1.36~2.82	＜.001
	Sibling's smoking (Ref.: no)	Yes	1.27	1.02~1.58	.035
	Exposure to secondhand smoking at home (Ref.: no)	Yes	1.01	0.85~1.20	.882
	Close friend's smoking (Ref.: no)	Yes	1.16	0.76~1.78	.489
	Observing teachers and other staff smoking	Yes	0.88	0.70~1.10	.259
	at school (Ref.:no)
	Academic achievement (Ref.: low)	Middle	1.25	1.05~1.50	.014
		High	1.62	1.32~1.98	＜.001
	Participation in anti-smoking education (in a year) (Ref.: no)	Yes	0.92	0.78~1.07	.275

Ref.=reference; OR=odds ratio; CI=confidence interval.

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