簡易檢索 / 詳目顯示

研究生: 劉美媛
Meei-Yuan Liou
論文名稱: 台北市某高職學生吸菸行為之探討─跨理論模式之應用
Application of the Transtheoretical Model to smoking behavior among a vocational high school students in Taipei city.
指導教授: 呂昌明
Lu, Chang-Ming
學位類別: 博士
Doctor
系所名稱: 健康促進與衛生教育學系
Department of Health Promotion and Health Education
論文出版年: 2006
畢業學年度: 94
語文別: 中文
論文頁數: 193
中文關鍵詞: 跨理論模式吸菸行為高職學生
英文關鍵詞: transtheoretical model, smoking behavior, vocational high school student
論文種類: 學術論文
相關次數: 點閱:211下載:83
分享至:
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報
  • 本研究目的乃是應用跨理論模式,探討台北市某高職學生的吸菸行為,以瞭解其吸菸階段分期及不同吸菸階段與改變方法、自我效能及決策權衡的相關。以台北市某高職學生為對象,採隨機集束抽樣方法進行抽樣,最後取得有效樣本1095份,回應率為93.7%。
    結果如下:
    一、本研究對象目前吸菸率為20.6%,男生吸菸率為25.6%,女生為6.4%。有7.9%已戒菸,男生已戒菸率是8.8%,女生是5.0%。共有71.5%未曾吸菸,其中有4.0%想嘗試吸菸。目前吸菸者中,有58.0%有意願戒菸。在已戒菸者中,有75%已持續戒菸六個月以上。
    二、不同吸菸階段的研究對象,在戒菸改變方法、拒菸自我效能/誘惑、吸菸決策權衡方面,皆有顯著差異。
    1.依據所處的吸菸戒除階段,在意圖戒除期給予意識覺醒、情感喚起、自我再評價,在準備戒除期強調增強管理、刺激控制,至於在戒除行動期已經戒菸的青少年,則十種方法皆可採用,而已經戒菸六個月以上者,則除了意識覺醒外,其餘九種方法皆很常用。在推展菸害防制時,如能依據青少年所處的吸菸階段,採用特定的戒菸改變方法,可增加戒菸介入計畫的成效,促使青少年戒菸,達到成功戒菸的目的。
    2.在吸菸戒除階段,各種拒菸自我效能/誘惑情境下的得分皆以無意圖戒除期的得分最高,在戒除維持期最低,呈線性降低的趨勢。處於無意圖戒除期者較易受菸癮/習慣的誘惑,已戒菸六個月以上者,則體重控制的誘惑程度最高,受到菸癮/習慣的誘惑最小。在無意圖戒除期者自覺吸菸的好處高於壞處,在意圖戒除期與準備戒除期者,認為吸菸的壞處稍為高於吸菸的好處,到了戒除維持期,自覺吸菸的壞處遠大於好處。研究對象自覺吸菸適應好處與吸菸社會好處的看法相近似。
    3.在吸菸獲得階段,想嘗試吸菸者各類情境下之誘惑度都增加,其中以正向社交情境之誘惑最大,體重控制的誘惑最小。在無意圖嘗試期吸菸決策權衡達到平衡,對吸菸壞處、好處之同意度相等,但想嘗試吸菸者則較同意吸菸之好處,包括吸菸的適應好處與吸菸的社會好處,認為吸菸所帶來的好處高於壞處。
    研究結果支持跨理論模式的有用性,並提供教育者作為發展不同吸菸階段介入以促進菸害防制的參考。

    The purpose of this study was to assess the relationships of the stages of change with processes of change, self-efficacy/temptation and decisional balance, and to examine the utility of the transtheoretical model in understanding smoking behavior. A random clustered sample of 1095 was recruited from a vocational high school in Taipei city.
    Findings showed that current smoking prevalence was 20.6%, 25.6% among boys and 6.4% among girls. The percent of already quitting smoking was 7.9%, 8.8% among boys and 5.0% among girls. The rate of never smokers was71.5%, 4.0% of never smokers were planning to try smoking. 58.0% of current smokers were contemplating quitting, 75% of former smokers were long-term quitters (> 6 months).
    Subjects in acquisition and cessation stages were compared on 10 processes of change, self efficacy/temptation and decisional balance. Results strongly support the transtheoretical model. Results indicate that smokers : (a) use the fewest processes of change during precontemplation stage; (b) emphasize consciousness raising, dramatic relief and self-reevaluation during the contemplation stage; (c) emphasize reinforcement management and stimulus control in preparation stage; (d) use all 10 process activities during the action stage; and (e) use all 10 process activities except consciousness raising in maintenance stage.
    Participants in acquisition precontemplation scored the lowest and those in cessation precontemplation scored the highest on the self-efficacy/temptation, benefit and decisional balance indices, with the trend reversed on the cons (disadvantages) scale. Smokers at cessation-precontemplation stage were most tempted by habit strength. Exsmokers at cessation- maintenance stage were most tempted by weight control and least tempted by habit strength.
    Never smokers were most tempted to try smoking when they anticipated that smoking would help increase positive social mood, and least tempted when they anticipated that smoking would help control body weight.
    These findings offer support for the transtheoretical model to apply in the antismoking programs, and implications for use of the findings by educator in developing stage-based interventions.

    書名頁 i 論文口試委員審定書 ii 授權書 iii 誌謝 iv 中文摘要 vi 英文摘要 vii 目錄 x 表目錄 xii 圖目錄 xv 第一章 緒論 1 第一節 研究動機及重要性 1 第二節 研究目的 5 第三節 研究問題 6 第四節 研究假設 6 第五節 名詞界定 7 第六節 研究限制 9 第二章 文獻探討 10 第一節 青少年吸菸概況及相關因素的探討 10 第二節 跨理論模式(Transtheoretical Model, TTM) 16 第三節 跨理論模式在吸菸行為的應用 27 第三章 材料與方法 37 第一節 研究設計 37 第二節 研究對象與抽樣方法 38 第三節 研究工具 38 第四節 研究步驟 47 第五節 資料處理與分析 49 第四章 結果 51 第一節 研究對象基本資料分析 51 壹、 研究對象一般概況 51 貳、 吸菸階段分佈 51 參、 吸菸狀況及親友吸菸情形 52 肆、 社會心理變項 53 第二節 個人背景因素與吸菸階段的關係 69 壹、 社會人口學變項與吸菸戒除階段的關係 69 貳、 社會人口學變項與吸菸獲得階段的關係 70 參、 親友吸菸情況與吸菸戒除階段的關係 70 肆、 親友吸菸情況與吸菸獲得階段的關係 71 伍、 目前吸菸者之吸菸行為相關變項與吸菸戒除階段的關係 71 第三節 個人背景因素與社會心理變項的關係 78 壹、 性別與社會心理變項的關係 78 貳、 年齡與社會心理變項的關係 79 參、 年級與社會心理變項的關係 79 肆、 學期成績與社會心理變項的關係 80 伍、 曾經工作、打工與社會心理變項的關係 81 陸、 有無參加學校社團與社會心理變項的關係 82 柒、 親友吸菸與社會心理變項的關係 83 捌、 菸癮強度與社會心理變項的關係 89 玖、 吸菸頻率與社會心理變項的關係 89 拾、戒菸次數與社會心理變項的關係 90 拾壹、第一次吸菸年齡與社會心理變項的關係 90 第四節 社會心理變項與吸菸階段的關係 122 壹、 改變方法與吸菸戒除階段的關係 122 貳、 拒菸自我效能/誘惑與吸菸階段的關係 124 參、 吸菸決策權衡與吸菸階段的關係 127 肆、 拒菸改變方法、拒菸自我效能/誘惑及吸菸決策權衡等TTM社會 心理變項與吸菸階段的關係 131 第五章 討論 152 第一節 吸菸階段的分佈 152 第二節 社會人口學變項與吸菸階段的關係 155 第三節 吸菸行為相關變項、親友吸菸狀況與吸菸戒除階段的關係 155 第四節 戒菸改變方法與吸菸戒除階段的關係 157 第五節 拒菸自我效能/誘惑與吸菸階段的關係 159 第六節 吸菸決策權衡與吸菸階段的關係 161 第七節 研究限制 164 第六章 結論與建議 166 第一節 結論 166 第二節 建議 167 參考文獻 170 附錄一: 問卷內容效度審查專家學者名單 187 附錄二: 吸菸行為問卷 188 表 目 錄 表1 以TTM研究吸菸行為所用之改變階段之定義及測量標準 19 表2 戒菸改變方法與吸菸階段的關係 23 表3-1 開放式引導問卷題目及目的 39 表3-4-1 戒菸改變方法量表及次量表之內在一致性信度分析 46 表3-4-2 拒菸自我效能/誘惑量表及次量表之內在一致性信度分析 46 表3-4-3 吸菸決策權衡量表及次量表之內在一致性信度分析 47 表3-2 研究目的、研究問題與統計方法一覽表 50 表4-1-1 研究對象基本資料 60 表4-1-2 研究對象吸菸階段:獲得階段及戒除階段 60 表4-1-3 研究對象吸菸階段:獲得階段及戒除階段性別比 61 表4-1-4 研究對象之吸菸盛行率 61 表4-1-5 目前吸菸者之菸癮強度、吸菸頻率 62 表4-1-6 目前吸菸者、已戒菸者之戒菸次數、第一次吸菸年齡 62 表4-1-7 研究對象親友目前之吸菸情形 63 表4-1-8 研究對象各項戒菸改變方法得分表 63 表4-1-9 研究對象戒菸經驗性改變方法次量表 64 表4-1-10 研究對象戒菸行為性改變方法次量表 65 表4-1-11 研究對象吸菸決策權衡量表 66 表4-1-12 吸菸者、已戒菸者之拒菸自我效能/誘惑量表 67 表4-1-13 從不吸菸者、只哈過幾口者之拒菸自我效能/誘惑量表 68 表4-2-1 社會人口學變項與吸菸戒除階段與之關係 73 表4-2-2 社會人口學變項與吸菸獲得階段之關係 74 表4-2-3 親友吸菸情況變項與吸菸戒除階段之關係 75 表4-2-4 親友吸菸情況變項與吸菸獲得階段之關係 76 表4-2-5 目前吸菸者之菸癮強度、吸菸頻率與吸菸戒除階段之關係 77 表4-2-6 目前吸菸者、已戒菸者之戒菸次數及第一次吸菸年齡與吸菸 戒除階段之關係 77 表4-3-1 吸菸者、已戒菸者之性別與社會心理變項之關係 92 表4-3-2 從不吸菸者、只哈過幾口菸者之性別與社會心理變項之關係 93 表4-3-3 吸菸者、已戒菸者之年齡與社會心理變項之關係 94 表4-3-4 從不吸菸者、只哈過幾口菸者之年齡與社會心理變項之關係 95 表4-3-5 吸菸者、已戒菸者之年級與社會心理變項之關係 96 表4-3-6 從不吸菸者、只哈過幾口菸者之年級與社會心理變項之關係 97 表4-3-7 吸菸者、已戒菸者之學期成績與社會心理變項之關係 98 表4-3-8 從不吸菸者、只哈過幾口菸者之學期成績與社會心理變項之關係 99 表4-3-9 吸菸者、已戒菸者之曾經工作(打工)過與社會心理變項之關係 100 表4-3-10 從不吸菸者、只哈過幾口菸者之曾經工作(打工)過與社會心理 變項之關係 101 表4-3-11 吸菸者、已戒菸者之參加學校社團與社會心理變項之關係 102 表4-3-12 從不吸菸者、只哈過幾口菸者之參加學校社團與社會心理變項 之關係 103 表4-3-13 吸菸者、已戒菸者之父親與社會心理變項之關係 104 表4-3-14 從不吸菸者、只哈過幾口菸者之父親與社會心理變項之關係 105 表4-3-15 吸菸者、已戒菸者之母親與社會心理變項之關係 106 表4-3-16 從不吸菸者、只哈過幾口菸者之母親與社會心理變項之關係 107 表4-3-17 吸菸者、已戒菸者之哥哥與社會心理變項之關係 108 表4-3-18 從不吸菸者、只哈過幾口菸者之哥哥與社會心理變項之關係 109 表4-3-19 吸菸者、已戒菸者之弟弟與社會心理變項之關係 110 表4-3-20 從不吸菸者、只哈過幾口菸者之弟弟與社會心理變項之關係 111 表4-3-21 吸菸者、已戒菸者之姊姊與社會心理變項之關係 112 表4-3-22 從不吸菸者、只哈過幾口菸者之姊姊與社會心理變項之關係 113 表4-3-23 吸菸者、已戒菸者之妹妹與社會心理變項之關係 114 表4-3-24 從不吸菸者、只哈過幾口菸者之妹妹與社會心理變項之關係 115 表4-3-25 吸菸者、已戒菸者之同學朋友與社會心理變項之關係 116 表4-3-26 從不吸菸者、只哈過幾口菸者之同學朋友與社會心理變項之關係 117 表4-3-27 吸菸者之菸癮強度與社會心理變項之關係 118 表4-3-28 吸菸者之吸菸頻率與社會心理變項之關係 119 表4-3-29 吸菸者、已戒菸者之戒菸次數與社會心理變項之關係 120 表4-3-30 吸菸者、已戒菸者之第一次吸菸年齡與社會心理變項之關係 121 表4-4-1 不同吸菸戒除階段在戒菸改變方法之多變項變異數分析摘要表 134 表4-4-2 吸菸者、已戒菸者之戒菸改變方法在吸菸戒除階段上的差異 135 表4-4-3 各吸菸戒除階段使用頻率較高的拒菸改變方法 138 表4-4-4 不同吸菸戒除階段在拒菸自我效能/誘惑之多變項變異數分析摘要表 139 表4-4-5 吸菸者、已戒菸者之拒菸自我效能/誘惑在吸菸戒除階段上的差異 139 表4-4-6 不同吸菸獲得階段在拒菸自我效能/誘惑之多變項變異數分析摘要表 141 表4-4-7 從不吸菸者、只哈過幾口者之拒菸自我效能/誘惑在吸菸獲得階段 上的差異 141 表4-4-8 不同吸菸戒除階段在吸菸決策權衡之多變項變異數分析摘要表 145 表4-4-9 吸菸者、已戒菸者之吸菸決策權衡在吸菸戒除階段上的差異 145 表4-4-10 不同吸菸獲得階段在吸菸決策權衡之多變項變異數分析摘要表 147 表4-4-11 從不吸菸者、只哈過幾口者之吸菸決策權衡在吸菸獲得階段上的 差異 147 表4-4-12 不同吸菸戒除階段在TTM社會心理變項之多變項變異數分析 摘要表 150 表4-4-13 不同吸菸獲得階段在TTM社會心理變項之多變項變異數分析 摘要表 15 圖 目 錄 圖1 吸菸獲得階段及戒除階段說明圖 8 圖3-1 研究架構圖 37 圖4-4-1 經驗性改變方法與吸菸戒除階段之關係 136 圖4-4-2 行為性改變方法與吸菸戒除階段之關係 137 圖4-4-3 戒菸改變方法與吸菸戒除階段之關係 137 圖4-4-4 吸菸者、已戒菸者之拒菸自我效能/誘惑與吸菸戒除階段之關係 140 圖4-4-5 不吸菸者、只哈過幾口菸者之拒菸自我效能/誘惑與吸菸獲得階段 之關係 142 圖4-4-6 在吸菸獲得階段之男女性之負向情緒情境T值線形圖 142 圖4-4-7 在吸菸獲得階段之男女性之好奇T值線形圖 143 圖4-4-8 在吸菸獲得階段之男女性之體重控制T值線形圖 144 圖4-4-9 吸菸者、已戒菸者之吸菸決策權衡與吸菸戒除階段之關係 146 圖4-4-10 不吸菸者、只哈過幾口菸者之吸菸決策權衡與吸菸獲得階段之 關係 148 圖4-4-11 在吸菸獲得階段之男女性之自覺吸菸社會好處T值線形圖 149

    呂昌明、郭曉文、王淑芳、林旭龍、李碧霞(2003):應用跨理論模式於學童母親運動行為之研究。衛生教育學報,19,57-70。
    李淑卿(2003):戒菸教育計劃介入成效之研究─以台北縣某技術學院學生為對象。台北:國立台灣師範大學碩士論文(未出版)。
    李景美、張鳳琴、賴香如、李碧霞、陳雯昭(2002):台北縣高職一年級學生成癮物質濫用之危險與保護因子研究。衛生教育學報,17,73-88。
    李碧霞、吳德敏、祝年豐、賴香如、趙國欣、李欣憶等(2004) :宜蘭縣九所國、高中職學生吸菸行為之影響因素研究。衛生教育學報,22,21-39。
    李蘭、潘怜燕(2000):台灣地區成年人之吸菸率與吸菸行為:八十八年度之全國性調查。 中華公共衛生雜誌,19(6),423-436。
    李蘭、潘怜燕、晏涵文、李隆安(1994):台灣地區成年人之吸菸現況:盛行率及危險因子。中華公共衛生雜誌,13(4),371-380。
    林宜蕙(2005):學生戒菸教育計劃成效之研究─以台北市立某高級中學為例。台北:國立台灣師範大學碩士論文(未出版)。
    林旭龍、呂昌明(2002):應用改變階段模式於大學女生身體活動之研究─改變階段模式之效度。衛生教育學報,18,127-140。
    林旭龍、呂昌明 (2001):應用改變階段模式於運動行為之研究─以大學女生為例。衛生教育學報,16,19-34。
    姜逸群、黃雅文、黃春太(2003):台灣地區國中生物質濫用行為及相關因素之研究。衛生教育學報,20,89-109。
    黃松元、馬藹屏(2002):學校菸害防制教育介入計畫。台灣菸害防制研討會。
    黃淑貞(1997):大學生健康信念、自我效能、社會支持與吸菸行為研究。學校衛生,31,30-44。
    黃婉茹(2002):應用跨理論模式於職場女性運動行為之研究─以行政院及其所屬主管機關女性公務人員為例。台北:國立台灣師範大學碩士論文(未出版)。
    陳秀娟(2002):桃園縣高中職學生吸菸行為之相關探討─跨理論模式之應用。台中:中山醫學大學碩士論文(未出版)。
    張明惠(2004):青少年戒菸教育課程介入成效之探討─以台北市某公立高職學生為對象。台北:國立台灣師範大學碩士論文(未出版)。
    國家衛生研究院(2000):吸菸之行為研究。台北市:國家衛生研究院。
    蔡佳宏(2001):應用跨理論模式於老人運動行為之研究─以台北市中山區長青學苑為例。台北:國立台灣師範大學碩士論文(未出版)。
    廖梨伶、劉潔心(2002):運用網際網路於青少年戒菸行為之介入研究。衛生教育學報,17,109-126。
    潘怜燕(2001):有吸菸經驗男性成人之戒菸階段的相關因素探討。台北:國立台灣大學博士論文(未出版)。
    鄭丁原、溫啟邦、蔡孟娟、蔡善璞(2002):國人吸菸行為現況:2001年國民健康調查之分析。台灣衛誌,22(6),453-464。
    劉美媛、呂昌明(2005):探討大一學生的吸菸行為─跨理論模式的應用。衛生教育學報,24,47-70。
    劉潔心、劉貴雲、蔡春美(2000):青少年互動式戒菸自助手冊教材發展及介入效果之初探性研究。衛生教育學報,13,73-89。
    賴香如、吳德敏、邱詩揚、李碧霞、趙國欣、鍾宜君(2004):家長預防措施與子女菸害知識、反菸態度和吸菸行為研究。衛生教育學報,22,41-62。
    謝淑卿、尹祚芊(1996):成人菸害認知與行為衝突之探討。護理研究,4(3),219-230。
    顏效禹(2001):應用跨理論模式在台北市國中生的吸菸行為。台北:國立陽明大學碩士論文(未出版)。
    Anatchkova, M. D., Redding, C. A., & Rossi, J. S. (2006). Development and validation of decisional balance and temptations measures for Bulgarian adolescent smokers. Addictive Behaviors, 31, 155-161.
    Armitage, C.T., Sheeran, P., Conner, M., & Arden, M. (2004). Stages of change or change of stage? Predicting transions in Transtheoretical Model stages in relation to healthy food choice. Journal of Consulting & Clinical Psychology, 72(3), 491-499.
    Ayanian, J. Z., & Cleary, P. D. (1999). Perceived risks of heart disease and cancer among cigarette smokers. JAMA, 281(11), 1019-1021.
    Baer, P.E., Foreyt, J. P., & Wright, S. (1977). Self-directed termination of excessive cigarette use among untreated smokers. Journal of Behavior Therapy and Experimental Psychiatry, 8(1), 71-74.
    Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191-215..
    Bandura, A. (1986). Social foundations of thought and action: A Social Cognitive Theory. Englewood Cliffs, NJ: Prentice-Hall.
    Bauman, K. E., Carver, K., & Gleiter, K. (2001). Trnds in parent and friend influence during adolescence the case of adolescent cigarette smoking. Addictive Behaviors, 26, 349-361.
    Borland, R., Chapman, S., Owen, N., & Hill, D. (1990). Effects of workplace smoking bans on cigarette consumption. American Journal of Public Health, 8092), 178-180.
    Centers for Disease Control and Prevention. (2000, October). Youth tobacco surveillance: United States, 1998-1999. Morbidity and Mortality Weekly Report, 49, NO. SS-10.
    Centers for Disease Control and Prevention. (2001, November). Youth tobacco surveillance: United States, 2000. Morbidity and Mortality Weekly Report, 50, NO. SS-4.
    Chen, H. S., Melanie, S. P., & Sharon, D. H. (2001). Cigarettes: A growing problem for Taiwanese adolescents. Journal of Community Health Nursing, 18(3), 167-175.
    Chen, K., & Kandel, D. B. (1998). Predictors of cessation of marijuana use: an event history analysis. Drug & Alcohol Dependence. 50(2), 109-121.
    Chen P. H., White H.R., & Pandina R.J. (2001). Predictors of smoking cessation from adolescence into young adulthood. Addictive Behaviors, 26, 517-529.
    Chou, P., Liou, M-Y., Lai, M-Y., Hsiao, M-L., & Chang H-J. (1999). Time trend of substance use among adolescent students in Taiwan, 1991-1996. J Formos Med Assoc, 98(12), 827-831.
    Clausen, J. (1968). Socialization and society. Boston: Little Brown.
    Conrad, K. M., Flay, B. R., & Hill, D. (1992). Why children start smoking cigarettes: Predictors of onset. British Journal of Addiction, 87, 1711-1724.
    Covey, L. S., & Tam, D. (1990). Depressive mood, the single-parent home, and adolescent cigarette smoking. American Journal Of Public Health, 80(10), 1330-1333.
    DiClemente, C. C., & Prochaska, J. O. (1982). Self-change and therapy change of smoking behavior: a comparison of processes of change in cessation and maintenance. Addictive Behaviors, 7, 133-142.
    DiClemente, C. C., Prochaska, J. O., & Gibertini, M. (1985). Self-efficacy and stages of self-change of smoking. Cognitive therapy and Research, 9(2), 181-200.
    DiClemente, C. C. (1986). Self-efficacy and the addictive behaviors. Journal of Social and Clinical Psychology, 4, 302-315.
    DiClemente, C. C., Prochaska, J. O., Velicer, W. F., Fairhurst, S., Rossi, J. S., & Velasquez, M. (1991). The process of smoking cessation: an analysis of precontemplation, contemplation and preparation stages of change. Journal Consulting and Clinical Psychology, 59, 295-304.
    Dijkstra, A., Bakker, M., & de Vries. (1997). Subtypes with a sample of precontemplation smokers: A preliminary extensive of the stage of change. Addictive Behaviors, 22(3), 327-337.
    Dino, G., Kamal, K., Horn, K., Kalsekar, I., & Fernandes, A. (2004). Stage of change and smoking cessation outcaomes among adolescents. Addictive Behaviors, 29, 935-940.
    DuRant, R. H., Smith, J. A., Kreiter, S. R., & Krowchuk, D. P. (1999). The relationship between early age of onset of initial substance use and engaging in multiple health risk behaviors among young adolescents. Archives of Pediatrics & Adolescent Medicine, 153(3), 286-291.
    Eissenberg, T., & Baleter, R. L. (2000). Initial tobacco use episodes in children and adolescents: current knowledge, future directions. Drug & Alcohol Dependence, 59) suppl 1), s41-s60.
    Ellickson, P. L., & Hays, R.D. (1990). Belief about resistance self-efficacy drug prevalence: Do they really affect drug use? International Journal of the Addictions, 25, 1353-1378.
    Engles, R. C., Knibbe, R. A., Drop, M. J., & Haan, Y. (1997). Homogeneity of cigarette smoking within peer groups: Influence or selection? Journal of Health and Human Behavior, 24, 801-811.
    Etter, J. F., Perneger, T. V., & Ronchi, A. (1997). Distributions of smokers by stage: International comparison and association with smoking prevalence. Preventive Medicine, 26, 580-585.
    Etter, J. F. (2004). Association between smoking prevalence, stage of change, cigarette consumption, and quit attempts across the United States.. Preventive Medicine, 38, 369-373.
    Everett, S. A., Husten, C. G., Kann, L., Warren, C. W., Sharp, D., & Crossett, L. (1999). Smoking initiation and smoking patterns among US college student. Journal of American College Health, 48(2), 55-60.
    Fagan, P., Eisenberg, M., Frazier, L., Stoddard, A. M., Avrunin, J. S., & Sorensen, G. (2003). Employed adolescents and beliefs about self-efficacy to avoid smoking. Addictive Behaviors, 28, 613-626.
    Fagerstrom K.O., & Schneider N.G. (1989). Measuring nicotine dependence: a review of the Fargestrom Tolerance Questionnaire. Journal of Behavioral Medicine, 12(2), 159-182.
    Fergusson, D. M., Horwood, J. (1995). Transitions to cigarette smoking during adolescence. Addictive Behaviors, 20(5), 627-642.
    Flay, B. R., Hu, F. B., & Richardson, J. (1998). Psychosocial predictors of different stages of cigarette smoking among high school students. Preventive Medicine, 27, A9-A19.
    French, S. A., & Jeffery, R. W. (1995). Weight concerns and smoking: a literature review. Annals of Behavioral Medicine, 17, 234-244.
    French, S. A., & Perry, C. L. (1996). Smoking among adolescent girl: Prevalence and etiology. Journal of American Women’s Association, 51, 25-28.
    Gilpin, E. A., Choi, W. S., Berry, C., & Pierce, J. P. (1999). How many adolescents start smoking each day in the United Stated States? Journal of Adolescent Health, 25(4), 248-255.
    Graham, J. W., Marks, G., & Hansen, W. B. (1991). Social influence process affecting adolescent substance use. Journal of Applied Psychology, 76, 291-298.
    Griffin, K. W., Botvin, G. J., Doyle, M. M., Diaz, T., & Epstein, J. A. (1999). A six-year follow-up study of determinants of heavy cigarette smoking among high-school seniors. Journal of Behavioral Medicine, 22(3), 271-284.
    Guillot, J., Kilpatrick, M., Hebert, E., & Hollander, D. (2004). Applying the Transtheoretical Model to exercise adherence in clinical settings. American Journal of Health Studies, 19(1), 1-10.
    Hahn, G., Sussman, S., Dent, C. W., Manzi, J., Stacy, A. W., Flay, B. F., Hansen, W. B., & Burton, D. (1990). Adolescents’ first and most recent use situations of smokeless tobacco and cigarettes: Similarities and differences. Addictive Behaviors, 15, 439-448.
    Harrison, L. D. (1992). Trends in illicit drug use in the United States: Conflicting results from national surveys. International Journal of the Addictions, 27(7), 817-847.
    Hirschi, T. (1969). Causes of delinquency. Berkeley, CA: University of California Press.
    Hu, T. W., Lin, Z., & Keeler, T. E. (1998). Teenage smoking, attempts to quit, and school performance. American Journal of Public Health, 88(6), 940-943.
    Hudmon, K. S., Prokhorov, A. V., Koehly, L. M., DiClemente, C. C. & Gritz, E. R. (1997). Psychometric properties of the decisional balance scale and the temptation to try smoking inventory in Adolescents. Journal of Child and Adolescent Substance Abuse, 6(3), 1-18.
    Ian, S., & Paul, W. (1998). Patterns of alcohol, cigarette and illicit drug use in English adolescents. Adolescent Substance Abuse, 93(8), 1199-1208.
    Isohanni, M., Moilanen, I., & Rantakallio, P. (1991). Determinants of teenage smoking, with special reference to non-standard family background. British Journal of Addiction, 86(4), 391-398.
    Janis, I.L., & Mann, L. (1977). Decision making: A psychological analysis of conflict, choice and commitment. New York: Free Press.
    Janson, H. (1999). Longitudinal patterns of tobacco smoking from childhood to middle age. Addictive Behaviors, 24(2), 239-249.
    John, U., Meyer, C., Rumpf, H. J., & Hapke, U. (2003). Relation among stage of change, demographic characteristics, smoking history, and nicotine dependence in an adult German population. Preventive Medicine, 37, 368-374.
    Johnston, L. D., Bachman, J. G., & Omalley, P. M. (1996). Monitoring the future: Questionnaire responses from the National’s High School Seniors, 1994 Ann Arbor: Institute for Social Research, University of Michigan.
    Jones, D. N., Schroeder, J. R., & Moolchan, E. T. (2004). Time spent with friends who smoke and quit attempts among teen smokers. Addictive Behaviors, 29, 723-729.
    Juniper, K. C., Oman, R.F., Hamm, R. M., & Kerby, D.S. (2004). The relationships among constructs in the Health Belief Model and the Transtheoretical Model among African-American college woman for physical activity. American Journal of Health Promotion, 18(5), 354-357.
    Kandel, D. B., & Andrews, K. (1987). Processes of adolescent socialization by parents and peers. The International Journal of the Addictions, 22(4), 319-342.
    Kelaher, M., Gillespie, A. G., Allotey, P., Manderson, L., Potts, H., Sheldrake, M., & Young, M. (1999). The Transtheoretical Model and cervical screening: It’s application among culturally diverse communities in Queensland, Australia. Ethnicity and Health, 4(4), 259-276.
    Kessler, D. A., Natanblut, S. L., Wilkenfeld, J. P., Lorraine, C. C., Mayl, S. L., Bernstein, I. B., & Thompson, L. (1997). Nicotine addiction: a pediatric disease. The Journal of Pediatrics, 130(4), 518-524.
    Klesges, R. C., Elliott, V. E., & Robinson, L. A. (1997). Chronic dieting and the belief that smoking controls body weight in a biracial, population-based adolescent samples. Addictive behaviors, 6, 89-94.
    Kremers S.P.J., Mudde A.N., & Vries H. (2001). Subtypes within the precontemplation stage of adolescent smoking acquisition. Addictive behaviors, 26, 237-251.
    Krohn, M.D., Naughton, M.J., & Skinner, W. F. (1986). Social disaffection, friendship patterns and adolescent cigarette use: The MUSCATINE Study. Journal of School Health, 56(4), 146-150.
    Lawrance, L. & Rubinson, L. (1986). Self-efficacy as a predictor of smoking behavior in young adolescents. Addictive Behaviors, 11(4), 367-382.
    Liaw, K-M. & Chen, C-J. (1998). Mortality attributable to cigarette smoking in Taiwan: a 12-year follow-up study. Tobacco Control, 7, 141-148.
    Liu, X. (2003). Cigarette smoking, life stress, and behavioral problems in Chinese adolescents. Journal of Adolescents Health, 33(3), 189-192.
    Ma, G. X., Tan, Y., Toubbeh, J., & Su, X. (2003). Differences in stages of change of smoking behavior among current smokers of four Asian American subgroups. Addictive Behaviors, 28, 1431-1439.
    Manley, M., Lynn, W., Payne, E. R., Grande, D., Glynn, T., & Shopland, d. (1997). The American Stop Smoking Intervention Study for cancer prevention: An overview. Tobacco Control, 6(Suppl2), S5-11.
    Marcus, B. H., Banspach, S. W., Lefebvre, R. C., Rossi, J. S., Carleton, R. A. &Abrams, D. B. (1992). Using the stages of changes model to increase the adoption of physical participants. American Journal of Health Promotion, 6(6), 424-429.
    Marcus, B. H., Rossi, J. S., Selby, V. C., Niaura, R. S., & Abrams, D. B. (1992). The stages and processes of exercise adoption and maintenance in a worksite sample. Health Psychology, 11, 386-395.
    McConnaughy E.A., Prochaska J.O., & Velicer W.F. (1983). Stages of change in psychotherapy: measurement and sample profiles. Psychotherapy, 20(3), 368-375.
    Migneault, J. P., Velicer, W. F., Prochaska, J. O., & Steveson, J. F. (1999). Decisional balance for immoderate drinking in college students. Substance Use and Misuse, 34(10), 1325-1346.
    Nigg, C. R., Burbank, P. M., Padala, C. Dufresne, R., Rossi, J. S., Velicer, W. F., Laforge, R. R., & Prochaska, J. O. (1999). Stages of change across ten health risk behaviors for older adults. The Gerontologist, 39(4), 473-482.
    O’Campo, R. O., Fogarty, L., Gielen, A. C., Amstrong, K., Bond, L., Galavotti, C., & Green, B. M. (1999). Distribution along a stage-of-behavioral-change continuum for condom and contraceptive use among women accessed in different settings. Journal of Community Health, 24(1), 61-72.
    Ockene, J. K., Emmons, K. M., Mermelstein, R. J., Perkins, K. A., Bonollo, D. S., & Voorhees, C. C. (2000). Relapse and maintenance issues for smoking cessation. Health Psychology, 19 (Suppl.1), 17-31.
    Oetting, E. R., & Beauavis, F. (1986). Peer cluster theory: Drug and the adolescent. Journal of Counseling and Development, 65, 17-22.
    Olds, R. S., & Thombs, D. L. (2001). The relationship of adolescent perceptions of peer norms and parent involvement to cigarette and alcohol use. Journal of School Health, 71(6), 223-228.
    Osaki, Y., & Minowa, M. (1996). Cigarette smoking among junior and senior high school students in Japan. Journal of Adolescent Health, 18, 59-65.
    Osler, M., & Prescott, E. (1998). Psychosocial, behavioral, and health determinants of successful smoking cessation: A longitudinal study of Danish adults. Tobacco Control, 7(3), 762-767.
    Otero-Sabogal, R., Sabogal, F., & Perez-Stable, E. J. (1995). Psychosocial correlates of smoking among immigrant Latin adolescents. Journal of the National Cancer Institute Monographs, 18, 65-71.
    Pallonen, U. E. (1998).Transtheoretical measures for adolescent and adult smokers: similarities and differences. Preventive Medicine, 27,A29-A38.
    Pallonen, U. E., Prochaska, J. O., Velicer, W. F., Prokhorov, A. V., & Smith, N. F. (1998). Stages of acquisition and cessation for adolescent smoking: an empirical integration. Addictive Behaviors, 23(3), 303-324.
    Perz, C. A., DiClemente, C. C., & Carbonari, J. P. (1996). Doing the right thing at the right time? The interaction of stages and processed of change in successful smoking cessation. Health Psychology, 15(6), 462-468.
    Plummer, B. A., Velicer, W. F., Redding, C. A., Prochaska, J. A., Rossi, J. S., Pallonen, U. E., & Meier, K. S. (2001). Stages of change, decisional balance, and temptation for smoking measurement and validation in a large, school-based population of adolescents. Addictive Behaviors, 26, 551-571.
    Presti, D. E., Ary, D. V., & Lichtenstein, E. (1992). The context for smoking initiation and maintenance: Findings from interviews with youths. Journal of substance Abuse, 4, 35-45.
    Prochaska, J. O., & DiClemente, C. C. (1982). Transtheoretical therapy: Toward a more integrative model of change. Psychotherapy: Theory Research and Practice, 19, 276-288
    Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: toward an integrative model of change. Journal of Consulting & Clinical Psychology, 51(3), 390-395.
    Prochaska, J. O., & DiClemente, C. C. (1984). Self-change processes, self-efficacy and decisional balance across five stages of smoking cessation. Advanced Cancer Control: Epidemiology Research, 131-140.
    Prochaska J.O., DiClemente C.C., Velicer W.F., Ginpil S., & Norcross J.C. (1985). Predicting change in smoking status for self-changers. Addictive Behaviors, 10(4), 395-406.
    Prochaska J.O., Velicer W.F., DiClemente C.C., & Fava J.L. (1988). Measuring processes of change: applications to the cessation of smoking. Journal of Consulting and Clinical Psychology, 56(4), 520-528.
    Prochaska, J. O., DiClemente, C. C. & Norcross, J. C. (1992). In search of how people change: applications to addictive behaviors. American Psychology, 47(9), 1102-1114.
    Prochaska J.O., Velicer W.F., Rossi J.S., Goldstein M.G., Marcus B.H., Rakowski W., Fiore L., Harlow L.L., Redding C.A., Rosenbloom D., & Rossi S.R. (1994). Stages of change and decisional balance for 12 problem behaviors. Health Psychology, 13(1), 39-46.
    Prochaska J.O. (1994). Strong and weak principles for progressing from precontemplation to action on the basis of twelve problem behaviors. Health Psychology, 13(1), 47-51.
    Prochaska, J. O., Redding, C. A., Harlow, L. L., Rossi, J. S. & Velicer, W. F. (1994). The Transtheoretical Model of change and HIV prevention: a review. Health Education Quarterly, 221(4), 471-486.
    Prochaska, J. O. & Velicer, W. F. (1997) . The transtheoretical model of health behavior change. American Journal of Health Promotion, 12(1), 38-48.
    Prochaska, J. O., Velicer, W. F., Fava, J. L., Rossi, J. S., & Tsoh, J. Y. (2001). Evaluating a population-based recruitment approach and a stage-based expert system intervention for smoking cessation. Addictive Behaviors, 26, 583-602.
    Prokhorov, A. V., Hudmon, K. S., & Stancic, N. (2003). Adolescent smoking epidemiology and approaches for achieving cessation. Pediatric Drugs, 5(1), 1-10.
    Resnick, M. D., Bearman, P. S., Blum, R. W., Bauman, K. E., Harris, K. M., Jones, J., Tabor, J., Beuhring, T., Sieving, R. E., Ireland, M., Bearinger, L. H., & Udry, J. R. (1997). Protecting adolescents from harm. Findings from the national longitudinal study on adolescent health. Journal of the American Medical Association, 278(10), 823-832.
    Robinson, L. A., Klesges, R. C., Zbikowski, S. M., & Glaser, R. (1997). Predictors of risk for different stages of adolescent smoking. Journal of Consulting and Clinical Psychology, 65, 653-662.
    Rossi, J. S. (1990). Statictical power of psychological research: What have we gained in 20 years? Journal of Consulting and Clinical Psychology, 58, 646-656.
    Rowe, D. (1994). The limits of family influence: Gene, experience and behavior. New York, NY: The Guilford Press.
    Sasco, A J., & Kleihues, P. (1999). Why can’t we convince the young not to smoke? European Journal of Cancer, 35(4), 1933-1940.
    Schinke, S. P., & Gilchrist, L. D. (1983). Primary prevention of tobacco smoking. Journal of School Health, 53, 416-419.
    Schofield, P. E., Pattison, P. E., Hill, D. J., & Borland, R. (2001). The influence of group identification on the adoption of peer group smoking norms. Psychology and health, 16, 1-16.
    Schwartz, M. D., Taylor, K. L., Willard, K. S., Siegel, J. E., Lamdan, R. M., & Moran, K. (1999). Distress, personality, and mammography utilization among women with a family history of breast cancer. Health Psychology, 18(4), 327-332.
    Spencer, L., Pagell, F., & Adams T. (2005). Applying the Transtheoretical Model to cancer screening behavior. American Journal of Health Behavior, 29(1), 36-56.
    Spencer, L., Pagell, F., Hallion, M. E., & Adams T.B. (2002). Applying the Transtheoretical Model to Tobacco Cessation and Prevention: A review of literature. American Journal of Health Promotion, 17(11), 7-71.
    Stanton, W.R. (1995). DSM-Ⅲ-R Tobacco dependence and quitting during late adolescence. Addictive Behaviors, 20(5), 595-603.
    Stanton, W., Oei, T., & Silva, P. (1994). Socio-demographic characteristics of adolescent smokers. International Journal of Addiction, 29, 913-925.
    Steeland, K. (1992). Passive smoking and the risk of heart disease. Journal of American Medical Association, 267, 94-99.
    Stern, R. A., Prochaska, J. O., Velicer, W. F., & Elder, J. (1987). Stages of adolescent cigarette smoking acquisition: measurement and sample profiles. Addictive Behaviors, 12, 319-329.
    Steptoe, A., Wardle, J. & Lipsey, Z. (1998). A longitudinal study of work load and variations in psychological well-being, cortisol, smoking, and alcohol consumption. Annals of Behavioral Medicine, 20(2), 84-91.
    Strecher, V. J., Devellis, B. M., Becker, M. H., & Rosenstock, I. M. (1986). The role of self-efficacy in achieving health behavior change,. Health Education Quarterly, 13(1), 73-91.
    Sullum, J., Clark, M. M., & King, T. K. (2000). Predictors of exercise relapse in a college population. Journal of American College Health, 48(4), 175-180.
    Sutherland, E. H., & Cressey, D. R. (1966). Principles of criminology (7th ed.). Philadelphia: Lippincott.
    Terence, W., & Schlam, G., & Tanya, R. (2004). The Transtheoretical Model and motivational interviewing in the treatment of eating and weight disorders. Clinical Psychology Review, 24(3), 361-378.
    Tyas, S. L., & Pederson, L.L. (1998). Psychosocial factors related to adolescent smoking: A critical review of the literature. Tobacco Control, 7, 409-420.
    Ulrich, J., Meyer, C., Rumpf, H-J., & Hapke, U. (2003). Relation among stage of change, demographic characteristics, smoking history, and nicotine dependence in as adult German population. Preventive Medicine, 37, 368-374.
    Unger, J. B., Yan, L., Chen, X., Jiang, X., Azen, S., Qian, G., Tan, S., Jie, G., Sun, P., ChunHong, L., Chou, C. P., Zheng, H., & Johnson, A. C. (2001). Adolescent smoking in Wuhan, China: Baseline data from the Wuhan Smoking Prevention Trial. American Journal of Preventive Medicine, 21(3), 162-169.
    Unger, J. B., Yan, L., Shakib, S., & Johnson, C. A. (2002). Peer Influences and access to cigarettes as correlates of adolescent smoking: a cross-cultural comparison of Wuhan, China, and California. Preventive Medicine, 34, 476-484.
    URI Cancer Prevention Research Center (2002), Measures: smoking: Processes of Change, from
    http://www.uri.edu/research/cprc/Measures/Smoking05.htm
    U. S. Centers for Disease Control. (2004). Cigarette use among high school students-United States 1991-2003: Smoking continues to fall among US teens. Morbidity and Mortality Report, 53(23), 499-502.
    U.S. Department of Health and Human Service. (1989). The health consequences of smoking: 25years of progress. A report of the surgeon general. US Department of Health and Human Services, Public Health Services, Center for Disease Control, Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. DHHS Publication No (CDC) 89-8411.
    U.S. Department of Health and Human Service. (1994). Preventing tobacco use among young people: A report of the surgeon general. Rockville, Maryland: Public Health service, Centers for Disease Control, office on Smoking and Health.
    Velicer W.F., DiClemente C.C., Prochaska J.O., & Brandenburg N. (1985) Decisional Balance measure for assessing and predicting smoking status. Journal of Personality and Social Psychology, 48(5), 1279-1289.
    Velicer, W. F., DiClemente, C. C., Rossi, T. S., & Proshaska, J. O. (1990). Relapse situations and self-efficacy: An integrative model. Addictive Behaviors, 15, 271-283.
    Velicer, W. F., Fava, J. L., Prochaka, J. O., Abrams, D. B., Emmons, K. M., & Pierce, J. (1995). Distribution of smokers by stage in three representative samples. Preventive Medicines, 24, 401-411.
    Velicer W.F., Rossi J.S., Prochaska J.O., & DiClemente C.C. (1996). A criterion measurement model for health behavior change. Addictive Behaviors, 21(5), 555-584.
    Wang, M. Q., Eddy, J. M., & Fitzhugh, E. C. (2000). Smoking acquisition: peer influence and self-selection. Psychological Reports, 86(3 Pt 2), 1241-1246.
    Wang, Wei-Dean.(1994).Feasibility and effectiveness of a stages-of-change model in cigarette smoking cessation counseling. J Formos Med Assoc, 93(9),752-757.
    Wen, C. P., Tsai, S.P., & Yen, D. D. (1994). The health impact of cigarette smoking in Taiwan. Asia-Pacific Journal of Public Health, 7(4), 206-213.
    Wewers, M. E., Stillman, F. A., Hartman, A. M. & Shoplandm D. R. (2003). Distribution of daily smokers by stage of change: Current population survey results. Preventive Medicina, 36, 710-720.
    Wilcox, N., Prochaska, J. O., Velicer, W. F., & DiClemente, C. C. (1985). Client characteristics as predictors of self-change in smoking cessation. Addictive Behaviors, 40, 407-412.
    Xiaoming, L., Xiaoyi, F., & Bonita, S. (1999). Cigarette smoking among schoolboys in Beijing, China. Journal of Adolescence, 22, 621-625.
    Young, R., Oei, T. P. S., & Crook, G. (1993). Drinking resusal self-efficacy. Cognitive Therapy and Research, 17, 511-530.

    QR CODE