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Why they smoke: A qualitative study among Taiwanese university students
Abstract
The aim of this study was to collect data from in-depth interviews with university students and to explore the reasons for smoking in order to design an effective intervention campaign. Smoking is highly detrimental to the health situation in Taiwan, with 19 072 deaths attributable to smoking, representing 19% of all deaths in 1989 (Wen et al., 1992). The smoking rate is high among males (55%) and moderate among females (3.2%) (Li, 1995). The prevalence of smoking among young people is also high, at 30% among male college students and 2.9% among female students (Huang et al., 1988). In this study, we examined the influences of cognitive factors and the social environment (Janz & Becker, 1974; Langlie, 1977; Mermelstein et al., 1983) on the smoking behaviour of university students.
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Multiple regression analyses are used to assess the ability of the Health Belief Model to account for observed variation in a variety of preventive health behaviors (PHB) in a sample of urban adults (N = 383). In addition to the impact of the social psychological attributes posited by the Health Belief Model, the effects of the individual's social milieu on PHB are measured with and without controls for age, gender, and situational factors. The independent variables are tested in relation to two different kinds of PHB. One dependent measure is labelled Indirect Risk PHB: this is a scale composed of indicators for seat belt use, exercise and nutrition behavior, medical checkups, dental care, immunizations, and miscellaneous screening exams. The other dependent measure is called Direct Risk PHB and includes driving and pedestrian behavior, personal hygiene, and smoking behavior. Both social-psychological and social-group characteristics are important in accounting for differences in Indirect Risk PHB, but exert little influence on Direct Risk PHB. Conversely, appropriate Direct Risk PHB is strongly associated with older age and female gender, although some of the social-psychological attributes continue to have a small independent effect on this kind of PHB. A new model of PHB is tentatively proposed in order to account for the bi-dimensional character of PHB and for differences in the consistency of people's behavior.
This paper reviews historical, anthropological and contemporary survey data concerning gender differences in tobacco use in Africa, Asia, the Pacific, and Latin America. In many cultural groups in these regions, tobacco use has been substantially more common among men than among women. In some groups, tobacco use has been about equally common for both sexes. No evidence was found of any group in which tobacco use has been substantially more common among women. The widespread pattern of greater tobacco use by men appears to be linked to general features of sex roles. For example, men have often had greater social power than women, and this has been expressed in greater restrictions on women's behavior, including social prohibitions against women's smoking. These social prohibitions against women's smoking have strongly inhibited women's tobacco use and thus have been a major cause of gender differences in tobacco use. Gender differences in tobacco use have varied in magnitude, depending on the type of tobacco use and the particular cultural group, age group and historical period considered. Causes of the variation in gender differences in tobacco use include variation in women's status and variation in the social significance and benefits attributed to particular types of tobacco use in different cultures. Contact with Western cultures appears to have increased or decreased gender differences in smoking, depending on the specific circumstances. The patterns of gender differences in tobacco use in non-Western societies are similar in many ways to the patterns observed in Western societies, but there are several important differences.(ABSTRACT TRUNCATED AT 250 WORDS)
Since the last comprehensive review in 1974, the Health Belief Model (HBM) has continued to be the focus of considerable theoretical and research attention. This article presents a critical review of 29 HBM-related investigations published during the period of 1974-1984, tabulates the findings from 17 studies conducted prior to 1974, and provides a summary of the total 46 HBM studies (18 prospective, 28 retrospective). Twenty-four studies examined preventive-health behaviors (PHB), 19 explored sick-role behaviors (SRB), and three addressed clinic utilization. A "significance ratio" was constructed which divides the number of positive, statistically-significant findings for an HBM dimension by the total number of studies reporting significance levels for that dimension. Summary results provide substantial empirical support for the HBM, with findings from prospective studies at least as favorable as those obtained from retrospective research. "Perceived barriers" proved to be the most powerful of the HBM dimensions across the various study designs and behaviors. While both were important overall, "perceived susceptibility" was a stronger contributor to understanding PHB than SRB, while the reverse was true for "perceived benefits." "Perceived severity" produced the lowest overall significance ratios; however, while only weakly associated with PHB, this dimension was strongly related to SRB. On the basis of the evidence compiled, it is recommended that consideration of HBM dimensions be a part of health education programming. Suggestions are offered for further research.
Risk assessment of active and passive smoking in Taiwan-Smoking attributable mortality
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