Determinants of Tobacco Use among Korean Female Adolescents: Longitudinal test of the theory of triadic influence
Dr. JongSerl Chun’s most recent publication, “Determinants of tobacco use among Korean female adolescents: Longitudinal test of the theory of triadic influence” in Children and Youth Services Review, has made a significant achievement in examining the determinants of tobacco use among female adolescent in South Korea. The findings from this contribute to providing a theoretical framework for prevention and cessation of female adolescent smoking.
Although the prevalence of smoking has decreased among adult males in South Korea, the prevalence among adult females increased from 6.5% in 1998 to 7.9% in 2012 (Korean Ministry of Health and Welfare & Korea Centers for Disease Control and Prevention, 2013). This is potentially a crtical public health issue for women, as smoking is more harmful to women than men. Because women have slower metabolisms than men, nicotine is likely to stay inside their bodies longer (Hall, 1994). According to the Korean Association on Smoking and Health (2014), female smokers are three times more likely to suffer from myocardial infarction and twice as likely to experience cerebral infarction when compared with male smokers. In addition, smoking increases the female-related diseases such as cervix cancer, breast cancer, infertility, and premature menopause.
Tobacco use begins and becomes established primarily during adolescence. Moreover, most of habitual smokers start smoking by the age of 18 years (Substance Abuse and Mental Health Services Administration, 2011). In light of the rapidly increasing female smoking population, the tobacco use of female adolescents is one of the most important public health issues that need to be addressed. However, little attention has been devoted to the female adolescent smoking issues in South Korea, and this study attempts to fill the knowledge gap in this population.
This study examined the influences of social, attitudinal, and intrapersonal factors at three levels (proximal, distal, and ultimate) of tobacco use among female adolescents in South Korea using national longitudinal data. The study analyzed data from the Korean Youth Panel Study, with a study population consisting of middle-school second-graders (equivalent to the eighth grade in the United States) (n=1,594). Using time-dependent Cox regression, this study yielded the following main findings: All of the social factors at the three levels, including ‘parental supervision’, ‘attachment to friends’, and ‘peer smoking prevalence’ were found to influence tobacco use among Korean female adolescents. ‘Stigma’ on the distal level and ‘attitude towards smoking’ on the proximal level were significant attitudinal factors. Among intrapersonal factors, ‘self-control’ on the distal level and ‘stress’ on the proximal level were found to be significant.
The study findings suggest that providing education to parents of the supervision skills and promoting ‘attachment to non-smoking friends’, as well as enhancing sound relationships with them, would provide an effective strategy for the prevention and cessation of female adolescent smoking. Prevention and cessation need to include strategies that alleviate stigma and stress, and improve negative attitude toward smoking and the level of self-control.
Dr. JongSerl Chun is an Associate Professor at Department of Social Welfare at Ewha Womans University. Dr. Chun earned her PhD from the School of Social Work at the University of Texas at Austin. Also, she completed her National Institute on Drug Abuse sponsored post-doctoral fellowship, and received a research specialist appointment at Department of Psychiatry & Institute for Health Policy Studies in the University of California, San Francisco. Dr. Chun’s research focuses on drug addiction including nicotine and alcohol, and gambling and internet addiction. Her work has resulted in more than 60 publications in top national and international journals such as Addiction, Nicotine & Tobacco Research, and The American Journal of Drug and Alcohol Abuse. She was also honored as one of the top research professors in Ewha Womans University in 2014. Dr. Chun serves as a managing editor of The Asian Journal of Gambling Issues and Public Health, and as an editorial board member of Journal of Psychoactive Drugs.
* Related Article and Site
Determinants of Tobacco Use among Korean Female Adolescents: Longitudinal test of the theory of triadic influence, Children and Youth Services Review, Volume 50, 2015, Pages 83–87
Hall, S. M. (1994). Women and drugs. In V. J. Adesso, D. M. Reddy, R. Fleming (Eds.), Psychological perspectives on women’s health (pp. 101-126). Washington, DC: Taylor & Francis.
Korean Association on Smoking and Health (2014). Women’s smoking. Seoul: Author.
Korean Ministry of Health & Welfare and Korea Centers for Disease Control & Prevention (2013). Korea health statistic 2012: Korea national health and nutrition examination survey. Seoul: Author.
Substance Abuse and Mental Health Services Administration (2011). Results from the 2010 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-41, HHS Publication No. (SMA) 11-4658. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2011.