Utility of the theory of reasoned action and theory of planned behavior for predicting Chinese adolescent smoking

One third of smokers worldwide live in China. Identifying predictors of smoking is important for prevention program development. This study explored whether the Theory of Reasoned Action (TRA) and Theory of Planned Behavior (TPB) predict adolescent smoking in China. Data were obtained from 14,434 middle and high school students (48.6% boys, 51.4% girls) in seven geographically varied cities in China. TRA and TPB were tested by multilevel mediation modeling, and compared by multilevel analyses and likelihood ratio tests. Perceived behavioral control was tested as a main effect in TPB and a moderation effect in TRA. The mediation effects of smoking intention were supported in both models (p<0.001). TPB accounted for significantly more variance than TRA (p<0.001). Perceived behavioral control significantly interacted with attitudes and social norms in TRA (p<0.001). Therefore, TRA and TPB are applicable to China to predict adolescent smoking. TPB is superior to TRA for the prediction and TRA can better predict smoking among students with lower than higher perceived behavioral control.     

Smoking cessation: an application of theory of planned behavior to understanding progress through stages of change

The purpose of this research was to investigate variables relevant to smoking cessation early in the process of change through an application of the Theory of Planned Behavior [Ajzen, I. (1985). From intentions to actions: A theory of planned behavior. In J. Kuhl and J. Beckman (Eds). Action-control: From cognition to behavior (pp.11-39). Heidelberg: Springer.] to the temporal structure provided by the Transtheoretical Model. Study 1 was a preliminary elicitation study (n=68) conducted to ground the concepts used in the model testing in Study 2 [Ajzen, I., Fishbein, M. (1980). Understanding attitudes and predicting social behavior, Englewood Cliffs, NJ: Prentice-Hall.]. Study 2 tested the proposed model fit with data from a sample of 230 adult smokers. Structural equation modeling did not support the Theory of Planned Behavior as a model of motivation for progress through the stages of change and highlighted measurement issues with perceived behavioral control. A modified model using the Theory of Reasoned Action provided a good fit to the data, accounting for approximately 64% of the variance in intention to quit smoking and stage of change. This research addresses the need for a more complete theoretical rationale for progress through stages of change.     

Using an extended theory of planned behaviour to understand smoking amongst schoolchildren

This study employed an extended theory of planned behaviour (TPB) to investigate the factors underlying smoking intentions and subsequent smoking behaviour three months later in a population of schoolchildren (N?=?741). The TPB provided good predictions of both intentions (R²?=?0.518; attitude, subjective norm and perceived behavioural control significant) and smoking (R²?=?0.299; intentions and PBC significant). However, intention did not fully mediate the subjective norm–behaviour relationship. Moral norm explained additional variance in intentions but not smoking. Perceived family smoking and anticipated regret explained additional variance in both intentions and smoking. Perceived friends' smoking and past behaviour explained additional variance in smoking but not intentions. Findings are discussed in relation to how the TPB can further our understanding of adolescent smoking. Implications for additions to the theory and possible interventions are also considered.     

An extended version of the theory of planned behavour: Prediction of intentions to quit smoking using past behaviour as moderator

It was hypothesised that: (i) intentions to quit smoking were predictable from group identity, self-identity, moral norms and past quit attempts, beyond the components of the Theory of Planned Behaviour (TPB), and (ii) that past experiences with the behaviour (quit attempts) would increase the predictive utility of the extended TPB model on intentions. The data was collected among 357 daily smoking students (M = 24 years). The TPB components accounted for 12.3% of the variance in quitting intentions, while the extension variables added 16.5% to the explained variance in intentions beyond the impact of the TPB. Past behaviour had the strongest impact on intentions (α = 0.30), followed by moral norms (α = 0.25), perceived behavioural control (PBC, α = 0.20), attitude (α = 0.18) and group commitment (α = ?0.11). By splitting the sample into three categories of past quit attempts the picture changed, revealing that the predictive utility of the TPB increased with the number of quit attempts (no past quit attempt, R² = 1%, ns and several past quit attempts, R² = 12.3%, p < 0.001). Moreover, PBC and group commitment were significantly stronger predictors of intention among those who had several previous quit attempts compared with those who never had tried to quit smoking. The extended TPB model explained 1% and 28% of the variance in intentions among those with no and several previous quit attempts, respectively. The practical implications of these results for the development of interventions to encourage smokers to quit smoking are outlined.     

The theory of planned behavior and binge drinking among undergraduate students: assessing the impact of habit strength

The present study sought to apply the theory of planned behavior (TPB) to the prediction of binge drinking intentions and behavior among undergraduate students and to test whether habit strength explains additional variance in binge drinking behavior. Undergraduate students (N = 137) completed measures of the TPB (i.e., attitude, subjective norm, self-efficacy, perceived control, and intention) and habit strength (Self-Report Habit Index) in relation to binge drinking. Frequency of binge drinking was assessed one month later (n = 109). The TPB explained 75% of the variance in binge drinking intentions, with attitude and self-efficacy making significant contributions, and 35% of the variance in binge drinking behavior at one-month follow-up, with only intention making a significant contribution. Habit strength explained additional variance in binge drinking behavior (?R² = .06), although intention remained as a significant predictor. The results suggest that binge drinking among undergraduate students is under the control of both intentional and habitual processes. Interventions to reduce binge drinking should therefore focus on the motivational determinants (e.g., perceived positive and negative consequences) of binge drinking as well as the environmental factors (i.e., contextual cues) that promote binge drinking.     

Differences in quit attempts between non-Hispanic Black and White daily smokers: The role of smoking motives

Introduction

The prevalence of smoking across racial/ethnic groups has declined over the years, yet racial health disparities for smoking persist. Studies indicate that non-Hispanic Black smokers attempt to quit smoking more often compared to non-Hispanic White smokers but are less successful at doing so. Research suggests that motives to quit smoking differ by race, however, less is known about the role of motives to smoke in explaining racial differences in attempts to quit smoking.

Methods

This study examined whether smoking motives accounted for the differential rates in quit attempts between non-Hispanic Black (n = 155) and non-Hispanic White (n = 159) smokers. Data were culled from a larger study of heavy-drinking smokers. The Wisconsin Index of Smoking Dependence Motives (WISDM) assessed motives to smoke.

Results

As expected, Black and White smokers reported similar smoking patterns, yet Black smokers reported higher rates of failed attempts to quit smoking than White smokers. Findings indicated that Black, compared to White, smokers endorsed lower scores in the negative reinforcement, positive reinforcement, and taste WISDM subscales and scores in these subscales mediated the relationship between race and quit attempts.

Conclusions

In this study, Blacks, compared to Whites, endorsed lower motives to smoke, which are generally associated with successful quit attempts, yet they experienced more failed attempts to quit smoking. This study demonstrates racial health disparities at the level of smoking motives and suggests that Black smokers remain vulnerable to failed quit attempts despite reporting lower motives to smoke.     

Application of the Protection Motivation Theory in predicting cigarette smoking among adolescents in China

Reducing tobacco use among adolescents in China represents a significant challenge for global tobacco control. Existing behavioral theories developed in the West — such as the Protection Motivation Theory (PMT) — may be useful tools to help tackle this challenge. We examined the relationships between PMT factors and self-reported cigarette smoking behavior and intention among a random sample of vocational high school students (N = 553) in Wuhan, China. Tobacco-related perceptions were assessed using the PMT Scale for Adolescent Smoking. Among the total sample, 45% had initiated cigarette smoking, and 25% smoked in the past month. Among those who never smoked, 15% indicated being likely or very likely to smoke in a year. Multiple regression modeling analysis indicated the significance of the seven PMT constructs, the four PMT perceptions and the two PMT pathways in predicting intention to smoke and actual smoking behavior. Overall, perceived rewards of smoking, especially intrinsic rewards, were consistently positively related to smoking intentions and behavior, and self-efficacy to avoid smoking was negatively related to smoking. The current study suggests the utility of PMT for further research examining adolescent smoking. PMT-based smoking prevention and clinical smoking cessation intervention programs should focus more on adolescents' perceived rewards from smoking and perceived efficacy of not smoking to reduce their intention to and actual use of tobacco.     

Tobacco policies and on-premise smoking in bars and clubs that cater to young African Americans following the Maryland Clean Indoor Air Act of 2007

African American young adults ages 18–25 smoke less than their Caucasian peers, yet the burden of tobacco-related illness is significantly higher in African Americans than in Caucasians across the lifespan. Little is known about how clean indoor air laws affect tobacco smoking among African American young adults. We conducted a systematic observation of bars and clubs with events targeted to African American adults 18–25 in Baltimore City at two timepoints (October and November of 2008 and 2010) after enforcement of the Maryland Clean Indoor Air Act (CIAA). Twenty venues—selected on the basis of youth reports of popular venues—were rated during peak hours. All surveillance checklist items were restricted to what was observable in the public domain. There was a significant decrease in observed indoor smoking after CIAA enforcement. Observed outdoor smoking also decreased, but this change was not significant. Facilities for smoking outdoors increased significantly. The statewide smoking ban became effective February 1, 2008, yet measurable changes in smoking behavior in bars were not evident until the City engaged in stringent enforcement of the ban several months later.     

The theory of planned behavior and binge drinking: assessing the impact of binge drinker prototypes

The present study assessed the value of including prototype perceptions within the theory of planned behavior (TPB) when predicting young people's binge drinking intentions and behavior. Undergraduate students (N=94) completed questionnaires assessing the main constructs of the TPB as well as measures of prototype evaluation and prototype similarity. Binge drinking behavior was assessed at one-week follow-up (N=79). The TPB explained 58% of the variance in binge drinking intentions and 22% of the variance in binge drinking at one-week follow-up. The prototype perception measures explained additional variance in both binge drinking intentions (DeltaR(2)=.04) and behavior (DeltaR(2)=.09), although only prototype similarity emerged as a significant predictor. In addition, a significant interaction was found between prototype similarity and subjective norm in relation to the prediction of binge drinking behavior, suggesting that the perception of supportive norms may enhance the impact of prototype perceptions on health-risk behavior. The implications of the findings for interventions to encourage more appropriate drinking behavior are outlined.     

基于计划行为理论探讨老年人自我药疗中不合理用药行为

在老年人自我药疗中不合理用药行为日渐频繁的情况下,通过文献研究,以计划行为理论为基础,从态度、主观规范、知觉行为控制三方面构建老年人在自我药疗中的不合理用药行为影响因素的理论模型,从而为相关措施的提出提供理论参考。     

Knowledge, attitudes, and practices of argileh (water pipe or hubble-bubble) and cigarette smoking among pregnant women in Lebanon

BACKGROUND: Currently, little is known about argileh (water pipe or hubble-bubble) and cigarette smoking among pregnant women in the Arab world, despite emerging evidence on the adverse health effects of argileh smoking and well-established knowledge about the health risks of cigarette smoking during pregnancy. OBJECTIVES: The present study assesses pregnant Arab women's knowledge of chemical contents and related harmful effects of argileh and cigarettes, their attitudes towards smoking argileh and cigarettes, and their actual smoking of argileh and cigarettes, both before and during pregnancy. METHODS: A stratified sample of 864 women from 23 health care centers in Lebanon completed a structured, interviewer-administered questionnaire. Information was collected on basic demographic variables, women's knowledge, attitudes, and cigarette and argileh smoking. RESULTS: Women were partially knowledgeable about the health risks of cigarette smoking, knew little about the harmful ingredients of argileh smoking, and had many misconceptions regarding how argileh worked or how it can produce harm. Attitudes were permissive towards all forms of smoking. Almost one quarter (23%) of participants reported smoking during pregnancy, with 17% smoking only cigarettes, 4% smoking only argileh, and 1.5% smoking both cigarette and argileh. CONCLUSION: A significant and growing percentage of pregnant Arab women are smoking in Lebanon, with four cigarette smokers for every argileh smoker. Smoking behaviors are empirically linked with important gaps in knowledge and with permissive attitudes. These data may be used to design more effective prevention programs targeting this vulnerable population.     

An application of the Theory of Planned Behavior to sorority alcohol consumption

Greek-affiliated college students have been found to drink more heavily and frequently than other students. With female student drinking on the rise over the past decade, sorority women may be at particular risk for heavy consumption patterns. The current study is the first to apply the Theory of Planned Behavior (TPB) to examine drinking patterns among a sorority-only sample. Two-hundred and forty-seven sorority members completed questionnaires measuring TPB variables of attitudes, norms, perceived behavioral control, and intentions, with drinking behaviors measured one month later. Latent structural equation modeling examined the pathways of the TPB model. Intentions to drink mediated the relationship between attitudes and norms on drinking behavior. Subjective norms predicted intentions to drink more than attitudes or perceived behavioral control. Perceived behavioral control did not predict intentions but did predict drinking behaviors. Interpretation and suggestions from these findings are discussed.     

计划行为理论对心力衰竭患者自我护理行为的影响

目的 观察基于计划行为理论的护理干预对心力衰竭患者自我护理行为的影响.方法 选择120例心力衰竭患者,随机分成两组,试验组采用计划行为理论护理模式,对照组给予常规的护理.比较干预效果.结果 干预后1个月与3个月试验组SCHFI量表各维度得分均高于对照组,差异有统计学意义(P＜0.05);试验组干预后1个月、3个月健康行为评分与对照组比较差异有统计学意义(P＜0.05);试验组满意度高于对照组(91.67％比71.67％),差异有统计学意义(P＜0.05).结论 基于计划行为理论的护理干预可以提升心力衰竭患者的自我护理能力,改善患者的健康行为,值得临床推广.     

孕期被动吸烟对注意缺陷多动障碍患儿认知和行为的影响

目的研究孕期被动吸烟对注意缺陷多动障碍（ADHD）患儿认知和行为的影响。方法选取伴孕期被动吸烟ADHD患儿92例、不伴孕期被动吸烟ADHD患儿99例及正常儿童100例,通过智力测定、Stroop测验和威斯康星卡片分类评估研究对象的认知和行为能力。结果ADHD患儿言语智商（VIQ）、操作智商（HQ）和总智商（FIQ）均较较正常儿童低,其中有孕期被动吸烟史的患儿更低。ADHD患儿的A、B、C卡片耗时均较对照组患儿长,而B、C卡片正确数均较对照组患儿低,有孕期被动吸烟史的ADHD患儿更为显著。ADHD患儿的错误应答数、持续性应答数、持续性错误数、持续性错误百分数和非持续性错误数均较正常儿童高,而概念化水平均较正常儿童低,且有孕期被动吸烟史的患儿更为明显。结论孕期被动吸烟损害能加重缺陷多动障碍患儿的认知和行为的缺陷。     

Predictors of success in smoking cessation among Italian adults motivated to quit

We examined the role of sexual gender, age, working status, education, cigarettes per day, Fagerström test, age of onset, pharmacologic intervention (bupropion or varenicline), 10 sessions of cognitive–behavioral group counseling therapy (GCT) conducted over 6 weeks, and level of attendance of the counseling program as predictors of smoking cessation on 1282 Italian adult smokers. Results of a multi-variate forward stepwise conditional logistic analysis, at the first step, indicate that subjects who attended the program from 4 to 6 sessions and from 1 to 3 sessions, respectively, resulted about 3 times and 24 times more likely to smoke than those attending from 7 to 10 sessions; at the second step, subjects with high Fagerström score were 2 times more likely to smoke than subjects with low/middle Fagerström; at the third step, subjects treated only with GCT were 2 times more likely to smoke than subjects with combined pharmacologic interventions and GCT; at the fourth step, subjects with age of onset less than 17 years were 1.5 times more likely to smoke than subjects with a higher age of onset; eventually, at the fifth step women resulted 1.5 times more likely to smoke than men. In conclusion, we found that a steady attendance of the cognitive behavioral program, as well as the addition of pharmacologic interventions to counseling, remarkably increased the probability of the smoking cessation behavior to be determined. Nevertheless, FTQ was a valid measure in predicting the smoking cessation, and women revealed to be more likely to keep the smoking behavior, as well as subjects who declared an age of onset less than 17 years.