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      The Stages of Change in Smoking Cessation in a Representative Sample of Korean Adult Smokers

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          Abstract

          This study reports the stages of change in smoking cessation in a representative sample of Korean adult smokers. The study subjects, all adult smokers (n=2,422), were recruited from the second Korea National Health and Nutrition Examination Survey conducted in 2001. The stages of change were categorized using demographic (age and sex), socioeconomic (education, residence, and household income), and smoking characteristics (age at smoking onset, duration of smoking, and number of cigarettes smoked per day). Age-stratified analyses of the association of socioeconomic and smoking characteristics with the stages of change in male and female smokers were also conducted. According to the stages of change, the study population consisted of 37.6% (95% CI, 35.7-39.5) pre-contemplation, 56.0% (54.0-58.0) contemplation, and 6.4% (5.4-7.4) preparation. The associations between the characteristics of the smokers and the stages of change were all statistically significant. The age-stratified analyses showed that all the socioeconomic and smoking characteristics were significantly associated with the stages in males, while education and residence had significant associations in females. This study revealed that a relatively small number of Korean smokers were prepared to quit and the stage distribution might be influenced by demographic, socioeconomic, and smoking char-acteristics.

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          Most cited references23

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          In search of how people change. Applications to addictive behaviors.

          How people intentionally change addictive behaviors with and without treatment is not well understood by behavioral scientists. This article summarizes research on self-initiated and professionally facilitated change of addictive behaviors using the key trans-theoretical constructs of stages and processes of change. Modification of addictive behaviors involves progression through five stages--pre-contemplation, contemplation, preparation, action, and maintenance--and individuals typically recycle through these stages several times before termination of the addiction. Multiple studies provide strong support for these stages as well as for a finite and common set of change processes used to progress through the stages. Research to date supports a trans-theoretical model of change that systematically integrates the stages with processes of change from diverse theories of psychotherapy.
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            The process of smoking cessation: an analysis of precontemplation, contemplation, and preparation stages of change.

            Traditionally smoking cessation studies use smoker and nonsmoker categories almost exclusively to represent individuals quitting smoking. This study tested the transtheoretical model of change that posits a series of stages through which smokers move as they successfully change the smoking habit. Subjects in precontemplation (n = 166), contemplation (n = 794), and preparation (n = 506) stages of change were compared on smoking history, 10 processes of change, pretest self-efficacy, and decisional balance, as well as 1-month and 6-month cessation activity. Results strongly support the stages of change model. All groups were similar on smoking history but differed dramatically on current cessation activity. Stage differences predicted attempts to quit smoking and cessation success at 1- and 6-month follow-up. Implications for recruitment, intervention, and research are discussed.
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              Educational differences in smoking: international comparison.

              To investigate international variations in smoking associated with educational level. International comparison of national health, or similar, surveys. Men and women aged 20 to 44 years and 45 to 74 years. 12 European countries, around 1990. Relative differences (odds ratios) and absolute differences in the prevalence of ever smoking and current smoking for men and women in each age group by educational level. In the 45 to 74 year age group, higher rates of current and ever smoking among lower educated subjects were found in some countries only. Among women this was found in Great Britain, Norway, and Sweden, whereas an opposite pattern, with higher educated women smoking more, was found in southern Europe. Among men a similar north-south pattern was found but it was less noticeable than among women. In the 20 to 44 year age group, educational differences in smoking were generally greater than in the older age group, and smoking rates were higher among lower educated people in most countries. Among younger women, a similar north-south pattern was found as among older women. Among younger men, large educational differences in smoking were found for northern European as well as for southern European countries, except for Portugal. These international variations in social gradients in smoking, which are likely to be related to differences between countries in their stage of the smoking epidemic, may have contributed to the socioeconomic differences in mortality from ischaemic heart disease being greater in northern European countries. The observed age patterns suggest that socioeconomic differences in diseases related to smoking will increase in the coming decades in many European countries.
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                Author and article information

                Journal
                J Korean Med Sci
                JKMS
                Journal of Korean Medical Science
                The Korean Academy of Medical Sciences
                1011-8934
                1598-6357
                October 2006
                31 October 2006
                : 21
                : 5
                : 843-848
                Affiliations
                Department of Occupational and Environmental Medicine, Hangang Sacred Heart Hospital, Hallym University, Seoul, Korea.
                [* ]Center for Cancer Prevention and Detection, National Cancer Center, Goyang, Korea.
                Author notes
                Address for correspondence: Hong-Gwan Seo, M.D. Center for Cancer Prevention and Detection, National Cancer Center, 809 Madu1-dong, Ilsandong-gu, Goyang 410-769, Korea. Tel: +82.31-920-1707, Fax: +82.31-920-1520, hongwan@ 123456ncc.re.kr
                Article
                10.3346/jkms.2006.21.5.843
                2721994
                17043417
                6f14546f-0751-4d19-a243-4b6fb7f1ad57
                Copyright © 2006 The Korean Academy of Medical Sciences

                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.

                History
                : 09 November 2005
                : 07 March 2006
                Categories
                Original Article

                Medicine
                smoking, behavioral modification,behavior therapy
                Medicine
                smoking, behavioral modification, behavior therapy

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