Application of transtheoretical model to explain adolescents’ smoking behavior

Objective: The study investigated the smoking distribution of adolescents, examined the differences in the TTM constructs (self-efficacy, pros, cons, and cognitive processes of changes, and behavioral processes of changes) by the stages of smoking, and tested the relationship between smoking and the TTM constructs. Methods: The participants included 932 secondary school students ranging from 7th to 12th grade (males: 505, females: 427) in Nowon-gu, Seoul. Four Korean-version questionnaires were used to identify the stages of smoking behavior and the TTM constructs. Results: Adolescents’ smoking behavior differed according to gender. In addition, behavioral and cognitive processes of change, self-efficacy, and pros significantly differed across the stages of smoking behavior, and the TTM constructs had a significant impact on smoking behavior. Conclusions: This study could spawn the development of theory-based and empirically supported smoking cessation strategies and programs directed toward adolescents in the public health and health care settings.