Effects of adolescents’ self-efficacy and social anxiety on attitudes toward pros and cons of smoking

Knowledge of smoking and influencing factors among school-going adolescents in Timor-Leste

OBJECTIVES

Knowledge of smoking is a protective factor for adolescent smoking. This study is the first to examine sociodemographic and lifestyle factors associated with adolescents' knowledge of smoking in Timor-Leste. It is also a pioneering investigation into the ways in which exposure to anti-tobacco messages and health warnings on cigarette packages, and involvement in smoking-related education at schools and home mediate the relationship between school grade levels and smoking knowledge.

METHODS

Data were obtained from the Global Youth Tobacco Survey Timor-Leste. Ordered logistic regressions were used to examine the associations between knowledge of smoking and sociodemographic, and lifestyle factors. Structural equation modelling was utilized to explore the mediating effects.

RESULTS

Adolescents were less likely to have high knowledge of smoking if they were lower-secondary students, were males, had unemployed parents and had no closest friends who smoked. The relationship between grade levels and smoking knowledge was partly mediated by awareness of anti-tobacco messages on mass media, school education about the dangers of smoking and family discussion about smoking.

CONCLUSIONS

Sociodemographic and lifestyle factors play an important role in determining knowledge of smoking among adolescents. To some extent, awareness-, education- and family-related variables explain how grade levels affect smoking knowledge.

Impact of Physical Activity on the Association Between Unhealthy Adolescent Behaviors and Anxiety Among Korean Adolescents: A Cross-sectional Study

OBJECTIVES

Adolescents who engage in unhealthy behaviors are particularly vulnerable to anxiety. We hypothesized that participation in physical activity could influence the relationship between anxiety and unhealthy behaviors in adolescents. These behaviors include smoking, alcohol consumption, and unsafe sexual activity.

METHODS

This study included 50 301 students from the first year of middle school to the third year of high school, all from Korea. The unhealthy adolescent behaviors examined included current alcohol consumption, current smoking, and unsafe sexual behavior. Anxiety levels were assessed using the Generalized Anxiety Disorder-7 questionnaire (GAD-7).

RESULTS

The participants had a mean age of 15.19 years and an average GAD-7 score of 4.23. No significant differences were observed in GAD-7 score among exercising participants when categorized by smoking status (p=0.835) or unsafe sexual behavior (p=0.489). In contrast, participants in the non-exercise group who engaged in these behaviors demonstrated significantly higher GAD-7 scores (p<0.001 and 0.016, respectively). The only significant interaction was found between unsafe sexual behavior and exercise (p=0.009). Based on logistic regression analysis, within the non-exercise group, significant positive associations were observed between current smoking and anxiety (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.18 to 1.57), as well as between unsafe sexual behavior and anxiety (OR, 1.33; 95% CI, 1.02 to 1.73). However, within the exercise group, no significant association was found between anxiety and either smoking or unsafe sexual behavior. Furthermore, no significant interaction was observed between unhealthy behaviors and exercise.

CONCLUSIONS

These findings are insufficient to conclude that physical activity influences the relationship between unhealthy behaviors and anxiety.

Anxiety in social interactions and nicotine dependence in nicotine-dependent men: The role of metacognitions about smoking

Anxiety in social interactions is an important factor in cigarette use and nicotine dependence. Metacognitions about smoking have been found to predict smoking behavior and may help understand the relationship between anxiety in social interactions and nicotine dependence. In the current study, we evaluated the direct effect of anxiety in social interactions on nicotine dependence and its indirect effect through metacognitions (controlling for anhedonia and depression) in nicotine-dependent men (n = 388). Participants completed measures of anxiety in social interactions [the Social Interaction Anxiety Scale (SIAS)], anhedonia [the Snaith HamiltonPleasure Scale (SHAPS)], metacognitions about smoking [e.g., theMetacognitions aboutSmoking Questionnaire (MSQ)] nicotine dependence [the Fagerström Test for Nicotine Dependence (FTND)], and clinical factors related to smoking including depressive symptoms [e.g., the Beck Depression Inventory-II (BDI-II)]. As expected, after controlling for depressive symptoms and anhedonia, anxiety in social interactions indirectly affected nicotine dependence through negative metacognitions about smoking, but not positive metacognitions. These findings are discussed in relation to the metacognitive model of addictive behaviors.

A Self-Reflection Program for Smoking Cessation in Adolescents: A Phenomenological Study

The study aimed to understand the experiences of adolescent smokers who participated in a self-reflection program for smoking cessation and to develop the theoretical basis for constructing similar programs. The program is unique from other smoking cessation programs in that it seeks to be creative and allow participants to establish an individualized vision for themselves. The participants, ten students from middle and high schools located in cities A and S, were interviewed right after the program ended. Data were collected from August to December 2019 and analyzed using a phenomenological approach to understand participant experiences in depth. The analysis revealed five major themes: ‘Uniqueness of the Program,’ ‘Perception of Smoking Cessation,’ ‘Positive Reflection on Life,’ ‘Understanding Others,’ and ‘A Search for Hope and Vision in Life.’ The findings revealed that their smoking behaviors were changed through self-reflection and enhancement of self-efficacy and that the program facilitated the formation of identity and vision for the future, which may indirectly strengthen the motivation for adolescent smokers to quit smoking. These findings suggest the need for a smoking cessation program that enhances self-concept and self-esteem. Moreover, it highlights the importance of follow-up research to ensure effectiveness and the need to develop programs with creative content.