Smoking in adolescence is a risk factor of lung cancer and death from cardio-cerebral vascular disease in adulthood; in the short term, it can also be associated with adolescents’ poor psychological heath such as depression or suicidal ideation. However, approximately one quarter of adolescents appear to underestimate the harm caused by smoking. In particular, adolescents who engage in intermittent (i.e., smoking on 1–29 days out of every 30) and light smoking (smoking less than 10 cigarettes per day) were more likely to consider that their smoking behaviors were not harmful to their health. Similarly, intermittent and light smokers were less often advised to quit smoking by health care providers than were heavy smokers, and showed more increased risk for cancer, cardiovascular disease, and respiratory symptoms than non-smokers. Most adolescent smokers, including those in the Republic of Korea, exhibited intermittent and light smoking. Thus, adolescents who are still intermittent and light smokers might be an important target group for school-based smoking cessation programs. To maximize the effect of these programs by tailoring them to their target group, the identification of factors associated with intermittent and light smoking among adolescents would be a first step. The purpose of this study is to identify the factors associated with intermittent and light smoking among Korean adolescents based on biopsychosocial model.
Methods:
In this cross-sectional study, we employed secondary data from the 2015 Korea Youth Risk Behavior Web-Based Survey, and used the biopsychosocial model as a framework. The analysis was performed using the data of 31,038 high school students (both non-smokers and current smokers). We defined intermittent and light smoking as smoking for 1–29 days in a 30-day period and smoking less than 10 cigarettes per day. Logistic regression analysis using the complex samples procedure was applied to examine the factors associated with intermittent and light smoking among adolescents.
Results:
Among all study participants, 11.7% were current smokers; of these current smokers, 42.2% were intermittent and light smokers. The significant factors predicting intermittent and light smoking were male gender (as a biological factor); depressive symptoms and alcohol consumption (as psychological factors); and having siblings and close friends who smoke, observing teachers and other staff smoking in school, academic achievement, and participation in smoking cessation education in school (as sociocultural factors).
Conclusion:
In smoking cessation programs, health care providers in both the school and community should consider the unique biological, psychological, and sociocultural characteristics of intermittent and light smoking behaviors among adolescents.