Tohid Hizlinda, Ishak Noriah Mohd, Muhammad Noor Azimah, Ahmad Farah Naaz Momtaz, Aziz Abdul Anis Ezdiana, Omar Khairani
Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.
Malays J Med Sci. 2012 Apr;19(2):35-47.
The prevalence of teenage smoking has decreased over the past decade following the implementation of the national tobacco control programme. However, the effect of the programme on smoking cessation in teenagers has not been determined.
Twenty-eight participants (12 teenagers, 8 teachers, and 8 doctors) were interviewed using 5 in-depth interviews and 3 group discussions. Social cognitive theory (SCT) was applied as the theoretical framework. Semi-structured interview protocols were used, and thematic analysis and analytic generalisation utilising SCT were performed.
The current national tobacco control programme was found to be ineffective in promoting smoking cessation among teenagers. The participants attributed the ineffective campaign to the followings: inadequacy of message content, lack of exposure to the programme, and poor presentation and execution. In addition, the participants perceived the developed tobacco control policies to be a failure based on poor law enforcement, failure of retailers to comply with the law, social availability of cigarettes to teenagers, and easy availability of cheap, smuggled cigarettes. This study highlighted that the programme-related problems (environmental factors) were not the only factors contributing to its perceived ineffectiveness. The cunning behaviour of the teenagers (personal factor) and poor self-efficacy to overcome nicotine addiction (behavioural factor) were also found to hinder cessation.
Tobacco control programmes should include strategies beyond educating teenagers about smoking and restricting their access to cigarettes. Strategies to manage the cunning behaviour of teenagers and strategies to improve their self-efficacy should also be implemented. These comprehensive programmes should have a foundation in SCT, as this theory demonstrates the complex interactions among the environmental, personal, and behavioural factors that influence teenage smoking.
在实施国家烟草控制计划后的过去十年里，青少年吸烟率有所下降。然而，该计划对青少年戒烟的效果尚未确定。
通过5次深度访谈和3次小组讨论，对28名参与者（12名青少年、8名教师和8名医生）进行了访谈。采用社会认知理论（SCT）作为理论框架。使用半结构化访谈方案，并运用SCT进行主题分析和分析性归纳。
发现当前的国家烟草控制计划在促进青少年戒烟方面无效。参与者将该活动无效归因于以下几点：信息内容不足、对该计划的曝光度不够、展示和执行不佳。此外，参与者认为制定的烟草控制政策失败，原因包括执法不力、零售商未遵守法律、青少年可轻易获得香烟以及廉价走私香烟容易获取。这项研究强调，与计划相关的问题（环境因素）并非导致其被认为无效的唯一因素。还发现青少年的狡黠行为（个人因素）和克服尼古丁成瘾的自我效能低下（行为因素）也阻碍了戒烟。
烟草控制计划应包括除了教育青少年吸烟危害和限制他们获取香烟之外的策略。还应实施管理青少年狡黠行为的策略以及提高他们自我效能的策略。这些综合计划应以SCT为基础，因为该理论展示了影响青少年吸烟的环境、个人和行为因素之间的复杂相互作用。
