Zhao Xiang, White Katherine M, McD Young Ross
a School of Psychology and Counselling, Institute of Health and Biomedical Innovation , Queensland University of Technology , Brisbane , Australia.
b Faculty of Health, Institute of Health and Biomedical Innovation , Queensland University of Technology , Brisbane , Australia.
Subst Use Misuse. 2019;54(3):459-472. doi: 10.1080/10826084.2018.1508298. Epub 2018 Dec 30.
China is the world's largest tobacco consumer and its adolescent smoking rate is increasing. Smoking interventions among high school students are limited. The aim of this study was to deliver and evaluate a brief theory-based smoking intervention in China, with a focus on anti-smoking cognitions.
The intervention was based on the constructs of an extended theory of planned behavior and life skills training. Using class-level randomization sampling, 106 tenth graders from two high schools in Kunming, China received a four-session intervention; 101 students were assigned as control group members. Surveys were conducted at three time-points (1 week before the intervention, 1 week post-intervention, and 6 months post-intervention). MANOVA and latent class analysis were used to test the intervention's effectiveness and personal change trajectories over time.
The intervention failed to change smoking behavior, intention or willingness, but improved anti-smoking attitudes and perceived control over smoking. Skills showed a general enhancement, consistent with participants' qualitative feedback. Trajectories of smoking behavior, intention, and willingness all assumed two distinct but constant latent classes independent of the intervention.
This study suggests that addressing attitudinal and control beliefs among adolescents and building on assertiveness via additional strategies in life skills such as appropriate refusal skills may be beneficial. The absence of a successful change in subjective norm should be a focus for future anti-smoking programs in China.
中国是世界上最大的烟草消费国，其青少年吸烟率正在上升。针对高中生的吸烟干预措施有限。本研究的目的是在中国开展并评估一项基于理论的简短吸烟干预措施，重点关注反吸烟认知。
该干预措施基于计划行为扩展理论和生活技能培训的架构。采用班级层面的随机抽样，中国昆明两所高中的106名十年级学生接受了为期四节的干预；101名学生被分配为对照组成员。在三个时间点（干预前1周、干预后1周和干预后6个月）进行了调查。使用多变量方差分析和潜在类别分析来测试干预措施的有效性以及随时间推移的个人变化轨迹。
该干预措施未能改变吸烟行为、意图或意愿，但改善了反吸烟态度和对吸烟的感知控制。技能总体上有所提高，这与参与者的定性反馈一致。吸烟行为、意图和意愿的轨迹都呈现出两个不同但稳定的潜在类别，且与干预无关。
本研究表明，解决青少年的态度和控制信念问题，并通过生活技能中的其他策略（如适当的拒绝技能）培养自信可能会有所帮助。在中国，主观规范未能成功改变应成为未来反吸烟项目的重点。
