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Mediation of Smoking Abstinence Self-Efficacy on the Association between Nicotine Dependence and the Intention to Quit Smoking
J Korean Soc Res Nicotine Tob 2023; 14(3): 110-117
Published online September 30, 2023
© 2023 The Korean Society for Research on Nicotine and Tobacco.

Yongho Jee1*, Gyu Ri Kim2, Mikyung Ryu3, Sung-il Cho4

1Advanced Biomedical Research Institute, Ewha Womans University Seoul Hospital, Seoul, 2Hanam Sungshim Hospital, Gwangju, 3Genetic Epidemiology Research Institute, Basgenbio, Co. Seoul, 4Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
Correspondence to: *吏슜샇
씠솕뿬옄븰援 쓽怨쇰븰 遺냽꽌슱蹂묒썝
Received September 1, 2023; Revised September 21, 2023; Accepted September 22, 2023.
This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, dis-tribution, and reproduction in any medium, provided the original work is properly cited.
Background: Although smoking abstinence self-efficacy (SASE) has been reported to have positive effects on the intention to quit smoking, previous studies fail to provide adequate coverage on the issue, especially among Korean young adults. Therefore, our study aimed to assess the mediation of SASE on the association between nicotine dependence (ND) and the intention to quit smoking.
Methods: Cross-sectional data designed to investigate the smoking behavior among 2,500 Korean young adults, 20-29 years in age, were proportionally recruited with respect to sex, age, region, and smoking status, in September 2017. We used Velicer’s survey to assess SASE. Structural equation modeling was used to estimate the mediating role of smoking self-efficacy on the relationship between ND and the intention to quit smoking.
Results: Higher ND was associated with lower intention to quit smoking in the future (OR=0.94; BC bootstrap 95%; CI 0.893-0.977). ND had a significantly inverse correlation with the intention to quit smoking (OR=0.954; BC bootstrap 95%; CI 0.936-0.971). The total effect was found to be significant (OR=0.893; BC bootstrap 95%; CI 0.856-0.928, P竊0.001).
Conclusion: Our study indicated that SASE had a partial mediating effect on the association between ND and the intention to quit smoking cessation. Therefore, smoking interventions for young adults should consider the mediation effect of SASE in order to design more effective smoking control interventions for those with high nicotine dependency.
Keywords : Nicotine dependency; Smoking abstinence self-efficacy; Intention to quit smoking; Factor analysis; Structural equation modeling
  1. World Health Organization WH. WHO report on the global tobacco epidemic, 2011: warning about the dangers of tobacco. Geneva: World Health Organization, 2011.
  2. Jee SH, Samet JM, Ohrr H, Kim JH, Kim IS. Smoking and cancer risk in Korean men and women. Cancer Causes & Control. 2004; 15: 341-8.
    Pubmed CrossRef
  3. Korea Health Statistics 2016: Korea National Health and Nutrition Examination Survey(KNHANES VII-1).
  4. Jee YH, Cho S-i. Age-period-cohort analysis of smoking prevalence among young adults in Korea. Epidemiology and health. 2016; 38.
    KoreaMed CrossRef
  5. Monso E, Campbell J, Tønnesen P, Gustavsson G, Morera J. Sociodemographic predictors of success in smoking intervention. Tobacco Control. 2001; 10: 165-9.
    Pubmed KoreaMed CrossRef
  6. Lee C-w, Kahende J. Factors associated with successful smoking cessation in the United States, 2000. American Journal of Public Health 2007;97:1503-1509.
    Pubmed KoreaMed CrossRef
  7. Caponnetto P, Polosa R. Common predictors of smoking cessation in clinical practice. Respiratory medicine. 2008; 102: 1182-92.
    Pubmed CrossRef
  8. Rose JS, Chassin L, Presson CC, Sherman SJ. Prospective predictors of quit attempts and smoking cessation in young adults. Health Psychology. 1996; 15: 261.
    Pubmed CrossRef
  9. Chandola T, Head J, Bartley M. Socio-demographic predictors of quitting smoking: how important are household factors? Addiction 2004; 99: 770-7.
    Pubmed CrossRef
  10. Fagerström K, Russ C, Yu CR, Yunis C, Foulds J. The Fagerström Test for Nicotine Dependence as a predictor of smoking abstinence: a pooled analysis of varenicline clinical trial data. Nicotine & Tobacco Research. 2012; 14(12): 1467-73.
    Pubmed CrossRef
  11. Siahpush, M., McNeill, A., Borland, R., & Fong, T. G. Socioeconomic variations in nicotine dependence, self-efficacy, and intention to quit across four countries: Findings from the international tobacco control (ITC) four country survey. Tobacco Control. 2006;15 (suppl_3), iii71- iii75.
    Pubmed KoreaMed CrossRef
  12. Ussher M, Kakar G, Hajek P, West R. Dependence and motivation to stop smoking as predictors of success of a quit attempt among smokers seeking help to quit. Addictive Behaviors. 2016; 53, 175-80.
    Pubmed CrossRef
  13. Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychological review. 1977; 84: 191.
    Pubmed KoreaMed CrossRef
  14. Bandura A. The assessment and predictive generality of self-percepts of efficacy. Journal of behavior therapy and experimental psychiatry. 1982; 13: 195-9.
    Pubmed CrossRef
  15. Velicer WF, Diclemente CC, Rossi JS, Prochaska JO. Relapse situations and self-efficacy: an integrative model. Addict Behav. 1990; 15(13): 271-83.
    Pubmed CrossRef
  16. John U, Meyer C, Rumpf HJ, Hapke U. Self-efficacy to refrain from smoking predicted by major depression and nicotine dependence. Addictive Behaviors. 2004; 29: 857-66.
    Pubmed CrossRef
  17. Gwaltney CJ, Shiffman S, Balabanis MH, Paty JA. Dynamic self-efficacy and outcome expectancies: prediction of smoking lapse and relapse. Journal of abnormal psychology. 2005; 114: 661.
    Pubmed CrossRef
  18. Gwaltney CJ, Metrik J, Kahler CW, Shiffman S. Self-efficacy and smoking cessation: a meta-analysis. Psychology of Addictive Behaviors. 2009; 23: 56.
    Pubmed KoreaMed CrossRef
  19. Hymowitz N, Cummings KM, Hyland A, et al. Predictors of smoking cessation in a cohort of adult smokers followed for five years. Tobacco Control. 1997; 6:s57-62.
    Pubmed KoreaMed CrossRef
  20. Tillgren P, Halund BJ, Lundberg M, et al. The sociodemographic pattern of tobacco cessation in the 1980s: results from a panel study of living condition surveys in Sweden. J Epidemiol Community Health. 1996; 50: 625-30.
    Pubmed KoreaMed CrossRef
  21. Stuart K, Borland R, McMurray N. Self-efficacy, health locus of control, and smoking cessation. Addictive Behaviors. 1994; 19: 1-12.
    Pubmed CrossRef
  22. Heatherton TF, Kozlowski LT, Frecker RC, FAGERSTROM KO. The Fagerström test for nicotine dependence: a revision of the Fagerstrom Tolerance Questionnaire. British journal of addiction. 1991; 86: 1119-27.
    Pubmed CrossRef
  23. VanderWeele, T. (2015). Explanation in causal inference: methods for mediation and interaction. Oxford University Press.
    Pubmed KoreaMed CrossRef
  24. Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behavior research methods. 2008; 40: 879-91.
    Pubmed CrossRef
  25. Ben-Shlomo Y, Kuh D. A life course approach to chronic disease epidemiology: conceptual models, empirical challenges and 124 interdisciplinary perspectives. Int J Epidemiol. 2002; 31(2): 285-93.
    Pubmed CrossRef
  26. Margaritis V, Mamai-Homata E. Physical and psychological nicotine dependence in Greeks: an epidemiological study. Oral health & preventive dentistry. 2010; 8.
  27. Shadel WG, Shiffman S, Niaura R, Nichter M, Abrams DB. Current models of nicotine dependence: what is known and what is needed to advance understanding of tobacco etiology among youth. Drug and alcohol dependence. 2000; 59: 9-22.
    Pubmed CrossRef