Cross-Cultural Analysis of Cognitive Attributions of Smoking in Thai and South Korean Adolescents

Abstract

BACKGROUND: Understanding the cognitive attributions of smoking has the potential to advance youth smoking prevention efforts; however, research on this subject is limited in Asian countries. We attempted to determine the degree to which cognitive attributions of smoking differ among adolescents in 2 Asian countries, Thailand and South Korea. METHODS: We surveyed 10th-to 12th-grade students in Chiang Mai, Thailand (N = 2516) and Seoul, South Korea (N = 1166). Logistic regression determined association of attributions and current smoking and differences in attributions between Thai and South Korean students. RESULTS: Items with the highest agreement among South Koreans were "helps me to deal with stress'' and "helps relax'' and among Thai were "feel like I am making my own decisions'' and "keeps from being bored.'' Significant predictors of current smoking were different between samples. Only 1 cognitive attribution predicted current smoking in both samples ("helps me to deal with stress''). CONCLUSION: The pattern of relevant cognitive attributions of smoking for the 2 samples was distinct, suggesting that cross-cultural differences merit consideration when designing prevention and cessation programs. Health education should strive to dispel the use of smoking as a coping strategy for dealing with stressful situations and distressful feelings and teach adolescents alternative healthy strategies for dealing with stress.