Evaluation of a school-based smoking education program : which incorporates the health belief model and its association with adolescent smoking attitudes and behavior

As the physiological effects of smoking cigarettes constitute major health-related disease, researchers must continue to investigate and evaluate programs that attempt to decrease the adaptation of the habit. The school-based education program was conducted in a local Salt Lake City high school with a known higher incidence of smoking behavior. The intervention program was designed specifically for the adolescent with two main objectives: 1. To demonstrate the immediate negative physiological effects of smoking, and 2. To both increase awareness of the social pressures present that encourage adaptation of the smoking behavior and ways to more effectively cope with these pressures. Using the Health Belief Model as the conceptual framework, it was hypothesized that by increasing perceptions of seriousness and susceptibility to the health hazards associated with smoking, the adolescent would decide to take recommended health promotion action, not to adopt the cigarette smoking habit, and/or alter current smoking behavior. This study was divided into two equally important parts. Part I investigated the relationships between the Health Belief Model and the adolescent's smoking-related attitudes and behavior while Part II evaluated the effectiveness of an intervention program on the participant's health beliefs, smoking-related attitudes and smoking behavior. Implementing a quasiexperimental design, pre- and posttesting were administered to both the control and experimental groups. In Part I, relationships were analyzed using a Spearman Rho correlation analysis to determine association between four variables: 2) demographic data, b) perceived susceptibility, c) perceived seriousness, and d) self-esteem, as well as smoking-related attitudes and behaviors. In Part II, using an analysis of variance (ANOVA), the efficacy of the intervention upon the subjects' health beliefs (perceived seriousness and perceived susceptibility), smoking-related attitude and smoking behaviors were measured. The finding as related to Part I revealed two demographic items of importance. Significant associations between employment status and grade in school were found. Both variables correlated positively with an increase in smoking behavior. Items measuring perceived susceptibility and perceived seriousness tended to correlate together especially with reference to the physiological effects of smoking in relationship to the adolescent and his/her environment. Also, lower scores of self-esteem correlated with a higher incidence of smoking behavior. The F-statistic was found to be insignificant with respect to the significance of the intervention. Although the findings (with respect to the intervention) did not reveal statistical significance, there is clinical meaningfulness. Continued research is clearly indicated in an effort to develop smoking education programs, especially designed to meet the unique needs of the adolescent. The adaptation of the Health Belief Model as a useful clinical tool in the development of such a programs is evident.