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


Randy M. Page, Professor, (, Department of Health Science, Brigham Young University, 221 Richards Building, Provo, UT 84602.


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.