This deals with review of related literature. The review has being presented under the following sub-heading:
- Conceptual framework
- Empirical studies
Several theories on tobacco smoking behaviour have been put forth by eminent scholars and researchers to conform both the existing definitions of these concepts. The procedure adopted in the present review has been to review the development in conceptualization of these concepts and the corresponding theories in this section.
The age at which children/youths begin to smoke is an a continual decline, with an estimated 60% of smokers starting by age 13 and 90% beginning by age 20. The prime age for tobacco use is 12-14 years, the younger the age of smoking initiation, the less likely that a person will ever quit (American cancer society, 1999: Meier, 1991).
The proposed theoretical framework was derived from the literature linking different concepts to smoking behaviours and from literature that supports recommended intervention methods. Bandura’s (1977, 1986) social Cognitive Theory and The Theory of Reasoned Action (Ajzen & Fishbrein, 1980) were also used as theoretical perspectives to help describe linkages of various concepts.
Social Cognitive Theory
Bandura’s Social Learning Theory (1977), renamed social cognitive theory (1986), is useful in understanding the psychosocial dynamics underlying behaviours. The theory provides a perspective for identifying methods, which can be utilized to promote certain behaviours. The basic premise of social cognitive theory is that the expectation of personal mastery and success influences whether or not an individual will engage in a particular behaviour. According to this theory, behaviour is determined by experiences and incentives, as perceived by an individual.
Incentives are the value of a particular outcome, including health status, physical appearance, peer approval, economic gain, or other consequences (Balir, 1993). Values are subjective; their meanings are interpreted and understood by the individual (Rosenstock, Strecher, and Becker, 1988).
Expectancies are also subjective beliefs that a person has regarding a particular outcome. Two types of expectancies exert powerful influences on behaviour outcome expectancy and self efficacy expectancy (Salazar, 1991). Outcome expectancy is the conviction that certain behaviours lead to certain outcomes, therefore reflecting the consequences of one’s own actions (Blair, 1993). Self-efficacy expectancy is the conviction that one can successfully execute the behaviour required to produce an outcome. It is an expectancy about one’s own competence to perform a behaviour (Blair, 1993). The cognitive mechanism of self-efficacy is posited by Bandura (1977,1986) to be the most powerful mediator of behaviour performance.
Underlying these expectancies are the individual’s beliefs regarding outcome and self-efficacy, it is the perception of this expectation that influence behaviour (Strecher, Devillis, Becker,& Roseenstock, 1986).
People often do not behave optimally, even though they have the appropriate knowledge. A person’s belief in the ability to perform or not perform a behaviour is an important link between knowing what to do and actually doing it (Bandura, 1982).
If self-efficacy beliefs are weak, people tend to behave ineffectually, even though they know what to do. The concept of self-efficacy does not, however, imply that efficacy and outcome expectations are the sole determinants of behaviour. Appropriate skills and adequate incentives are also necessary components of behavior decisions (Salazr, 1991)
According to Bandura (1977), a person’s self-efficacy beliefs may influence whether appropriate behaviours will be initiated and sustained in the face of obstacles. These beliefs are concerned with judgments of how well a person can successfully execute specific behaviours in specific situations (Bandura, 1982).
Researchers have indicated that perceptions of self-efficacy to resist smoking in sixth, seventh and eight grades are associated with their self-reported smoking behaviour (Lawrence and Rubinson, 1986). Successful interventions designed to prevent or eliminate smoking behaviours would be expected to increase self-efficacy expectations supporting the preteen’s or youth’s ability to resist or refuse to engage in smoking behaviours (Bandura, 1977; Condiotte and Lichrenstein, 1981). Bandura (1982) postulated that self-efficacy can be increased or enhanced through positive role modeling and by learning new skills to manage threatening activities. This position has been supported b y research on smoking and exercise in adults (Condiotte and Lichtenstein, 1981;
Hostettler, Hovel, and Salls, 1990), and diet and exercise in children (Parcel and Simmon-Morton, 1988). Self-efficacy is broadly conceptualized in this framework, encompassing many aspects of a preteen’s personality, with refusal skills being only one component.
Bandura (1977) maintained that to assist with problem solving and the development of refusal skills, positive strategies must be reinforced. One way this can be done is by providing peer feedback during role-playing activities. The success of this strategies may be determined by assessing the individual’s expectations for success in refusing to engage in specific behaviours (Bandura 1977).
Preteen children may be tempted by peer group pressures into taking risks (such as smoking) even when their better judgment tells them they should not. The peer pressure to smoke may be especially evident in preteens/youths from lower socio-economic groups (Conrad, Flay, &Hill, 1992; Harrel et all; 1998).
Being accepted by peers, asserting independence, and feeling attractive and mature are strong motivators to preteens. Even though they may know it is harmful, those who succumb to the pressure to smoke for any of the above reasons may have poorer refusal skills to help them cope with the pressure to smoke (Gidding, Morgan, Perry, Isabel-Jones, and Bricker, 1994).
Youths may be concerned about missing out on fun and losing friends if they refuse cigarettes. This population should assisted in developing refusal skills that include problem solving and countering negative peer pressure (EPPS, AND Mankey, 1993). It must be recognized, however, that preteens/youths are not always logical in their actions even when equipped with the appropriate skills; they are often impulsive. Refusal should, nonetheless, be taught and reinforced whenever possible.