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Background: The present study was to apply the Health Belief Model (HBM) to identify factors associated with
an assertive behavior of asking smokers not to smoke among college students in Korea when they were exposed
to secondhand smoke.
Methods: Data were collected from college students (n=2,061, 66.5% females) at two universities in Seoul and
Gyeonggi-do. A main outcome measure was the assertive behavior. HBM factors including perceived susceptibility
to illness, perceived severity of illness, perceived barrier to the assertive behavior, and cues to action were
self-administrated.
Results: The mean of the assertive behavior (range 1-5 points) was 2.20 points with 39.1% never being assertive
and 4.2% always being assertive. Based on results of a multiple logistic regression analysis, high levels of
perceived severity (odds ratio, OR 2.04, 95% confidence interval, CI 1.40-2.97) and perceived barrier (OR 1.72,
95% CI 1.41-2.08) were significantly associated with the assertive behavior, while perceived susceptibility and
cues to action were not.
Conclusions: Perceived severity and perceived barrier of the HBM model were significant factors associated
with the assertive behavior among college students. Modifying these factors may lead to enhancing the assertive
behavior of asking smokers not to smoke when college students were exposed to secondhand smoke.
Keywords: Secondhand smoke, Assertiveness, Behavior, Theoretical models |