Using the Unified Theory of Acceptance and Use of Technology (UTAUT) and E-health Literacy(e-HL) to Investigate the Tobacco Control Intentions and Behaviors of Non-smoking College Students in China: a Cross-sectional Investigation

Overview

Journal BMC Public Health

Publisher Biomed Central

Specialty Public Health

Date 2023 Apr 25

PMID 37098499

Authors

Yuanyuan Ma

Mengxia Zhou

Wenli Yu

Ziyue Zou

Pu Ge

Zheng Feei Ma

Yuting Tong

Wei Li

Qiyu Li

Yunshan Li

Siya Zhu

Xinying Sun

Yibo Wu

Affiliations

Soon will be listed here.

Abstract

Background: Non-smoking college students are starting to smoke in increasing numbers, which shows that their tobacco control situation seems not optimistic. The UTAUT and e-HL are commonly used models and theories to predict health behaviors, while there are few studies on tobacco control. This paper aims to study the influencing factors of tobacco control intention and behavior of non-smoking college students in China by combining the UTAUT and e-HL.

Methods: Based on the stratified sampling method, 625 college students from 12 universities were selected. Data were collected using a self-made questionnaire designed based on the UTAUT and e-health literacy scales. Data were analyzed by SPSS 22 and AMOS 26, including descriptive statistics, one-way variance analysis and structural equation model analysis.

Results: The results of one-way variance analysis showed that there were significant differences in the score of non-smoking college students' tobacco control intention or behavior by hometowns, monthly living expenses, and parents' smoking history. Performance expectancy, effort expectancy, social influence had direct positive effects on behavioral intention. Facilitating condition, behavioral intention had direct positive impacts on use behavior and e-HL had an indirect positive impact on use behavior.

Conclusions: The combination of the UTAUT and e-HL can be used as an appropriate framework to predict the influencing factors of non-smoking college students' intention and behavior of tobacco control. Improving performance expectancy, effort expectancy, and e-HL among non-smoking college students, creating positive social environments, and providing facilitating condition are key aspects of increasing their tobacco control intention and behavior. It is also beneficial to promote the implementation of smoke-free campus and smoke-free family projects.

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References

Atri S, Sahebihagh M, Jafarabadi M, Behshid M, Ghasempour M, Abri F . The Relationship between Health Literacy and Stages of Change in Smoking Behavior among Employees of Educational Health Centers of Tabriz University of Medical Sciences (2016). Int J Prev Med. 2018; 9:91. PMC: 6202775. DOI: 10.4103/ijpvm.IJPVM_259_17. View

Bast L, Lund L, LauemOller S, Kjeld S, Due P, Andersen A . Socio-economic differences in smoking among adolescents in a school-based smoking intervention: The X:IT II study. Scand J Public Health. 2021; 49(8):961-969. DOI: 10.1177/14034948211007683. View

Ozdemir U, Tuncay T . Correlates of loneliness among university students. Child Adolesc Psychiatry Ment Health. 2008; 2(1):29. PMC: 2572161. DOI: 10.1186/1753-2000-2-29. View

Lupton J, Townsend J . A Systematic Review and Meta-analysis of the Acceptability and Effectiveness of University Smoke-Free Policies. J Am Coll Health. 2015; 63(4):238-47. DOI: 10.1080/07448481.2015.1015029. View

Rogers C, Barrington-Trimis J, Unger J, Forster M . Changes in smoking prevalence and perception of smoking on campus before and after a smoke-free university campus policy. J Am Coll Health. 2020; 70(4):973-977. DOI: 10.1080/07448481.2020.1786097. View

Zheng P, Berg C, Kegler M, Fu W, Wang J, Zhou X . Smoke-free homes and home exposure to secondhand smoke in Shanghai, China. Int J Environ Res Public Health. 2014; 11(11):12015-28. PMC: 4245657. DOI: 10.3390/ijerph111112015. View

Robertson L, Marsh L . Smoke-free policies in New Zealand public tertiary education institutions. Health Educ Res. 2015; 30(2):347-58. DOI: 10.1093/her/cyv004. View

Meijer E, Korst J, Oosting K, Heemskerk E, Hermsen S, Willemsen M . "At least someone thinks I'm doing well": a real-world evaluation of the quit-smoking app StopCoach for lower socio-economic status smokers. Addict Sci Clin Pract. 2021; 16(1):48. PMC: 8320182. DOI: 10.1186/s13722-021-00255-5. View

Westmaas J, Bontemps-Jones J, Bauer J . Social support in smoking cessation: reconciling theory and evidence. Nicotine Tob Res. 2010; 12(7):695-707. DOI: 10.1093/ntr/ntq077. View

10.

Almutham A, Altami M, Sharaf F, Alaraj A . E-cigarette use among medical students at Qassim University: Knowledge, perception, and prevalence. J Family Med Prim Care. 2019; 8(9):2921-2926. PMC: 6820393. DOI: 10.4103/jfmpc.jfmpc_567_19. View

11.

Reid J, Hammond D, Boudreau C, Fong G, Siahpush M . Socioeconomic disparities in quit intentions, quit attempts, and smoking abstinence among smokers in four western countries: findings from the International Tobacco Control Four Country Survey. Nicotine Tob Res. 2010; 12 Suppl:S20-33. PMC: 2948137. DOI: 10.1093/ntr/ntq051. View

12.

Alzalabani A, Eltaher S . Perceptions and reasons of E-cigarette use among medical students: an internet-based survey. J Egypt Public Health Assoc. 2020; 95(1):21. PMC: 7431502. DOI: 10.1186/s42506-020-00051-0. View

13.

Pereira M, Assis B, Gomes N, Alves A, Reinaldo A, Beinner M . Motivation and difficulties to reduce or quit smoking. Rev Bras Enferm. 2020; 73(1):e20180188. DOI: 10.1590/0034-7167-2018-0188. View

14.

Mitsutake S, Shibata A, Ishii K, Okazaki K, Oka K . [Developing Japanese version of the eHealth Literacy Scale (eHEALS)]. Nihon Koshu Eisei Zasshi. 2011; 58(5):361-71. View

15.

Fitrianie S, Horsch C, Beun R, Griffioen-Both F, Brinkman W . Factors Affecting User's Behavioral Intention and Use of a Mobile-Phone-Delivered Cognitive Behavioral Therapy for Insomnia: A Small-Scale UTAUT Analysis. J Med Syst. 2021; 45(12):110. PMC: 8589825. DOI: 10.1007/s10916-021-01785-w. View

16.

Musmar S . Smoking habits and attitudes among university students in Palestine: a cross-sectional study. East Mediterr Health J. 2012; 18(5):454-60. DOI: 10.26719/2012.18.5.454. View

17.

Hoover D, Vidrine J, Shete S, Spears C, Cano M, Correa-Fernandez V . Health Literacy, Smoking, and Health Indicators in African American Adults. J Health Commun. 2015; 20 Suppl 2:24-33. PMC: 4725699. DOI: 10.1080/10810730.2015.1066465. View

18.

Tan X, Liu X, Shao H . Healthy China 2030: A Vision for Health Care. Value Health Reg Issues. 2017; 12:112-114. DOI: 10.1016/j.vhri.2017.04.001. View

19.

Hong K, Park N, Heo S, Hyun Jung S, Lee Y, Hwang J . Effect of e-Health Literacy on COVID-19 Infection-Preventive Behaviors of Undergraduate Students Majoring in Healthcare. Healthcare (Basel). 2021; 9(5). PMC: 8151528. DOI: 10.3390/healthcare9050573. View

20.

Stoddard J, Augustson E, Mabry P . The importance of usability testing in the development of an internet-based smoking cessation treatment resource. Nicotine Tob Res. 2007; 8 Suppl 1:S87-93. DOI: 10.1080/14622200601048189. View