Assessing Gender Differences in College Cigarette Smoking Intenders and Nonintenders

Randy M. Page Robert S. Gold

ABSTRACT

variation^ In cigaretie smoking patterns between men and women have led to ihc ipeculat ion that !here may be systematic gender differences which account lor t h e w paiternc. I he purpose of the current study was to defermine whether w c h gender difterences exist in beliefs about the consequences of smoking. ?\alii:it ion\ of thoqe Consequences. one's normative beliefs and one's n i o t i ~ a t i o n ~ to comply among 221 college-age cfudents. These subcomponents o f I i\hbein'c model of behavioral intentions were tested with multivariate analysis Iprocedurer. Significanr gender differences found in beliefs about the conwquericcr of smoking, normative beliefs concerning smoking, and iiiotibation\ to coniplv indicate fhar educational and treatment programs should ;rddrev rncniherr o f rhe two s e w s in different way5.

I NT RO DUCT1 0 N

Traditionally, the prevalence of cigarette smoking among males has been higher than among females. However, patterns of cigarette smoking among both males and females have changed. However, patterns of cigarette smoking among both males and females have changed. The rates are decreasing for male and female adults, as well as for teenage boys and girls. While the prevalence of smoking among teenage boys and girls is decreasing, rates among teen-age boys are declining more rapidly. The percentage of male smokers aged 12 to 18 between 1974 and 1979 decreased from 15.8% to 10.7%. During the same period, the percentage of female smokers of the same age decreased from 15.3% to 12.7%. As a result, a higher proportion of females (12.7%) than males (10.7%) between the ages of 12-18 were smoking cigarettes in 1979.' It is also suspected that cigarette smoking is more prevalent among college females than college males. A continuation of present trends in cigarette smoking could lead to more female smokers than male smokers in all age groups.' In addition, the cessation rate has been consistently lower for women than men.4

These differing patterns of cigarette smoking be- havior among males and females has lead to speculation that men and women may start, continue or quit smok- ing cigarettes for very different reason^.^ If such differ- ences do in fact exist, research on cigarette smoking be- havior should lead to some clarification of these differ- ences, and future smoking education programs should be structured to account for differences.J

The purpose of the present investigation was to iden- tify and determine whether there were differences in be- liefs about the consequences of cigarette smoking, eval- uations of those consequences, normative beliefs and motivations to comply between males and females who were enrolled in personal health classes at Southern Illinois University at Carbondale. Beliefs, evaluations, normative beliefs and motivations to comply are sub- components of Fishbein's model of behavioral inten- tions. The Fishbein model has been described in this journaL6 The model has been used successfully to predict or account for 47% of the variance in the inten- tion to smoke cigarettes within a seven-day period among college females.' The model is important to health educators who are interested in behavior change because of the relationship between beliefs, evaluations, normative beliefs and motivations to comply with be- havior. According to the theory of the model, once a person's salient beliefs (as well as evaluations, norma- tive beliefs and motivations to comply) are determined educational strategies can be aimed at changing beliefs, evaluations, normative beliefs and motivations to comply and thereby change behavior.

METHODOLOGY Sampling

During the 1981 fall semester, there were 34 personal health classes at SIU-C. The instrument used in this study was administered in all 34 classes, resulting in more than 500 completed instruments. All of the instru- ments completed by students who stated that they in- tended to smoke cigarettes during the next 24 hours were included in the sample. This resulted in 68 female intenders and 53 male intenders. In addition, 50 male nonintenders and 50 female nonintenders were random- ly selected as part of the sample. The resulting sample consisted of 221 students (118 females and 103 males).

Instrumentation An adaptation of the instrument used by Roberts

served as the survey instrument for this study.' Beliefs

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about the consequences of smoking, evaluations of the consequences, normative beliefs and motivations to comply were measured by single seven-point bipolar scales. Since Roberts was interested in very specific smoking behaviors (i.e., increasing rate of smoking, decreasing rate of smoking, changing to lower tar and nicotine cigarettes, quitting smoking, starting to smoke, continuing to smoke at the same rate), his scales were designed to measure beliefs associated with these specific behaviors. For the current study the wording of the belief and normative belief scales was modified to deal with the behavior of cigarette smoking behavior in general. For example, a belief statement such as, “in- creasing my rate of cigarette smoking would increase my chances of getting cancer,” was modified to read, “my smoking cigarettes would increase my chances of getting cancer.” The scales developed by Roberts designed to measure evaluations were used without any modifica- tions. Only one of the motivations to comply scales was modified. Because this study included both males and females, Roberts’ scale which is used to measure the motivation to comply with “a boyfriend” was changed to read “my best friend of the opposite sex.”

Beliefs about the consequences of smoking were mea- sured on scales with “likely - unlikely” endpoints,

while evaluations of the consequences of smoking had “good - bad” endpoints. Normative belief scales em- ployed the endpoints “ I should - I should not” and motivations to comply used “I want to do - 1 don’t want to do” as the endpoints. All scales were weighted from + 3 (for extremely good, extremely likely, I should and I want to do) to -3 (for extremely bad, extremely un- likely, I should not and I do not want to do). The zero point on the scales was interpreted as nonagreement with either member of the objective pair.

Smoking intention was obtained by asking subjects how many cigarettes they intended to smoke during the next 24 hours. This question along with items that asked subjects about demographic information and 52 single- response scales, which measured beliefs about the con- sequences of cigarette smoking, evaluations of consequences, normative beliefs and motivations to comply, were combined to make up the survey instru- ment. Of the 52 scales, 16 measured beliefs of the conse- quences of smoking and 16 measured corresponding evaluations of the consequences. Ten scales measured normative beliefs and 10 measured motivations to com- ply. Examples of the questions used to operationalize the variables used in the Fishbein model are included in Figure 1.

Figure 1 Sample Questionnaire items

BKLIKI‘S A B D l l T T H E C O N S E Q U E N C E S OF C I G A R E T T E S M O K I N G

My smoking cigarettes would relieve nervous tension.

-

CVALlJATT(1N.S Ot’ T H E C O N S E Q U E N C E S O F C I G A R E T T E S M O K I N G

N O M A T I V E ~ BE1,IEFS

My mottier t t l i n k s

I s l iould : : : : : : I s h o u l d n o t smoke cigarettes

M ( 0 T I V A T I ON S TI COMPLY

I I I c3rnt:ral

I want to d o : : : : : : I don’t w a n t to do what my r n o t h c s r think., I should do.

~~

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Data Analysis Gender was used as the independent variable in this

study. Beliefs, evaluations, normative beliefs and moti- vations to comply, which are the four subcomponents of the behavioral intention model, represent four sets of dependent variables. Because each subcomponent con- tains several dependent variables, multivariate analysis of variance (MANOVA) tests were computed for each of the four subcomponents: beliefs; evaluations; normative beliefs; and motivations to comply. An alpha level of .05 was used as the criterion for significance. When significance was found, multiple discriminant analysis techniques were applied to determine the major contributors to differences between males and females. Structure correlations (correlations between each dependent variable and the discriminant function) were used to identify which specific variables contributed the most to differences because they are not affected by relationships with other dependent variables. A struc- ture correlation of .25 was used as the minimum level of acceptability for determining which variables contri- buted to gender differences. The sample size varied from analysis to analysis because of differences in the patterns of missing data. Duncan’s Multiple Range Test was used to explain differences between males and females for those variables which contributed signifi- cantly to gender differences.

RESULTS MANOVA testing indicated that there were signifi-

cant gender differences on beliefs [F(16,194) = 2.16, p e .05], normative beliefs [F(10,202) = 1.99, p < .05], and motivations to comply [F(10,199) = 3.19, p < .05]. There was not a significant gender difference on evaluations.

Gender Differences in Beliefs The canonical correlation of the discriminant func-

tion associated with beliefs about the consequences of cigarette smoking was .37 (p 4.05, df = 16). Structure correlations and mean scores on beliefs by gender are presented in Table 1. The beliefs that contributed the most to the difference between males and females on the discriminant function were: “would leave a bad odor on clothing”; “would keep weight down”; “would give something to do with hands”; “would help to concen- trate”; “would increase dependency on cigarettes”; and “would be expensive.” Using Duncan’s Multiple Range Tests, it was determined that females were significantly more likely than males to believe that cigarette smoking would “leave a bad odor on clothing” and “increase dependency on cigarettes.” Males were significantly more likely than females to believe that cigarette smoking would not “keep weight down” and “help to concentrate.”

Table 1 Structure Correlations (n = 202) and Mean Scores (n = 209)

for Beliefs by Gender - I--

I.cavc ;I 1)xI odor on c l o t h i n g Keep weight down (j ive sc.iiiletli~ ng t o do w i tti I le 1 p t o c onz en t r a t e Incrcase dependency on c i g a r e t t e s Be expens ive Increiisc chance of g e t t i n g c a n c e r I,ead t o hav ing b r e a t h i n g problems IReldx lie acce1)tt.d by peers Be o f f e n s i v e t o o t h e r s Ilelp t o i n t e r a c t i n s o c i a l s i t u a t i o n s Be haririful t o h e a l t h Kcl i c v e nervous t e n s i o n Cause bad b r e a t h Give a p l e a s a n t t a s t e e x p e r i e n c e

,4215 .4060 .386R .3491 ,2935 .2553 .2178 .2169 .1953 .1608

- . 1476 .1131 .0737 .0781

- . ( I512 - .0235

1 . 8 8

0.15 -1 .?6

1 . 9 2 1 .93 2 .32 1 . 9 3

- (1 . :i 0 -n . 3 R

1 .67 - 1 . 1 0 2 .52

1 .94 -1 . O R

- I . i n

0 .00

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Table 2 Structure Correlations (n = 202) and Mean Scores (n = 211)

for Normative Beliefs by Gender

-

Noriiiativc fie1 iefs S t r u c t u r e Mean Scores C o r r e l a t i o n s blalcs Ferllalcs

Most nonsmokers Doc: t o r s best f r i e n d of t h e o p p o s i t e sex Friends I iitiler blost siiiokcrs (:I g n r c t t e i i iariufacturers Motller Most ~icople who a re iiiiportant Other iiicnibers o f faiiii l y

.6298

.4940

.3994

.2619

.2608 . .2583 . ,7087 . L939 .0624 .(I037

-1.91 -2.38 -1.84 -1 .51 - 2 . 2 2 -0.88

2 . 2 0 - 2 . 3 9 - 2 . 2 3 -2 .15

- 2 . 3 9 * - 2 . 7 1 * - 2 . 1 8 - 1 . 7 9 - 2 . 2 7 -0 . O ( 1

I . 9 s - 2 . 4 6 - 2 . 3 4 -2 .09

*I’ .-. us Gender Differences in Normative Beliefs females did not differ significantly on any other

The canonical correlation of the discriminant func- normative beliefs. tion associated with normative beliefs was .31 (p c .05, df = 10). Structure correlations and mean scores on Gender Differences in Motivations to Comply normative beliefs by gender are presented in Table 2. The canonical correlation of the discriminant func- The normative beliefs that contributed the most to the tion associated with motivations to comply was .32 difference between males and females on the discrimin- (p .C .05, df = 10). Structure correlations and mean ant function were: “most nonsmokers”; “doctors”; scores on motivations to comply by gender are present- “best friend of the opposite sex”; “friends”; ed in Table 3. The motivations to comply that contri- “fathers”; “most smokers.” Females were more likely buted the most to the difference between males and than males to believe that doctors and most nonsmokers females on the discriminant function were: “most think that they should not smoke cigarettes. Males and people who are important”; “doctors”; “mother”; and

Table 3 Structure Correlations (n = 202) and Mean Scores (n = 202)

for Motivations to comply by Gender _-

S t r u c t u r e Mean scorcs C o r r e l a t i o n Males I :e ma 1 cx s blut i v ; i t i o i i s t o Comply

h i o b t peolile N I I O a r e iiiiportant .51S8 0 . 8 0 1.3.3* Pot‘ t 0 I’5 . 4 7 0 4 1.11 1 .6Kk Blot he I‘ .4(>62 0 .50 0 . 98*

(:j g a r c t t e iiianiifucturers . 2 199 -1 .83 - 1 . 6 7 hlu s t nonsino hers .? I85 0 . 1 7 0 . 4 2 O t hcr nremhcrs of fuii i i l y . ? ( I I 2 0.28 0 . 5 5 I.;ltller . I 5 9 0 0 .48 0 .64 I k s t frierid o € t h e oppositc sex ,1567 0.35 0 . 4 7 blot;t sniohcrs .1506 -1.10 - 1 . ? X

Ibrj eiids - , 3372 -0.30 - 0 . 7.1

534 JOSH November 1983, Vol. 53, No. 9

“friends.” Females were significantly more willing than males to do what their mothers and most people who are important to them think they should do. Females also were more willing to comply with doctors than were males.

DI SC U WON

The results derived from this study indicate that males and females differ from each other in beliefs about the consequences of cigarette smoking, normative beliefs concerning smoking and motivations to comply. How- ever, males and females do not differ in their evalua- tions of the consequences of cigarette smoking. Based upon these findings, it is concluded that gender differ- ences should be taken into account in order to better understand cigarette smoking behavior and in develop- ing smoking education programs and materials. Further study is recommended to see if the predictability of Fishbein’s model of behavioral intentions (when applied to cigarette smoking) differs for males and females.

The gender differences in this study support the thinking of Clausen that different etiological factors are involved in male and female cigarette smoking.’ Addi- tionally, these findings support the earlier ideas of Williamsz and other^^.^ that: 1 ) males and females should be studied separately in research on cigarette smoking; and 2) consideration should be given to struc- turing smoking prevention and cessation programs dif- ferently for males and females.

Males and females differ on a number of specific be- liefs. The greatest difference was on the belief that cig- arette smoking would “leave a bad odor on clothing.” Females appear to be more sensitive to the odor of cigarette smoke than do males. Smoking education and antismoking appeals directed toward girls and women may benefit from emphasizing the bad odor effects of smoking on clothing, furniture and in cars and other places.

Females in college are more likely to believe that smoking cigarettes will result in “keeping weight down” than males. A reliance on smoking by women in order to maintain or lose weight may be a contributing factor in women’s greater difficulty in smoking cessation. It may also be a factor in the greater prevalence of female than male smokers in high school and college popula- tions. Many women may perceive the need to keep their weight down as more important than quitting or not smoking. The topic of weight control and maintenance should be considered for inclusion in smoking pre- vention and cessation programs especially those which are directed at females. Females should be informed that there are better alternatives for controlling their weight than smoking cigarettes. Weight control tech- niques should also be taught.

Females also are more likely than males to believe that cigarette smoking “increases dependency on cigar- ettes.” This finding that women recognize the depend- ency nature of cigarettes more strongly than men may reflect the fact that women are at higher risk of dependency on cigarettes than men. This is supported by an earlier finding by Radius’ that adolescent girls are more likely to continue smoking than boys after experi- menting with cigaretes. Also, as mentioned earlier, women are less successful than men in quitting smoking.

Conclusions that can be drawn from gender differ- ences in motivations to comply are: 1) females are more willing than males to comply with most people who arc important to them; and 2) females are more willing than males to do what physicians think they should. I t is also interesting to note that females perceive physicians as not wanting them to smoke cigarettes more strongly than do males. Perhaps the use of physicians should be emphasized in smoking education programs that are directed at women.

Future research is needed to confirm these findings among other populations (i.e., noncollege, different age groups). The reader should be careful not to generalize these findings beyond a college population. A follow-up study needs to be conducted to determine whether the predicative ability of beliefs, evaluations, normative beliefs, and motivations to comply in predicting inten- tion to smoke cigaretts differs for males and females.

References

I . National Institute of Education. Teenage Si?wkrrfe: / v i m ~ d r o / ~ and Long Term Parterns. Washington. DC. l ! .S. <io\t.rnmcnt Printing Office, 1980.

2. Wechsler H. Gottlieb NH: Smoking among NCH. Fngland college men and women. J A m Coll Healrh .4s.soc~ ZR:l5S-I57. 1979.

3. Office on Smoking and Health. Smoking and Healrh: 4 Keporr ofrheSurgeon General. Warhington, DC‘. U .S . Governnicnt Ptirlting Office, 1979.

4. Office on Smoking and Health. The Hed lh Conreqrrcwcet ( J f Smoking for Women: A Reporf of the Surgeon General. Wachington. DC, U.S. Government Printing Office, 1980.

5 . Williams AF: Personality characteristics associated m i t h cigarette smoking among teenagers. J Heolih SOC Hehais 14374-379, 1973.

6. London FB: Attitudinal and social normative lactor\ a\ predictors of intended alcohol abuse among f i l t h - and ?eventh-grade students. J Sch Healrh 52:244-249, 1982.

7 . Roberts S: Beliefs associated with smoking intenlions o f college women. Doctoral dissertation. University of lllinoi\, 1979.

8. Clausen JA: Adolescent antecedents of cigareite Smoking: Daia from the Oakland growth study. Soc Sci Med 1:357-382. 1968.

9. Radius SM, Dielman TE, Becker MH. Rosenqock I M . Harvath WJ: Health beliefs of the school-aged child and their relationship to risk-taking behavior?. Inr J Healrh E d t ~ 23:277-372, 1980. Randy M. Page, PhD, Robert S . Gold, PhD, DrPH, Department of Health Education, Southern Illinois University at Carbondale, Carbondate, IL 62901.

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