Thesis (Ph.D.)--Chulalongkorn University, 2012

The purposes of this survey research for casual analysis were to develop and examine the casual relationship among nicotine dependence, severity of alcohol dependence, stages of change, process of change, decisional balance, self-efficacy and smoking cessation in Thai alcohol dependent treatment centers and Thailand National Quitline, participated in this study. Research instruments included the demographic characteristics questionnaire, Fagerstrom Test for Nicotine Dependence, The Severity of Alcohol Dependence Questionnaire, Smoking Stage of Change, Processes of Change Questionnaire, Smoking Self-efficacy Scale, and Smoking Decisional Balance Scale. The descriptive statistics and structural equation modeling were used to analyze data. The results showed that based on the Goodness of fit indices, the smoking cessation model fits with the empirical data and can explain 82.60% of the variance of smoking cessation among Thai alcohol-depedent smokers. Nicotine dependence had the most negative direct effect on smoking cessation. Severity of alcohol dependence had the most negative direct effect on smoking cessation but it had a positive indirect effect on smoking cessation through nicotine dependence. In addition, self-efficacy and decisional balance had significant positive direct effect on smoking cessation. Furthermore, stage of change had a negative indirect effect on smoking cessation through processes of change. These results contribute to a better understanding of the variables that influence smoking cessation in alcohol-dependent smokers. It is essential to gather information on smoking cessation interventions in alcohol-dependent smokers should assess both severity of alcohol dependence and level of nicotine dependence. In addition enhancing self-efficacy and encouraging decisional balance could be considered to promote cessation in this group.