Title Page
Contents
ABSTRACT 16
Ⅰ. INTRODUCTION 20
A. Statement of the Problem 20
B. Background of the study 24
C. Purpose of the Study 27
D. Research Questions 30
E. Research Hypotheses 31
F. Conceptual Framework 32
G. Definition of Terms 34
Ⅱ. REVIEW OF LITERATURE 39
A. Harmful Effects of Tobacco Smoking 39
B. Trends and Prevalence of Smoking among Pakistani University Students 40
C. Psychosocial Adaptation and Coping to Chronic Illness and Disability 46
D. Risk Factors 49
1. Familial Risk Factors 49
2. Primary Living Situation, Parents' Education, and Income 53
E. Protective Factors 57
1. Positive Psychological constructs 58
2. Health Values 69
3. Spiritual Well-Being 71
Ⅲ. METHODOLOGY 74
A. Participants 75
B. Research Design 78
C. Tools and Instruments 78
a. Brief Demographic Questionnaire 79
b. The Modified H A V- Health-As-A-Value 80
c. Family Substance Abuse Information 81
d. The Fagerström Test for Nicotine Dependence 84
e. Corner-Davidson Resilience scale (10 items, CD-RISC) 85
f. The Spiritual Well-being Scale (SWBS) 86
g. New General Self-Efficacy Scale (NGSE) 87
h. The Revised Life Orientation Test (LOT-R) 88
i. Perceived Stress Scale (PSS) 89
D. Procedure 90
E. Data Analyses 94
Ⅳ. RESULTS 99
A. Characteristics of the Sample 99
B. Hypothesis 1 104
C. Hypothesis 2 109
D. Hypothesis 3 113
E. Hypothesis 4 136
F. Hypothesis 5 142
Ⅴ. DISCUSSION 150
Summary of Findings 150
Ⅵ. CONCLUSION 155
A. Implications of Results 157
B. Limitations 165
C. Recommendations for Future Research 167
REFERENCES 170
APPENDICES 15
APPENDIX A. QUESTIONNAIRE 199
APPENDIX B. RESEARCH PERMISSION LETTER 213
Table 1. Demographic Characteristics of University Sample 101
Table 2. Intercorrelation between Resilience, Self-efficacy, and Optimism 105
Table 3. Intercorrelation between Resilience, Self-efficacy, Optimism, Health value, and Spiritual well-being 107
Table 4. Intercorrelation between Stress and Nicotine Dependence 110
Table 5. Intercorrelation between Resilience, Self-efficacy, Optimism, Health value, and Spiritual well-being 111
Table 6. Frequencies for Categories of Nicotine Dependence risk groups. 114
Table 7. Mean, Standard Deviation, and One-way Analysis of Variance in Resilience across Nicotine Dependence groups. 115
Table 8. Scheffe Post Hoc test for Resilience and Nicotine Dependence risk groups 116
Table 9. Robust Tests of Equality of Means for Resilience 117
Table 10. Mean, Standard Deviation and One-way Analysis of Variance in Self-efficacy across Nicotine Dependence Risk groups. 119
Table 11. Scheffe Post Hoc test for Self-efficacy and Nicotine Dependence risk groups. 120
Table 12. Robust Tests of Equality of Means for Self-efficacy 121
Table 13. Mean, Standard Deviation, and One-way Analysis of Variance in Optimism across Nicotine Dependence groups. 123
Table 14. Scheffe Post Hoc test for Optimism and Nicotine Dependence risk groups 123
Table 15. Mean, Standard Deviation, and One-way Analysis of Variance in Health Value across Nicotine Dependence groups. 126
Table 16. Scheffe Post Hoc test for Health-as-a-value and Nicotine Dependence risk groups. 127
Table 17. Mean, Standard Deviation and One-way Analysis of Variance in Spiritual Well-being across Nicotine Dependence groups. 129
Table 18. Scheffe Post Hoc test for Spiritual well-being and Nicotine Dependence risk groups. 130
Table 19. MANOVA tests for Nicotine Dependence risk with Resilience, self-efficacy, Optimism, Health values, and Spiritual well-being, 133
Table 20. Box's Test of Equality of Covariance Matrices 135
Table 21. Frequencies for Group 1 (Individuals with familial SUD history) and Group 2 (with no SUD history). 137
Table 22. Independent sample T-test for Resilience, self-efficacy, optimism, Health-as-a-Value, Spiritual well-being, and Familial problematic substance use. 139
Table 23. Intercorrelation between Resilience, Self-efficacy, Optimism, Health value and Spiritual well-being for individuals with Familial problematic substance use. 140
Table 24. Intercorrelation between Resilience, Self-efficacy, Optimism, Health value and Spiritual well-being for individuals with no Familial problematic substance use. 141
Table 25. Frequencies and Chi-square results for Primary living place, father's education,mother's education, and parent's monthly income Smoking status (smokers and non-... 143
Table 26. Frequencies and Chi-square results for Primary living place, father's education,mother's education, and parents' monthly income with Familial history of SUD (N=419) 147
Figure 1. Conceptual Framework 33
Figure 2. Resilience means plot for four categories of Nicotine Dependence Risk 115
Figure 3. Self-efficacy means plot for four categories of Nicotine Dependence Risk 119
Figure 4. Optimism means plot for four categories of Nicotine Dependence Risk 125
Figure 5. Health Value means plot for four categories of Nicotine Dependence Risk 128
Figure 6. Spiritual well-being means plot for four categories of Nicotine Dependence Risk 131