Journal of Preventive Medicine and Public Health

Original Articles

Teachers’ Negative Attitudes and Limited Health Literacy Levels as Risks for Low Awareness of Epilepsy in Turkey: Gulay Yilmazel; J Prev Med Public Health. 2023;56(6):573-582. Published online November 13, 2023; DOI: https://doi.org/10.3961/jpmph.23.330

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Abstract Summary PDF Supplementary Material: Objectives
For students with epilepsy, schools are a critical environment for managing the disease properly. This study examined awareness of epilepsy, attitudes toward epilepsy, and health literacy among school teachers in Turkey.
Methods
This study was conducted in a city in Turkey with 1408 public school teachers from June 2021 to September 2021.
Results
The median scores of the scales were 5, 29, and 32 for epilepsy awareness, epilepsy attitudes, and health literacy, respectively. Epilepsy awareness was higher in women, and epilepsy attitudes were more positive in women than men (p<0.05). While epilepsy awareness was higher in primary school teachers, epilepsy attitudes were more positive in secondary school teachers (p<0.05). Epilepsy awareness was lower in secondary school teachers (odds ratio [OR], 1.27; p<0.05), those who did not have an individual with epilepsy in their family/social environment (OR, 1.57; p<0.001), those who did not have a student with epilepsy in their class (OR, 1.45; p<0.05), and in those who had not witnessed an epilepsy seizure (OR,1.19; p<0.05). Compared to those with positive attitudes regarding epilepsy, epilepsy awareness was 1.36 times lower in those with negative attitudes (p<0.001). Epilepsy awareness was 1.92 times lower in those with limited health literacy than those with adequate health literacy (p<0.001).
Conclusions
In this study, low epilepsy awareness, negative epilepsy attitudes, and limited health literacy were common among teachers. The findings from this study suggest that panels, workshops, and health training on epilepsy should be organized for school teachers and included at regular intervals in certified first-aid practices.; Summary

Key Message
• This article examined school teachers' barriers to epilepsy awareness. • Awareness was low, negative attitudes were high, and health literacy level was limited. • Negative attitudes and limited health literacy were the most effective risks for poor awareness.

Ethnic Variation and Its Association With Malaria Awareness: A Cross-sectional Study in East Nusa Tenggara Province, Indonesia: Robertus Dole Guntur, Jonathan Kingsley, Fakir M. Amirul Islam; J Prev Med Public Health. 2022;55(1):68-79. Published online November 15, 2021; DOI: https://doi.org/10.3961/jpmph.21.367

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Objectives
This study investigated associations between ethnicity and malaria awareness in East Nusa Tenggara Province (ENTP), Indonesia.
Methods
A community-based cross-sectional study was conducted upon 1503 adults recruited by multi-stage cluster random sampling. A malaria awareness questionnaire was used to collect data, according to which participants were classified as aware or unaware of malaria. Logistic regression was applied to quantify the strength of associations of factors with malaria awareness.
Results
The participation rate in this study was high (99.5%). The participants were distributed relatively evenly among the Manggarai, Atoni, and Sumba ethnicities (33.0, 32.3, and 30.2%, respectively). Malaria awareness was significantly different amongst these groups; it was most common in the Manggarai ethnicity (65.1%; 95% confidence interval [CI], 59.9 to 70.3) and least common in the Sumba ethnicity (35.0%; 95% CI, 27.6 to 42.4). The most prominent factor influencing the malaria awareness in the Sumba and Manggarai ethnicities was education level, whilst it was socioeconomic status (SES) in the Atoni ethnicity. The likelihood of malaria awareness was significantly higher in adults with an education level of diploma or above (adjusted odds ratio [aOR], 21.4; 95% CI, 3.59 to 127.7 for Manggarai; aOR, 6.94; 95% CI, 1.81 to 26.6 for Sumba). Malaria awareness was significantly more common amongst high-SES adults in the Atoni group (aOR, 24.48; 95% CI, 8.79 to 68.21).
Conclusions
Low education levels and low SES were prominent contributors to lower levels of malaria awareness in rural ENTP. Interventions should focus on improving malaria awareness to these groups to support the Indonesian government’s national commitment to achieve a malaria elimination zone by 2030.

Summary

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The Declined Trend of Malaria over a Ten-year Period in the Rural East Nusa Tenggara Province, Indonesia: A Medical Record Analysis
Maria Lobo, Robertus Dole Guntur, Damai Kusumaningrum, Yulianti Paula Bria
Open Access Macedonian Journal of Medical Sciences.2024; 12(1): 107. CrossRef
The Variation of Malaria Prevention Measures Knowledge and their Associated Factors in Rural East Nusa Tenggara Province, Indonesia
Robertus Dole Guntur, Maria A. Kleden, Damai Kusumaningrum, Fakir M. Amirul Islam
Open Access Macedonian Journal of Medical Sciences.2023; 11(E): 378. CrossRef

Special Article

Trends of the Global Hepatitis C Disease Burden: Strategies to Achieve Elimination: Nathalie Brunner, Philip Bruggmann; J Prev Med Public Health. 2021;54(4):251-258. Published online June 24, 2021; DOI: https://doi.org/10.3961/jpmph.21.151

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Abstract PDF

Hepatitis C infection is responsible for high morbidity and mortality rates globally as well as for significant indirect costs. The disease burden caused by the hepatitis C virus (HCV) is comparable to the one caused by human immunodeficiency virus or tuberculosis. Today, simple detection methods, highly effective and easy to administer therapies and efficient preventative measures are available to combat hepatitis C. Nevertheless, in most countries around the world, the World Health Organization target of eliminating this infectious disease and its consequences by 2030 are not being met. Significant gaps in care for hepatitis C sufferers still exist, the shortcomings ranging from education and treatment to aftercare. Hepatitis C infection was and still is not on the radar of most politicians and health authorities. National programmes and strategies to combat the disease exist or are being developed in many countries. However, for these to be implemented efficiently and successfully, clear political commitment, strong civil society actors, well-functioning public health structures and the relevant support from global donors are needed.

Summary

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Original Articles

Sex Differences Associated With Hepatitis B Virus Surface Antigen Seropositivity Unwareness in Hepatitis B Virus Surface Antigen-positive Adults: 2007‐2012 Korea National Health and Nutrition Examination Survey: Suk-Yong Jang, Sung-In Jang, Hong-Chul Bae, Jaeyong Shin, Eun-Cheol Park; J Prev Med Public Health. 2015;48(2):74-83. Published online March 16, 2015; DOI: https://doi.org/10.3961/jpmph.14.034

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Abstract PDF

Objectives
To examine the sex-specific factors associated with being unaware of one’s hepatitis B virus surface antigen (HBsAg) seropositivity status in a large, HBsAg-positive population of Koreans.
Methods
In total, 1197 subjects aged 19 years or older who were HBsAg-positive according to data from the 2007-2012 Korea National Health and Nutrition Examination Survey were included. Subjects were considered unaware of their HBsAg seropositivity status if they answered that they had no knowledge of being previously infected by the hepatitis B virus (HBV) or diagnosed with HBV hepatitis. Multivariate Poisson regression models with robust variance estimate were used to assess the significance of the variables using weighted frequencies.
Results
The majority (77.8%) of HbsAg-positive Korean adults (females, 81.9%; males, 74.6%) were unaware of their HBsAg seropositivity status. We found that sex (female: prevalence ratio [PR] 1.19), household income (low: PR, 1.15), marital status (never married: PR, 1.18), self-rated health (moderate: PR, 1.14; good: PR, 1.12), and alcohol use (at least 2-3 times/wk: PR, 1.21) were associated with being unaware. In females, age (50 to 59 years: PR, 1.29; ≥70 years: PR, 1.30), household income (low: PR, 1.37; middle–low: PR, 1.24), and marital status (never married: PR, 1.33) were associated with being unaware. In males, self-rated health (moderate: PR, 1.14; good: PR, 1.21) and alcohol use (at least 2–3 times/wk: PR, 1.21) were associated with being unaware.
Conclusions
Factors related to the socioeconomic status of females and the health-related behaviors of males were found to be associated with being unaware of one’s HBsAg seropositivity status.

Summary

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Association of perceived life satisfaction with attitudes toward life-sustaining treatment among the elderly in South Korea: a cross-sectional study
Il Yun, Hyunkyu Kim, Eun-Cheol Park, Suk-Yong Jang
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A Trend Analysis of the Prevalence, Awareness, Treatment, and Control of Hypertension by Age Group: Jong Youn Moon, Kwan Jun Park, Young Hwangbo, Mee Ri Lee, Byoung In Yoo, Jong Hye Won, Yoon Hyung Park; J Prev Med Public Health. 2013;46(6):353-359. Published online November 28, 2013; DOI: https://doi.org/10.3961/jpmph.2013.46.6.353

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Abstract PDF

Objectives

We examined the trends in prevalence, awareness, treatment, and control of hypertension in Korea as a basis for improving hypertension control programs.

Methods

12 598 participants of the Korean National Health and Nutrition Examination Survey were included in this study. Weighted linear regression to test time trends from 2007 to 2011 was performed.

Results

The prevalence of hypertension was 20.7% in 2007, 29.4% in 2009, and 26.2% in 2011. Awareness of hypertension was 64.8% in 2007 and 61.1% in 2011. Awareness in those aged 65 and over was greater than in younger groups (age 19 to 44 and 45 to 64; p<0.001). The treatment rates were 58.4% in 2007 and 56.8% in 2011. The treatment rate was greater for those 65 and over than for younger age groups (p<0.001). The percentage of controlled hypertension was 37.6% in 2011. The percentage of controlled hypertension in those 65 and over was higher than in younger age groups (p<0.001). The treatment-control rates were 65.9% in 2007 and 67.7% in 2011. The prevalence of hypertension was higher in the males (p<0.001), while the awareness (p<0.001), treatment (p<0.001), and control (p<0.001) rates were higher in the females.

Conclusions

The prevalence of hypertension was increasing and the hypertension awareness, treatment, and control rates were low in younger age groups and males.

Summary

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Vaccine Storage Practices and the Effects of Education in Some Private Medical Institutions: Saerom Lee, Hyun-Sul Lim, Ohyon Kim, Jeonggyeong Nam, Yeongsun Kim, Hyungrae Woo, Woojin Noh, Kyenam Kim; J Prev Med Public Health. 2012;45(2):78-89. Published online March 31, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.2.78

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Abstract PDF

Objectives

Although vaccination rates have increased, problems still remain in the storage and handling of vaccines. This study focused on inspecting actual vaccine storage status and awareness, and comparing them before and after education was provided.

Methods

In the primary inspection, a status survey checklist was completed by visual inspection. A questionnaire on the awareness of proper vaccine storage and handling was also administered to vaccine administrators in private medical institutions in 4 regions in Gyeongsangbuk-province. One-on-one education was then carried out, and our self-produced manual on safe vaccine storage and management methods was provided. In the secondary inspection, the investigators visited the same medical institutions and used the same questionnaire and checklist used during the primary inspection. The results before and after education were compared, by treating each appropriate answer as 1 point.

Results

The average checklists score was 9.74 (out of 15 points), which increased significantly after education was provided (by 0.84, p<0.001). The participants demonstrated improved practices in recording storage temperatures (p=0.016), storing vaccines in the center of the refrigerator (p=0.004), storing vaccines with other medication and non-medical items (p=0.031) after education. The average score calculated from the questionnaires was 10.48 (out of 14 points), which increased after education (by 1.03, p<0.001).

Conclusions

This study suggests that vaccine storage practices and awareness are inadequate, but can be partially improved by providing relevant education. Repetitive education and policy-making are required to store vaccines safely because one-off education and unenforced guidelines offer limited efficacy.

Summary

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Juny Sebastian, Gurumurthy Parthasarathi, Mandyam Dhati Ravi
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Anika Thielmann, Marie-Therese Puth, Birgitta Weltermann, Abhijit P. Pakhare
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Trials.2015;[Epub] CrossRef

English Abstracts

Awareness, Treatment and Control of Hypertension and Related Factors in the Jurisdictional Areas of Primary Health Care Posts in a Rural Community of Korea.: Hyung Min Lee, Yu Mi Kim, Cheol Heon Lee, Jin Ho Shin, Mi Kyung Kim, Bo Youl Choi; J Prev Med Public Health. 2011;44(2):74-83.; DOI: https://doi.org/10.3961/jpmph.2011.44.2.74

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OBJECTIVES
This study aimed to identify and assess the factors related to the awareness, treatment, and control of hypertension based on jurisdictional areas of primary health care posts in a rural community of Korea. METHODS: This study was performed on 4598 adults aged over 30 years in a rural community and we measured their blood pressure (BP) from October. 2007 to August. 2009. Hypertension is defined as a condition characterized by a systolic BP > or =140 mmHg, a diastolic BP > or =90 mmHg or reported treatment with antihypertensive medications. We analyzed the factors related with the prevalence, awareness, treatment and control of hypertension using chi-square test and multivariate logistic regression analysis. RESULTS: The age-adjusted prevalence of hypertension was 34.7%. The age-adjusted rates of hypertension awareness, treatment and control were 50.6%, 93.9% and 64.1%, respectively. Awareness of hypertension was related with increasing age. Higher awareness was found among men who were felt more stress, were obese and had hypercholesterolemia, and among women who were regulary taking medicine for hypertension, were obese and had diabetes mellitus. In women, the hypertension treatment was related a Medical aid and education for hypertension management. Controlled hypertension was more common among men who were educated about the management of hypertension and among women who had hypercholesterolemia. CONCLUSIONS: The awareness of hypertension was low and the control of hypertension was high compared with the nationwide data (KNHANES 2005). The results suggest that understanding the characteristics of hypertension in a community is important to perform a community based hypertension control program.

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Min So Kim, Kyae Hyung Kim, Sang Min Park, Jong-goo Lee, Yeon Seo Ko, A Ra Cho, Yoon Su Ku
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The Effect of Special Medical Examination for Night Shift Workers and Follow-Up Management Against Hypertension
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Decrease in Smoking and Related Factor after the Price Raise of Tobacco in Hypertension Patients: Using 2015 Korea National Health and Nutrition Examination Survey
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Factors Related to Blood Pressure Control in Hypertensive Patients in Jeju Province
Yeong Ju Ko, Eunok Park
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Awareness and Attitude Toward Suicide in Community Mental Health Professionals and Hospital Workers.: Soung Nam Kim, Kang Sook Lee, Seon Young Lee, Jae Hee Yu, A Rum Hong; J Prev Med Public Health. 2009;42(3):183-189.; DOI: https://doi.org/10.3961/jpmph.2009.42.3.183

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OBJECTIVES
The purpose of this study was to evaluate community mental health professionals and hospital workers attitude and awareness towards suicide. METHODS: This study investigated 264 community mental health professionals and 228 hospital workers. SOQs (Suicidal Opinion Questionnaires) were used from July 2007 to September 2007. After a factor analysis for the attitude towards suicide, the items on ethics, mental illness, religion, risk, and motivation were included in the subsequent analysis. RESULTS: There were significant differences in the attitude towards suicide according to religion, age, educational background, the marriage status, the economic position, and different professional licenses. Hospital workers' view was different from the community workers'. The hospital workers judged that suicide was due to mental illness, and suicide was high for the people in a special environment and who lacked motivation, which caused them to fall in a dangerous situation. For the lower educational group, they thought that suicide was attributable to mental illness. The awareness for suicide was significantly higher in the group with a postgraduate education, unmarried people, mental health professionals and the persons who had concern and experience with suicide. The factors that had an influence on the awareness of suicide were the items of mental illness, religion, risk and motivational factors. CONCLUSIONS: This study suggested that the factors to increase the awareness and attitude for suicide were the experience of increased education and case management of suicide. Therefore, education dealing with suicide and reinforcement of crisis management programs should be developed.

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Physician Factors Associated with the Blood Pressure Control among Hypertensive Patients.: So Young Kim, In Sook Cho, Jae Ho Lee, Ji Hyun Kim, Eun Jung Lee, Jong Hyock Park, Jin Seok Lee, Yoon Kim; J Prev Med Public Health. 2007;40(6):487-494.; DOI: https://doi.org/10.3961/jpmph.2007.40.6.487

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OBJECTIVES
Little is known about the physician-related factors that are associated with the management of hypertension. The purpose of this study was to determine the physician-related factors associated with blood pressure control in hypertensive patients. METHODS: We surveyed 154 physicians at 117 public health (subhealth) centers in Gyeonggi-do. Forty-one physicians completed the survey (response rates: 26.6%) and 31 physicians were finally included as the study subjects. Using the information obtained from the selfreported survey, we measured the physician-related factors associated with hypertension control, including their perception of hypertension, prescription patterns (combination prescription rates, specific antihypertensives prescription rates among patients with diabetes mellitus), and sociodemographic factors. We then collected data on blood pressure and medication use in patients seen by these physicians from the health center's information system. We compared the physicians' perceived hypertension control rates with the actual rates, and then evaluated the rate of high overestimation (overestimation by more than 25% of the median degree of hypertension control rate overestimation) among the physicians. The physicians' antihypertensive prescription patterns were also evaluated. Multiple logistic regression analysis was used to evaluate the independent association between hypertension control and physicianrelated factors. RESULTS: The physicians tended to overestimate the proportion of their patients with controlled blood pressure (79.5% perceived vs. 57.8% actual). The percentage of physicians with high overestimation was 35.5% (11 physicians). The physicians with lower control rates were more likely to highly overestimate their patients' control rates. Physicians with below-median actual control rates tended to prescribe fewer combination treatments for patients with uncontrolled blood pressure and angiotensinconverting enzyme inhibitors or fewer angiotensin receptor blockers for patients with diabetes mellitus. The rate of high overestimation by physicians was 1.31 times higher in patients with uncontrolled blood pressure than in patients with other conditions (OR=1.31, 95% CI: 1.17-1.48). CONCLUSIONS: Physicians have a tendency to overestimate the rates of hypertension control in their patients. Because physicians have a direct role in treatment outcomes, physicians' overestimation about hypertension management contributes to inadequate blood pressure control. Thus, interventions for improving physician' awareness regarding the management of patients with hypertension are needed.

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Psychometric Properties of a Short Self-Reported Measure of Medication Adherence Among Patients With Hypertension Treated in a Busy Clinical Setting in Korea
Jeung-Hee Kim, Weon-Young Lee, Yeon-Pyo Hong, Wang-Seong Ryu, Kwang Je Lee, Wang-Soo Lee, Donald E. Morisky
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Awareness, Treatment, and Control Rates of Hypertension and Related Factors of Awareness among Middle Aged Adult and Elderly in Chuncheon: Hallym Aging Study(HAS).: Jin Young Jeong, Yong Jun Choi, Soong Nang Jang, Kyung soon Hong, Young ho Choi, Moon ki Choi, Dong Hyun Kim; J Prev Med Public Health. 2007;40(4):305-312.; DOI: https://doi.org/10.3961/jpmph.2007.40.4.305

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OBJECTIVES
To estimate the awareness, treatment and control rate, as well as to identify the awareness-related factors for hypertension. METHODS: The study participants were 482 adults (men 206, women 276), aged 45 or over, diagnosed with hypertension and living in Chuncheon. The awareness rate was defined as the proportion of persons among those with hypertension who had previously been diagnosed by a physician. The treatment rate was defined as the proportion of persons who had used anti-hypertensive medication, among those who were aware of their hypertension. The control rate was defined as the proportion of persons who kept blood pressure normal, among those who had been treated for their hypertension. Multivariable logistic regression analysis was carried out for the awarenessrelated factors using SAS VER 8.1. RESULTS: The awareness, treatment, and control rate were 55.8% (53.4% for men; 57.6% for women), 89.6% (87.2% for men; 91.2% for women), and 34.4% (28.1% for men; 38.6% for women), respectively. The awarenessrelated factors included a family history of hypertension (odds ratio[OR], 5.63; 95% confidence interval[95% CI]=1.53-20.72), smoking([Ex; OR 0.38, 95% CI= 0.15- 0.96)], [Current; OR 0.28, 95% CI=0.10-0.80]), and alcohol intake ([Ex; OR 3.22, 95% CI 1.03-10.09],[Current; OR 3.36, 95% CI=1.30-8.71]) for men, and education(OR 2.23, 95% CI=1.10-4.53), body mass index(OR 2.72, 95% CI=1.13-6.53), and self-rated health(OR 2.38, 95% CI=1.07-5.30) for women. CONCLUSIONS: The awareness rate of hypertension among the middle aged and elderly in Chuncheon was 55.8%. The related factors of awareness were gender specific. Further studies are needed to elucidate the putative reasons for these gender differences.

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Original Articles

Awareness, Treatment, Control, and Related Factors of Hypertension in Gwacheon.: Youn Hee Choi, Chung Mo Nam, Mi Hyun Joo, Ki Tae Moon, Jee Seon Shim, Hyeon Chang Kim, Il Suh; Korean J Prev Med. 2003;36(3):263-270.

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Abstract PDF: OBJECTIVES
To identify the factors related to awareness, treatment, and control of hypertension in a Gwacheon population. METHODS: This study surveyed 1, 176 Gwacheon residents older than 40 years, and measured blood pressure using a standardized guideline in 1999. The study subjects were 473 adults (175 males, 298 females) with hypertension defined as a systolic blood pressure > or= 140 mmHg, diastolic blood pressure > or= 90 mmHg or reported treatment with antihypertensive medications. Information on awareness, treatment, and control of hypertension, and sociodemographic and health-related factors was collected through person-to-person interviews with a structured questionnaire. RESULTS: Overall, 252 (53.3%) of hypertensive subjects were aware of their condition, of whom as many as 193 (76.6%) were being treated, and 81 (42.0%) had their blood pressure controlled at the recommended level (< 140/90 mmHg). However, of the 473 subjects found to have hypertension, only 40.8% were being treated, and 17.1% were under control. There were no significant differences in the proportions of awareness, treatment, and control of hypertension. In multiple logistic regression models, awareness of hypertension was positively associated with age and family history of hypertension in females. Control of hypertension was also positively associated with having a partner and marital status in females. CONCLUSION: These findings demonstrate that much greater efforts on improving awareness, treatment, and control of hypertension are needed, even in urban community settings, considering related factors such as age, family history, and marital status. However, these factors should be further investigated for their causal relationship.; Summary

The Prevalence, Awareness, Treatment, and Control of Hypertension, and Related Factors in Rural Korea.: Yong Chan Ha, Hyun Ju Chun, Hae Kyoung Hwang, Byung Sung Kim, Jang Rak Kim; Korean J Prev Med. 2000;33(4):513-520.

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Abstract PDF: OBJECTIVES
To estimate the prevalence of hypertension, rates of awareness, treatment modalities, and control of hypertension, and also to identify factors in rural Korea that are related to these aspects of hypertension. METHODS: A cross-sectional survey, including blood pressure(BP) measurements and interviews, investigating the variables in the health belief model was performed from August to November, 1999 on 1,426 (79.4%) study subjects out of 1,797 registered residents over 30 years old in Ibansong-Myun, Chinju City. A second survey was performed from January to March, 2000 on 376 (80.0%) subjects out of 470 hypertensive (or suspected hypertensive) subjects found in the first survey. Two BP readings were taken in each survey using a standard mercury sphygmomanometer. Hypertension was defined as either a BP reading < 140/90 mmHg in both surveys, or as subjects on oral hypertensive medication. RESULTS: Estimated hypertension prevalence was 24.9% for men, and 30.4% for women. Rates of hypertension awareness, treatment (the regular use of oral hypertensives), and control (reduction of BP to <140/90 mmHg) were 52.5%, 34.4%, and 12.9%, respectively. The factors related to lower hypertension awareness in the logistic regression analysis were male gender, farming occupation, and higher perceived barrier to medical treatment (those for whom visiting health professionals is a burden). CONCLUSIONS: To improve the low awareness, treatment, and control of hypertension, a more active and out-reaching hypertension control program, including routine BP measurements for every visitor to primary care facilities, is needed in rural Korea.; Summary

The Awareness and Countermeasures against Harmful Effect of Passive Smoking in Korean Adults.: Hong Seok Sim, Kang Sook Lee, Hyun Sook Hong, Kwang Ho Meng; Korean J Prev Med. 2000;33(1):91-98.

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Abstract PDF: OBJECTIVES
This study is to evaluate the awareness, attitude, practice and the countermeasures against passive smoking in Korean adults. METHODS: By self-administered questionnaires, we assessed the knowledge, attitude, behavior for passive smoking and the countermeasure for reduction of it's harmful effects in 289 men and 238 women. RESULTS: The subjects that have heard about passive smoking were 96.8% in total and well known were 26.4% of current smoker, 56.6% of ex-smoker, and 14.8% of non-smoker(p=0.001). The irritative symptom from passive smoking was the most frequent in non-smokers and the most common place where exposed to passive smoking was public place. For attitude against passive smoking in 'no smoking allowed area', ex-smokers were the most active to recommend to stop smoking. And for opinion about establishment of 'no smoking allowed area', the restriction by law was the best acceptable method in smokers, exsmokers, and nonsmokers. In marking of 'no smoking allowed area', 69.9% of smokers answered no smoking, but in non-marking area only 6.3% stop smoking. When smokers were recommended to stop smoking, the more subjects stop smoking with good feeling in marking area, but the less in non-marking area. The factor associated the high awareness of passive smoking were aged(OR=1.07, 1.03-1.12), men(OR=4.34, 2.32-8.46). The persons who have known well about passive smoking had good attitude and behavior to prevent of harmful effect of passive smoking. CONCLUSIONS: This study suggested that education program would be necessary to reduce the passive smoking.; Summary

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