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Original Articles
Longitudinal Effects of Life Satisfaction on Smoking Status of Korean Adult Men
Baksun Sung
J Prev Med Public Health. 2025;58(4):388-395.   Published online April 21, 2025
DOI: https://doi.org/10.3961/jpmph.24.664
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AbstractAbstract AbstractSummary PDF
Objectives
The prevalence of smoking among adult men remains high in Korea. Additionally, life satisfaction can influence health behaviors. Therefore, the objective of this study was to examine the longitudinal effects of life satisfaction on smoking status among Korean adult men.
Methods
This study utilized panel data from wave 1 (2005) to wave 12 (2016) of the Korea Welfare Panel Study. Life satisfaction was measured using 8 variables, representing satisfaction with leisure, social relations, family relations, health, job, family income, residential environment, and overall life. A Cox proportional hazards model was employed to assess the causal relationship between life satisfaction and smoking status.
Results
Over the 11-year follow-up period, improved leisure satisfaction was associated with a decreased hazard of smoking (hazard ratio [HR], 0.83; p<0.01). In contrast, greater satisfaction with social relations was linked to an increased hazard (HR, 1.23; p<0.05). Improved satisfaction with family relations was associated with a decreased hazard of smoking (HR, 0.84; p<0.05).
Conclusions
Certain life satisfaction variables appear to influence the incidence of smoking among Korean adult men.
Summary
Korean summary
본 연구는 한국복지패널(2005년-2016년)을 이용해서 20세 ~ 64세 한국 성인 남성들의 삶의 만족도가 흡연여부에 미치는 종단적 효과를 분석하였다. 11년 동안 추적조사 한 결과, 다양한 삶의 만족도 변수들에 따라 흡연위험이 다르다는 것이 확인되었다. 구체적으로, 여가생활 만족도 또는 가족관계 만족도가 개선되면 흡연위험이 감소하였다. 대조적으로, 사회관계 만족도가 개선되면 흡연위험이 증가하였다. 이러한 인과관계들은 한국의 사회문화적 요소들과 얽혀 있는 것으로 추정된다.
Key Message
This longitudinal study's results demonstrated that over the 11-year follow-up period (2005-2016), the risk of smoking varied between different types of life satisfaction among Korean adult men (aged 20-64 years). Specifically, the risk of smoking decreased as satisfaction with leisure or family relations improved. In contrast, the risk of smoking increased as social relations satisfaction improved. Socio-cultural factors appear intertwined with these causal relationships.
Smoking-attributable Mortality in Korea, 2020: A Meta-analysis of 4 Databases
Eunsil Cheon, Yeun Soo Yang, Suyoung Jo, Jieun Hwang, Keum Ji Jung, Sunmi Lee, Seong Yong Park, Kyoungin Na, Soyeon Kim, Sun Ha Jee, Sung-il Cho
J Prev Med Public Health. 2024;57(4):327-338.   Published online July 3, 2024
DOI: https://doi.org/10.3961/jpmph.23.471
  • 14,031 View
  • 379 Download
  • 5 Web of Science
  • 7 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Objectives
Estimating the number of deaths caused by smoking is crucial for developing and evaluating tobacco control and smoking cessation policies. This study aimed to determine smoking-attributable mortality (SAM) in Korea in 2020.
Methods
Four large-scale cohorts from Korea were analyzed. A Cox proportional-hazards model was used to determine the hazard ratios (HRs) of smoking-related death. By conducting a meta-analysis of these HRs, the pooled HRs of smoking-related death for 41 diseases were estimated. Population-attributable fractions (PAFs) were calculated based on the smoking prevalence for 1995 in conjunction with the pooled HRs. Subsequently, SAM was derived using the PAF and the number of deaths recorded for each disease in 2020.
Results
The pooled HR for all-cause mortality attributable to smoking was 1.73 for current men smokers (95% confidence interval [CI], 1.53 to 1.95) and 1.63 for current women smokers (95% CI, 1.37 to 1.94). Smoking accounted for 33.2% of all-cause deaths in men and 4.6% in women. Additionally, it was a factor in 71.8% of men lung cancer deaths and 11.9% of women lung cancer deaths. In 2020, smoking was responsible for 53 930 men deaths and 6283 women deaths, totaling 60 213 deaths.
Conclusions
Cigarette smoking was responsible for a significant number of deaths in Korea in 2020. Monitoring the impact and societal burden of smoking is essential for effective tobacco control and harm prevention policies.
Summary
Korean summary
한국의 흡연율은 상당 수준 감소하였지만 흡연의 장기적인 건강영향은 지속적으로 나타나고 있다. 4개의 대규모 코호트와 1995년 흡연율을 사용하여 2020년 한국의 흡연기인 사망자수를 산출한 결과 남성 53,930명, 여성 6283명으로 총 60,213명이였다. 효과적인 담배규제와 금연 정책을 위하여 장기적인 사망자수 모니터링이 필요할 것이다.
Key Message
Despite the significant decrease in smoking rates in South Korea, the long-term health effects of smoking continue to manifest. Our analysis using four large-scale cohorts and 1995 smoking prevalence revealed that in 2020, the number of smoking-attributable death in South Korea was 53,930 for men and 6,283 for women, totaling 60,213. Long-term monitoring is necessary for effective tobacco control and smoking cessation policies.

Citations

Citations to this article as recorded by  
  • Early age at smoking initiation is associated with elevated cardiovascular disease and mortality risk in a nationwide population-based cohort
    Jung Hun Koh, Kyungdo Han, Minsang Kim, Jeong Min Cho, Sehyun Jung, Soojin Lee, Yaerim Kim, Semin Cho, Hyuk Huh, Seong Geun Kim, Eunjeong Kang, Kwon Wook Joo, Dong Ki Kim, Sehoon Park
    Scientific Reports.2026;[Epub]     CrossRef
  • Risk of all-cause mortality by various cigarette smoking indices: A longitudinal study using the Korea National Health Examination Baseline Cohort in South Korea
    Heewon Kang, Eunsil Cheon, Jieun Hwang, Suyoung Jo, Kyoungin Na, Seong Yong Park, Sung-il Cho
    Tobacco Induced Diseases.2025; 23(January): 1.     CrossRef
  • Cohort profile: the Korean National Health Examination Baseline (KNHEB) cohort for longitudinal health monitoring in South Korea
    Suyoung Jo, Eunsil Cheon, Heewon Kang, Min Kyung Lim, Wankyo Chung, Sun Ha Jee, Keum Ji Jung, Yeun Soo Yang, Seong Yong Park, Sunmi Lee, Jin-Kyoung Oh, Kyoungin Na, Soyeon Kim, Jieun Hwang, Sung-il Cho
    BMC Public Health.2025;[Epub]     CrossRef
  • Preventable Cancers Caused by Infection in Korea From 2015 to 2030
    Sungji Moon, Jeoungbin Choi, Soseul Sung, Youjin Hong, Kwang-Pil Ko, Jung Eun Lee, Inah Kim, Seungho Ryu, Sun Ha Jee, Guen Hui Kim, Sun Young Yang, Aesun Shin, Sun-Seog Kweon, Jeongseon Kim, Jieun Jang, Sangjun Lee, Kyungsik Kim, Woojin Lim, Yoon-Jung Cho
    Journal of Korean Medical Science.2025;[Epub]     CrossRef
  • Analysis of clinical and epidemiological interactions of phenol and phthalate levels in blood and urine with anamnestic and biochemical health measures during the formation of multisystem organ pathology
    I. Yu. Torshin, O. A. Gromova, T. E. Bogacheva, A. N. Gromov
    FARMAKOEKONOMIKA. Modern Pharmacoeconomics and Pharmacoepidemiology.2025; 18(3): 376.     CrossRef
  • Association between secondhand smoke exposure and incidence of metabolic syndrome: analyses of Korean Genome and Epidemiology Study (KoGES) data
    Seungmi Choi, Sanghyuk Bae
    Epidemiology and Health.2025; 47: e2025041.     CrossRef
  • The economic cost of direct smoking in South Korea
    Kristine Namhee Kwon, Kangyeon Lee, Wankyo Chung
    Preventive Medicine Reports.2024; 46: 102865.     CrossRef
Impact of Physical Activity on the Association Between Unhealthy Adolescent Behaviors and Anxiety Among Korean Adolescents: A Cross-sectional Study
Hyo-jung Lee, Jeong Pil Choi, Kunhee Oh, Jin-Young Min, Kyoung-Bok Min
J Prev Med Public Health. 2023;56(6):552-562.   Published online November 15, 2023
DOI: https://doi.org/10.3961/jpmph.23.313
  • 5,388 View
  • 148 Download
AbstractAbstract AbstractSummary PDF
Objectives
Adolescents who engage in unhealthy behaviors are particularly vulnerable to anxiety. We hypothesized that participation in physical activity could influence the relationship between anxiety and unhealthy behaviors in adolescents. These behaviors include smoking, alcohol consumption, and unsafe sexual activity.
Methods
This study included 50 301 students from the first year of middle school to the third year of high school, all from Korea. The unhealthy adolescent behaviors examined included current alcohol consumption, current smoking, and unsafe sexual behavior. Anxiety levels were assessed using the Generalized Anxiety Disorder-7 questionnaire (GAD-7).
Results
The participants had a mean age of 15.19 years and an average GAD-7 score of 4.23. No significant differences were observed in GAD-7 score among exercising participants when categorized by smoking status (p=0.835) or unsafe sexual behavior (p=0.489). In contrast, participants in the non-exercise group who engaged in these behaviors demonstrated significantly higher GAD-7 scores (p<0.001 and 0.016, respectively). The only significant interaction was found between unsafe sexual behavior and exercise (p=0.009). Based on logistic regression analysis, within the non-exercise group, significant positive associations were observed between current smoking and anxiety (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.18 to 1.57), as well as between unsafe sexual behavior and anxiety (OR, 1.33; 95% CI, 1.02 to 1.73). However, within the exercise group, no significant association was found between anxiety and either smoking or unsafe sexual behavior. Furthermore, no significant interaction was observed between unhealthy behaviors and exercise.
Conclusions
These findings are insufficient to conclude that physical activity influences the relationship between unhealthy behaviors and anxiety.
Summary
Korean summary
이 연구는 신체활동이 한국 청소년들사이에서 불안과 불건강행태간의 관계에 어떠한 영향을 미치는지 조사하였다. 이 연구에서 신체활동을 하지 않는 청소년에서만 흡연 및 불안전한 성행위와 같은 불건강행태와 불안 간의 유의미한 연관성을 보였음에도 불구하고, 이러한 불건강행태와 운동 간에는 같은 방향의 유의미한 상호작용이 관찰되지 않았다. 따라서 이 연구는 신체 활동이 청소년들의 불건강행태와 불안간의 관계에 직접 미치는 영향에 대해 명확하게 결론을 내릴 수 없었다.
Key Message
Among Korean adolescents, this study found that significant associations between unhealthy behaviors such as smoking and unsafe sex, and anxiety were only observed in adolescents who did not engage in physical activity. Despite this, no significant interaction was observed between these unhealthy behaviors and exercise. Contrary to popular belief, this study concludes that the evidence is insufficient to definitively say that physical activity influences the relationship between adolescent unhealthy behaviors and anxiety.
Association Between Tobacco Smoking and Dental Caries in the Indonesian Population: Results of a National Study in 2018
Lelly Andayasari, Rofingatul Mubasyiroh, Iin Nurlinawati, Irna Sufiawati
J Prev Med Public Health. 2023;56(4):357-367.   Published online July 10, 2023
DOI: https://doi.org/10.3961/jpmph.22.417
  • 10,456 View
  • 305 Download
  • 6 Web of Science
  • 8 Crossref
AbstractAbstract PDF
Objectives
The 2018 Basic Health Research (RISKESDAS), conducted by the Ministry of Health of the Republic of Indonesia showed a high prevalence of dental caries (88.8%) in Indonesia and suggested that smoking tobacco was associated with an increased risk of dental caries. This study analyzed the association between tobacco smoking and dental caries in the Indonesian population.
Methods
This was a cross-sectional analysis of secondary data collected from RISKESDAS 2018. The study population included 35 391 Indonesians aged ≥10 years from all 34 provinces. The decayed, missing, and filled teeth (DMFT) index was used to measure dental caries. Smoking status was assessed qualitatively based on smoking activity, and the level of smoking exposure was assessed based on the Brinkman index. A multivariable logistic regression analysis was employed to examine the relationships of smoking status and smoking exposure levels with the DMFT index.
Results
Of the population aged ≥10 years, 36% had a DMFT≥8 (females: 37.5%, males: 33.9%). Almost one-fourth (23.4%) were current smokers, and 4.1% were ex-smokers. Furthermore, 26.4% had a Brinkman index ≥400, indicating heavy smoking. According to the multivariate analysis, current smoking status was associated with the risk of DMFT≥8 in males (adjusted odds ratio [aOR], 1.40; 95% CI, 1.27 to 1.55; p<0.001) and overall (aOR, 1.07; 95% CI, 1.00 to 1.14; p=0.037). In females, ex-smoking was associated with a 41% higher risk of DMFT≥8 (aOR, 1.41; 95% CI, 1.07 to 1.84; p=0.014). Heavy smoking was associated with a higher risk of DMFT≥8 in males (aOR, 1.38; 95% CI, 1.25 to 1.52; p<0.001) and females (aOR, 1.24; 95% CI, 1.03 to 1.50; p=0.022).
Conclusions
Tobacco smoking was associated with dental caries in the Indonesian population.
Summary

Citations

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  • The SMILE study cohort: Baseline comparison of oral health and dental aesthetics among smokers in Italy, Poland, Moldova, and Indonesia
    Jan Kowalski, Giusy Rita Maria La Rosa, Fabio Cibella, Salvatore Urso, Riccardo Polosa, Andrea Di Stefano, Debora Gangi, Sebastiano Antonio Pacino, Eugenio Pedullà, Luigi Generali, Ugo Consolo, Vittorio Checchi, Stefan Gospodaru, Gheorghe Bordeniuc, Valer
    Journal of Dentistry.2026; 166: 106229.     CrossRef
  • Construction and validation of a risk prediction model for oral frailty in elderly patients with esophageal cancer
    Jingwen Lv, Jianwei Li, Yu Wang, Sipeng Liu, Yunhong Du, Li Wang, Hui Wang, Yao Shi
    Frontiers in Oncology.2026;[Epub]     CrossRef
  • Associated factors of dental caries among middle-aged adults in Guizhou Province, China (2019–2020)
    Arsy Huda Fathaniard, Jiangling Sun, Xinyue Chen, Liangsa Zhang, Taiming Dai, Juanjuan Wu, Liming Chen
    BMC Oral Health.2025;[Epub]     CrossRef
  • Urinary total 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanonol is positively associated with tooth loss
    Lin Niu, Yuwei Zhang, Hu Zhu, Yue Jia, Changjie Sun, Yifei Zhang, Xuefei Sun, Zhaojing Ding, Jingning Gou, Luming Wang, Rui Zou, Shaojie Dong
    BMC Public Health.2025;[Epub]     CrossRef
  • Dental caries in smokers aged 20–40 years in Mosul City
    Layth M. Ghanim, Saher Sami Gasgoos
    Dental Journal.2025; 58(3): 289.     CrossRef
  • Association between passive smoking and oral health among children: an umbrella review
    V. Mehta, A. Mathur, M. Bhadania, K. S. Dash, S. Tripathy, T. Noor, S. Ghose
    European Archives of Paediatric Dentistry.2025;[Epub]     CrossRef
  • Potential interaction of sugar intake and tobacco exposure on dental caries in adults-A cross-sectional study from the National Health and Nutrition Examination Survey
    Xuewei Niu, Xiaoan Rong, Hantang Sun
    Journal of Dental Sciences.2024; 19(3): 1792.     CrossRef
  • Letter to the Editor: Tobacco Use: Strategies for Prevention in Low and Middle-income Countries
    Israel Oluwasegun Ayenigbara
    Journal of Preventive Medicine and Public Health.2023; 56(5): 485.     CrossRef
Associations Between Indoor Air Pollutants and Risk Factors for Acute Respiratory Infection Symptoms in Children Under 5: An Analysis of Data From the Indonesia Demographic Health Survey
Ichtiarini Nurullita Santri, Yuniar Wardani, Yohane Vincent Abero Phiri, Gunchmaa Nyam, Tyas Aisyah Putri, Khoiriyah Isni, Dyah Suryani, Grace Sambo
J Prev Med Public Health. 2023;56(3):255-263.   Published online April 18, 2023
DOI: https://doi.org/10.3961/jpmph.22.470
  • 8,305 View
  • 261 Download
  • 2 Web of Science
  • 2 Crossref
AbstractAbstract PDF
Objectives
The study investigated the association between indoor air pollution (IAP) and risk factors for acute respiratory infection (ARI) symptoms in children under 5 years of age.
Methods
A cross-sectional study was conducted using data derived from Indonesia Demographic and Health Survey in 2017. Binary logistic regression modeling was employed to examine each predictor variable associated with ARI among children under 5 years of age in Indonesia.
Results
The study included a total of 4936 households with children. Among children under 5 years old, 7.2% reported ARI symptoms. The presence of ARI symptoms was significantly associated with the type of residence, wealth index, and father’s smoking frequency, which were considered the sample’s socio-demographic characteristics. In the final model, living in rural areas, having a high wealth index, the father’s smoking frequency, and a low education level were all linked to ARI symptoms.
Conclusions
The results revealed that households in rural areas had a substantially higher level of reported ARI symptoms among children under 5 years old. Furthermore, the father’s smoking frequency and low education level were associated with ARI symptoms.
Summary

Citations

Citations to this article as recorded by  
  • Factors Associated with Acute Respiratory Infections in Children Under Five Years Old: Analysis of the Demographic and Family Health Survey
    Diego A. Polo-Pucho, Javier J. Gonzales-Carrillo, Miguel A. Arce-Huamani
    Children.2025; 12(9): 1242.     CrossRef
  • Indoor air pollution exposure and acute respiratory infection among under-five children in low- and middle-income countries: a systematic review and meta-analysis of epidemiological studies
    Belay Desye, Abebe Kassa Geto, Chala Daba, Gete Berihun, Leykun Berhanu
    BMC Infectious Diseases.2025;[Epub]     CrossRef
Effectiveness of a Social Marketing Mix Intervention on Changing the Smoking Behavior of Santri in Traditional Islamic Boarding Schools in Indonesia
Ismail Ismail, Teuku Tahlil, Nursalam Nursalam, Zurnila Marli Kesuma, Syarifah Rauzhatul Jannah, Hajjul Kamil, Fithria Fithria, Kintoko Rochadi
J Prev Med Public Health. 2022;55(6):586-594.   Published online November 17, 2022
DOI: https://doi.org/10.3961/jpmph.22.231
  • 8,272 View
  • 248 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDF
Objectives
This study investigated the effectiveness of the social marketing mix approach in increasing students’ knowledge about smoking, promoting positive attitudes toward smoking cessation, and decreasing smoking behavior.
Methods
This quantitative research study incorporated a quasi-experimental method with a pretest-posttest non-equivalent group design. Using the purposive sampling technique, 152 smoking students were selected as participants. They were divided into 2 equal groups, with 76 students in the control group and 76 in the intervention group. The data were collected using questionnaires and analyzed with the chi-square test, independent t-test, Wilcoxon signed-rank test, and Mann-Whitney U-test.
Results
The social marketing mix intervention was effective in increasing the students’ knowledge about smoking (p<0.001), improving their attitude toward smoking cessation (p<0.001), and reducing their smoking behavior (p=0.014).
Conclusions
This approach should be implemented by local governments to reduce smoking behavior in the community, especially among teenagers, in addition to instituting a smoking ban and applying fines.
Summary

Citations

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  • School‐based interventions targeting substance use among young people in low‐and‐middle‐income countries: A scoping review
    Abdul Cadri, Ameena Nizar Beema, Tibor Schuster, Tracie Barnett, Emmanuel Asampong, Alayne M. Adams
    Addiction.2024; 119(12): 2048.     CrossRef
Brief Report
Reliability and Validity of a Life Course Passive Smoke Exposure Questionnaire in an Australian Cohort From Childhood to Adulthood
Chigozie Ezegbe, Costan G. Magnussen, Amanda Louise Neil, Marie-Jeanne Buscot, Terence Dwyer, Alison Venn, Seana Gall
J Prev Med Public Health. 2021;54(2):153-159.   Published online March 10, 2021
DOI: https://doi.org/10.3961/jpmph.20.559
  • 7,045 View
  • 115 Download
  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
Life course exposure to passive smoke may predict health, but there are few validated measures. We tested the reliability and validity of a retrospective life course passive smoking questionnaire.
Methods
Participants from the third follow-up of the Childhood Determinants of Adult Health study (2014-2019, ages 36-49 years) retrospectively reported mother/father/other household member smoking when living at home during childhood, including duration (years) and smoking location (never/sometimes/always inside house). The severity of exposure index (SEI; sum of mother/father/other years smoked multiplied by smoking location), cumulative years of exposure (CYE; sum of mother/father/other years), and total household smokers (THS) were derived. The reliability of retrospective passive smoking reports was examined with intraclass correlation coefficients (ICCs) using household smoking reported 34 years earlier in 1985 by participants when aged 7-15 years. Construct validity was examined by correlating retrospective passive smoking with participants’ smoking in adulthood and lung function in childhood and adulthood.
Results
Among 2082 participants (mean±standard deviation [SD], 45.0±2.5 years; 55.2% females), THS ranged from 0 to 5 (mean± SD, 0.9±1.0), CYE ranged from 0 to 106 (mean±SD, 10.5±13.9), and SEI ranged from 0 to 318 (mean±SD, 24.4±36.0). Retrospective measures showed moderate agreement with total household smokers reported in childhood (ICC, 0.58 to 0.62). The retrospective measures were weakly but significantly (p<0.05) correlated with participants’ smoking (r=0.13 to 0.15) and lung function (r= -0.05 to -0.06).
Conclusions
The retrospective passive smoking questionnaire showed reasonable reliability and validity. This measure may be useful for epidemiological studies.
Summary

Citations

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  • Childhood secondhand smoke exposure and respiratory disease mortality among never-smokers: the Japan collaborative cohort study for evaluation of cancer risk
    Haruna Kawachi, Masayuki Teramoto, Isao Muraki, Kokoro Shirai, Kazumasa Yamagishi, Akiko Tamakoshi, Hiroyasu Iso
    Journal of Public Health.2023; 45(3): 604.     CrossRef
Original Articles
Factors Associated With Quitting Smoking in Indonesia
Rimawati Aulia Insani Sadarang
J Prev Med Public Health. 2021;54(2):137-144.   Published online March 8, 2021
DOI: https://doi.org/10.3961/jpmph.20.293
  • 9,621 View
  • 290 Download
  • 4 Web of Science
  • 5 Crossref
AbstractAbstract PDF
Objectives
The aim of this study was to identify factors associated with quitting smoking in Indonesia
Methods
Data on 11 115 individuals from the fifth wave of the Indonesia Family Life Survey were analyzed. Quitting smoking was the main outcome, defined as smoking status based on the answer to the question “do you still habitually (smoke cigarettes/smoke a pipe/use chewing tobacco) or have you totally quit?” Logistic regression was performed to identify factors associated with successful attempts to quit smoking.
Results
The prevalence of quitting smoking was 12.3%. The odds of successfully quitting smoking were higher among smokers who were female (adjusted odds ratio [aOR], 2.69; 95% confidence interval [CI], 2.08 to 3.33), were divorced (aOR, 2.45; 95% CI, 1.82 to 3.29), did not chew tobacco (aOR, 3.01; 95% CI, 1.79 to 5.08), found it difficult to sacrifice smoking at other times than in the morning (aOR, 1.29; 95% CI, 1.14 to 1.46), and not smoke when sick (aOR, 1.32; 95% CI, 1.14 to 1.54). About 59% of variance in successful attempts to quit smoking could be explained using a model consisting of those variables.
Conclusions
Female sex, being divorced, not chewing tobacco, and nicotine dependence increased the odds of quitting smoking and were associated with quitting smoking successfully. Regular and integrated attempts to quit smoking based on individuals’ internal characteristics, tobacco use activity, and smoking behavior are needed to quit smoking.
Summary

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  • The Influence of Risk Perception, Smoking Fatwa Knowledge, and Smoking Behavior on the Intention to Quit Smoking in Adolescents
    Ayuning Tyas, Retnaningsih Retnaningsih
    Journal of Consumer Sciences.2025; 10(2): 394.     CrossRef
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    Omid Dadras
    Frontiers in Psychiatry.2024;[Epub]     CrossRef
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    Diyan Ermawan Effendi, Irfan Ardani, Sri Handayani, Rozana Ika Agustiya, Arief Priyo Nugroho, Oktriyanto Oktriyanto, Astridya Paramita, Deasy Febriyanty, Risqa Novita, Aris Yulianto
    Clinical Epidemiology and Global Health.2024; 28: 101672.     CrossRef
  • Individual-, social- and policy- factors associated with smoking cessation among adult male cigarette smokers in Hanoi, Vietnam: a longitudinal study
    Thi Ngoc Phuong Nguyen, Jesper Love, Monica Hunsberger, Thi Phuong Thao Tran, Thuy Linh Nguyen, Thi Hai Phan, Ngoc Khue Luong, Van Minh Hoang, Nawi Ng
    BMC Public Health.2023;[Epub]     CrossRef
  • Quit Smoking Clinic: Factors Associated with Successful Quit Smoking in Besut District, Terengganu State of Malaysia
    Nur Raihan Ismail, Hafizuddin Awang, Nurul Jannah A Rahman, Arfizah Ahmad Daud, Mohd Fariz Zulrushdi, Azmi Zainuddin, Mohd Anuar Abd Rahman, Kasemani Embong
    European Journal of Medical and Health Sciences.2022; 4(6): 6.     CrossRef
Age-period-cohort Analysis of Healthy Lifestyle Behaviors Using the National Health and Nutrition Survey in Japan
Tasuku Okui
J Prev Med Public Health. 2020;53(6):409-418.   Published online August 13, 2020
DOI: https://doi.org/10.3961/jpmph.20.159
  • 14,833 View
  • 258 Download
  • 18 Crossref
AbstractAbstract PDF
Objectives
This study conducted an age-period-cohort (APC) analysis of trends in healthy lifestyle behaviors in Japan.
Methods
We used National Health and Nutrition Survey data on salt intake and prevalence of smoking, drinking, and physical activity between 1995 and 2018 in Japan. Age groups were defined from 20 years to 69 years old in 10-year increments. Cohorts were defined for each age group of each year with a 1-year shift, and cohorts born in 1926-1935 (first cohort) until 1989-1998 (last cohort) were examined. We conducted a Bayesian APC analysis, calculating estimated values for each behavior by age group, period, and cohort.
Results
Estimated salt intake decreased from cohorts born in the 1930s to the 1960s, but increased thereafter in both genders, and the magnitude of increase was larger for men. Estimated smoking prevalence increased in the cohorts starting from the 1930s for men and the 1940s for women, and then decreased starting in the cohorts born in the 1970s for both genders. Although estimated drinking prevalence decreased starting in the cohorts born in approximately 1960 for men, for women it increased until the cohorts born in approximately 1970. Estimated physical activity prevalence decreased starting in the cohorts born in the 1940s in both genders, but the magnitude of decrease was larger for women.
Conclusions
Trends in cohort effects differed by gender, which might be related to changes in the social environment for women. Improvements in dietary and exercise habits are required in more recently born cohorts of both genders.
Summary

Citations

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Brief Report
Impact of Admission Diagnosis on the Smoking Cessation Rate: A Brief Report From a Multi-centre Inpatient Smoking Cessation Programme in Singapore
Jason Jia Hao See, Kay Choong See
J Prev Med Public Health. 2020;53(5):381-386.   Published online July 17, 2020
DOI: https://doi.org/10.3961/jpmph.20.134
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AbstractAbstract PDF
Objectives
Few studies have been published regarding the relevance of the admission diagnosis to the smoking cessation rate. We studied smoking cessation rates in relation to admission diagnoses in our inpatient smoking cessation programmes.
Methods
This retrospective study included all patients recruited into our inpatient smoking cessation programmes at 2 institutions in Singapore between June 2008 and December 2016. Patients were given individualized intensive counselling and were followed up via phone interviews for up to 6-month to assess their smoking status. Multivariable logistic regression was used to analyse potential associations between admission diagnoses and 6-month abstinence.
Results
A total of 7194 patients were included in this study. The mean age was 54.1 years, and 93.2% were male. In total, 1778 patients (24.7%) were abstinent at the 6-month follow-up call. Patients who quit smoking tended to be of Chinese ethnicity, have initiated smoking at a later age, be better educated, and have lower Fagerström Test of Nicotine Dependence scores. After adjusting for these factors, patients with a cardiovascular admission diagnosis had a significantly higher probability of quitting tobacco use than patients with a respiratory or other diagnosis.
Conclusions
In patients acutely admitted to the hospital, a diagnosis of cardiovascular disease was associated with the highest quit rate. Smoking cessation interventions need to be incorporated into all cardiovascular disease treatment pathways to leverage the patient’s motivation and to improve the quit rate. In addition, patients in groups with lower quit rates may benefit from more intensive programmes to increase the rate of successful cessation.
Summary
Original Articles
Interactions of Behavioral Changes in Smoking, High-risk Drinking, and Weight Gain in a Population of 7.2 Million in Korea
Yeon-Yong Kim, Hee-Jin Kang, Seongjun Ha, Jong Heon Park
J Prev Med Public Health. 2019;52(4):234-241.   Published online July 3, 2019
DOI: https://doi.org/10.3961/jpmph.18.290
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AbstractAbstract AbstractSummary PDF
Objectives
To identify simultaneous behavioral changes in alcohol consumption, smoking, and weight using a fixed-effect model and to characterize their associations with disease status.
Methods
This study included 7 000 529 individuals who participated in the national biennial health-screening program every 2 years from 2009 to 2016 and were aged 40 or more. We reconstructed the data into an individual-level panel dataset with 4 waves. We used a fixed-effect model for smoking, heavy alcohol drinking, and overweight. The independent variables were sex, age, lifestyle factors, insurance contribution, employment status, and disease status.
Results
Becoming a high-risk drinker and losing weight were associated with initiation or resumption of smoking. Initiation or resumption of smoking and weight gain were associated with non-high-risk drinkers becoming high-risk drinkers. Smoking cessation and becoming a high-risk drinker were associated with normal-weight participants becoming overweight. Participants with newly acquired diabetes mellitus, ischemic heart disease, stroke, and cancer tended to stop smoking, discontinue high-risk drinking, and return to a normal weight.
Conclusions
These results obtained using a large-scale population-based database documented interactions among lifestyle factors over time.
Summary
Korean summary
이 분석은 흡연, 음주, 체중의 동시적 변화에 대해 패널분석방법론인 고정효과 모형을 이용하여 분석하였으며, 2009년부터 2016년까지 2년 주기로 4차례 모두 건강검진을 수검받은 720만 명을 대상으로 하였다. 흡연, 음주, 체중의 동시적 변화에 대한 방향성을 탐색하여 생활습관 관련 행태가 독자적이 아닌 유기적으로 변화하는 양상을 확인하였다, 또한 당뇨병, 뇌졸중, 암이 신규로 진단되었을 때 행태 변화가 나타나는 것을 확인하였다.

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Factors Related to Smoking Status Among Young Adults: An Analysis of Younger and Older Young Adults in Korea
Yeji Lee, Kang-Sook Lee
J Prev Med Public Health. 2019;52(2):92-100.   Published online January 22, 2019
DOI: https://doi.org/10.3961/jpmph.18.201
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  • 24 Crossref
AbstractAbstract AbstractSummary PDF
Objectives
Young adulthood represents a critical developmental period during which the use of tobacco may begin or cease. Furthermore, differences in smoking behaviors between younger (aged 18-24 years) and older (aged 25-34 years) young adults may exist. This study aimed to characterize patterns related to current smoking in younger and older young adults.
Methods
This study used data acquired from the Sixth Korea National Health and Nutrition Examination Survey conducted from 2013 to 2014. A total of 2069 subjects were categorized as younger (712 subjects) and older (1357 subjects) young adults. The chi-square test was used to assess the relationships between smoking status and socio-demographic, health-related, and smoking-related factors. Multivariable logistic regression models were constructed to assess the factors affecting current smoking in these age groups.
Results
The current smoking prevalence was 18.3% among the younger young adults and 26.0% among the older young adults. Sex, education level, occupation, perceived health status, alcohol consumption, and electronic cigarette use were related to current smoking in both age groups. Secondhand smoke exposure at home and stress levels showed significant relationships with smoking in younger and older young adults, respectively.
Conclusions
Strong correlations were found between the observed variables and smoking behaviors among young adults. Determining the factors affecting smoking and designing interventions based on these factors are essential for smoking cessation in young adults.
Summary
Korean summary
본 연구는 국민건강영양조사 제 6기 2013-2014년도 자료를 이용하였으며, 대상자 중 청년(18-34세)인 총 2,069명의 자료를 활용하여 전기 청년(18-24세)과 후기 청년(25-34세)인 두 연령 집단(18-24세, 25-34세)으로 나누어서 각 집단의 현재 흡연에 미치는 요인을 분석하고자 하였다. 본 연구 결과, 두 연령 집단 모두에서 성별, 대학교육 여부, 직업, 자가보고 건강수준, 음주, 그리고 평생 전자담배 사용은 현재 흡연과 유의한 관련이 있게 나타났으며, 가정실내 간접흡연 노출은 전기 청년에서만, 스트레스 정도는 후기 청년에서만 유의한 관련이 있었다. 본 연구는 전기 청년과 후기 청년에서 사회경제적 요인, 건강관련 요인, 흡연 관련 요인이 중요한 예측인자로 나타난 것을 알 수 있었으며 이에 따른 맞춤형 금연 프로그램의 적용이 필요할 것으로 시사한다.

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Trends in Inequality in Cigarette Smoking Prevalence by Income According to Recent Anti-smoking Policies in Korea: Use of Three National Surveys
Youngs Chang, Sanghyun Cho, Ikhan Kim, Jinwook Bahk, Young-Ho Khang
J Prev Med Public Health. 2018;51(6):310-319.   Published online October 30, 2018
DOI: https://doi.org/10.3961/jpmph.18.225
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AbstractAbstract PDFSupplementary Material
Objectives
This study examined trends in inequality in cigarette smoking prevalence by income according to recent anti-smoking policies in Korea.
Methods
The data used in this study were drawn from three nationally representative surveys, the Korea National Health and Nutrition Examination Survey, the Korea Community Health Survey, and the Social Survey of Statistics Korea. We calculated the age-standardized smoking prevalence, the slope index of inequality, and the relative index of inequality by income level as a socioeconomic position indicator.
Results
Smoking prevalence among men decreased during the study period, but the downward trend became especially pronounced in 2015, when the tobacco price was substantially increased. Inequalities in cigarette smoking by income were evident in both genders over the study period in all three national surveys examined. Absolute inequality tended to decrease between 2014 and 2015 among men. Absolute and relative inequality by income decreased between 2008 and 2016 in women aged 30-59, except between 2014 and 2015.
Conclusions
The recent anti-smoking policies in Korea resulted in a downward trend in smoking prevalence among men, but not in relative inequality, throughout the study period. Absolute inequality decreased over the study period among men aged 30-59. A more aggressive tax policy is warranted to further reduce socioeconomic inequalities in smoking in young adults in Korea.
Summary

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Brief Report
National Trends in Smoking Cessation Medication Prescriptions for Smokers With Chronic Obstructive Pulmonary Disease in the United States, 2007-2012
Min Ji Kwak, Jongoh Kim, Viraj Bhise, Tong Han Chung, Gabriela Sanchez Petitto
J Prev Med Public Health. 2018;51(5):257-262.   Published online August 23, 2018
DOI: https://doi.org/10.3961/jpmph.18.119
  • 8,165 View
  • 157 Download
  • 8 Crossref
AbstractAbstract PDF
Objectives
Smoking cessation decreases morbidity and mortality due to chronic obstructive pulmonary disease (COPD). Pharmacotherapy for smoking cessation is highly effective. However, the optimal prescription rate of smoking cessation medications among smokers with COPD has not been systemically studied. The purpose of this study was to estimate the national prescription rates of smoking cessation medications among smokers with COPD and to examine any disparities therein.
Methods
We conducted a retrospective study using National Ambulatory Medical Care Survey data from 2007 to 2012. We estimated the national prescription rate for any smoking cessation medication (varenicline, bupropion, and nicotine replacement therapy) each year. Multiple survey logistic regression was performed to characterize the effects of demographic variables and comorbidities on prescriptions.
Results
The average prescription rate of any smoking cessation medication over 5 years was 3.64%. The prescription rate declined each year, except for a slight increase in 2012: 9.91% in 2007, 4.47% in 2008, 2.42% in 2009, 1.88% in 2010, 1.46% in 2011, and 3.67% in 2012. Hispanic race and depression were associated with higher prescription rates (odds ratio [OR], 5.15; 95% confidence interval [CI], 1.59 to 16.67 and OR, 2.64; 95% CI, 1.26 to 5.51, respectively). There were no significant differences according to insurance, location of the physician, or other comorbidities. The high OR among Hispanic population and those with depression was driven by the high prescription rate of bupropion.
Conclusions
The prescription rate of smoking cessation medications among smokers with COPD remained low throughout the study period. Further studies are necessary to identify barriers and to develop strategies to overcome them.
Summary

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    Erin S. Rogers, Christina N. Wysota
    American Journal of Preventive Medicine.2019; 57(5): 687.     CrossRef
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Original Articles
Differential Association of Vitamin D Deficiency With Albuminuria by Sex in the Korean General Population: A Cross-sectional Study of the Korea National Health and Nutrition Examination Survey 2011-2012
Yongwoo Jeon, Jaeyong Shin, Jong Hyun Jhee, Youngdae Cho, Eun-Cheol Park
J Prev Med Public Health. 2018;51(2):92-99.   Published online February 6, 2018
DOI: https://doi.org/10.3961/jpmph.17.005
  • 10,423 View
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  • 3 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
Albuminuria has emerged as a biomarker for several medical conditions, and vitamin D has received attention due to its associations with various disorders. We evaluated the association between low serum vitamin D levels and prevalent albuminuria by sex in the Korean general population. Methods: We analyzed 9823 participants (4401 males, 5422 females) from the Korea National Health and Nutrition Examination Survey 2011-2012 (KNHANES V-2), and categorized them as having a normal range of vitamin D levels, vitamin D insufficiency, or vitamin D deficiency. A multivariable logistic regression model was used to compare the risk of albuminuria across these groups. Stratified analyses were conducted by smoking status, obesity, and renal function. Results: Albuminuria was found in 325 of the 4401 male participants (7.4%) and in 455 of the 5422 female participants (8.4%). Among the males, vitamin D deficiency was associated with an odds ratio (OR) for albuminuria of 1.78 (95% confidence interval [CI], 1.07 to 2.97, p<0.05). However, such an association was not found in females. The association was stronger in male current smokers (OR, 3.54; 95% CI, 1.47 to 8.50; p=0.005). Conclusions: The findings of this study suggest that sex differences exist in the association between serum vitamin D deficiency and albuminuria. Additionally, we observed that the association was stronger in current smokers than in the overall male population, but was not seen in non-smokers. Therefore, different approaches by sex and smoking status might be needed when considering using vitamin D as a biomarker for renal function.
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  • Association between serum 25-hydroxyvitamin D and albuminuria in Korean adolescents: evidence from a national survey
    Young Hoon Cho, Sojung Ryu, Joonho Ahn
    Pediatric Nephrology.2025;[Epub]     CrossRef
  • Association between environmental chemical exposure and albumin-to-creatinine ratio is modified by hypertension status in women of reproductive age
    Gowoon Lee, Sunmi Kim, Inae Lee, Habyeong Kang, Jung Pyo Lee, Jeonghwan Lee, Young Wook Choi, Jeongim Park, Gyuyeon Choi, Kyungho Choi
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    Zhi-Hui Zhang, Biao Luo, Shen Xu, Zhi-Cheng Zhang, Wei-Yang Xing, Yuan-Hua Chen, Cheng Zhang, Hua Wang, Dong-Dong Xie, De-Xiang Xu
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Peer Smoking and Smoking-related Beliefs Among College Students in Bangladesh
Akiko Kamimura, Zobayer Ahmmad, Mu Pye, Bethany Gull
J Prev Med Public Health. 2018;51(1):51-58.   Published online January 22, 2018
DOI: https://doi.org/10.3961/jpmph.17.146
  • 11,533 View
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  • 13 Crossref
AbstractAbstract PDF
Objectives
Smoking is a significant public health issue in Bangladesh. The purpose of this study was to examine peer smoking and smoking-related beliefs among college students in Bangladesh.
Methods
College students at two universities in Dhaka, Bangladesh participated in a self-administered survey in May and June 2017.
Results
First, being a current or former smoker is associated with lower levels of beliefs among respondents that they would not smoke even with smoker friends or nervousness, and lower levels of intentions that they would not smoke, while current smokers and former smokers have different smoking-related beliefs. Second, having smoker friends is associated with lower levels of intentions that they would not smoke. Third, higher levels of normative beliefs that it is important not to smoke are associated with higher levels of beliefs that they would not smoke even with smoker friends or nervousness, higher levels of intentions that they would not smoke, and higher levels of avoidance of smoking.
Conclusions
Smoking-related beliefs and perceived norms in individuals’ social networks are important components in promoting tobacco cessation in Bangladesh. But it is challenging to prevent or intervene in smoking because of the high rates of smoking in this country and the high prevalence of smokers in individuals’ social networks. Future studies should examine the most effective interventions to combat smoking in high-smoking social networks, such as using mobile apps or social media, and evaluate the effectiveness of such interventions.
Summary

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Special Article
Scientific Evidence for the Addictiveness of Tobacco and Smoking Cessation in Tobacco Litigation
Sungwon Roh
J Prev Med Public Health. 2018;51(1):1-5.   Published online November 29, 2017
DOI: https://doi.org/10.3961/jpmph.16.088
  • 13,193 View
  • 301 Download
  • 8 Crossref
AbstractAbstract PDF
Smokers keep smoking despite knowing that tobacco claims many lives, including their own and others’. What makes it hard for them to quit smoking nonetheless? Tobacco companies insist that smokers choose to smoke, according to their right to self-determination. Moreover, they insist that with motivation and willpower to quit smoking, smokers can easily stop smoking. Against this backdrop, this paper aims to discuss the addictive disease called tobacco use disorder, with an assessment of the addictiveness of tobacco and the reasons why smoking cessation is challenging, based on neuroscientific research. Nicotine that enters the body via smoking is rapidly transmitted to the central nervous system and causes various effects, including an arousal response. The changes in the nicotine receptors in the brain due to continuous smoking lead to addiction symptoms such as tolerance, craving, and withdrawal. Compared with other addictive substances, including alcohol and opioids, tobacco is more likely to cause dependence in smokers, and smokers are less likely to recover from their dependence. Moreover, the thinning of the cerebral cortex and the decrease in cognitive functions that occur with aging accelerate with smoking. Such changes occur in the structure and functions of the brain in proportion to the amount and period of smoking. In particular, abnormalities in the neural circuits that control cognition and decision-making cause loss of the ability to exert self-control and autonomy. This initiates nicotine dependence and the continuation of addictive behaviors. Therefore, smoking is considered to be a behavior that is repeated due to dependence on an addictive substance, nicotine, instead of one’s choice by free will.
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Original Articles
Using Focus Group Interviews to Analyze the Behavior of Users of New Types of Tobacco Products
Jinyoung Kim, Sungkyu Lee
J Prev Med Public Health. 2017;50(5):336-346.   Published online September 18, 2017
DOI: https://doi.org/10.3961/jpmph.17.052
  • 20,344 View
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  • 10 Crossref
AbstractAbstract PDF
Objectives
To characterize the usage patterns of new types of tobacco products (NTTPs) to develop effective strategies for the regulation of NTTPs in Korea. Methods: We conducted focus group interviews to identify the NTTP usage patterns of research subjects. The NTTPs were limited to electronic cigarettes (e-cigarettes), waterpipe tobacco, and rolling tobacco. We categorized 30 research subjects into 4 groups. The e-cigarette group was divided into adult and adolescent groups. Each group contained 7-8 subjects. An interview lasting approximately 2 hours was conducted with each group. Results: Ninety percent of NTTP users used an NTTP in combination with conventional cigarettes. Subjects mostly bought NTTPs online, unlike how they bought cigarettes. Additionally, a great deal of information, such as how to use NTTPs and descriptions of NTTP products, was exchanged through online or offline societies. The primary reason why the subjects used NTTPs was that NTTPs offer a greater range of flavors and aromas than cigarettes. Moreover, NTTPs were felt to be less repulsive than cigarettes. NTTPs were not used as a cigarette substitute; rather, they were mostly used in places and situations where traditional cigarette smoking was not allowed. Conclusions: Based on the results of this study, the government should conduct studies on the effects of the combined use of NTTPs and cigarettes on the human body, obtain and provide accurate data regarding NTTP use, and develop and implement polices to ban NTTP advertising, which may arouse adolescents’ curiosity, and the addition of flavoring substances to tobacco products.
Summary

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    Mouhamad Bigwanto, Mochamad Iqbal Nurmansyah, Elizabeth Orlan, Yoli Farradika, Tri Bayu Purnama
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Assessing Health Impacts of Pictorial Health Warning Labels on Cigarette Packs in Korea Using DYNAMO-HIA
Eunjeong Kang
J Prev Med Public Health. 2017;50(4):251-261.   Published online June 25, 2017
DOI: https://doi.org/10.3961/jpmph.17.032
  • 13,616 View
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  • 16 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
This study aimed to predict the 10-year impacts of the introduction of pictorial warning labels (PWLs) on cigarette packaging in 2016 in Korea for adults using DYNAMO-HIA. Methods: In total, four scenarios were constructed to better understand the potential health impacts of PWLs: two for PWLs and the other two for a hypothetical cigarette tax increase. In both policies, an optimistic and a conservative scenario were constructed. The reference scenario assumed the 2015 smoking rate would remain the same. Demographic data and epidemiological data were obtained from various sources. Differences in the predicted smoking prevalence and prevalence, incidence, and mortality from diseases were compared between the reference scenario and the four policy scenarios. Results: It was predicted that the optimistic PWLs scenario (PWO) would lower the smoking rate by 4.79% in males and 0.66% in females compared to the reference scenario in 2017. However, the impact on the reduction of the smoking rate was expected to diminish over time. PWO will prevent 85 238 cases of diabetes, 67 948 of chronic obstructive pulmonary disease, 31 526 of ischemic heart disease, 21 036 of lung cancer, and 3972 prevalent cases of oral cancer in total over the 10-year span due to the reductions in smoking prevalence. The impacts of PWO are expected to be between the impact of the optimistic and the conservative cigarette tax increase scenarios. The results were sensitive to the transition probability of smoking status. Conclusions: The introduction of PWLs in 2016 in Korea is expected reduce smoking prevalence and disease cases for the next 10 years, but regular replacements of PWLs are needed for persistent impacts.
Summary

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Assessment of Tobacco Habits, Attitudes, and Education Among Medical Students in the United States and Italy: A Cross-sectional Survey
Grayson W. Armstrong, Giacomo Veronese, Paul F. George, Isacco Montroni, Giampaolo Ugolini
J Prev Med Public Health. 2017;50(3):177-187.   Published online April 14, 2017
DOI: https://doi.org/10.3961/jpmph.15.061
  • 10,705 View
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  • 30 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
Medical students represent a primary target for tobacco cessation training. This study assessed the prevalence of medical students’ tobacco use, attitudes, clinical skills, and tobacco-related curricula in two countries, the US and Italy, with known baseline disparities in hopes of identifying potential corrective interventions.
Methods
From September to December 2013, medical students enrolled at the University of Bologna and at Brown University were recruited via email to answer survey questions assessing the prevalence of medical students’ tobacco use, attitudes and clinical skills related to patients’ smoking, and elements of medical school curricula related to tobacco use.
Results
Of the 449 medical students enrolled at Brown and the 1426 enrolled at Bologna, 174 Brown students (38.7%) and 527 Bologna students (36.9%) participated in this study. Italian students were more likely to smoke (29.5% vs. 6.1%; p<0.001) and less likely to receive smoking cessation training (9.4% vs. 80.3%; p<0.001) than their American counterparts, even though the majority of students in both countries desired smoking cessation training (98.6% at Brown, 85.4% at Bologna; p<0.001). Additionally, negative beliefs regarding tobacco usage, the absence of formal training in smoking cessation counseling, and a negative interest in receiving specific training on smoking cessation were associated with a higher risk of not investigating a patient’s smoking status during a routine history and not offering tobacco cessation treatment to patients.
Conclusions
Medical curricula on tobacco-related health hazards and on smoking cessation should be mandatory in order to reduce smoking among medical students, physicians, and patients, thereby improving tobacco-related global health.
Summary

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Income Differences in Smoking Prevalences in 245 Districts of South Korea: Patterns by Area Deprivation and Urbanity, 2008-2014
Ikhan Kim, Jinwook Bahk, Tae-Ho Yoon, Sung-Cheol Yun, Young-Ho Khang
J Prev Med Public Health. 2017;50(2):100-126.   Published online February 9, 2017
DOI: https://doi.org/10.3961/jpmph.16.069
  • 17,801 View
  • 326 Download
  • 23 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
The aim of this study was to measure income differences in smoking prevalence at the district level and to investigate correlations among area deprivation, smoking prevalence, and income differences in smoking prevalence, stratified by urbanity.
Methods
Data were pooled from the Community Health Survey data of South Korea between 2008 and 2014. The age-standardized prevalence of smoking and its interquintile income differences were calculated. We conducted correlation analyses to investigate the association of the deprivation index with smoking prevalence and interquintile differences in smoking prevalence.
Results
Across 245 districts, the median prevalence of smoking in men was 45.9% (95% confidence interval [CI], 43.4 to 48.5%), with an interquartile range (IQR) of 4.6% points. In women, the median prevalence was 3.0% (95% CI, 2.4 to 3.6%) and IQR was 1.6% points. The median interquintile difference in smoking prevalence was 7.4% points (95% CI, 1.6 to 13.2% points) in men and 2.7% points (95% CI, 0.5 to 4.9% points) in women. The correlation coefficients for the association between the deprivation index and smoking prevalence was 0.58, 0.15, -0.22 in metropolitan, urban, and rural areas, respectively, among men, and 0.54, -0.33, -0.43 among women. No meaningful correlation was found between area deprivation and interquintile difference in smoking prevalence. The correlation between smoking prevalence and interquintile difference in smoking prevalence was more evident in women than in men.
Conclusions
This study provides evidence of geographical variations in smoking prevalence and interquintile difference in smoking prevalence. Neither smoking prevalence nor the deprivation index was closely correlated with interquintile income difference in smoking prevalence. Measuring inequalities in smoking prevalence is crucial to developing policies aimed at reducing inequalities in smoking.
Summary

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The Association Between Smoking Tobacco After a Diagnosis of Diabetes and the Prevalence of Diabetic Nephropathy in the Korean Male Population
Hyungseon Yeom, Jung Hyun Lee, Hyeon Chang Kim, Il Suh
J Prev Med Public Health. 2016;49(2):108-117.   Published online March 23, 2016
DOI: https://doi.org/10.3961/jpmph.15.062
  • 12,884 View
  • 147 Download
  • 22 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
Smoking is known to be associated with nephropathy in patients with diabetes. The distinct effects of smoking before and after diabetes has been diagnosed, however, are not well characterized. We evaluated the association of cigarette smoking before and after a diagnosis of diabetes with the presence of diabetic nephropathy.
Methods
We analyzed data from the 2011-2013 editions of the Korea National Health and Nutrition Examination Survey. A total of 629 male patients diagnosed with diabetes were classified as non-smokers (90 patients), former smokers (225 patients), or continuing smokers (314 patients). A “former smoker” was a patient who smoked only before receiving his diagnosis of diabetes. A “continuing smoker” was a patient who smoked at any time after his diabetes had been diagnosed. Diabetic nephropathy was defined as the presence of albuminuria (spot urine albumin/creatinine ratio ≥30 mg/g) or low estimated glomerular filtration rate (<60 mL/min/1.73 m2). Multiple logistic regression models were used to assess the independent association after adjusting for age, duration of diabetes, hemoglobin A1c, body mass index, systolic blood pressure, medication for hypertension, and medication for dyslipidemia. Female patients were excluded from the study due to the small proportion of females in the survey who smoked.
Results
Compared to non-smokers, continuing smokers had significantly higher odds ratio ([OR], 2.17; 95% confidence interval [CI], 1.23 to 3.83) of suffering from diabetic nephropathy. The corresponding OR (95% CI) for former smokers was 1.26 (0.70 to 2.29).
Conclusions
Smoking after diagnosis of diabetes is significantly associated with the presence of diabetic nephropathy in the Korean male population.
Summary

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Interaction of Vitamin D and Smoking on Inflammatory Markers in the Urban Elderly
Hyemi Lee, Kyoung-Nam Kim, Youn-Hee Lim, Yun-Chul Hong
J Prev Med Public Health. 2015;48(5):249-256.   Published online September 17, 2015
DOI: https://doi.org/10.3961/jpmph.15.042
  • 13,587 View
  • 136 Download
  • 13 Crossref
AbstractAbstract PDFSupplementary Material
Objectives
Epidemiological studies have reported that vitamin D deficiency is associated with inflammatory disease. Smoking is a well-known risk factor for inflammation. However, few studies have investigated the interactive effect of vitamin D deficiency and smoking on inflammation. This study aims to investigate the interaction of vitamin D and smoking with inflammatory markers in the urban elderly.
Methods
We used data from the Korean Elderly Environmental Panel Study, which began in August 2008 and ended in August 2010, and included 560 Koreans ≥60 years old living in Seoul. Data was collected via questionnaires that included items about smoking status at the first visit. Vitamin D levels, high-sensitivity C-reactive protein (hs-CRP), and white blood cell (WBC) counts were repeatedly measured up to three times.
Results
The association of vitamin D and hs-CRP was significant after adjusting for known confounders (β=-0.080, p=0.041). After separate analysis by smoking status, the association of vitamin D deficiency and hs-CRP in smokers was stronger than that in nonsmokers (smokers: β=-0.375, p=0.013; non-smokers: β=-0.060, p=0.150). Smoking status was an effect modifier that changed the association between vitamin D deficiency and hs-CRP (interaction estimate: β=-0.254, p=0.032). Vitamin D was not significantly associated with WBC count (β=0.003, p=0.805).
Conclusions
Vitamin D deficiency was associated with hs-CRP in the urban elderly. Smoking status was an effect modifier of this association. Vitamin D deficiency was not significantly associated with WBC count.
Summary

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Effects of Smoking on Menopausal Age: Results From the Korea National Health and Nutrition Examination Survey, 2007 to 2012
Hee Jung Yang, Pae Sun Suh, Soo Jeong Kim, Soon Young Lee
J Prev Med Public Health. 2015;48(4):216-224.   Published online July 27, 2015
DOI: https://doi.org/10.3961/jpmph.15.021
  • 19,801 View
  • 150 Download
  • 21 Crossref
AbstractAbstract PDF
Objectives
Decreased fertility and impaired health owing to early menopause are significant health issues. Smoking is a modifiable health-related behavior that influences menopausal age. We investigated the effects of smoking-associated characteristics on menopausal age in Korean women.
Methods
This study used data from the Korea National Health and Nutrition Examination Survey from 2007 to 2012. Menopausal age in relation to smoking was analyzed as a Kaplan-Meier survival curve for 11 510 women (aged 30 to 65 years). The risk of entering menopause and experiencing early menopause (before age 48) related to smoking were assessed using a Cox proportional hazards model.
Results
The menopausal age among smokers was 0.75 years lower than that among non-smokers (p<0.001). The results of the Cox proportional hazards model showed pre-correction and post-correction risk ratios for entering menopause related to smoking of 1.26 (95% confidence interval [CI], 1.09 to 1.46) and 1.27 (95% CI, 1.10 to 1.47), respectively, and pre-correction and post-correction risk ratios for experiencing early menopause related to smoking of 1.36 (95% CI, 1.03 to 1.80) and 1.40 (95% CI, 1.05 to 1.85), respectively.
Conclusions
Smokers reached menopause earlier than non-smokers, and their risk for experiencing early menopause was higher.
Summary

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Influence of Asthma on the Longitudinal Trajectories of Cigarette Use Behaviors From Adolescence to Adulthood Using Latent Growth Curve Models
Jisuk Bae
J Prev Med Public Health. 2015;48(2):111-117.   Published online March 24, 2015
DOI: https://doi.org/10.3961/jpmph.14.053
  • 11,556 View
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  • 3 Crossref
AbstractAbstract PDF
Objectives
While epidemiologic research indicates that the prevalence of risk-taking behaviors including cigarette smoking among young people with asthma is substantial, the longitudinal patterns of cigarette smoking in this vulnerable population have received little attention. The aim of this study was to evaluate differences in the longitudinal trajectories of cigarette use behaviors from adolescence to adulthood between young people with and without asthma.
Methods
Data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) during the years 1994 to 1995 (Wave I, adolescence), 2001 to 2002 (Wave III, young adulthood), and 2007 to 2008 (Wave IV, adulthood) were analyzed (n=12 244). Latent growth curve models were used to examine the longitudinal trajectories of cigarette use behaviors during the transition to adulthood according to asthma status.
Results
Regardless of asthma status, the trajectory means of cigarette use behaviors were found to increase, and then slightly decrease from adolescence to adulthood. In total participants, there were no statistically significant differences in initial levels and changes in cigarette use behaviors according to asthma status. However, in select sex and race subgroups (i.e., females and non-whites), former asthmatics showed greater escalation in cigarette use behaviors than did non-asthmatics or current asthmatics.
Conclusions
This study indicated that the changing patterns of cigarette use behaviors during the transition to adulthood among young people with asthma are comparable to or even more drastic than those among young people without asthma.
Summary

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Age at Smoking Initiation and Subsequent Smoking Among Korean Adolescent Smokers
Jun Hyun Hwang, Soon-Woo Park
J Prev Med Public Health. 2014;47(5):266-272.   Published online September 12, 2014
DOI: https://doi.org/10.3961/jpmph.14.032
  • 16,523 View
  • 136 Download
  • 30 Crossref
AbstractAbstract PDF
Objectives
The aim of this study was to investigate the relationship between age at cigarette smoking initiation and smoking level among adolescent current smokers. Methods: In 2007, students from one or two classes of the 10th or 11th grade were randomly selected using the probability proportional to size sampling method. In total, 743 current smokers were included. Multiple logistic regression was used to determine the association between age at smoking initiation and smoking level as either frequent, daily, or heavy smokers. Results: The adjusted odds ratios for each smoking level were significantly higher for younger ages of smoking initiation than those for older ages of initiation were (p for trend <0.001). Compared with the students who started smoking in grades 10 to 11, the adjusted odds ratios for frequent, daily, and heavy smokers increased from 2.24 (95% confidence interval [CI], 1.30 to 3.87) to 3.90 (95% CI, 2.02 to 7.56), from 1.56 (95% CI, 0.92 to 2.62) to 3.17 (95% CI, 1.70 to 5.92), and from 2.56 (95% CI, 1.21 to 5.42) to 5.67 (95% CI, 2.61 to 12.30) with younger ages of smoking initiation. Conclusions: Smoking frequency and amount were closely associated with age at smoking initiation. Therefore, smoking prevention programs should be initiated from the young adolescent period.
Summary

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Associations Between Socio-demographic Characteristics and Healthy Lifestyles in Korean Adults: The Result of the 2010 Community Health Survey
So Yeon Ryu, Jong Park, Seong Woo Choi, Mi Ah Han
J Prev Med Public Health. 2014;47(2):113-123.   Published online March 31, 2014
DOI: https://doi.org/10.3961/jpmph.2014.47.2.113
  • 15,175 View
  • 127 Download
  • 20 Crossref
AbstractAbstract PDF
Objectives

Several previous studies have found that healthy behaviors substantially reduce non-communicable disease incidence and mortality. The present study was performed to estimate the prevalence of four modifiable healthy behaviors and a healthy lifestyle among Korean adults according to socio-demographic and regional factors.

Methods

We analyzed data from 199 400 Korean adults aged 19 years and older who participated in the 2010 Korean Community Health Survey. We defined a healthy lifestyle as a combination of four modifiable healthy behaviors: non-smoking, moderate alcohol consumption, regular walking, and a healthy weight. We calculated the prevalence rates and odds ratios of each healthy behavior and healthy lifestyle according to socio-demographic and regional characteristics.

Results

The prevalence rates were as follows: non-smoking, 75.0% (53.7% in men, 96.6% in women); moderate alcohol consumption, 88.2% (79.7% in men, 96.9% in women); regular walking, 45.0% (46.2% in men, 43.8% in women); healthy weight, 77.4% (71.3% in men, 73.6% in women); and a healthy lifestyle, 25.5% (16.4% in men, 34.6% in women). The characteristics associated with a low prevalence of healthy lifestyle were male gender, younger age (19 to 44 years of age), low educational attainment, married, living in a rural area, living in the Chungcheong, Youngnam, or Gwangwon-Jeju region, and poorer self-rated health.

Conclusions

Further research should be implemented to explore the explainable factors of disparities for socio-demographic and regional characteristics to engage in the healthy lifestyle among adults.

Summary

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Differences in Cigarette Use Behaviors by Age at the Time of Diagnosis With Diabetes From Young Adulthood to Adulthood: Results From the National Longitudinal Study of Adolescent Health
Jisuk Bae
J Prev Med Public Health. 2013;46(5):249-260.   Published online September 30, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.5.249
  • 11,677 View
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  • 6 Crossref
AbstractAbstract PDF
Objectives

Previous observations propose that risk-taking behaviors such as cigarette smoking are prevailing among young people with chronic conditions including diabetes. The purpose of this study was to examine whether cigarette smoking is more prevalent among diabetics than non-diabetics and whether it differs by age at the time of diagnosis with diabetes from young adulthood (YAH) to adulthood (AH).

Methods

We used US panel data from the National Longitudinal Study of Adolescent Health (Add Health Study) during the years 2001 to 2002 (Wave III, YAH) and 2007 to 2008 (Wave IV, AH). Multivariate logistic regression models were applied to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of cigarette use behaviors according to age at the time of diagnosis with diabetes, after adjusting for demographic and selected behavioral factors.

Results

Of 12 175 study participants, 2.6% reported having been diagnosed with diabetes up to AH. Early-onset diabetics (age at diagnosis <13 years) were more likely than non-diabetics to report frequent cigarette smoking (smoking on ≥20 days during the previous 30 days) in YAH (OR, 3.34; 95% CI, 1.27 to 8.79). On the other hand, late-onset diabetics (age at diagnosis ≥13 years) were more likely than non-diabetics to report heavy cigarette smoking (smoking ≥10 cigarettes per day during the previous 30 days) in AH (OR, 1.54; 95% CI, 1.03 to 2.30).

Conclusions

The current study indicated that diabetics are more likely than non-diabetics to smoke cigarettes frequently and heavily in YAH and AH. Effective smoking prevention and cessation programs uniquely focused on diabetics need to be designed and implemented.

Summary

Citations

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Special Article
Burden of Noncommunicable Diseases and National Strategies to Control Them in Korea
Young-Ho Khang
J Prev Med Public Health. 2013;46(4):155-164.   Published online July 31, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.4.155
Correction in: J Prev Med Public Health 2013;46(5):292
  • 25,921 View
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AbstractAbstract PDF

Noncommunicable diseases (NCDs) are the most important causes of premature mortality and disability-adjusted life years in Korea. NCDs are also the main contributor to socioeconomic inequalities in mortality and life expectancy. Reduction of NCDs and NCD inequalities would result in significant improvement in healthy life expectancy and health equity in Korea. Major NCD risk factors such as dietary risks (including salt intake), alcohol consumption, cigarette smoking, and high blood pressure were found to be the leading modifiable risk factors of disability-adjusted life years in Korea, based on the 2010 Global Burden of Disease Study. Several Korean studies have shown that these risk factors play an important role in creating socioeconomic inequalities in NCD mortality and total mortality. Current international discussions on NCD policies in the United Nations and the World Health Organization would provide better opportunities for developing aggressive population-wide policy measures in Korea. Considering the paucity of population-wide policies to control major NCD risk factors in Korea, rigorous population approaches such as taxation and regulation of unhealthy commodities as well as public education and mass campaigns should be further developed in Korea.

Summary

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Original Articles
Factors Related to Increasing Trends in Cigarette Smoking of Adolescent Males in Rural Areas of Korea
Nam Soo Hong, Sin Kam, Keon Yeop Kim
J Prev Med Public Health. 2013;46(3):139-146.   Published online May 31, 2013
DOI: https://doi.org/10.3961/jpmph.2013.46.3.139
  • 12,363 View
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AbstractAbstract PDF
Objectives

Cigarette smoking prevalence among adolescent males in rural areas of Korea has increased in recent years. The aim of this study was to explore the factors related to increasing trends in cigarette smoking among adolescent males living in rural areas.

Methods

The raw data from the Korea Youth Risk Behavior Web-based Survey from 2006 to 2009 were used. Data were analyzed by using the method of complex survey data analysis considering complex sampling design. Multiple logistic regression models were used to explore the factors affecting cigarette smoking. We evaluated the linear time trends in the prevalence of factors that were related to current smoking status and the linear time trends in cigarette smoking in groups stratified by the exposure to each factor using logistic regression models. Finally, we examined the contributions of the factors to the time trends in cigarette smoking by adjusting for each of those factors in the baseline regression models and changes in the adjusted odds ratio by survey year.

Results

A statistically significant increasing trend in smoking was observed after adjusting for the factors affecting cigarette smoking. Significant factors related to cigarette use were perceived stress, experience with depression, current alcohol drinking, exposure to secondhand smoke, and academic performance. The factor related to increasing trends in cigarette smoking was academic performance.

Conclusions

Stress about academic performance is an important factor affecting the increase in cigarette smoking among adolescent males in a rural area of Korea.

Summary

Citations

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Relationship Between Cigarette Smoking and Muscle Strength in Japanese Men
Takeshi Saito, Nobuyuki Miyatake, Noriko Sakano, Kanae Oda, Akihiko Katayama, Kenji Nishii, Takeyuki Numata
J Prev Med Public Health. 2012;45(6):381-386.   Published online November 29, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.6.381
  • 16,444 View
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  • 28 Crossref
AbstractAbstract PDF
Objectives

To investigate the link between cigarette smoking and muscle strength in Japanese men.

Methods

We used data on 4249 Japanese men, aged 43.3±13.9 years, in this cross-sectional investigation study. Grip strength and leg strength were measured as indicators of overall muscle strength. Meanwhile, subjects' cigarette smoking habits were recorded by trained medical staff. The effect of cigarette smoking on muscle strength was evaluated.

Results

A total of 1618 men (38.1%) were smokers and 1481 men (34.9%) exercised regularly. Significant differences in muscle strength were noted between men with and without a Brinkman index of 400 or greater, after adjusting for age. After adjusting for age, height, body weight and exercise habits, associations between the Brinkman index and leg strength and the ratio of leg strength to body weight were attenuated.

Conclusions

Cigarette smoking might be negatively associated with muscle strength, especially grip strength in Japanese men.

Summary

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Smoking Is Associated With Abdominal Obesity, Not Overall Obesity, in Men With Type 2 Diabetes
Ji Eun Yun, Heejin Kimm, Young Ju Choi, Sun Ha Jee, Kap Bum Huh
J Prev Med Public Health. 2012;45(5):316-322.   Published online September 28, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.5.316
  • 12,971 View
  • 101 Download
  • 21 Crossref
AbstractAbstract PDF
Objectives

Abdominal obesity increases mortality and morbidity from cardiovascular disease and there is a possibility that smoking effects obesity. However, previous studies concerning the effects of smoking on obesity are inconsistent. The objective of this study was to examine whether smoking is positively related to abdominal obesity in men with type 2 diabetes.

Methods

Subjects consisted of 2197 type 2 diabetic patients who visited Huh's Diabetes Center from 2003 to 2009. Indices of abdominal obesity were defined as visceral fat thickness (VFT) measured by ultrasonography and waist circumference (WC). Overall obesity was defined as body mass index (BMI).

Results

Statistically significant differences in WC and VFT by smoking status were identified. However, there was no statistical difference in BMI according to smoking status. Means of WC and VFT were not significantly higher in heavy smokers and lower in mild smokers. Compared to nonsmokers, the BMI confounder adjusted odds ratio and 95% confidence interval for VFT in ex-smokers and current-smokers were 1.70 (1.21 to 2.39) and 1.86 (1.27 to 2.73), respectively.

Conclusions

Smoking status was positively associated with abdominal obesity in type 2 diabetic patients.

Summary

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Cigarette Smoking and Serum Bilirubin Subtypes in Healthy Korean Men: The Korea Medical Institute Study
Jaeseong Jo, Heejin Kimm, Ji Eun Yun, Kyu Jang Lee, Sun Ha Jee
J Prev Med Public Health. 2012;45(2):105-112.   Published online March 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.2.105
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AbstractAbstract PDF
Objectives

Cigarette smoking is a modifiable risk factor for cardiovascular disease. Bilirubin is a potent antioxidant and its concentration decreases in smokers. However, studies about the association between cigarette smoking and bilirubin are scarce and most are limited to total bilirubin. Additionally, bilirubin is highly related to hemoglobin. Therefore, this study evaluates the association between bilirubin subtypes and cigarette smoking in healthy Korean men independently of hemoglobin.

Methods

This study included 48 040 Korean men aged 30 to 87 years who visited the Korea Medical Institute for routine health examinations from January to December, 2007. The association of smoking with total, direct, and indirect bilirubin was assessed by logistic regression analysis taking into consideration differences in subjects and smoking characteristics.

Results

Current smokers had lower bilirubin concentrations than never-smokers and ex-smokers. Smoking amount and duration were inversely significantly associated with total, direct, and indirect bilirubin. In a multivariable adjusted model, compared to never-smokers, the odds ratios (ORs) and 95% confidence intervals (CIs) of current smokers with the highest number of pack-years were 1.7 (1.6 to 1.9) for total, 1.5 (1.4 to 1.6) for direct, and 1.7 (1.6 to 1.9) for indirect bilirubin. After further adjustment for hemoglobin, this association became stronger (OR [95% CI], 2.1 [1.9 to 2.2] for total; 1.9 [1.8 to 2.0] for direct; 2.0 [1.9 to 2.2] for indirect bilirubin).

Conclusions

In this study, bilirubin subtypes are inversely associated with smoking status, smoking amount, and smoking duration in healthy Korean men independently of hemoglobin. Further studies are needed to investigate this association in healthy Korean women.

Summary

Citations

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Social Determinants of Smoking Behavior: The Healthy Twin Study, Korea
Youn Sik Kim, Hansoo Ko, Changgyo Yoon, Dong-Hun Lee, Joohon Sung
J Prev Med Public Health. 2012;45(1):29-36.   Published online January 31, 2012
DOI: https://doi.org/10.3961/jpmph.2012.45.1.29
  • 12,791 View
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  • 11 Crossref
AbstractAbstract PDF
Objectives

The purpose of this study was to identify any influence of socioeconomic status on smoking and smoking cessation in a situation where genetic factors are controlled.

Methods

The sample for this study was 2502 members of the twins and families cohort who participated in the Korean Healthy Twins Study from 2005 to 2009. Groups of brothers or sisters, including twins and fraternal twins, were compared in terms of smoking and smoking cessation behaviors according to differences in socioeconomic status and gender.

Results

In a situation with complete control of genetic factors, results showed that the daily smoking amount, cumulative smoking amount, and dependence on nicotine decreased with higher-status occupations, and the rate of smoking and amount of cumulative smoking decreased with higher levels of education. Regarding smoking cessation behavior, a higher level of education was associated with a lower smoking cessation rate, and no significant gender differences were found.

Conclusions

Environmental factors had a stronger influence on smoking behavior than did genetic factors. Genetic factors had greater influence on smoking cessation than did environmental factors; however, this requires verification in further studies.

Summary

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Trends in Cigarette Use Behaviors Among Adolescents by Region in Korea
Nam Soo Hong, Keon Yeop Kim, Soon-Woo Park, Jong-Yeon Kim, Jisuk Bae, Won Kee Lee, Ki Su Kim
J Prev Med Public Health. 2011;44(4):176-184.   Published online July 29, 2010
DOI: https://doi.org/10.3961/jpmph.2011.44.4.176
  • 13,716 View
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AbstractAbstract PDF
Objectives

Understanding recent trends in cigarette smoking among adolescents is important in order to develop strategies to prevent cigarette smoking. The aim of this study was to compare recent trends in cigarette smoking for adolescents living in rural areas, small towns and metropolitan cities in Korea.

Methods

The raw data from the Korea Youth Risk Behavior Web-based Survey (KYRBWS) from 2005 to 2009 were used. Data were analyzed by using the method of complex survey data analysis considering complex sampling design. Logistic regression models were used to evaluate significant linear time trends in cigarette smoking. The indicators of cigarette use behaviors were 'current smoking rate', 'frequent smoking rate', 'heavy smoking rate' and 'smoking experience rate before 13 years of age'. All analyses were conducted according to gender.

Results

Statistically significant increasing trends in current smoking rate and frequent smoking rate were observed and borderline significant increasing trends in heavy smoking rate were shown among rural boys. Among metropolitan city boys, statistically significant increasing trends were also seen for frequent smoking. Statistically significant decreasing trends in current smoking rate were observed among small town and metropolitan city girls. Smoking experience rate before 13 years of age for rural girls decreased significantly.

Conclusions

Cigarette smoking prevalence among adolescents in the rural areas has increased in the last five years especially among boys. Our findings suggest that anti-tobacco program for adolescents should be conducted primarily for those in rural areas.

Summary

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Modifying Effect of Suicidal Ideation on the Relationship Between Asthma and Cigarette Use Behaviors Among Korean Adolescents
Jisuk Bae, Eun Young Park, Soon-Woo Park
J Prev Med Public Health. 2011;44(3):118-124.   Published online May 17, 2010
DOI: https://doi.org/10.3961/jpmph.2011.44.3.118
  • 10,514 View
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AbstractAbstract PDF
Objectives

Although cigarette smoking is known to be related to the exacerbation of asthma symptoms, several studies have indicated that the prevalence of cigarette smoking among asthmatic adolescents is similar to or even higher than that among non-asthmatic adolescents. The aim of this study was to evaluate the relationship between asthma and cigarette use behaviors and whether or not the presence of suicidal ideation modifies this relationship among Korean adolescents.

Methods

We analyzed data from the 2008 Korea Youth Risk Behavior Web-based Survey, which included a nationally representative sample of middle and high school students. Multiple logistic regression models were used to calculate odd ratios and 95% confidence intervals of cigarette use behaviors among current asthmatics, former asthmatics, and non-asthmatics, after adjusting for gender, grade, school records, socioeconomic status, current alcohol use, and suicidal ideation.

Results

Of 75 238 study participants, 3.5% were current asthmatics and 4.5% were former asthmatics. Compared with non-asthmatics, asthmatics were more likely to report current cigarette use, frequent and heavy cigarette use, and cigarette use before 13 years of age. There were statistically significant interactions between asthma and suicidal ideation in cigarette use behaviors.

Conclusions

This study demonstrated that asthmatic adolescents are more likely than non-asthmatic adolescents to engage in cigarette use behaviors and the presence of suicidal ideation is an effect modifier of the relationship between asthma and cigarette use behaviors. Particular attention should be paid to the awareness of health risks of cigarette smoking and mental health problems among asthmatic adolescents.

Summary

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    Kevin W. Hoffman, Elina Visoki, Stirling T. Argabright, Laura M. Schultz, Grace E. Didomenico, Kate T. Tran, Joshua H. Gordon, Barbara H. Chaiyachati, Tyler M. Moore, Laura Almasy, Ran Barzilay
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English Abstract
Smoking Relapse and Related Factors Within One Year Among Successes of the Smoking Cessation Clinics of Public Health Centers.
Mi Jag Kim, Ihn Sook Jeong
J Prev Med Public Health. 2011;44(2):84-92.
DOI: https://doi.org/10.3961/jpmph.2011.44.2.84
  • 6,454 View
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AbstractAbstract PDF
OBJECTIVES
This study aimed to investigate smoking relapse and the related factors within 1 year after discharge from the smoking cessation clinics (SCCs) of public health centers (PHCs). METHODS: Data were collected with a structured questionnaire from 395 people who success fully stopped smoking at 4 SCCs in Busan between May and June 2009, and this data were analyzed by Kaplan-Meier survival curves and the Cox proportional hazard model. RESULTS: The rate of smoking relapse within 1 year after discharge from SCCs was 39.2% and this decreased rapidly over 6 months after discharge. The factors related to smoking relapse within 1 year after discharge from SCCs were being female (HR, 2.11; 95% CI, 1.17 to 3.82), a trial of smoking cessation with any assistants (HR, 1.95; 95% CI, 1.19 to 3.19), more than 7 ppm of exhaled CO2 on the SCCs' registration (HR, 1.81; 95% CI, 1.24 to 2.64), use of pharmacotherapy after discharge from SCCs (HR, 2.00; 95% CI, 1.36 to 2.93), alcohol drinking more than once a week after discharge from SCCs (HR, 3.32; 95% CI, 2.15 to 6.78), and a perceived barrier (HR, 1.21; 95% CI, 1.14 to 1.30) after discharge from the SCCs. CONCLUSIONS: According to the results, at least 6 months follow-up after discharge from SCCs of public health centers is recommended to reduce the rate smoking relapse. It is also recommended to strengthen the education on how to overcome barriers such as drinking in the course of smoking cessation clinics.
Summary

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Research Support, Non-U.S. Gov't
The Korean Prediction Model for Adolescents' Future Smoking Intentions.
Sungkyu Lee, Ji Eun Yun, Ja Kyoung Lee, Il Soon Kim, Sun Ha Jee
J Prev Med Public Health. 2010;43(4):283-291.
DOI: https://doi.org/10.3961/jpmph.2010.43.4.283
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AbstractAbstract PDF
OBJECTIVES
The purpose of this study was to develop a prediction model for future smoking intention among Korean adolescents aged 13 to 15 in order to identify the high risk group exposed to future smoking. METHODS: The data was collected from a total of 5940 students who participated in a self-administrated questionnaire of a cross-sectional school-based survey, the 2004 Korea Global Youth Tobacco Survey. Chi-square tests and logistic regression analyses were carried out to identify the relevant determinants associated with intentions of adolescents' future smoking. Receiver Operation Characteristic (ROC) assessment was applied to evaluate the explanation level of the developed prediction model. RESULTS: 8.4% of male and 7.2% of female participants show their intentions of future smoking. Among non-smoking adolescents; who have past smoking experience [odds ratio (OR) 2.73; 95% confidence interval (CI) 1.92 - 3.88]; who have intentions of smoking when close friends offer a cigarette (OR 31.47; 95% CI = 21.50 - 46.05); and who have friends that are mostly smokers (OR 5.27; 95% CI = 2.85 - 9.74) are more likely to be smokers in the future. The prediction model developed from this study consists of five determinants; past smoking experience; parents smoking status; friends smoking status; ownership of a product with a cigarette brand logo; and intentions of smoking from close friends' cigarette offer. The area under the ROC curve was 0.8744 (95% CI=0.85 - 0.90) for current non-smokers. CONCLUSIONS: For efficiency, school-based smoking prevention programs need to be designed to target the high risk group exposed to future smoking through the prediction model developed by the study, instead of implementing the programs for all the students.
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Original Article
A Longitudinal Study on the Causal Association Between Smoking and Depression.
Eunjeong Kang, Jaehee Lee
J Prev Med Public Health. 2010;43(3):193-204.
DOI: https://doi.org/10.3961/jpmph.2010.43.3.193
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AbstractAbstract PDF
OBJECTIVES
The objective of this study was to analyze the causal relationship between smoking and depression using longitudinal data. METHODS: Two waves of the Korea Welfare Panel collected in 2006 and 2007 were used. The sample consisted of 14 426 in 2006 and 13 052 in 2007 who were aged 20 and older. Smoking was measured by smoking amount (none/ or = two packs). Depression was defined when the summated CESD (center for epidemiological studies depression)-11 score was greater than or equal to 16. The causal relationship between smoking and depression was tested using logistic regression. In order to test the causal effect of smoking on depression, depression at year 2 was regressed on smoking status at year 1 only using the sample without depression at year 1. Likewise, smoking status at year 2 was regressed on depression at year 1 only using those who were not smoking at year 1 in order to test the causal effect of depression on smoking. The statistical package used was Stata 10.0. Sampling weights were applied to obtain the population estimation. RESULTS: The logistic regression testing for the causal relationship between smoking and depression showed that smoking at year 1 was significantly related to depression at year 2. Smoking amounts associated with depression were different among age groups. On the other hand, the results from the logistic regression testing for the opposite direction of the relationship between smoking and depression found no significant association regardless of age group. CONCLUSIONS: The study results showed some evidence that smoking caused depression but not the other way around.
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Multicenter Study
Cigarette Smoking and Mortality in the Korean Multi-center Cancer Cohort (KMCC) Study.
Eun Ha Lee, Sue K Park, Kwang Pil Ko, In Seong Cho, Soung Hoon Chang, Hai Rim Shin, Daehee Kang, Keun Young Yoo
J Prev Med Public Health. 2010;43(2):151-158.
DOI: https://doi.org/10.3961/jpmph.2010.43.2.151
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AbstractAbstract PDF
OBJECTIVES
The aim of this study was to evaluate the association between cigarette smoking and total mortality, cancer mortality and other disease mortalities in Korean adults. METHODS: A total of 14 161 subjects of the Korean Multi-center Cancer Cohort who were over 40 years of age and who were cancer-free at baseline enrollment reported their lifestyle factors, including the smoking status. The median follow-up time was 6.6 years. During the follow-up period from 1993 to 2005, we identified 1159 cases of mortality, including 260 cancer mortality cases with a total of 91 987 person-years, by the national death certificate. Cox proportional hazard regression model was used to estimate the hazard ratio (HR) of cigarette smoking for total mortality, cancer mortality and disease-specific mortality, as adjusted for age, gender, the geographic area and year of enrollment, the alcohol consumption status, the education level and the body mass index (BMI). RESULTS: Cigarette smoking was significantly associated with an increased risk of total mortality, all-cancer mortality and lung cancer mortality (p-trend, <0.01, <0.01, <0.01, respectively). Compared to non-smoking, current smokers were at a higher risk for mortality [HR (95% CI)=1.3 (1.1-1.5) for total mortality; HR (95% CI)=1.6 (1.1-2.2) for all-cancer mortality; HR (95% CI)=3.9 (1.9-7.7) for lung cancer mortality]. CONCLUSIONS: This study's results suggest that cigarette smoking might be associated with total mortality, all-cancer mortality and especially lung cancer mortality among Korean adults.
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Original Articles
Workplace Smoking Ban Policy and Smoking Behavior.
Beomsoo Kim
J Prev Med Public Health. 2009;42(5):293-297.
DOI: https://doi.org/10.3961/jpmph.2009.42.5.293
  • 7,467 View
  • 99 Download
  • 18 Crossref
AbstractAbstract PDF
OBJECTIVES
To evaluate the impact of the workplace smoking ban in South Korea, where the male smoking rate is high (57%), on smoking behavior and secondhand smoke exposure. METHODS: A workplace smoking ban legislation implemented in April 2003 requires offices, meeting rooms, and lobbies located in larger than 3,000 square meter buildings (or 2,000 square meter multipurpose buildings) should be smoke free. A representative cross-sectional survey, the third wave (2005) of health supplements in the National Health Nutrition Survey of South Korea, was used to measure the impact of the 2003 workplace smoking ban implementation on smoking behavior. It contained 3,122 observations of adults 20 to 65 years old (excluding self-employed and non-working populations). A multivariate statistical model was used. The self-reported workplace smoking ban policy (full workplace ban, partial workplace ban, and no workplace ban) was used as the key measure. RESULTS: A full workplace smoking ban reduced the current smoking rate by 6.4 percentage points among all workers and also decreased the average daily consumption among smokers by 3.7 cigarettes relative to no smoking ban. Secondhand smoke showed a dramatic decrease of 86 percent (= -1.74/2.03)from the sample mean for full workplace ban. However, public anti-smoking campaign did not show any significant impact on smoking behavior. CONCLUSIONS: The full workplace ban policy is effective in South Korea. Male group showed bigger impact of smoking ban policy than female group. The public antismoking campaign did not show any effectiveness.
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Validity of Self-reported Smoking Using Urinary Cotinine among Vocational High School Students.
Soon Woo Park, Jong Yeon Kim
J Prev Med Public Health. 2009;42(4):223-230.
DOI: https://doi.org/10.3961/jpmph.2009.42.4.223
  • 6,878 View
  • 90 Download
  • 27 Crossref
AbstractAbstract PDF
OBJECTIVES
This study was conducted to validate self-reported smoking among high school students using urinary cotinine. METHODS: A self report of smoking behavior was collected together with urine sample for cotinine analysis from 130 male and female students in two vocational high school students in November, 2007. Validity and agreement between self-reported smoking and urinary cotinine was analyzed with STATA 9.0 for different definitions of current smokers, and frequent and daily smokers. Urinary cotinine concentration was measured by the DRI Cotinine Assay for urine (Microgenics Corp., Fremont, CA) on Toshiba 200FR. The cut-off point of urinary cotinine was 50 ng/dl. RESULTS: The concentrations of urinary cotinine were significantly different according to the frequency and amount of smoking. Sensitivity and specificity was 90.9% and 91.8% respectively, and the Cohen's kappa value was 0.787 among the current smokers who smoked at least one day during one month preceding the survey. The comparable high sensitivity, specificity, and kappa value were shown also among the other definitions of current smokers, that is, subjective smokers, and weekly smokers. CONCLUSIONS: The results showed the high validity of self-reported smoking among high school students. However, due to the small sample size and limitation of the participants, it is cautious to generalize the results to overall high school students.
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English Abstracts
Association of Current and Past Smoking with Metabolic Syndrome in Men.
A Rum Hong, Kang Sook Lee, Seon Young Lee, Jae Hee Yu
J Prev Med Public Health. 2009;42(3):160-164.
DOI: https://doi.org/10.3961/jpmph.2009.42.3.160
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  • 11 Crossref
AbstractAbstract PDF
OBJECTIVES
The objective of this study was to determine the relationship between past smoking and the risk factors for metabolic syndrome. METHODS: From January 2007 to December 2007, a total of 3,916 over thirty years old male health screen examinees were divided into the nonsmoking, smoking, ex-smoking groups. The diagnosis of metabolic syndrome was based on the criteria of the NCEP ATP (Executive Summary of The Third Report of The National Cholesterol Education Program). Metabolic syndrome was defined as the presence of three or more of the following: a blood pressure > or = 130/85 mmHg, a fasting glucose level > or = 110 mg/dL, a HDL-C (High Density Lipoprotein Cholesterol) level < 40 mg/dL, a triglyceride level > or = 150 mg/dL and, a waist circumference men > or = 102 cm, but a waist to hip ratio > 0.90 was used as a surrogate for the waist circumference. RESULTS: After adjustment for age, alcohol consumption and, exercise in the smokers, for the ex-smokers compared with the nonsmokers, the odds ratio (OR) of a lower HDL cholesterol level (< 40 mg/dL) was 1.29 (95% CI=1.03-1.61) in the smokers, the ORs of a higher triglyceride level were 1.35 (95% CI=1.09-1.66) in the ex-smokers and, 2.12 (95% CI=1.75-2.57) in the smokers, and the OR of a waist to hip ratio was 1.25 (95% CI=1.03-1.52) in the ex-smokers. When there were over three components of metabolic syndrome in the ex-smokers and smokers as compared with the nonsmokers, the odds ratio against the risk of metabolic syndrome were 2.39 (95% CI=1.00-6.63) and 2.37 (95% CI=1.02-6.46), respectively. CONCLUSIONS: The present study suggested that there is an association of smoking with metabolic syndrome in men.
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Predictors of Current Smoking among Male Students in a Technical High School: A Prospective Study.
Jong Yeon Kim, Soon Woo Park
J Prev Med Public Health. 2009;42(1):59-66.
DOI: https://doi.org/10.3961/jpmph.2009.42.1.59
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AbstractAbstract PDF
OBJECTIVES
This study was performed using a longitudinal approach to explore the predictors for current smoking among male high school students. METHODS: Baseline data was collected in May 2004 through a self-administrated questionnaire completed by 607 male students in a technical high school in Daegu city, Korea. Subsequently, their smoking behaviors were followed one year after. Among the 544 followed participants, data for 439 non-smokers in the first year was used in longitudinal analysis. Current smokers were defined as those respondents who had smoked one or more cigarettes within the 30 days preceding the survey. Several potential predictors for smoking were investigated including smoking history (never, experimental, former smoker), sociodemographic factors, environmental factors, attitudes toward smoking, and behavioral factors. Logistic regression was used to predict smoking with SPSS ver. 12.0. RESULTS: According to multiple logistic regression analysis, those students who were more likely to smoke after one year were former smokers (OR: 2.12, 95% CI=1.01-4.44), current drinkers (OR: 2.55, 95% CI=1.33-4.89), who had four or five smokers among five best friends (OR: 3.43. 95% CI=1.14-10.30). In addition, those who had smokers among family members besides parents or siblings (OR: 1.66, 95% CI=0.92-2.98), exhibited a high level of subjective stress (OR: 1.77, 95% CI=0.96-3.26), or had a very good relationship with friends (OR: 1.93, 95% CI=0.99-3.75) were also more likely to smoke albeit with marginal statistical significance (p<0.1). CONCLUSIONS: A smoking prevention program aimed at high school students may be more effective with due consideration of the predictors highlighted in this study. However, further studies with larger sample size and various target populations are necessary to find potential predictors not found in this study but suggested in other longitudinal studies.
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Evaluation Studies
The Factors Implicated When an Individual Starts to Smoke Again After a 6 Month Cessation.
Hyo Kyung Son, Un Young Jung, Ki Soo Park, Sin Kam, Sun Kyun Park, Won Kee Lee
J Prev Med Public Health. 2009;42(1):42-48.
DOI: https://doi.org/10.3961/jpmph.2009.42.1.42
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AbstractAbstract PDF
OBJECTIVES
This study was conducted to examine the factors implicated when people start smoking again after a 6 month cessation, and was carried out at the smoking cessation clinic of a public health center. METHODS: The study subjects were 191 males who had attended the smoking cessation clinic of a public health center for 6 months in an attempt to quit smoking. Data was collected, by phone interview, regarding individual smoking habits, if any, over the 6 month study period. The factors which may have caused an individual to smoke again were examined. This study employed a health belief model as it theoretical basis. RESULTS: Following a 6 month cessation, 24.1% of the study group began to smoke again during the 6 month test period. In a simple analysis, the factors related to individuals relapsing and smoking again included barriers of stress reduction, body weight gain and induction of smoking by surroundings among perceived barriers factor of our health belief model (p<0.05). In multiple logistic regression analysis for relapsed smoking, significant factors included barriers of stress reduction and induction of smoking by surroundings (p<0.05). The most important reason of for an individual to relapse into smoking was stress (60.9%) and the most likely place for a relapse to occur was a drinking establishment (39.1%). CONCLUSIONS: Our results indicate that both regular consultations and a follow-up management program are important considerations in a public health center program geared towards maintaining smoking cessation.
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English Abstract
The Effect of Smoking Status upon Occurrence of Impaired Fasting Glucose or Type 2 Diabetes in Korean Men.
Chang Hae Park, Hyuk Ga, Jong Han Leem, Seung Min Kwak, Hwan Cheol Kim, Ji Ho Choi
J Prev Med Public Health. 2008;41(4):249-254.
DOI: https://doi.org/10.3961/jpmph.2008.41.4.249
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AbstractAbstract PDF
OBJECTIVES
To investigate whether smoking and the smoking status are predictors of the incident impaired fasting glucose (IFG) or type 2 diabetes in Korean men. METHODS: A cohort of 1,717 Korean men without IFG or diabetes, who underwent annual periodic health examinations for 4 years (2002-2006), were retrospectively investigated. IFG and diabetes were defined as a serum fasting glucose concentration of 100-125 mg/dL and more than 126 mg/dL, respectively. Cox's proportional hazards model was used to evaluate the association between smoking and development of IFG or type 2 diabetes. RESULTS: A total of 558 cases (32.5%) of incident IFG and 50 cases (2.9%) of diabetes occurred. After controlling for the potential predictors of diabetes, the relative risk for IFG, compared with the never smokers, was 1.02 (95% CI=0.88 to 1.19) for the ever-smokers, 0.96 (95% CI=0.79-1.16) for those who smoked 1-9 cigarettes/d, 1.15 (95% CI=1.01 to 1.30) for those who smoked 10-19 cigarettes/d, and 1.31 (95% CI=1.10 to 1.57) for those who smoked 20 or more cigarettes/d (the P value for the current smokers was only p<0.002). The respective multivariate adjusted relative risks for type 2 diabetes, compared with the neversmokers, were 1.07 (95% CI=0.64 to 1.92), 1.47 (95% CI=0.71 to 3.04), 1.84 (95% CI=0.92-3.04), and 1.87 (95% CI=1.13-3.67), respectively (the P value for the current smokers was only p=0.004). CONCLUSIONS: The smoking status and the number of cigarettes smoked daily are associated with an increased risk for developing IFG or type 2 diabetes in Korean men.
Summary

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    Journal of the Korean Society of Food Science and Nutrition.2014; 43(1): 141.     CrossRef
  • Associated Factors of Impaired Fasting Glucose in Some Korean Rural Adults
    Hye Eun Yun, Mi-ah Han, Ki Soon Kim, Jong Park, Myeng Guen Kang, So Yeon Ryu
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  • Association of passive and active smoking with incident type 2 diabetes mellitus in the elderly population: the KORA S4/F4 cohort study
    Bernd Kowall, Wolfgang Rathmann, Klaus Strassburger, Margit Heier, Rolf Holle, Barbara Thorand, Guido Giani, Annette Peters, Christine Meisinger
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Multicenter Study
Cigarette Smoking and Gastric Cancer Risk in a Community-based Cohort Study in Korea.
Yeonju Kim, Aesun Shin, Jin Gwack, Jae Kwan Jun, Sue Kyung Park, Daehee Kang, Hai Rim Shin, Soung Hoon Chang, Keun Young Yoo
J Prev Med Public Health. 2007;40(6):467-474.
DOI: https://doi.org/10.3961/jpmph.2007.40.6.467
  • 8,059 View
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  • 12 Crossref
AbstractAbstract PDF
OBJECTIVES
Gastric cancer is the most common incident cancer in Korea. Although Helicobacter pylori infection is the most important risk factor for the development of gastric cancer, cigarette smoking has also been suggested to play an important role in the development of gastric cancer. The objective of this study is to evaluate the relationship between cigarette smoking and gastric cancer risk in a Korean population. METHODS: The study population consisted of 13,785 subjects who had been enrolled in the Korean Multi-Center Cancer Cohort between 1993 and 2002. As of December 2002, 139 incident gastric cancer cases were ascertained through the Korea Central Cancer Registry and the National Death Certificate Database. Relative risks (RR) and 95% confidence intervals (CI) for gastric cancer were estimated using CoxZs proportional hazard model adjusted for age, education, alcohol drinking status and history of gastritis or ulcer. RESULTS: Significant dose-response relationships were observed between the duration of smoking and the risk of gastric cancer among the male subjects in comparison to non-smokers: men who smoked for 20-39 years had a 2.09- fold (95% CI 1.00-4.38) increase, and those who smoked for more than 40 years had a 3.13-fold (95% CI 1.59-6.17) increase in the risk of gastric cancer (Ptrend<0.01). CONCLUSIONS: This study suggests that a longer duration of cigarette smoking may increase the risk of gastric cancer development in a dose-response manner in Korean men. The association between smoking and gastric cancer risk in women should be verified in future studies with a larger number of cases.
Summary

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    Asher Lippe, Scott Lippe
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    Minkyo Song, Hwi-Won Lee, Daehee Kang
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    Amartya Roy, Jyotirmoy Sikdar, Paromita Seal, Rajen Haldar
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    In-Seob Lee, Young-Soo Park, Jeong Hoon Lee, Ji Young Park, Hee-Sung Kim, Beom-Su Kim, Jeong-Hwan Yook, Sung-Tae Oh, Byung-Sik Kim
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English Abstract
The Effect of Cigarette Price on Smoking Behavior in Korea.
Woojin Chung, Seungji Lim, Sunmi Lee, Sungjoo Choi, Kayoung Shin, Kyungsook Cho
J Prev Med Public Health. 2007;40(5):371-380.
DOI: https://doi.org/10.3961/jpmph.2007.40.5.371
  • 7,339 View
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  • 6 Crossref
AbstractAbstract PDF
OBJECTIVES
To determine the impact of cigarette prices on the decision to initiate and quit smoking by taking into account the interdependence of smoking and other behavioral risk factors. METHODS: The study population consisted of 3,000 male Koreans aged > or =20. A survey by telephone interview was undertaken to collect information on cigarette price, smoking and other behavioral risk factors. A two-part model was used to examine separately the effect of price on the decision to be a smoker, and on the amount of cigarettes smoked. RESULTS: The overall price elasticity of cigarettes was estimated at -0.66, with a price elasticity of -0.02 for smoking participation and -0.64 for the amount of cigarettes consumed by smokers. The inclusion of other behavioral risk factors reduced the estimated price elasticity for smoking participation substantially, but had no effect on the conditional price elasticity for the quantity of cigarettes smoked. CONCLUSIONS: From the public health and financial perspectives, an increase in cigarette price would significantly reduce smoking prevalence as well as cigarette consumption by smokers in Korea.
Summary

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    Philip DeCicca, Donald Kenkel, Michael F. Lovenheim
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Multicenter Study
Cigarette Smoking, Alcohol Consumption, Tuberculosis and Risk of Lung Cancer: The Korean Multi-center Cancer Cohort Study.
Jisuk Bae, Jin Gwack, Sue Kyung Park, Hai Rim Shin, Soung Hoon Chang, Keun Young Yoo
J Prev Med Public Health. 2007;40(4):321-328.
DOI: https://doi.org/10.3961/jpmph.2007.40.4.321
  • 7,753 View
  • 134 Download
  • 12 Crossref
AbstractAbstract PDF
OBJECTIVES
The aim of this study was to evaluate the roles of cigarette smoking, alcohol consumption, tuberculosis, and their interactions in the risk of lung cancer in a Korean cohort. METHODS: The study subjects comprised 13,150 males and females aged above 20 years old. During the follow up period from 1993 to 2002, 79 lung cancer cases were identified by the central cancer registry and the national death certificate database. Information on cigarette smoking, alcohol consumption and the history of physiciandiagnosed tuberculosis was obtained by interview. Indirect chest X-ray findings were also evaluated to ascertain tuberculosis cases. Cox proportional hazard models were used to estimate relative risks (RR) and 95% confidence intervals (CI) after adjusting for age and gender. RESULTS: Cigarette smoking was statistically significantly associated with an increased risk of lung cancer [for current smokers, RR = 2.33 (95% CI = 1.23 - 4.42) compared to non-smokers]. After further adjustment for cigarette smoking, both alcohol consumption and tuberculosis showed no statistically significant association with the risk of lung cancer [for current drinkers, RR = 0.80 (95% CI = 0.48 - 1.33) compared to non-drinkers] [for tuberculosis cases, RR = 1.17 (95% CI = 0.58 - 2.36) compared to noncases]. There was no statistically significant interaction between cigarette smoking and alcohol consumption (pinteraction = 0.38), or cigarette smoking and tuberculosis (p-interaction = 0.74). CONCLUSIONS: Although cigarette smoking was confirmed as a risk factor of lung cancer in this cohort study, this study suggests that alcohol consumption and tuberculosis may not be associated with the risk of lung cancer.
Summary

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Validation Studies
Validity of Expired Carbon Monoxide and Urine Cotinine Using Dipstick Method to Assess Smoking Status.
Su San Park, Ju Yul Lee, Sung Il Cho
J Prev Med Public Health. 2007;40(4):297-304.
DOI: https://doi.org/10.3961/jpmph.2007.40.4.297
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AbstractAbstract PDF
OBJECTIVES
We investigated the validity of the dipstick method (Mossman Associates Inc. USA) and the expired CO method to distinguish between smokers and nonsmokers. We also elucidated the related factors of the two methods. METHODS: This study included 244 smokers and 50 exsmokers, recruited from smoking cessation clinics at 4 local public health centers, who had quit for over 4 weeks. We calculated the sensitivity, specificity and Kappa coefficient of each method for validity. We obtained ROC curve, predictive value and agreement to determine the cutoff of expired air CO method. Finally, we elucidated the related factors and compared their effect powers using the standardized regression coefficient. RESULTS: The dipstick method showed a sensitivity of 92.6%, specificity of 96.0% and Kappa coefficient of 0.79. The best cutoff value to distinguish smokers was 5-6ppm. At 5 ppm, the expired CO method showed a sensitivity of 94.3%, specificity of 82.0% and Kappa coefficient of 0.73. And at 6 ppm, sensitivity, specificity and Kappa coefficient were 88.5%, 86.0% and 0.64, respectively. Therefore, the dipstick method had higher sensitivity and specificity than the expired CO method. The dipstick and expired CO methods were significantly increased with increasing smoking amount. With longer time since the last smoking, expired CO showed a rapid decrease after 4 hours, whereas the dipstick method showed relatively stable levels for more than 4 hours. CONCLUSIONS: The dipstick and expired CO methods were both good indicators for assessing smoking status. However, the former showed higher sensitivity and specificity and stable levels over longer hours after smoking, compared to the expired CO method.
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