• 한국병원경영학회지
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• 제27권1호
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• pp.43-57
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• 2022

Background: Avoidable mortality rate has been widely used as an indicator of the quality of health care and the degree of inequality in health levels. The purpose of this study was to identify the factors affecting the avoidable mortality rate in the region. Methods: The data was MDIS(Microdata Integrated Service) Causes of Death Statistics, and the analysis period was from 2010 to 2019. Panel analysis was performed to identify the influencing factors on the avoidable mortality rate. Findings: Result showed that the current smoking rate had a significant positive effects on the avoidable mortality rate of both men and women. And the smoking cessation trial rate, low salt diet rate, weight control trial rate, annual vaccination rate had a significant negative effect. In the social environment, the divorce rate had a significant positive effect. In the economy environment, financial independence and social welfare budget rate had a significant negative effect. In the physical environment, the factory area rate had a significant positive effect. Practical Implication: Practical implication in order to lower the local avoidable mortality rate, various social determinants of health as well as health care resources should be considered together.

• Genomics & Informatics
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• 제3권4호
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• pp.166-171
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• 2005

Background: Smoking effects are relatively well-documented, especially on cancers and cardiovascular diseases. However, the direction and magnitude of association between smoking and obesity remain unclear. Conflicting results so far are thought to stem from the multiple confounding structure of smoking and other obesogenic life style characteristics. Methods: Cotwin control study is a genomic epidemiology design, in which the other twin (=cotwin) serves as a control of the twin. Cotwin control study, discordant for smoking habits can provide powerful evidence of association between smoking and obesity by completely matching genomic information, intrauterine environment, and almost all environmental factors. We selected 3,697 like-sex twin pairs (2,762 male and 935 female pairs) out of 63,666 pairs of adult twins in the existing Korea Twin and Family Register, whose smoking habits are discordant. We used the information of obesity as body mass index (BMI, $kg/m^2$) blood pressure, and blood cholesterol level at the time or later than the smoking information. Paired t-test was done to compare the smoking effects. Results: Lifetime smoking rate was 80.1 % (47.9 current smoker) for men and 10% (1.7% current smoker) for women. Among 2,762 and 935 male and female like-sex twin pairs, 363 male pairs and 20 female pairs correspond to the definition of smoker-nonsmoker pair. The male smokers demonstrated increase in BMI by 0.47, while female smokers show slight decrease (by 0.13), which were not statistically significant. Diastolic and systolic blood pressure, and cholesterol level were slightly increased among smokers by 1.85 mmHg, 0.62 mmHg, and 1.28 mg/dl for men. For women, the results show increase in diastolic blood pressure (3.42mmHg) and cholesterol level (1.25 mg/dl), and systolic pressure (8.17 mmHg). Conclusion: The results refute the possibility that smoking can reduce BMI. Considering the direct adverse effect of smoking, it should be emphasized that smoking do not decrease obesity and thus increase overall metabolic syndrome.

• 치위생과학회지
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• 제9권5호
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• pp.513-518
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• 2009

본 연구는 청주시 소재 실업계 남자고등학교 2학년 학생 281명을 대상으로 고등학교 남학생의 흡연과 치은염과의 관련성을 알아보고자 설문조사와 구강검사를 시행한 결과 다음과 같은 결론을 얻었다. 1. 본 연구는 대상자의 흡연 경험률은 59.4였으며, 현재 흡연율은 41.3%로 나타났다. 학생들의 평균 치은염이환율은 61.5%, 그 중 흡연 경험이 있는 학생이 44.8%였다. 평균 치은염지수는 $0.20{\pm}0.27$로 그 중 흡연 경험 있는 학생이 $0.29{\pm}0.31$로 나타났다. 2. 흡연경험이 있는 경우 치은염을 가지고 있는 확률이 높았고 (p = 0.000), 음주경험이 있을수록 치은염 이환율이 높았다(p = 0.010). 3. 음주경험, 구강보건교육경험, 최근 1년 동안 치과내원 유무, 치석제거경험, 칫솔질 횟수를 통제한 다변량 분석에서 치은염 이환의 경우 비흡연군에 비해 흡연 경험군이 5.5배(p = 0.000)로 높았다. 하루 흡연량이 6개비 이상인 경우 비흡연군에 비해 8.4배(p = 0.000)로 높았다. 흡연 기간이 25개월 이상인 경우 비흡연군에 비해 13.2배(p = 0.000)로 높았다. 4. 치은염지수의 결정요인분석에서 흡연기간과 치석제거 경험이 높은 관련성을 보였고, 36.2%의 설명력을 보였다. 결론적으로 본 연구의 결과 남자고등학생들의 흡연은 치은염의 영향력을 보였다. 청소년기는 학동기에 이어 영구치의 치아우식이 계속 진행되는 연령이며 치주질환이 시작되는 시기이다. 그러므로 금연으로 구강상태를 조절할 수 있도록 동기 유발과 구강교육이 이루어지도록 청소년 구강보건 향상에 주력해야 할 것이다.

• 한국산학기술학회논문지
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• 제20권8호
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• pp.47-55
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• 2019

이 연구는 한국 성인의 전자담배 사용과 관련된 요소들을 조사하기 위해 수행되었다. 카이제곱 검정, 로지스틱회귀분석을 통해2015년 한국질병통제센터에서 실시한 지역건강조사228,477건을 분석하였다. 전자담배평생 유병율이 남성 11.1%, 여성 0.8%로 나타났다. 현재 전자담배 흡연율은 남성이 24.2%, 여성이 26.1%로 였다. 평생전자담배 흡연경험율은 연령 교육수준, 직업, 소득상태 및 현재흡연상태와 각각 유의미하게 관련되어 있었다. 현재의 보편적인 전자담배 흡연이 현 흡연상태와 유의한 관련이 있는 것은 과거에 흡연했던 그룹보다 현재흡연자 그룹이 현저히 높은 경험을 보이고 있는 것이다. 전자담배의 선호는 높았다. 전자담배는 금연을 목적으로 하는 이들이 전자담배가 일반담배에 비해 금연 효과가 있는 것처럼 인식하고 있었고, 흡연에서 오는 쾌감이나 중독성을 만족시켜 주었다. 따라서 전자담배는 흡연에 대한 딜레마에서 벗어날 수 있는 해결책으로 반영되어 선호도가 높았다. 2014년 전자담배 수입은 전년도 대비 약 3배 증가했고 세계적으로도 전자담배에 대한 관심이 증가하고 있다. 우리는 전자담배의 예방과 중단에 관련된 특징을 고려해야 한다. 흡연자들이 잘못된 흡연관련 건강인식을 개선하기 위한 금연교육 강화와 금연 위해성에 대한 적극적인 홍보가 필요하다. WHO에서도 전자담배의 안전성을 담보하거나 효과가 있다고 인정한 근거가 부족하다고 권고하고 있다. 전자 담배의 사용 동기에 있어서 중요한 환경적인 요인들을 확인하고 전자담배인식과 사용에 대한 연관성을 분석하는 연구들을 모색해야 한다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권5호
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• pp.2891-2896
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• 2013

Background: To illustrate multiple approaches and to assess participation rates adopted for a community based smoking cessation intervention programme in rural Kerala. Materials and Methods: Resident males in the age group 18-60 years who were 'current daily smokers' from 4 randomly allocated community development blocks of rural Thiruvananthapuram district, Kerala (2 intervention and 2 control groups) were selected. Smoking status was assessed through house-to-house survey using trained volunteers. Multiple approaches included awareness on tobacco hazards during baseline survey and distribution of multicolour anti-tobacco leaflets for intervention and control groups. Further, the intervention group received a tobacco cessation booklet and four sessions of counselling which included a one-time group counselling cum medical camp, followed by proactive counselling through face-to-face (FTF) interview and mobile phone. In the second and fourth session, motivational counselling was conducted. Results: Among 928 smokers identified, smokers in intervention and control groups numbered 474 (mean age: 44.6 years, SD: 9.66 years) and 454 respectively (44.5 years, SD: 10.30 years). Among the 474 subjects, 75 (16%) had attended the group counselling cum medical camp after completion of baseline survey in the intervention group, Among the remaining subjects (n=399), 88% were contacted through FTF and mobile phone (8.5%). In the second session (4-6 weeks time period), the response rate for individual counselling was 94% (78% through FTF and 16% through mobile phone). At 3 months, 70.4% were contacted by their mobile phone and further, 19.6% through FTF (total 90%) while at 6 months (fourth session), the response rate was 74% and 16.4% for FTF and mobile phone respectively, covering 90.4% of the total subjects. Overall, in the intervention group, 97.4% of subjects were being contacted at least once and individual counselling given. Conclusion: Proactive community centred intervention programmes using multiple approaches were found to be successful to increase the participation rate for intervention.

• 한국보건간호학회지
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• 제14권2호
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• pp.281-292
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• 2000

This study was conducted from Nov. 15 to Dec. 20. 1999, covering 3.214 fourth. fifth, and sixth graders in 25 schools. one from each Ku in Seoul. in order to provide basic data for developing smoking prevention program. The results of the study were as follows : 1. Among the students under inquiry. $10.2\%$ answered they had the experience of smoking, while $6.3\%$ said they are current smokers. 2. With regard to smokers' smoking behavior. about 90% of them smoke one or two cigarettes a day. A lot of them was their own or friends' homes to smoke. but not at specific time. Many students who smoke say they was cigarettes stored and/or picked up at home. $28.9\%$ of them have friends who know that they smoke and $27.7\%$ of them have siblings are aware they are smokers. $24.2\%$ of them said no one around them is aware of the fact they. smoke. 3. Forth grade is the most frequent year students start smoking$(23.5\%)$. Most of them had their first smoking experience at their homes out of curiosity. 4. Profile of a typical smoker would; be male; from miscellaneous religions; have very few friends: have hard time to fit in at school and he/she has a poor academic record. 5. Environmental profile of a smoker consists of: commercial area resident: single-parented; lacks attention from parents; has hard time at home; has someone who smokes within the family. 6. Regarding the experience of smoking prevention education. the rate of current smokers who have learned about smoking prevention was lower than that of who have not learned. 7. Among the non-smoking students. $81.3\%$ of them said they would keep away from smoking and $1.6\%$ of them said they would like to smoke in the future. while $17.1\%$ were undecided. Among the students who smoke. $93.7\%$ wish to quit smoking.

• Journal of Acupuncture Research
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• 제29권5호
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• pp.127-137
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• 2012

Objectives : The purpose of this study is to review on current status of use and measurement condition of heart rate variability(HRV) by reviewing clinical studies published in journal of Korean medicine registered Korea citraion index(KCI). Methods : One hundred twenty articles were found by searching the representative Korean databases. At first analysis was performed by current status of use(journal, academic field of corresponing author, purpose of study, disease of subject, HRV measurement devices, intervention methods and tests compared to HRV). At second analysis was performed by measurement condition(uncontrolled study, relaxation before measurement, measurement position, measurement place, measurement time period and restriction of smoking, alcohol, caffeine, meal). Results : The analysis showed that department of acupuncture & moxibustion, department of oriental neuropsychiatry are major part in journal & academic field. The purpose of study were classified under studies to verify therapeutic effect on normal subject(39%), to verify therapeutic effect on the patients(8%), to investigate characteristics of the patients(34%) and to be compared with other test(19%). Disease of subject & measurement devices in article were so various. Major intervention methods were acupuncture(61.4%), mind-body intervention(19.2%). Studies that measurement condition were not controlled were relax time(24%), measurement position(19%), measurement place(26%), measurement time period(91%) and restriction of smoking, alcohol, caffeine, meal(49%). Conclusions : This study showed that current status of use of HRV is widespread in Korean medicine but more controlled measurement conditon are needed to get more reliable result from clinical studies and to improve diagnosis and treatment of Korean medicine.

• 한국학교보건학회지
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• 제18권2호
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• pp.133-140
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• 2005

Purpose： This study estimated the prevalence of smoking among male and female school employees. This study also correlated key indicators of health with the number of cigarettes consumed per day by the male smokers. The indicators of health included health behavior, blood pressure (mmHg), BMI (kg/m2), diabetes, total cholesterol, GOT, GPT and GTP. Methods： Subjects included 2,640 male and 2,747 female employees working at elementary, middle, and high schools who received a physical check-up at the Seoul School Health Center in 2002. Data was obtained from the physical examinations, questionnaires, and laboratory results. Results： 39.7% of males and 0.4% of females were current smokers. 60% of the male smokers consumed between 10 and 19 cigarettes per day, and39.6% of male smokers had been smoking between 10 and 19 years. Smokers who consumed more than one pack per day had a relatively higher BMI than the non-smokers (24.7 24.1, respectively). However, smokers had lower blood pressure than non-smokers. The mean systolic and diastolic blood pressure of current-smokers were 128.2 and 82.8, respectively, while the values among non-smokers were 129 and 84.5, respectively. The proportion of current smokers with severe obesity (over BMI 30) was 5.0%. This was considerably higher than the 1.3% of severely obese non-smokers. Current-smokers also had mean and abnormal rate of fasting blood glucose, total cholesterol, GOT, GPT, and GTP that were higherthan those of non-smokers. The frequency of red meat consumption, alcohol use, perceived incidents of stress were alsomore frequent in current-smokers than in non-smokers. Exercise frequency was also lower among smokers. In multiple regression after adjusting all possible confounding factors including age, BMI, diet, and drink, the parameter value of fasting blood glucose, cholesterol, GOT, GPT, and GTP increased relative to the level of cigarette consumption. Conclusion： Among school employees, health behavior, and general health status including BMI, total cholesterol, GOT, GPT, GTP, and fasting blood glucose were worse in smokers than in non-smoker.

• 보건행정학회지
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• 제13권3호
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• pp.1-20
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• 2003

The purpose of this study was to investigate the current status of health promotion policies about antismoking, and the relationship between policy status, enforcement of smoking restrictions and perceptions of smoking behaviour among teachers. A representative sample of 173 teachers$.$school inspectors from 150 elementary$.$middle$.$high schools in Gangwon-do was surveyed during Gangwon-do Office of Education's antismoking and temperance training course in 2002 (response rate 60.7%). One staff member from each school was also analyzed regarding school antismoking polices for students and teachers in several locations within and outside the school building. The results showed that 118 elementary$.$middle$.$high schools (78.7%) had an antismoking policy and more schools had a written policy on student antismoking than on teacher antismoking. Most schools (92.4%) in the sample banned smoking by students, but 52 schools (44.1%) allowed smoking by teachers in restricted areas. However, teachers reported seeing smoking sometimes in the toilets (42.7%) or the playground (40.0%) among students and sometimes in the staff room (31.3%) or about every day on school premises (52.7%) among teachers. Irrespective of the type of policy or restrictions on smoking, the association between having a ban on student/teacher smoking and teachers' perceptions of student/teacher smoking in school was not significant. In conclusion, we suggest that most schools must have explicitly an antismoking policy on both students & teachers and enforce consistently a ban in promoting a healthy school environment(smoke-free schools).

• Journal of Oral Medicine and Pain
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• 제36권4호
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• pp.225-234
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• 2011

흡연은 전신건강 뿐 아니라 구강건강에도 유해하여 구강암과 치주염의 발생, 창상치유 지연, 치아상실 등과 관련성을 가지는 것으로 알려져 있다. 이미 흡연과 구강건강의 관련성에 대한 연구가 많이 있지만, 구강건강에 대한 인식도나 위생관리 등 흡연 외의 다양한 요소가 구강건강에 영향을 줄 수 있으며 타액 분비나 구취처럼 흡연과의 관련성이 확실히 밝혀지지 않은 부분도 존재한다. 그러므로 구강위생에 대한 인식 수준이 상대적으로 높고 추적조사가 용이한 치과대학생이라는 집단에서 흡연자와 비흡연자의 구강건강을 상태를 장기적, 포괄적으로 비교한다면 흡연이 구강건강에 미치는 영향을 보다 명확하게 확인할 수 있을 것이다. 본 연구는 장기적 연구에 앞서 치과대학생 중 흡연자들의 흡연 특성을 파악하고, 흡연자들과 비흡연자들의 전반적인 구강건강상태를 비교하여 보고하고자 하였다. 2010년 4월 21일부터 2011년 4월 20일까지 단국대학교 치과대학 치의학과에 재학 중인 1학년부터 4학년까지의 남학생 224명 중 지원자 192명(85.7%)을 대상으로 하여 설문지 조사와 임상검사를 시행하였다. 설문지조사에는 흡연 양태, 음주, 니코틴의존도, 구강위생관리, 간이심리검사가 포함되었고 임상검사에는 치아 및 치주 상태, 니코틴 착색, 타액분비량, 전기 미각역치, 구취에 대한 평가가 시행되었다. 본 연구에서, 흡연자군은 금연자군, 비흡연자군에 비해 연령이 약간 높고, 음주를 하는 경우가 많았으며 알코올섭취량도 많았다(p<0.05). 세 군은 타액분비율, 구취, 전기미각역치 등의 임상조사에서는 유의한 차이를 보이지 않았으나, 양치질 횟수나 치과방문 횟수에 차이가 없음에도 불구하고 우식경험영구치율(DMFT rate), 치주가료필요 정도 및 니코틴 착색 정도에 있어서 흡연자군과 비흡연자군 사이에는 차이가 관찰되었다(p<0.05). 본 연구의 피검자들이 평균 25세로서 흡연자군이라 해도 흡연기간이 길지 않고 흡연량이나 니코틴의존도가 낮은 수준임에도 불구하고 치주조직에는 이미 유해한 효과를 주고 있다고 판단된다. 기초 자료 분석이지만 흡연은 치주조직에 신속히 영향을 미치므로 금연 치료를 조기에 시행할 필요가 있다.