• 기본간호학회지
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• 제8권1호
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• pp.69-80
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• 2001

This study was done to investigate the relation of smoking temptation, stage of change in smoking cessation, nicotine dependency and perceived health status in middle aged men. Convenience samples of 176 subjects who were either smoked or used to smoke, aged between 30 to 64, living in Seoul and Kyungi province area in Korea were selected for the study. The data was collected from December 1, 1999 to June 30, 2000. The research instrument were Stage of Change of Smoking Cessation Measure (DiClemente et al. 1991). Smoking Temptation Measure (Velicer, DiClemente, Rossi, Prochaska. 1990), Perceived Health Status Measure (McDowell & Newell, 1996), and Nicotine Dependency Scale (FTQ: Fagerstrom, 1978). The data were analyzed using the SAS Program. The result of the study are as follows : 1. The analysis of variance and multiple comparison showed that according to the stage of change, there were significant mean differences in the three sub-factors of smoking temptation; 'positive affect situation (F=12.64, p=.0001)', 'negative affect situation (F=16.01, p=.0001)', 'habitual craving situation (F=14.43, p=.0001)' and nicotine dependency (F=4.12, p=.0033) The mean score for smoking temptation for the subjects who were in the precontemplation stage outweighed the mean score for smoking temptation for subjects who were in the maintenance stage. 2. Through discriminant analysis, it was found that negative affect situation was the most influential variable of the smoking temptation sub-factors which can be used to discriminate stage of change. 3. The analysis of Pearson correlation coefficients showed that there was a significant positive relation between nicotine dependency and negative affect situation of smoking cessation((r=0.2182, p=0.0045) and a significant negative relation between nicotine dependency and perceived health status(r=-0.2115, p=0.0059).

• Journal of Preventive Medicine and Public Health
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• 제51권1호
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• pp.1-5
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• 2018

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.

• 기본간호학회지
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• 제20권4호
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• pp.429-437
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• 2013

Purpose: The purpose of this study was to identify factors influencing nicotine dependency among college students intending to quit smoking, and to provide data for the construction of programs that will be successful in helping the students quit smoking. Method: In this study a cross-sectional survey to analyze was used. The data were collected between April 22 and April 24, 2013 from 218 college students who had unsuccessfully tried to quit smoking in the past but were now intending to try and quit smoking again. Data were analyzed using frequency, independent t-test, one-way ANOVA and multiple regression with the SPSS 21.0. Results: Factors influencing nicotine dependency were self-efficacy for smoking abstinence (t=-6.60, p=<.001), length of time since beginning to smoke (t=5.39, p<.001), level of carbon monoxide intake (t=2.38, p=.018), and withdrawal symptoms as reasons why the students failed to quit smoking (t=2.22, p=.028). These 4 variables accounted for 35.0% of the variance with regard to nicotine dependency. Conclusions: To conduct a successful program for students who intend to quit smoking, self-efficacy for smoking abstinence, length of time since beginning to smoke, level of carbon monoxide, and withdrawal symptoms as reasons for failing to quit smoking should be considered.

• Journal of Korean Biological Nursing Science
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• 제16권3호
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• pp.173-181
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• 2014

Purpose: The purpose of this study was to analyze the effects of a quit smoking program using the Web and short message service on exhaled carbon monoxide, self-efficacy, and depression according to nicotine dependency level in undergraduate students. Methods: In this study a non-equivalent control group pretest-posttest design was applied. The participants included 90 students (52 in the low nicotine dependency group and 38 in the high nicotine dependency group) who succeeded in quitting smoking. Data were collected on 3 occasions, that is, before the program, immediately after the program, and 3 weeks after the program. Collected data were analyzed using independent t-test, repeated measure ANOVA, and paired t-test with SPSS 20.0. Results: Exhaled carbon monoxide was higher in the high nicotine dependency group than in the low nicotine dependency group. Self-efficacy significantly increased 3 weeks after the program in the low nicotine dependency group and significantly increased immediately after the program in the high nicotine dependency group. Depression significantly decreased 3 weeks after the program in the low nicotine dependency group. Conclusion: Self-efficacy may be enhanced when it is dealt with during an early phase of the quit smoking program for the high nicotine dependency group. Long-term intervention and persistent intervention are needed with regard to depression during a quit smoking program.

• 한국환경보건학회지
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• 제28권1호
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• pp.11-20
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• 2002

Tobacco smoke was confirmed as a human carcinogen by many research results. Because many adolescents stay long time in the PC game room, they are exposed to much of tobacco smoke. To evaluate the effect of passive smoking in the PC game room, airborne nicotine concentrations in 2 PC game rooms in Sung-nam city and urinary cotinine concentrations were measured for 20 adolescents. And the subjects were interviewed for duration and time in PC game room and smoking pattern. Subjects are composed of each of 10 smokers(5 males and 5 females) and 10 nonsmokers(5 males and 5 females). They stayed for three hours in the PC game room without smoking. Concentrations of nicotine in smokers and nonsmokers were 129.72 $\mu$g/$^3$ and 99.99 $\mu$g/m$^3$, respectively. Urinary cotinine concentrations were increased as time goes on after exposure to nicotine and showed maximum value at 9.45 hours after nicotine exposure and were 32.21 and 110.66 $\mu$g/L for nonsmoker and smokers. The more using time and frequency in PC game room, the higher urinary cotinine maximum concentration and the longer using duration, also the more increase urinary cotinine concentration. Urinary cotinine has a tendency to increase by passive smoking. Therefore, it is recommended that the effective control for indoor air quality and extensive research be needed to reduce nicotine concentration by passive smoking in the PC game room.

• 한국연초학회지
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• 제28권2호
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• pp.136-143
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• 2006

This study was conducted to determine the amount of unprotonated nicotine in cigarette mainstream smoke and to investigate its relationship to level of filter ventilation and machine smoking conditions. Unprotonated nicotine from TPM trapped on a Cambridge filter pad(CFP) was adsorbed by Carboxen/PDMS SPME fiber, thermally desorbed and determined by GC/MS. 2R4F reference cigarette, twelve commercial brands from the Korean market and five test cigarette samples, which had the same tobacco blend with different levels of filter ventilation, were analyzed for unprotonated nicotine. In commercial brands, the amount of unprotonated nicotine changed slightly depending on the pH values of smoke, and decreased as the tar level increased. filter ventilation in these commercial cigarettes was $28{\sim}80%$ and the higher filter ventilation increased relative unprotonated nicotine levels, but not significantly. However, in five test cigarettes with different filter ventilation$(0{\sim}70%)$, unprotonated nicotine levels increased almost linearly with the level of filter ventilation. Concentrations of unprotonated nicotine in mainstream smoke generally increased in order $HC\;<\;ISO\;{\leq}\;MDPH$ machine smoking conditions. The ratio of unprotonated nicotine to total nicotine among $cigarettes({\alpha}_{fb})$ increased in order RC < MDPB < ISO conditions. Concentrations of unprotonated nicotine varied with three machine smoking conditions.

• Asian Pacific Journal of Cancer Prevention
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• 제13권1호
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• pp.343-346
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• 2012

Two methods of identifying smokers with high nicotine dependence, the heaviness of smoking index (HSI) and number of cigarettes per day (CPD) were compared with the Fagerstrom test for nicotine dependence (FTND). The HSI, CPD and the FTND were administered to 316 adult Malaysian male, daily smokers aged between 25-64 years old in the Malaysian NCD Surveillance-1 Survey using a two-stage stratified random sampling of enumeration blocks and living quarters, via an interview based on a validated questionnaire. The cut-off point for classification of high nicotine dependence on the HSI was a score of four or higher, and for the heavy smoking category, smoking more than 20 cigarettes per day. Classification using each method was compared with classification by the FTND (score of six or more) as the reference standard. Sensitivity, specificity and kappa statistics for concordance between both measures and the FTND were evaluated. The HSI gave a similar prevalence rate of high nicotine dependence as the FTND. There was substantial agreement between the HSI and the FTND (kappa=0.63.), with moderate sensitivity (69.8%) and high specificity (92.5%). However, prevalence of high nicotine dependence using the CPD was 7% lower than the FTND. The heavy smoking category also showed fair agreement with the FTND (kappa=0.45) and moderate sensitivity (67.0%), but specificity was high (86.9%). The findings indicate that the HSI can be used as an alternative to the FTND in screening for high nicotine dependence among daily smokers in large population-based studies, while CPD may not be a suitable alternative to the FTND.

• 한국보건간호학회지
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• 제13권1호
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• pp.97-113
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• 1999

To investigate the actual condition of the adult-smoking in Chinan County. I used self-reporting questionnaires among 923 residents living in nine districts selected at random among the sites of eleven eup-myons from December 28. 1998 to January 6. 1999. collected data and analyized using SPSS. The smoking rate of adults in Chinan County was $36.9\%$. There was a significant difference in smoking rate according to the age. gender, education and job among general characteristics. The smoking rate in group of above 40s was about $40\%$ and that of the male took $55.5\%$ which was higher than that of female and the smoking rate of the people having high-school education was the highest$(46.2\%)$. With regard to the career. the smoking rate of the farmers ranked first$(46.1\%)$. Therefore anti-smoking business for smokers should be focused on above 40 years old, males. people having high school education and farmers. As the result of the survey of smoking habits of 340 people who smoke currently, the average smoking begining age was 21.8 and $81.5\%$ among them was between 16-25 years old. $4.4\%$ was under 15. during around the elementary school. Most motives to smoke were as followed; curiosity or taste$(33.6\%)$, relief of stress $(31.2\%)$, peer presure$(26.5\%)$ And considering the amount of the cigarette which is smoked per day, the case which is less than a pack of cigarettes was highest as $75.5\%$ and the people who smoke over one pack of cigarettes took $24.5\%$. As for the kind of tobacco which is smoked, how to smoke and the desire for the smoking, most case was toxin was moderate$(47.8\%)$ or mild$(46.9\%)$. shallowly$(49.0\%)$ or deeply$(46.3\%)$ and under stress$(33.4\%)$. after meals$(27.8\%)$, during drink$(15.7\%)$ and so on. The highest point marked among the factors of smoking motives was 'the reduce of negative emotion' $(3.27\pm1.00)$. followed by 'uncomfortable habits' $(2.87\pm1.02)$, 'addiction' $(2.84\pm1.06)$. 'habit' $(2.74\pm1.12)$. 'pleasure' $(2.70\pm1.04)$. 'stimulus' $(2.59\pm.90)$, 'sensation-exercise satisfaction' $(2.42\pm.97)$. Smokers smoke to reduce the negative emotions when angry in most common case. depressed. anxious. uncomfortable. lone. ashamed or embarrased. and intend to solve the certain problem. etc. Other motives are uncomfortable habit. addiction. habit. pleasure and the pursuit of stimulus. The level of nicotine dependence of adults m Chinan County was 10.57 which amount to 'high' wholly. As the resulf of the level of nicotine dependence score. the people who are low in the level of nicotine was $33.5\%$. the people who are high was $48.2\%$. very high was $18.4\%$. The approach for anti-smoking for smokers should be conducted differently according to the level of the nicotine. For the people who are in low level of nicotin dependence the prohibition of the smoking should be guided through the approach to foster strong will. for those who are in 'high' by acquiring proper method for the prohibition of smoking. and for those who are 'very high' the anti-smoking should be induced by providing proper program because of the possibility of the suffer from abstinence syndrome. The difference of the level of nicotine with the general characteristics of the objects had not statistically significant difference. The difference of the level of nicotine dependence accompanied by smoking habit had statistically significant difference according to the amount of smoke, the kind of tobacos. smoke inhale habit. In other words, the group of heavy smokers had higher level of the nicotine dependence than that of the light smokers relatively and the group which smoke strong taboaco has higher level of nicotine than that of which smoke mild or moderate. And the group of smokers who smoke deeply has higher level of nicotine than that who smoke shallowly or nonswallow. Aa a result of the analysis of the correlation between smoking motive factors and the level of nicotine, there was the indication that people who smoke for the decrease of the negative emotion. habit, pleasure. stimulus. sensation-exercise satisfaction had high level of the nicotine dependence. As the result of the anti-smoking will of smokers. $65.0\%$ of them had prohibition of smoking will. $29.3\%$ had no will to quit smoke. The most important reason for anti-smoking was health. $67.9\%$ had experience to try to quit smoke and the biggest reason to fail to quit smoking was the lack of the will power to keep anti-smoking. $52.8\%$ of them were advised to stop smoking from their spouses or children. only $2.8\%$ were by medical. The people who have the opinion to need anti-smoking education were $69.6\%$. Therefore when the business for the hygine of the mouth for adult is set. it should be centered on the people who have intention of prohibition of the smoking and help to quit smoking by way of other affirmative counter-program not smoking under stress.

• Asian Pacific Journal of Cancer Prevention
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• 제13권11호
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• pp.5483-5488
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• 2012

Background: Although nicotine dependence plays a role as a main barrier for smoking cessation, there is still a lack of solid evidence on the validity of biomarkers to determine nicotine dependence in clinical settings. This study aimed to investigate whether urinary cotinine levels could reflect the severity of nicotine dependence in active smokers. Materials and Methods: Data regarding general characteristics and smoking status was collected using a self-administered smoking questionnaire. The Fagerstr$\ddot{o}$m test for nicotine dependence (FTND) was used to determine nicotine dependence of the participants, and a total of 381 participants were classified into 3 groups of nicotine dependence: low (n=205, 53.8%), moderate (n=127, 33.3%), and high dependence groups (n=49, 12.9%). Stepwise multiple linear regression model and receiver operating characteristic (ROC) curves analyses were used to determine the validity of urinary cotinine for high nicotine dependence. Results: In correlation analysis, urinary cotinine levels increased with FTND score (r=0.567, P<0.001). ROC curves analysis showed that urinary cotinine levels predicted the high-dependence group with reasonable accuracy (optimal cut-off value=1,000 ng/mL; AUC=0.82; P<0.001; sensitivity=71.4%; specificity=74.4%). In stepwise multiple regression analysis, the total smoking period (${\beta}$=0.042, P=0.001) and urinary cotinine levels (${\beta}$=0.234, P<0.001) were positively associated with nicotine dependence, whereas an inverse association was observed between highest education levels (>16 years) and nicotine dependence (${\beta}$=-0.573, P=0.034). Conclusions: The results of this study support the validity of using urinary cotinine levels for assessment of nicotine dependence in active smokers.

• 지역사회간호학회지
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• 제16권3호
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• pp.282-288
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• 2005

Purpose: This study was to verify the effects of a smoking cessation program for adolescents. Method: This study was designed to use one group with one pre-test and two post-tests. One post-test was done immediately after the completion of the program and the other after eight weeks. The subjects were 21 male high school students who were smokers when this study was carried out. The smoking cessation program consisted of 5 sessions with smoking cessation education and e-mail service after the program. Variables in this research were nicotine dependency (using Fagerstrom Tolerance Questionnaire) and self-efficacy. Data were analyzed by descriptive statistics and Wilcoxon signed rank test. Results: Immediately after the program and eight weeks later, nicotine dependency for continuous smokers decreased significantly (after the program: Z=-2.319, p=.020, eight weeks later: Z=-1.999. p=.046) and self-efficacy increased significantly (after program: Z=-3.024. p=.002. eight weeks later: Z=-2.381. p=.017). Conclusions: The smoking cessation program was effective in decreasing nicotine dependency in the continuous adolescent smokers and in increasing their self-efficacy, Further study needs to be made with a lager number of smoking adolescents using control group design.