• Health Policy and Management
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• v.29 no.1
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• pp.4-10
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• 2019

The term new tobacco products (NTPs) refers to the new alternatives to conventional cigarettes. There are several kinds of NTPs in South Korea. The present study discusses the most widely used NTPs namely electronic cigarette (ECs) and heated tobacco products (HTPs). The aims of this study are to evaluate the risk related to the use of ECs and HTPs, introduce policy examples across different countries of management of this issue, and finally, present some policy implications of the problem and our response strategies. Since the advent of ECs, there has been a lot of debate about its risk. Some studies have reported that ECs are less harmful than conventional cigarettes and that they are effective in aiding smoking cessation. Nevertheless, the efficacy of ECs in smoking cessation and its potential health risks are still unclear. However, the obvious fact is that it is not harmless. Regulations on ECs differ from country to country. In many countries, they are strictly regulated as tobacco or toxic substances; however, in the United Kingdom, the use of ECs are included as part of their smoking cessation policy, and in Japan, they are treated as a form of medication. On the other hand, HTPs are the most recently introduced NTPs and they have attained sensational popularity because of the wrongly held belief that they are less harmful to health. So, what about our policy response to these two tobacco products? The research on ECs requires more systematic statistical monitoring, such as monitoring the ratio of dual-users. Further, the new EC smokers should be identified taking into account that the arguments for the use of ECs often emphasize smoking cessation or less risks to health, the government should further strengthen its policy to prevent those claims. The HTPs market experienced a very sharp growth and continues to grow because the government policy is too passive. Taking this as a lesson, it is necessary to approach NTPs, such as HTPs, proactively and increase their contribution to the National Health Promotion Fund by imposing greater taxes on them. Finally, considering the likelihood of NTPs being promoted as a less harmful tobacco product, it is essential to strictly regulate tobacco companies' publicity from the very beginning to ensure that potential consumer s are not mislead.

• Journal of Convergence for Information Technology
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• v.11 no.2
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• pp.153-162
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• 2021

The study was conducted to identify the relationship between the e-cigarette smoking rate and demographic factors, health status and health behavior factors within the last one month of adults over 19 years of age, and to provide basic data for cessation education and health policy establishment to reduce the e-cigarette smoking rate. This is a secondary data analysis study using survey data of 22,908 people over the age of 19 who participated in the 2018 Community Health Survey in Seoul and the SAS program was used for analysis. Smoking rate of e-cigarettes within the last one month was 4.5%, and as a result of multivariate logistic regression analysis, factors related to e-cigarette smoking were sex, age, education level, occupation and general cigarette smoking status. In order to prevent e-cigarette smoking and reduce the smoking rate, education should first be given to professionals with educational backgrounds of college graduates or higher to inform the dangers of e-cigarettes. In addition, public relations and campaigns to inform the general public that e-cigarette smoking is no different from general cigarette smoking are required, and deployment of the same anti-smoking policy that treats e-cigarettes as general cigarettes is required.

• Journal of The Korean Society of Clinical Toxicology
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• v.20 no.2
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• pp.82-85
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• 2022

Traditionally, most cases of nicotine poisoning have been due to ingestion of nicotine pesticides. However, the increasing use of electronic cigarettes (e-cigarettes) has resulted in both intentional and unintentional exposure to concentrated liquid nicotine or "e-liquid" leading to an increase in nicotine poisoning cases. However, fatalities following the ingestion of the e-liquid are extremely rare. We report a rare case of cardiac arrest and severe encephalopathy following the intentional ingestion of e-liquid. We present the case of a 20-year-old woman who intentionally ingested liquid nicotine intended for e-cigarette use. She was found in asystole and experienced a return of spontaneous circulation (ROSC) after undergoing approximately 46 mins of cardiopulmonary resuscitation. Her plasma nicotine levels were >500 ng/ml. Despite aggressive supportive care, she was found to have encephalopathy consistent with severe anoxic brain injury on magnetic resonance imaging. In recent times, there have been some reports of deaths following liquid nicotine ingestion. Our case illustrates the potential for fatal nicotine toxicity from ingestion of e-cigarettes.

• Journal of the Korean Society of Tobacco Science
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• v.37 no.1
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• pp.34-48
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• 2015

• Journal of The Korean Society of Clinical Toxicology
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• v.18 no.2
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• pp.51-56
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• 2020

Purpose: Acute nicotine poisoning by liquid nicotine in electronic cigarettes is becoming an increasing problem worldwide. The current systematic review aimed to determine the harm of acute nicotine poisoning by reviewing published case reports. Methods: An online literature search with PubMed, Embase, Cochrane Library, and KoreaMed database was performed to identify relevant studies addressing acute nicotine poisoning with electronic cigarettes. Two investigators searched the case reports written in English or Korean. Results: Twenty-six cases were included in this study. The routes of intoxication included ingestion in 18 cases, intravenous injection in three cases, subcutaneous injection in two cases, and ocular exposure in two cases. Ten cases had a cardiac arrest, and seven of them died. Seven out of 12 cases with intentional poisoning had a cardiac arrest. Nine children under 18 years were reported, and three of them had a cardiac arrest. Sixteen cases without a cardiac arrest recovered well, except for one case with sudden sensorineural hearing loss. Conclusion: The authors reviewed the risks of electronic cigarette liquid in terms of acute poisoning through a systematic review. The nicotine solution of an e-cigarette can be life-threatening in cases of acute poisoning. Therefore, active emergency treatment with early recognition is necessary. In addition, various management methods and regulations for preventing acute nicotine poisoning, such as restriction of distribution and nicotine concentration, should be considered.

• Journal of Rhinology
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• v.60 no.1
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• pp.20-28
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• 2022

Background: Whether the use of electronic cigarettes (ECs) is associated with upper airway diseases, including chronic rhinosinusitis (CRS) and allergic rhinitis (AR), remains unclear. Methods: We analyzed data from the nationwide cross-sectional surveys: the Korea National Health and Nutrition Examination Survey VI (2013-2015), VII (2016-2018), and VIII (2019). Logistic regression analysis was performed to assess the association between EC use and CRS or AR. Results: Among a total of 38,413 participants, 6.4% were former EC users and 2.5% were current EC users. Former EC users and current EC showed a significantly increased OR for CRS or AR compared with never EC users. In the subgroup analysis, the "current CC (conventional cigarette)-current EC" and the "current CC-formal EC" group had a significantly higher OR for CRS or AR than the "current CC-never EC" group. In addition, former CC smokers who currently use ECs showed a significantly higher OR for AR than former CC smokers without EC use. Conclusions: EC use is significantly associated with a high prevalence of CRS and AR in the adult population. These results indicate that the use of ECs may increase the risk of upper airway disease.

• Clinical and Experimental Pediatrics
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• v.59 no.12
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• pp.490-493
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• 2016

Electronic cigarettes are novel tobacco products that are frequently used these days. The cartridge contains liquid nicotine and accidental poisoning, even with a small oral dose, endangers children. We present here a mortality case of a 15-month-old child who ingested liquid nicotine mistaking it for cold medicine. When the emergency medical technicians arrived, she was found to have pulseless electrical activity. Spontaneous circulation was restored after approximately 40 minutes of cardiopulmonary resuscitation. The cotinine level in her urine was 1,716 ng/mL. Despite intensive supportive care, severe anoxic brain injury was found on computed tomography and the child ultimately died. This fatality highlights the need for public health efforts to minimize such accidents.

• Journal of the Korean Society of Tobacco Science
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• v.27 no.1 s.53
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• pp.83-93
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• 2005

This study was conducted to evaluate the effect of additives in low sidestream cigarette papers, such as Mg$(OH)__2,\;TiO_2\;and\;KH_{2}PO_4$ on the delivery of mainstream and sidestream smoke. From the analysis of tar and nicotine in sidestream and mainstream smoke, the delivered ratios of tar and nicotine by sidestream to mainstream smoke in common cigarette paper were 5.32 and 8.60, respectively. However, the delivered ratios of those of the paper containing $Mg(OH)_2\;were\;2.25\~3.23,\;4.86\~7.14,\;Mg(OH)_2\;and\;KH_{2}PO_4\;were\;2.12\~2.92,\;4.67\~6.89,\;TiO_2\;was\;3.21,\;7.51 $ respectively. The deliver patterns of semi-volatile components in the cigarettes were similar each there, but a slight different pattern in the amount was observed depending on the kinds of compounds added in cigarette papers. In the cigarettes made of $Mg(OH)_2$ added paper, the aromatic components such as benzene, toluene and phenol were generated more while the aliphatic components like neophytadiene, ethyl decanoate were delivered less than the cigarettes made of common cigarette papers. However, the cigarettes manufactured with $Mg(OH)_2\;and\;KH_2PO_4$ added paper showed an opposite trend. The cigarettes made of $TiO_2$ added paper showed relatively low delivery in the most compounds measured. In sensory evaluation, cigarette papers tested were noticed a distinguishable sensory character between the low sidestream smokes with additive cigarette papers except $TiO_2$ added one. Moreover, aroma patterns detected by a electronic nose system in TPM were a similar tendency.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.2
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• pp.155-163
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• 2018

This study was conducted to investigate the factors related to smoking and smoking differences among adolescents who have experienced smoking using data from the 11th (2015) Korean Youth Risk Behavior Web-based Survey. The data used in this study were from 5,347 middle and high school students who had cigarette smoking and electronic cigarette smoking experience among 68,043 respondents to the 11th (2015) Korean Youth Risk Behavior Web-based Survey. The data were evaluated by frequency analysis, the ${\chi}^2$ test and logistic regression analysis using weighted composite sample analysis. Overall 20% of the total smoking adolescents were dual users and 85.6% of the users of electronic cigarettes used nicotine. The results from multinomial regressions show that: male students (OR 1.63; 95% CI 1.15-2.31), living in the metropolitan area (OR 1.76; 95% CI 1.32-2.33), an average consumption of fast food of once or twice a day (OR 2.48; 95% CI 1.33-4.64), first started smoking during high school (OR 0.76; 95% CI 0.58-0.98), having experience with passive smoking (OR 1.24; 95% CI 1.07-1.44), experience drinking alcohol (OR 2.03; 95% CI 1.65-2.48) and those with higher weekly allowances were more likely to be at risk than dual users. This study provides basic data regarding the dual use of electronic cigarettes and cigarettes by adolescents. The results presented herein will facilitate development of a smoking cessation program and policy.

• Research in Community and Public Health Nursing
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• v.27 no.2
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• pp.95-105
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• 2016

Purpose: This study examined the characteristics differences associated with 1-year continuous smoking abstinence in Korean young adult and middle-aged male workers. Methods: 'Korea National Health and Nutrition Examination Survey (KNHANES)' is an ongoing surveillance system that assesses the health and nutritional status of Koreans. For a secondary analysis of cross-sectional data from KNHANES VI-1, this study selected 683 Korean male workers as a subpopulation, who were young adult or middle-aged. The subpopulation was composed of success or failure group of 1-year continuous smoking abstinence. Binomial logistic regression analysis was performed. Results: Success group was more likely to be older, live in urban areas, rate their health status as excellent or good, and have ever been diagnosed with hypertension than failure group. Additionally, Success group was less likely to have used electronic cigarettes (e-cigarettes), drink more than once a month, and have been exposed to secondhand smoking in workplace within a week. Conclusion: Developing smoking cessation programs requires consideration of resources in rural areas, promoting self-efficacy, restricting e-cigarettes and drinking, and promoting a smoke-free workplace.