• Tuberculosis and Respiratory Diseases
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• v.82 no.1
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• pp.1-5
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• 2019

Quitting smoking helps smokers maintain their health and extend their lifespan by 10 or more years. Treatment strategies for smoking cessation should be tailored to individual smokers with special needs based on their specific circumstances. It is recommended that pregnant women adopt smoking cessation through counseling and behavioral interventions because the safety of medications has yet to be established. Counseling is the main strategy for smoking cessation in adolescents and nicotine replacement therapy can be used with caution in individuals with serious nicotine dependence. It is important for smokers with psychiatric diseases to quit smoking following accurate assessment of their depression status. Nicotine replacement therapy, varenicline, and bupropion can be used for smoking cessation in smokers with psychiatric disorders. The incidence of cardiovascular disease decreased according to the smoking status and the duration of smoking cessation. In smokers with chronic obstructive pulmonary disease (COPD) who used a combination of counseling and pharmacotherapy the quitting rate was more than twice as high as subjects who used behavioral interventions alone. Varenicline can be used as the most effective anti-smoking drug by most smokers including those with psychiatric disorders, cardiovascular disease, and COPD.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.10
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• pp.4973-4977
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• 2012

Introduction: Tobacco use is a global health care problem. Repetitive exposure to nicotine produces neuroadaptation resulting in nicotine dependence. Smoking is associated with a range of diseases, causing high levels of morbidity and mortality and is one of the leading causes of preventable deaths, with more than 4.6 million smokers worldwide dying each year from smoking related illnesses. Stopping smoking has major health benefits. Quitting at any age provides both short and long term benefits. Materials and methods: 45 patients attending the outpatient department at the Oxford Dental College, Bangalore, were randomly allocated to three groups of interventions namely placebo, counseling and nicotine replacement therapy (NRT). Initially each one was assessed for carbon monoxide levels using a breath analyser (pico smokerlyser bedfont UK). They were followed up for six months and the carbon monoxide levels were again assessed using the same instrument. The paired t test was used to compare the results before and after the intervention. Results: The scores before the initiation of intervention and after treatment were compared and all three interventions were found to be statistically significant after six months. It was noticed that patients with very low or low dependence followed by high dependence had good response in the placebo group (68% and 47.6% respectively), in the counseling group maximum response was seen in the medium followed by the very low group (61% and 59% respectively), and maximum response was seen in very high followed by the very low group with NRT (78.7% and 60.5% respectively). Conclusion: The inference that can be drawn from the present study is that non-invasive, non pharmacological methods like placebo and counseling are effective in low to medium groups, and NRT is effective with higher nicotine dependence.

• Korean Journal of Clinical Pharmacy
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• v.27 no.1
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• pp.38-43
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• 2017

Objective: Seoul City has implemented the Safe Pharmacy in 2013. This study aimed to ascertain the success factors of the smoking cessation service of the Safe Pharmacy. Methods: The data for the smoking cessation registration cards were obtained from the pharmacies which participated in 2014 Safe Pharmacy. The sample included 289 smokers in 6 districts who participated at least one sessions of smoking cessation service. the service included both behavioral intervention and nicotine replacement therapy. In order to identify the effectiveness of the smoking cessation service, logistic regression analysis was used. The dependent variable was the success of quitting smoking at the 4th week. The independent variables included age, sex, employment, chronic disease, district, smoking amount, registration path, supporters for quitting smoking and number of service sessions. Results: Fifty eight point eight percent of the sample successfully quit smoking at the 4th week. Unemployment, higher smoking amount, and less service sessions were negatively related to the success of quitting smoking. There were differences in the success rate across districts. Age, sex, chronic disease, registration path, and anti-smoking supporters were not related to the success rate. Conclusion: Pharmacy can be an effective community resource for smoking cessation. Factors that could increase the effectiveness of smoking cessation service of the Safe Pharmacy and possible ways to enhance the participation of pharmacies in smoking cessation services were also discussed.

• Research in Community and Public Health Nursing
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• v.22 no.4
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• pp.365-376
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• 2011

Purpose: The purpose of this study was to investigate the patterns of smoking relapse and to identify risk factors related to smoking relapse among those successful in smoking cessation at the smoking cessation clinics of public health centers. Methods: Data were collected from 1,705 six-month quitters and analyzed by the Kaplan-Meier analysis and the Cox proportional hazard model. Results: The rate of smoking relapse was 38.2% in 1 year, 44.4% in 2 years, and 47.8% in 5 years. The vast majority of relapse (62.3%) occurred within the first six months after quitting. The risk factors related to smoking relapse were age (HR 1.964: 95% CI 1.545, to 2.497), nicotine dependence (HR 1.293: 95% CI 1.087 to 1.539), problem drinking (HR 1.497: 95% CI 1.116 to 2.008), behavioral therapy type (HR 1.398: 95% CI 1.193 to 1.638), and nicotine replacement therapy type (HR 1.363: 95% CI 1.077 to 1.724). Conclusion: For reducing smoking relapse, it is necessary to develop a smoking relapse prevention program for the first six months after quitting and to strengthen behavioral therapy in the course of smoking cessations clinics.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.15 no.1
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• pp.60-70
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• 2008

Purpose: This study was done to identify types of smoking decision making-temptation in adolescents and characteristics related to type among student smokers. Method: Data collection was done from March to July. 2006. A survey was administered to 275 students in 13 high schools and 15 middle schools in Seoul, South Korea. To identify types and characteristics smoking decision making-temptation in adolescents, cluster analysis using the K-mean method was employed. Characteristics of the influential variables according to the identified types of adolescent smokers were evaluated using ANOVA. Results: Four types of smoking pattern in adolescents were identified: habitual craving (17.7%), nicotine dependence (35.8%), feeblemindedness (28.4%), and self control (18.1%). The score for nicotine dependency was higher in the habitual craving type than any other type (F=11.79, p=.001), while the score for self efficacy for smoking abstinence was higher in the self control type (F=23.06, p=.000). Conclusions: Findings from this study suggest that effective interventions for smoking cessation in adolescents require not only active implementation of nicotine replacement therapy but also development of individualized approaches for each person targeting change in the social environment that may lead to positive smoking decisional balance.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.11
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• pp.6919-6924
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• 2013

Background: Between 1998-2009 South Korea experienced significant progress in reducing the male smoking rate from 66.3% to 46.9%. As part of a significant government effort in the area of smoking cessation intervention, the Korean government implemented the national "Smoking Cessation Clinics (SCC)" program in 2004. Materials and Methods: Data covered 804,334 adult male smokers participating in SCC program at 253 public health centers between 2006-2009. We examined participant cessation rates with the SCC program, their characteristics and program intervention components using health insurance status as a socioeconomic status (SES) indicator. Multivariate logistic regression analyses were performed correcting for intra-class correlations within public health centers. Results: The overall 6-month quit rate was high (46.8%). Higher odds of smoking cessation were positively associated with higher levels of behavioral counseling sessions, but not nicotine replacement therapy (NRT). Cessation rates were lower for Medicaid participants than for regular health insurance participants. Disadvantaged younger smokers were less likely to participate in the program. Older smokers were more likely to quit regardless of SES. Stress was cited as major reason for failure. Conclusions: SES inequalities across different age groups exist in smoking cessation among Korean adult male smokers. There is a need for intervention programs specifically targeting sub-populations of SES by different age groups.

• Korean Journal of Acupuncture
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• v.24 no.1
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• pp.13-25
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• 2007

목 적 : 흡연에 따른 건강적 피해가 많이 알려져 있음에도 불구하고 특히 여성 및 청소년 계층의 흡연이 증가하고 있으며 폐암 사망자수는 급격히 늘어나고 있는 상황이다. 완전한 금연이 실패하는 주요 이유는 담배의 중독성에서 비롯되며 금단현상을 극복하지 못해 일어나는 것으로 알려져 있다. 흡연의 중독성은 담배 주요성분 중의 하나인 니코틴(nicotine)에 의해 유발되며 따라서 모든 금연 요법 및 금연 치료보조제 들은 이 니코틴 작용을 어떻게 효과적으로 억제 또는 대체하느냐에 초점을 맞추고 있다. 최근 금연치료 요법으로 한방 침이 주목 받고 있으며 본 논문을 통해 한방 침의 금연효과에 대한 신경학적 기전을 고찰하고자 한다. 방 법 : 금연을 돕는 전형적인 보조 치료제 및 치료법이 몇 종류 개발되어 사용 중에 있으며 대표적으로 니코틴 대체 요법(nicotine replacement therapy, NRT)이나 항우울제로 사용되는 bupropion 등을 들 수 있다. 이 치료 방법들은 뇌의 도파민계 신경전달 체계에 영향을 미쳐 금연 효과를 발휘하게 되는데 실질적인 금연성공확률은 그리 높지 않은 것으로 알려져 있다 따라서 침의 자극에 대한 도파민계 신경전달 조절효과를 중심으로 고찰함으로써 침의 금연효과에 대한 의과학적 기전을 설명하고자 하였다. 결 과 : 침자극은 우수한 금연효과를 가져올 수 있는 치료법으로 기존의 금연 치료요법 및 치료제 들을 보완할 수 있는 보다 확실한 치료요법 중의 하나이며 특히 금연 후에 오는 금단현상을 효과적으로 완화시키는 작용을 한다. 그리고 이 같은 효과는 부분적으로 도파민계를 비롯한 신경전달계를 조절함으로써 가능한 것으로 판단된다. 결 론 : 본 논문을 통해 니코틴에 의한 금단현상의 신경학적 기전과 금연과 관련된 신경전달체계에 대한 침자극의 효능에 대해 고찰하였으며 기존의 금연보조치료법을 대체할 수 있는 우수한 의학적 치료법으로써의 침치료법을 제시하였다.

• Journal of Preventive Medicine and Public Health
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• v.51 no.5
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• pp.257-262
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• 2018

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.

• The Journal of Korean Academic Society of Nursing Education
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• v.8 no.1
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• pp.61-71
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• 2002

purpose : The purpose of this study was to find out the influencing factors of smoking-cessation behavior of patients with coronary heart disease and to suggest the model of smoking-cessation behavior which was based on the relationship between influencing factors and then to test its fitness empirically. method : This study was based on the Theory of Reasoned Action and a hypothetical model was constructed with fifteen paths in consideration of main predictive factors of smoking-cessation behavior such as biological factor, disease-related characteristics, self-efficacy, supportive factor, environmental factor, disease-related perception factor, intention-to-quit, and psychological factor. The validity of a smoking- cessation model was tested to 264 patients with coronary heart disease by using SPSS 8.0 and Window LISREL 8.12a. results : 1. Seven of the 15 paths of smoking-cessation behavior proved to be significant. 2. The final model excluded three paths in the hypothetical model was demonstrated to be improved by $x^2$=44.31 (df=38, p=.22), Goodness of Fit Index (GFI)=.98, Adjusted Goodness of Fit Index (AGFI)=.96, Non-Normed Fit Index(NNFI)=1.00, Normed Fit Index(NFI)=1.00, and Root Mean Square Residual(RMR)=.24. 3.The smoking-cessation behavior was influenced directly by biological factor, self-efficacy, supportive factor, environmental factor, intention-to-quit, and psychological factor. The smoking-cessation behavior was accounted for 82% of variance by these factors. conclusion : although the adolescents' smoking behavior can be predicted by only smoking intention, it is hard to predict the adults' smoking-cessation behavior by only this factor. Therefore, intention-to-quit, self-efficacy, supportive factor should be improved because these are promotive factors for smoking-cessation behavior. Biological factor, environmental factor, and psychological factor are inhibitive factors, so nicotine replacement therapy is helpful to the high nicotine-dependents, and ex-smokers avoid other smokers in their environment and also patients should learn and practice the stress coping-skills.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.1
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• pp.175-179
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• 2012

The objective of the study is to investigate the success rate of quit attempts and identify factors associated with success or failure of quit attempts in a quit smoking clinic. A cohort study was conducted with 495 smokers who enrolled in a quit smoking clinic from 2005 to 2008. The factors leading to quit smoking successfully were "being Malay", "having high blood pressure" "type of Nicotine Replacement Therapy" and "duration of follow up". In contrast, clerical staff had negative association to quit smoking. People who started smoking in their teenage years had a high risk of relapse. Integration of active follow up and tailor-made support programmes for quitters appear necessary in order to maintain their non-smoking status and encourage them to be permanent quitters. Integration of quit smoking clinics and primary care clinics could be another potential step for the success of quit smoking programmes.