• Asian Pacific Journal of Cancer Prevention
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• 제14권11호
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• pp.6769-6773
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• 2013

Background: Few local studies have explored the process of adverse transition of smoking stages among adolescents. The present investigation aimed to identify adverse transitions prospectively from the early stages till the escalation of the stages after one year. Materials and Methods: Data were collected in two waves from a cohort of 2,552 adolescents aged 12-13 years old studying in 15 secondary schools based in Kinta, Perak. A multistage sampling method was used to select the schools and a self-administered structured questionnaire was applied to help categorize the participants into five different smoking stages. Nonsmokers were divided into never smokers and susceptible never smokers. Ever-smokers were categorized as experimenters, current smokers or ex-smokers. Results: Among the participants 46.8% were Malay, 33.5% Chinese and 17.1% Indians. At baseline, we had 85.3% non-smokers and 14.6% ever smokers. Incidence of adverse transition among all our participants was 24.1%, with a higher value among male participants (16.8%). A higher proportion of susceptible never smokers and experimenters progressed to current smoking stage compared to never smokers. Conclusions: This study highlights the changes and patterns of adverse transition among adolescents. Male adolescents, those who are susceptible to smoking and those who had already tried experimenting with cigarettes have a higher chance of escalating to a higher smoking stage.

• 한국보건간호학회지
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• 제19권1호
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• pp.18-29
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• 2005

The purpose of this study was to analyze the smoking behavior and to provide the basic data required to develop a smoking cessation program. The study subjects were 407 industrial workers in Jecheon. The data were collected using a structured questionnaire. The data were analyzed by the SPSS 10.0 system using descriptive statistics, t-test, and Chi-square test. The study results were as follows 1. Current smokers were $64.0\%$, ex-smokers were $19.1\%$. and non-smokers were $16.9\%$. 2. The most common motives of smoking were anger. anxiety, depression. and stress in the workplace. 3. In smoking habits, about $65.1\%$ of the current smokers smoked 11-20 cigarettes/day, and $91.0\%$ had smoked for more than 5 years. The smoking areas of the workplace were outdoor $37.9\%,\;rest\;room\;34.2\%,\; lobby\;23.0\%,\;corridor\;21.4\%,\;and\;office\;8.6\%$. 4. Regarding smoking cessation, $78.2\%$ of current smokers had attempted. The frequency of smoking cessation attempts was 1-3 or less in $67.2\%$ of smokers. The duration of smoking cessation was 1-3 month or less in $61.6\%$ of the smokers. 5. The mean score for smoking knowledge was 17.62, smoking attitude 75.74. and perceived health state 12.27. 6. There were significant differences between smokers and non-smokers 10 smoking attitude (t=5.29, p=0.00), and perceived health state(t=6.47, p=0.00). 7. As a result of the homogeneity test, both types of smoking and perceived health state proved to have significant differences in the change of health state compared with 4 weeks ago'$(x^2=20.26,\;p=0.00)$ and the level of satisfaction of health state in activities of daily living'$(x^2=15.47,\; p=0.05)$. The important findings of this study showed that a smoking cessation program needs to be developed to enhance the negative smoking attitude. to promote the perceived health state through smoking cessation, to encourage the intention of smoking cessation, and to develop strategies of stress management.

• Tuberculosis and Respiratory Diseases
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• 제83권4호
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• pp.268-275
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• 2020

Background: It is not evident that the attributable risk of smoking on mortality in Korea has decreased. We investigated the impact of smoking on all-cause mortality and estimated the attributable risk of smoking in Korean adults. Methods: Those aged ≥20 years with smoking history in the Korean National Health and Nutrition Examination Surveys (KNHANES) 2007-2015 were enrolled. We categorized the participants into three groups as follows: never smoker, <20 pack-years (PY) smokers, and ≥20 PY smokers. We applied inverse probability weighting using propensity scores to control various confounders between the groups. All-cause mortality risks were compared between the groups using the Kaplan-Meier log-rank test. The effects of smoking-attributable risks (ARs) on mortality were also calculated. Results: A total of 50,458 participants were included. Among them, 19,334 (38.3%) were smokers and 31,124 (61.7%) were never smokers. Those with a smoking history of 20 PY or more (≥20 PY smokers), those with a smoking history of less than 20 PY (<20 PY smokers), and never smokers were 18.1%, 20.2%, and 61.7%, respectively, of the study population. Smokers had a higher risk of all-cause mortality compared to never smokers (log-rank test p<0.01). The ARs of smoking were 21.8% (95% confidence interval [CI], 5.7%-37.9%) and 9.0% (95% CI, 6.1%-12.0%) in males and females, respectively. ARs decreased from 24.2% to 19.5% in males and from 9.5% to 4.1% in females between 2007-2010 and 2011-2015. Conclusion: Our study using KNHANES IV-VI data demonstrated that smoking increased the risk of all-cause mortality in a dose-response manner and the ARs of smoking on mortality were 21.8% in males and 9.0% in females during 2007-2015. This suggests that the ARs of smoking on mortality have decreased since around 2010.

• 한국환경보건학회지
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• 제47권4호
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• pp.320-329
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• 2021

Background: Smoking exposure may be objectively assessed through specific biomarkers. The most common biomarker for smoking is cotinine concentration in urine, and setting an optimal cut-off point can accurately classify smoking status. Such a cut-off point for Korean adolescents has never been studied. Objectives: The aim of this study was to determine a cut-off point for urinary cotinine concentration for the discrimination of smoking in adolescents. Methods: Participants were adolescents aged 13~18 years who participated in the third cycle of the Korean National Environmental Health Survey. We used urine samples to confirm the level of cotinine concentrations. Smoking status was determined by self-reported questionnaire. We identified the optimal cotinine cut-off point for discriminating smoking status using receiver operating characteristic curve analysis. Results: Of the 904 participants, 28 (3.1%) were smokers, among whom 20 (71.4%) were male. The median urinary cotinine concentrations in smokers was 218 ㎍/L (male: 215 ㎍/L, female: 303 ㎍/L), and that in non-smokers was 1.31 ㎍/L (male: 1.46 ㎍/L, female: 1.18 ㎍/L). We found significant differences in urinary cotinine concentration according to smoking status and sex (p<0.001). Urinary cotinine concentrations performed well for identifying smoking adolescents [area under the curve: 0.954 (male: 0.963, female: 0.908)]. The cut-off that optimally distinguished smokers from non-smokers was 39.85 ㎍/L (sensitivity: 89.3%, specificity: 97.4%). Male [39.85 ㎍/L (sensitivity: 90.0%, specificity: 94.9%)] had a different optimal cut-off point than female [26.26 ㎍/L (sensitivity: 87.5%, specificity: 99.6%)]. Conclusions: This study determined a cut-off point for urinary cotinine of 39.85 ㎍/L (male: 39.85 ㎍/L, female: 26.26 ㎍/L) to distinguish smokers from non-smokers in adolescents.

• 의료법학
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• 제9권2호
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• pp.231-267
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• 2008

Tobacco has become the world's leading cause of deaths and diseases. And !be tobacco use and dependence itself is a kind of diseases, so-called "mental and be-havioural disorders due to use of tobacco" in "International Statistical Classification of Diseases and Related Health Problems(ICD-10)" and "Korean Standard Classification of Diseases". The tobacco use and dependence is a chronic disease that requires repeated clinical interventions and multiple attempts to quit. But effective treatments to the tobacco use and dependence are developed and exist that can significantly increase the rate of long-tenn smoking abstinence. So the physicians should warn smoking patients about the dangers of smoking to the health and the life, and the clinicians ought to provide one of more of the treatments which have been proven effective in helping smokers quit to smoke. It has been concluded that if a doctor failed to provide effective treatment for smokers, and the smokers subsequently died of the smokers-related conditions(tobaccosis) or became incapacitated by the tobaccosis the smokers were considered in the medical malpractice. Thus the smokers could sue the physician for medical malpractice, claiming that the doctor's legal responsibility of appropriate treatments including smoking-cessation which the physician deliberately or negligently breached.

• 보건교육건강증진학회지
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• 제22권3호
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• pp.1-12
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• 2005

Objectives: The purpose of this study was to investigate the factors contributing to intentions of quitting smoking, and use of smoking cessation services for daily smokers, and willingness of using smoking cessation services by the public health centers. Method: A total of 1,403 cases of male smokers were collected by a telephone survey. The age of smokers in the study ranged from 20 to 59. Socio-demographic variables, cigarette consumption behaviors, quit attempts and intentions of quitting smoking, and use of clinical services provided by the local public health centers were analysed using SPSS program. Result: About 77.8% of the smokers consumed a pack of cigarettes or less per day. About 20% of the smokers have used quit aides such as nicotine patch, gum, quit cigarettes, and acupuncture. These variables were associated with prior quit attempts in the past 1 year. Older age, degree of addiction(less time spent without smoking after a smoker gets up in the morning), prior quit attempts, panning to quit in one month, doctor's advice to quit were the major predictors of using the smoking cessation services provided by the public health centers. Conclusion: Health educators have to entice physicians to give smoking cessation advice to smokers, and have to provide many different types of educational programs to help quitting smoking.

• Journal of Preventive Medicine and Public Health
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• 제37권3호
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• pp.238-245
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• 2004

Objectives : This study was conducted to examine the smoking behaviors and the relationship between smoking and other health behaviors among medical students. Methods : A self-administrated questionnaire was administered to a sample of 1,775 students from four medical schools between April and May 2003. Due to the small number of female smokers, the characteristics of smoking behaviors were analyzed only for males. Results : A total of 1,367 students (920 males and 447 females) completed the questionnaires, with an overall response rate of 77.7%. The smoking rates for males and females were 31.5, and 2.2%, respectively. Among the male smokers, 70.7% smoked daily, and 39.0% smoked one pack or more per day. Male students on medical course were more likely to smoke daily, and one pack or more per day, than those on premedical course. Male daily smokers desired to quit smoking less than occasional smokers, and 65.0% of male daily smokers were not ready to quit compared with 37.8% of the occasional smokers. Among the male daily smokers, 29.6% were severely nicotine dependent. The most common reason for not to quit smoking among male smokers was 'no alternative stress coping method' (44.4%), followed by 'lack of will power' (25.4%), and 'no need to quit' (19.4%). Compared with male non-smokers, male smokers were more likely to drink alcohol more often and in larger amounts, take coffee more often, eat breakfast less regularly, and be overweight or obese. Conclusions : The results of this study suggest that many male medical students were serious smokers, especially those on medical course. It is necessary to install a smoking prevention program for pre-medical students, provide effective smoking cessation methods for smokers, teach positive stress coping methods, and make the school environment suitable for coping with stress.

• Tuberculosis and Respiratory Diseases
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• 제73권4호
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• pp.210-218
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• 2012

Background: The level of urine cotinine is an indicator of tobacco smoke exposure. The purpose of this study is to investigate urine cotinine for the purpose of assessing the smoking status of Korean smokers and non-smokers exposed to tobacco smoke. Methods: The subjects were identified from the 2007-2009 and the 2010 data sets of the Korea National Health and Nutrition Examination Survey (KNHANES). They were assigned as non-smokers, current smokers and ex-smokers. Non-smokers were also divided into three subset groups according to the duration of smoke exposure. Each group was stratified by gender prior to analysis. Results: The median value of urine cotinine in the male current smokers was 1,221.93 ng/mL which was the highest among all groups. The difference between levels of urine cotinine for male and the female groups was statistically significant (p<0.01). In the female group, passive smoke exposure groups reported higher urine cotinine levels than non-exposure groups (p=0.01). The cutoff point for the discrimination of current smokers from non-smokers was 95.6 ng/mL in males and 96.8 ng/mL in females. The sensitivity and specificity were 95.2% and 97.1%, respectively, in males, 96.1% and 96.5% in females. However, the determination of urine cotinine level was not useful in distinguishing between passive smoke exposure groups and non-exposure groups. Conclusion: Urine cotinine concentration is a useful biomarker for discriminating non-smokers from current smokers. However, careful interpretation is necessary for assessing passive smoke exposure by urine cotinine concentration.

• 보건교육건강증진학회지
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• 제9권1호
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• pp.39-47
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• 1992

This study was surveyed among 1136 respondent of high school girls in seoul from Feb. 6, till Feb. 22, 1992 for the purpose of analysing the smoking of high school girls and its factor. The data was analied by X²-test and Multiple Regression and shows the following. 1. Out of 1,136 respondent, the current smokers were found to be 176, 15.5% and the former smokers were 204, 18.0%. This implies that 23.5% of high school girls seoul have experience smoking. 2. For the first smoking time in both smoking group and former smokers, it shows that the third grade of middle school lead the lists. 36.9% (65) of the smokers and 37.3(75)of former smokers experienced the first smoking at that time. 70.5%(124) of the smoking group have the intention to stop smoking and the first reason of it is health problem, 65.6%(75). 3. For the type of the school the smoking rate rages from 2.7%(7) of literary part in day time to 25.3%(97) of vocational part in evening time and the rate of smoking experience shows from 9.9%(26) literary part in day time to 25.3%(97) of vocational part in evening time. This data show that literary part in day time has the lowst rate while vocational part in eveing time the highest rate. 4. Compared with non smoker group, smoking group and former smoking group spent more money (P<0.001) and felt dissatisfied with school life and didn't have good school records. 5. Smoking group and former smokers have more boy friends than non smoking group and in most cases their boy friend have smoking habits (P<0.001) and it is the same with their gril friend (P<0.001). 6. Compared with non smoker group, smoking group and former smokers lack of their parents' interest (P<0.001). But whether it is strict or free there is little difference among the three group. 7. For smoking group and former smoking group, in most cases their parent, brother and sister tend to smoke and especially their sisters' smoking has much influence on their smoking in comparison with non-smokers. 8. Compared with non-smoker group, smoking group and former smoking group tend to think less of the harm of smoking. In regard with health problem, more smoking group and former smokers think that smoking can relieve the stress (P<0.001), and more non-smokers know that when a pregnant woman smokes, it can cause the lack of supply of Oxygen{P<0.01). 9. Smoking group and former smoking group have more positive attitude towards smoking than non-smokers and tend to agree to their boy and girl friends' smoking(P<0.001).

• Asian Pacific Journal of Cancer Prevention
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• 제15권1호
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• pp.309-314
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• 2014

Purpose: Cigarette smoking causes many kinds of cancer, and it is more closely related with lung cancer, rather than other cancers. Smoking is the leading cause of lung cancer and ninety percent of the smokers are male in China, but there is little published data concerning the psychological responses in the male smokers with lung cancer and its influence on the symptom burden. The aim of the study was to verify the hypothesis that male smokers with lung cancer have more positive attitude and less symptom burden, comparing to male non-smokers. Methods: A total of 194 men with cancer in West China Hospital, Sichuan, China, were assessed by self-administered questionnaire. Psychological response was measured by the Chinese version of Mini-Mental Adjustment to Cancer scale (Mini-MAC), and symptom burden was measured by the physical symptom distress scale from the Rotterdam Symptom Checklist (RSCL). Results: We found that smokers with lung cancer got higher scores in positive attitude and a smaller symptom burden than non-smokers. Patients with education lower than high school got higher scores of positive attitude compared to college graduate patients (p=0.038). Smokers with lung cancer who knew the potential carcinogenicity of cigarette showed less negative emotions (p=0.011). The psychological response was not affected by age, clinical stage, cell type, smoking duration and amount. Conclusions: Male smokers with lung cancer have a more positive attitude and fewer symptoms, comparing to male non-smokers. Appropriate psychological intervention for non-smokers with lung cancer deserves more attention.