• 한국학교보건학회지
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• 제32권2호
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• pp.77-87
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• 2019

Purpose: This study was conducted to examine the prevalence of current smoking and the factors that influence current smoking among male high school students in Korea according to school type. Methods: Data were extracted from the Korea Youth Risk Behavior Web-Based Survey (2017) and multiple logistic regression was used based on complex sample analysis. The study sample comprised of 15,777 male high school students: 12,583 from general high schools (GHS) and 3,194 from specialized vocational high schools (SVHS). Results: The prevalence of current smoking was significantly higher in SVHS students (19.6%) compared to GHS students (12.6%). Low academic achievement, depressive symptoms, current drinking, and high household economic status were commonly associated with current smoking in male students from both school types. However, exposure to secondhand smoking at home, non-exposure to anti-smoking advertisement, exposure to tobacco advertisement, participation in smoking prevention or cessation education were related to current smoking in GHS students, while living in rural area was associated with current smoking in SVHS students. Conclusion: To reduce current smoking among male high school students, it is necessary to develop smoking prevention policies reflecting the factors associated with current smoking that are different by school type.

• 치위생과학회지
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• 제10권3호
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• pp.131-139
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• 2010

이 연구는 우리나라 군 장병이 복무를 하는 과정에서 병영 안의 내무반생활과 병영 밖의 군사훈련생활에서 흡연 양상의 차이와 이와 관련한 구강보건행태와 인식의 변화를 알아보고자 하였다. 이를 위해 2009년 3월 16일부터 6월 16일까지 육군 ${\bigcirc}{\bigcirc}$부대에 복무하고 있는 장병 367명의 설문 응답을 분석하여 다음의 연구결과를 얻었다. 1. 군인의 복무 상황에 따른 구강보건행태를 비교한 결과, 군사훈련생활에서는 내무반생활에 비하여 구강 건강을 적절히 관리하지 못하고 있었다. 칫솔 사용률은 내무반생활에서는 96.2%이었지만 군사훈련생활에서는 72.0%로 감소하였다. 내무반생활을 할 때에는 하루 3회 이상 칫솔질을 한다는 군인이 55.3%이었으나, 군사훈련생활을 할 때에는 29.3%로 크게 감소하였다. 2. 군에 입대한 후 구강예방진료, 구강보건교육, 금연교육을 받은 경험이 없는 군인이 각각 84.1%, 90.7%, 87.9%이었다. 3. 군인의 52.8%가 흡연자이고, 47.2%는 비흡연자이었다. 흡연자의 31.1%는 흡연 후에 아무런 구강건강관리행위를 하지 않았다. 흡연하는 담배 개비의 수는 내무반생활에서는 평균 13.97개비(표준편차 7.51), 군사훈련생활에서는 평균 13.02개비(표준편차 8.36)로서 통계적으로 유의한 차이는 없었다(p=0.109). 4. 흡연자는 칫솔질 횟수와 칫솔질 시간이 적을수록 Pack years가 높은 경향을 보이지만, 통계적으로 유의한 차이는 없었다(각각 p=0.063, p=0.184). 5. 흡연에 대한 구강보건인식을 조사한 결과, 흡연자의 77.9%와 비흡연자의 88.8%가 흡연이 구강건강에 영향을 미친다고 생각하였고(p=0.0095), 흡연자의 52.4%와 비흡연자의 72.5%가 구강건강이 전신건강에 영향을 미친다고 생각하였으며(p=0.0007), 또한 흡연자의 35.8%와 비흡연자의 59.1%가 군대 내에서 금연교육이 필요하다고 생각하였다(p<0.0001). 아울러 전체 대상자의 77.8%와 64.5%가 각각 군대 내에서 구강검진이 필요하고, 구강보건교육이 필요하다고 생각하였으나 이 두 가지의 인식에서는 흡연자와 비흡연자 사이에 통계적으로 유의한 차이는 없었다. 6. 군사훈련생활과 흡연 여부에 따른 칫솔질의 횟수 및 시간을 조사한 결과, 내무반생활에 비하여 군사훈련 생활에서 1회만 칫솔질을 할 확률은 2회 이상 칫솔질을 할 확률보다 9.29배 높았으며(p<0.01), 내무반 생활에 비하여 군사훈련생활에서 1분 이내로 칫솔질을 할 확률은 1분 이상 칫솔질을 할 확률보다 2.19배 높아 통계적으로 유의한 차이가 있었다(p<0.01). 하지만 칫솔질의 횟수와 시간 전체에 대해서는 군사훈련생활 여부와 계급을 보정한 결과, 비흡연자와 흡연자 사이에 통계적으로 유의한 차이가 없었다. 이번 연구를 통하여 우리나라의 군 병사는 내무반에서 생활할 때에 비하여 군사훈련의 생활을 할 때에 자가구강 관리에 어려움을 겪고 있으며, 흡연율이 높지만 군대 내의 금연교육과 구강보건교육은 부족하다는 사실을 확인할 수 있었다. 따라서 군에서는 군 장병이 군 복무를 하는 동안 구강건강이 증진될 수 있도록 의무 환경을 적극적으로 개선해야 할 것이다.

• 한국학교보건학회지
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• 제21권2호
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• pp.119-134
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• 2008

Purpose: The purpose of this study is to understand a variety of intervention studies to prevent smoking by adolescents in U.S. and find out implications for Korea. Methods: This study reviewed articles found in the internet and analysed the data of US DHHS and CDC. Results: The School Health Policies and Programs Study (SHPPS) is a national survey periodically conducted to assess school health policies and programs of U.S. The main components of SHPPS are health education and physical education, health services, mental health and social services, school policies, and school environments. The CDC guidelines for school health programs to prevent tobacco use and addiction are composed of policy, instruction, curriculum, training, family involvement, tobacco-use cessation efforts, and evaluation. School-based interventions to prevent smoking can be classified into the categories of information-giving curricula, social competence curricula, social influence approaches, combined methods draw on social competence and social influence approaches and multi-modal programmes and Youth Empowerment study. The key programs for adolescent smoking prevention are ALERT Project, HSPP, TNT Project, MPP, NC YES. Conclusions: As smoking is often the first step of unhealthy behaviour such as alcohol drinking, illegal drugs, and violence, smoking prevention programmes for adolescents in U.S. have been comprehensive school-based health programs. In smoking prevention programs for adolescents, CDC plays a critical role by supporting survey, research, policy, and funds. The effectiveness of the programs was high when it was based on school and involved parents, community, and mass media. As the effect of each programme is not expected to last for a long time, consistent repetition of these interventions is essential. Current smoking prevention programs for adolescents are exploring the empowerment approach focused on the active involvement of participants rather than traditional approaches using order and discipline.

• 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.

• Journal of Preventive Medicine and Public Health
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• 제50권6호
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• pp.386-392
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• 2017

Objectives: Refugees resettled in the US may be at risk for cardiovascular disease (CVD). However, little is known about CVD-related issues among Karen refugees who have migrated to the US from the Thai-Myanmar border. The purpose of this study was to examine CVD-related health beliefs and lifestyle issues among Karen refugees resettled in the US. Methods: Karen refugees resettled in the US from the Thai-Myanmar border (n=195) participated in a survey study on health beliefs related to CVD, salt intake, physical activity (PA), and smoking in the fall of 2016. Results: A high-salt diet, physical inactivity, and smoking were major lifestyle problems. Participants who adhered to a low-salt diet considered themselves to be susceptible to CVD. Most participants did not engage in regular PA. Regular PA was associated with less perceived susceptibility to CVD and greater perceived benefits of a healthy lifestyle for decreasing the likelihood of CVD. Conclusions: Each refugee population may require individualized strategies to promote PA and a healthy diet. Future studies should develop health education programs that are specifically designed for Karen refugees and evaluate such programs. In addition to health education programs on healthy lifestyle choices, tobacco cessation programs seem to be necessary for Karen refugees. At the same time, it is important to foster strategies to increase the utilization of preventive care among this population by promoting free or reduced-fee resources in the community to further promote their health.

• Asian Pacific Journal of Cancer Prevention
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• 제17권sup1호
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• pp.71-78
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• 2016

Printing of pictorial health warnings (PHWs) on cigarette packages became obligatory by the Vietnam Law on Prevention and Control of Tobacco Harm in May 2013. Literature from high-income countries suggests that PHWs motivate smokers to quit smoking although their long-term effects have been questioned due to reduction of impact over time. This study aimed to assess the salience of PHWs and smokers' reactions towards PHWs over time. In May 2014 and May 2015, a cross-sectional questionnaire-based household survey was administered to respectively 1,462 and 1,509 Vietnamese male smokers aged 18 to 35. The result showed that salience of the PHWs 2 years after the implementation was higher than at the point of 1 year after the implementation. The proportion of respondents who tried to avoid noting the PHWs was reduced from 35% in wave 1 to 23% in wave 2. However, "Tried to avoid looking/thinking about the PHWs" increased 1.5 times the odds of presenting quit intention compared to those respondents who did not try to avoid looking/thinking about the PHWs (OR=1.5; 95%CI: 1.2-2.0). In conclusion, avoidance regarding PHWs may not work as a barrier when aiming at a higher level of quit intention. Salience of the PHWs may increase in the period shortly after their introduction onto packs but can be expected to decrease with time. In other words, it might be advisable to change or renew PHWs after a period of implementation to maintain their beneficial effects.

• Journal of Preventive Medicine and Public Health
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• 제41권4호
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• pp.272-278
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• 2008

Objectives: To compare the health behaviors of widowed women with those of currently married women. Methods: We randomly sampled the subjects from the Jeollanamdo Resident Registration Data and we then selected 2,331 widowed women and 4,775 married women. Well-trained examiners measured the height, weight, blood pressure and abdomen circumference, and the women were interviewed with using a questionnaire. Logistic regression analysis was used to estimate the odds ratios(OR) of the two groups. Results: The smoking rate (OR=2.46; 95% confidence interval [CI]1.65, 3.66) was significantly higher for the widowed women. On the contrary, the awareness rate of a smoking cessation campaign (OR=0.80; 95% CI=0.70, 0.92), a quit tobacco telephone line (OR=0.73; 95% CI =0.61, 0.88) and a quit smoking clinic (OR=0.74; 95% CI=0.62, 0.89) were lower for the widowed women. The rate of receiving a health exam (OR=0.80; 95% CI=0.70, 0.91), the rate of undergoing gastric cancer screening (OR=0.77; 95% CI=0.68, 0.88), breast cancer screening (OR=0.79; 95% CI=0.69, 0.89), cervix cancer screening in the last 2 years (OR=0.81; 95% CI=0.71, 0.92), colon cancer screening in the last 5 years (OR=0.74; 95% CI=0.63, 0.87) were significantly lower for the widowed women. Conclusions: This study revealed that the health behaviors are significantly different between the widowed women and the married women. To improve the health behaviors of the widowed women, further study and research that will investigate the socioeconomic and environmental factors that affect the health behaviors of widowed women will be needed.

• Journal of Preventive Medicine and Public Health
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• 제51권1호
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• pp.51-58
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• 2018

Objectives: Smoking is a significant public health issue in Bangladesh. The purpose of this study was to examine peer smoking and smoking-related beliefs among college students in Bangladesh. Methods: College students at two universities in Dhaka, Bangladesh participated in a self-administered survey in May and June 2017. Results: First, being a current or former smoker is associated with lower levels of beliefs among respondents that they would not smoke even with smoker friends or nervousness, and lower levels of intentions that they would not smoke, while current smokers and former smokers have different smoking-related beliefs. Second, having smoker friends is associated with lower levels of intentions that they would not smoke. Third, higher levels of normative beliefs that it is important not to smoke are associated with higher levels of beliefs that they would not smoke even with smoker friends or nervousness, higher levels of intentions that they would not smoke, and higher levels of avoidance of smoking. Conclusions: Smoking-related beliefs and perceived norms in individuals' social networks are important components in promoting tobacco cessation in Bangladesh. But it is challenging to prevent or intervene in smoking because of the high rates of smoking in this country and the high prevalence of smokers in individuals' social networks. Future studies should examine the most effective interventions to combat smoking in high-smoking social networks, such as using mobile apps or social media, and evaluate the effectiveness of such interventions.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제26권2호
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• pp.99-115
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• 2023

Purpose: Exclusive breastfeeding promotes gut microbial compositions associated with lower rates of metabolic and autoimmune diseases. Its cessation is implicated in increased microbiome-metabolome discordance, suggesting a vulnerability to dietary changes. Formula supplementation is common within our low-income, ethnic-minority community. We studied exclusively breastfed (EBF) neonates' early microbiome-metabolome coupling in efforts to build foundational knowledge needed to target this inequality. Methods: Maternal surveys and stool samples from seven EBF neonates at first transitional stool (0-24 hours), discharge (30-48 hours), and at first appointment (days 3-5) were collected. Survey included demographics, feeding method, medications, medical history and tobacco and alcohol use. Stool samples were processed for 16S rRNA gene sequencing and lipid analysis by gas chromatography-mass spectrometry. Alpha and beta diversity analyses and Procrustes randomization for associations were carried out. Results: Firmicutes, Proteobacteria, Bacteroidetes and Actinobacteria were the most abundant taxa. Variation in microbiome composition was greater between individuals than within (p=0.001). Palmitic, oleic, stearic, and linoleic acids were the most abundant lipids. Variation in lipid composition was greater between individuals than within (p=0.040). Multivariate composition of the metabolome, but not microbiome, correlated with time (p=0.030). Total lipids, saturated lipids, and unsaturated lipids concentrations increased over time (p=0.012, p=0.008, p=0.023). Alpha diversity did not correlate with time (p=0.403). Microbiome composition was not associated with each samples' metabolome (p=0.450). Conclusion: Neonate gut microbiomes were unique to each neonate; respective metabolome profiles demonstrated generalizable temporal developments. The overall variability suggests potential interplay between influences including maternal breastmilk composition, amount consumed and living environment.

• 한국산학기술학회논문지
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• 제17권7호
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• pp.656-665
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• 2016

연구목적: 이 연구는 한국의 재림교인과 일반 인구집단간의 생활습관 및 건강행동 비교 분석 연구를 통하여 특성과 관련요인들을 도출하고자 실시하였다. 연구방법: 수도권 지역 만 20세 이상 재림교인 878명과 제4기 2차년도 국민건강영양 조사자료 중에서 수도권 지역 만 20세 이상 3,000명을 대상으로 건강행태와 관련된 건강검진, 흡연, 음주, 신체활동, 주관적 스트레스, 체중관리, 구강건강 관련 항목의 비교는 카이제곱 검정을 사용하였으며, 건강행동에 기여요인을 확인하기 위해 로지스틱회귀분석을 실시하였다. 연구결과: 건강검진율은 재림교인이 일반 인구집단보다 높게 나타났으며(p<0.001), 재림교인은 연령이 낮은 20-30대에서 검진율이 낮게 나타났다(p<0.001). 평생 흡연 경험율 및 현재 흡연율에서 재림교인이 일반 인구집단보다 현저하게 낮게 나타났으며(p<0.001), 재림교인 중 과거 흡연자의 금연 성공율은 매우 높게 나타났다. 음주율에서는 재림교인이 일반 인구집단보다 현저하게 낮게 나타났으며, 재림교인은 신앙기간이 짧을수록 음주를 많이 하는 것으로 나타났으며(p<0.001), 남자가 여자보다 음주율이 높은 것으로 나타났다(p<0.001). 중등도 신체활동 및 걷기 운동에서 재림교인은 일반 인구집단보다 실천율이 높게 나타났으며, 재림교인들의 남자가 여자보다 중등도 신체활동은 높은 것으로 나타났다(p<0.001). 결론: 이상에서 나타난 재림교인들의 건강생활습관에서 흡연 및 음주 등에서는 일반 인구집단에 보다 탁월하게 건강생활을 실천하고 있어 추후 보다 심층적인 추적관찰 연구 등이 필요해 보인다.