• 보건행정학회지
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• 제24권4호
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• pp.342-348
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• 2014

Background: Due to lack of regular and systematic evaluation tool, Korea's tobacco control policy has not been examined its overall process of implementation including efficiency and adequacy of the policies. This study developed policy monitoring and evaluation model to assess policy implementation and effectiveness of tobacco control in Korea. Methods: Based on World Health Organization operational manual for assessment, MPOWER (monitor tobacco use and prevention policies, protect from tobacco smoke, offer help to quit tobacco use, warn about the dangers of tobacco, enforce bans on tobacco advertising promotion and sponsorship, and raise taxes on tobacco) related policies were reviewed by rating policy efforts, programme management, people (human resources and their development), provision of organization, provision of fund and partnerships (range, 0 to 5). Results: As a result of the experts' assessment, overall Korean tobacco control policies scored 2.61 points, which is poor. In relation to each 'MPOWER' policies, 'W' scored the highest points (2.93), followed by 'O' (2.91), 'M' (2.87), 'P' (2.86), and 'E' (2.23). 'R' scored the lowest points of 1.87, meaning government efforts in tobacco price policy is insufficient. Conclusion: This study concludes that Korean tobacco control policy should strengthen tax and price measures, while programme infrastructure, people, and funds for policy enforcement should be secured. Furthermore, rather than focusing on one specific measure, a balanced approach reflecting various aspects of tobacco controls should be considered in order to decrease smoking rates and prevent smoking initiation.

• 보건교육건강증진학회지
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• 제33권4호
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• pp.11-19
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• 2016

Objectives: FCTC is the first international convention in public health field. Global progress report is about the implementations of the FCTC that are conducted with comparison and analysis for recent trend of tobacco control policies and convention performances on the global level. Methods: By conducting literature review related to tobacco control, expecially through reviewing Implementation of the WHO FCTC GPR(2014), this report compared and analyzed Korea's status of tobacco control based on tobacco control policy in every member state. Results: As a result of the comparison of FCTC to Korea's tobacco control policy, for the first, the most outstanding article that has been peformed continuously is Article 8, 12, 14. Secondly, the policy that has been partially renovated and reinforced is Article 6, 9, 10, 11, and for the last, the policy that has no progress and needs improvement is Article 13. Conclusions: For improvement in Korea's tobacco control policy in the future, first, betterment in policies on categories about advertisements, promotions, sponsorships on tobacco products that passed FCTC commitment period is required along with the modifications of FCTC related laws and reinforcement of the policies, and development of national core competence for an effective implementation of the convention.

• 보건교육건강증진학회지
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• 제30권4호
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• pp.9-16
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• 2013

Objectives: The purpose of this manuscript was to review Intersectoral Collaboration policies for Tobacco Control. Methods: The author selected the WHO Framework Convention on Tobacco Control and adopted guidelines, and reviewed intersectoral and multisectoral collaboration policy recommendations. Results: There are 11 chapters and 38 articles in the Convention. In the Demand reduction policies included price and non price measures. The author selected a few non price measures for cross sectoral collaboration examples. They are protection from exposure to tobacco emission, education and communication, banning advertising, promotion and sponsorship of tobacco products, and offering treatment to tobacco use cessation. Inter sectoral and multi sectoral approaches could increase effectiveness, and better outcome of the tobacco control policy for implementation of many different articles of FCTC. Conclusions: It is important to give a specific role in structures of different government sectors and infrastructure for intersectoral collaboration. In addition, the role of civil society is very important for implementation of tobacco control policy effectively, and governments have to support the civil society for anti-smoking activities and campaigns.

• Asian Pacific Journal of Cancer Prevention
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• 제17권6호
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• pp.2821-2826
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• 2016

Implementation of no tobacco policies in schools is associated with lower tobacco use among teachers and students. In this study we assessed the extent that a school-based intervention for teachers resulted in adoption and implementation of tobacco control policies. From a random sample of government schools ($8^{th}-10^{th}$), 72 were randomized into intervention and control conditions. Intervention included health education programs for teachers and support for tobacco control policy implementation. Adoption and implementation of policies were assessed at baseline and immediately after intervention. All 36 intervention and one control school adopted a tobacco-control policy. Higher enforcement of tobacco-control policy was at post intervention (OR=3.26; CI: 2.35, 4.54) compared to baseline in intervention schools. Some 64% of intervention and 28% control schools showed "improvement" in policy implementation. Adoption and implementation of no tobacco policies was positively impacted by intervention. This study provides support for scaling up of school-based tobacco control interventions to promote school tobacco control policies.

• Asian Pacific Journal of Cancer Prevention
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• 제17권1호
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• pp.275-280
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• 2016

Background: A tobacco-free workplace policy is identified as an effective means to reduce tobacco use and protect people from second-hand smoke; however, the number of tobacco-free policies (TFP) remains very low in workplaces in Malaysia. This study explored the factors affecting support for a tobacco-free policy on two healthcare campuses in Malaysia, prior to the implementation of TFP. Materials and Methods: This cross-sectional study was conducted among 286 non-smokers from two healthcare training centres and two nearby colleges in Malaysia from January 2015 to April 2015. A standardized questionnaire was administered via staff and student emails. The questionnaire collected information on sociodemographic characteristics, support for a tobacco-free policy and perceived respiratory and sensory symptoms due to tobacco exposure. Bivariate and multivariate logistic regression analyses were performed to estimate the independent effects of supporting a tobacco-free campus. Results: The percentage of individuals supporting completely tobacco-free facilities was 83.2% (N=238), as opposed to 16.7% (N=48) in support of partially tobacco-free facilities. Compared to the supporters of partially tobacco-free facilities, non-smokers who supported completely tobacco-free health facilities were more likely to be female, have higher education levels, to be very concerned about the effects of other people smoking on their health and to perceive a tobacco-free policy as very important. In addition, they perceived that tobacco smoke bothered them at work by causing headaches and coughs and, in the past 4 weeks, had experienced difficulty breathing. In the multivariate model, after adjusting for sociodemographic characteristics and other factors, only experiencing coughs and headaches increased the odds of supporting a completely tobacco-free campus, up to 2.5- and 1.9-fold, respectively. Conclusions: Coughs and headaches due to other people smoking at work enhances support for a completely tobacco-free campus among non-smokers.

• 보건행정학회지
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• 제27권3호
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• pp.219-228
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• 2017

Background: The purpose of this study is to investigate impact of increased tobacco price in 2015 on the adult smoking rate in South Korea. Methods: This study used 6th Korea National Health and Nutrition Examination Survey from 2013 to 2015. Total 14,860 adults were included in the analysis. The chi-square test, univariate- and multivariate survey logistic regressions, and subgroup analysis were conducted. Results: Results show that adult smoking rate before price increase were 19.08% and after price increase were 16.69%. Adjusted by variables associated with smoking behavior and others, multivariate survey logistic regressions revealed that smoking rate decreased after introduction of increased tobacco price policy (odds ratio [OR], 0.745; 95% confidence interval [CI], 0.575 to 0.967) and the impact was different by various social status (male: OR, 0.688; 95% CI, 0.523 to 0.905; age over 60: OR, 0.487; 95% CI, 0.315 to 0.754; rural area: OR, 0.531; 95% CI, 0.309 to 0.912; household income Q1: OR, 0.593; 95% CI, 0.352 to 0.999; household income Q4, OR, 0.616; 95% CI, 0.386 to 0.983). Conclusion: The study revealed decreased smoking rate after increased tobacco price policy and different trend depending on various social characteristics. We recommend that government agencies and policy makers should pursue tobacco price control policy continuously and population specific manner and concurrently non-price policy should be implemented as well.

• 보건행정학회지
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• 제29권1호
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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.

• 보건행정학회지
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• 제26권4호
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• pp.279-288
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• 2016

Graphic health warning on the tobacco product package is a cost-effective tobacco control policy to convey information on harmful effect of tobacco use to health, and it is known not only to motivate smokers to quit but also to deter adolescents from start smoking. In case of Korea, amendments to National Health Promotion Act requiring implementation of graphic health warning had been submitted 13 times, from 2002 to May 2015. In May 2015, the amendment had been approved by the National Assembly and it enters into force on December 23, 2016. This research analyzed the discussions from Health and Welfare Committee of the National Assembly during the implementation of the graphic health warning in order to study decision making process of legislators. Study found that there was a shift from a general opposition on implementing graphic health warning at first to a harsh conflict over relaxation of the regulation once discussing the implementation in earnest. Particularly, while the group supporting the implementation of the graphic health warning or opposing relaxation advocated the amendment with scientific and knowledge-based evidences including the World Health Organization Framework Convention on Tobacco Control, the group opposing the adoption of the amendment itself or suggesting relaxation tended to defend their position with empathy on smokers or tobacco industries.

• Journal of Korean Medical Science
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• 제33권47호
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• pp.302.1-303.10
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• 2018

Background: A considerable amount of research has shown that knowledge and appropriate awareness are essential for encouraging positive behaviors and promoting health. In Korea, the roles that behavioral changes play in the prevention of cancer have been an important issue since the introduction of the 10 codes for cancer prevention in 2006. Thus, the present study investigated the associations of tobacco-related knowledge with awareness and attitudes towards positive smoking-cessation behaviors. Methods: The present study analyzed data from the 2010 national questionnaire survey (n = 1,006). This study evaluated sociodemographic characteristics, smoking status, self-rated health status, health-related interests, and the accuracy of 12 tobacco-related statements to determine knowledge level and to investigate its impact on awareness and behaviors related to smoking. These parameters were examined and staged using the Precaution Adoption Process Model. Results: A higher level of tobacco-related knowledge was significantly associated with a positive attitude towards smoking cessation (5-8 correct answers: odds ratio [OR], 2.53; 95% confidence interval [CI], 1.57-4.08; ${\geq}9$ correct answers: OR, 3.90; 95% CI, 2.22-6.82; reference: ${\leq}4$ correct answers). Interestingly, among current smokers, only those who correctly responded to ${\geq}9$ of 12 tobacco-related statements were significantly associated with a positive attitude towards smoking cessation. Conclusion: This study found that having a higher level of tobacco-related knowledge had a significant impact on positive attitudes towards smoking cessation. This suggests that there is a need to disseminate appropriate knowledge to the general population to encourage positive attitudes and promote healthful behaviors in terms of smoking.

• Journal of Preventive Medicine and Public Health
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• 제47권3호
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• pp.129-135
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• 2014

Tobacco use is the most important preventable risk factor for premature death. The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC), the first international public health treaty, came into force in 2005. This paper reviews the present status of tobacco control policies in Korea according to the WHO FCTC recommendations. In Korea, cigarette use is high among adult males (48.2% in 2010), and cigarette prices are the lowest among the Organization for Economic Cooperation and Development countries with no tax increases since 2004. Smoke-free policies have shown incremental progress since 1995, but smoking is still permitted in many indoor public places. More than 30% of non-smoking adults and adolescents are exposed to second-hand smoke. Public education on the harmful effects of tobacco is currently insufficient and the current policies have not been adequately evaluated. There is no comprehensive ban on tobacco advertising, promotion, or sponsorship in Korea. Cigarette packages have text health warnings on only 30% of the main packaging area, and misleading terms such as "mild" and "light" are permitted. There are nationwide smoking cessation clinics and a Quitline service, but cessation services are not covered by public insurance schemes and there are no national treatment guidelines. The sale of tobacco to minors is prohibited by law, but is poorly enforced. The socioeconomic inequality of smoking prevalence has widened, although the government considers inequality reduction to be a national goal. The tobacco control policies in Korea have faltered recently and priority should be given to the development of comprehensive tobacco control policies.