• Asian Pacific Journal of Cancer Prevention
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• v.15 no.12
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• pp.4963-4968
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• 2014

Background: We evaluated whether providing health risk appraisal for Koreans (KHRA) in terms of 'health age' during smoking cessation program would effectively help smokers quit smoking or not. Materials and Methods: A total of 332 male smokers aged between 30-65 years old, registered for a smoking cessation program in a public health center in a city, were recruited and underwent a baseline survey from January 2010 to February 2011. They were then prospectively randomized to a conventional counseling group (n=165) or a KHRA group (n=167), and received conventional counseling or KHRA-based counseling for six months. Abstinence rates were identified through carbon monoxide measurement (at the $4^{th}$ and $24^{th}$ weeks) or urinary cotinine level (at the $12^th$ week). Results: The abstinence rate confirmed by exhaled carbon monoxide was significantly higher in the KHRA group (61.1%) than the control group (49.1%) at the $4^{th}$ week (absolute difference 12.0%, 95% CI: 1.4%-22.6%). However, there was no difference in abstinence rates between the two groups at the 12th and 24th weeks. The predicting factors of 24 week's smoking cessation success were age, older than 50 years old (OR 2.02, 95% CI: 1.16-3.52), lower Fagerstr$\ddot{o}$m Test for Nicotine Dependence score less than 4 (OR 1.84, 95% CI: 1.03-3.29), and higher Self Efficacy/Temptation score (OR 1.79, 95% CI: 1.05-3.06). Conclusions: Smoking cessation counseling with KHRA could be effective compared to conventional counseling in the short period of smoking cessation. Further study is needed to evaluate the long-term efficacy of KHRA in tobacco dependence treatment and to establish the indication and target population of this tool.

• Journal of Environmental Health Sciences
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• v.40 no.6
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• pp.492-501
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• 2014

Objectives: The purpose of this study was to assess the validity of self-reported cigarette smoking status and investigate factors associated with the accuracy self-reported and measured urinary cotinine in Korean adults. Methods: We used data from the $1^{st}$ Korean National Environmental Health Survey (2009-2011) among adults aged ${\geq}19$ years (N=6,246). The survey examined self-reported smoking status, and urinary cotinine was regarded as the biomarker of exposure to tobacco smoke. Urinary cotinine was analyzed using a gas chromatography-mass spectrometry (GC/MS) and data analysis was conducted using IBM SPSS version 20.0, which uses the sample weight and calculates variance estimates to adjust for the unequal probability of selection into the survey. Results: We calculated a cut-off point (53.3 ug/L) by using a ROC (Receiver Operating Characteristic) curve. The smoking prevalence was 24.6% based on self-reported data and 28.2% based on urinary cotinine concentrations. When we assessed the agreement between self-reported and urinary cotinine, we found an average agreement of 97.7% among self-reported smokers and 94.5% among self-reported non-smokers. Among self-reported smokers, factors affected the discrepancy were age, household economic status and average number of cigarettes smoked per day. On the other hand, gender, former smoking experience, and exposure to SHS (second hand smoke) were associated with discrepancies among self-reported non-smokers. Conclusion: These results suggest that self-reported data on smoking status provide a valid estimate of actual smoking status. In future research, we will conduct a continuous monitoring study for reliability verification of the data to reduce potential interpretation errors.

• The Korean Journal of Pain
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• v.33 no.4
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• pp.359-377
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• 2020

Background: This study investigated whether current smoking and a higher nicotine dependency were associated with chronic low back pain (LBP), lumbar related leg pain (sciatica) and/or radicular neuropathic pain. Methods: A cross-sectional study was conducted on 150 patients (mean age, 60.1 ± 13.1 yr). Demographic data, the International Association for the Study of Pain (IASP) neuropathic pain grade, STarT Back tool, and the Fagerström test were completed. A control group (n = 50) was recruited. Results: There was a significant difference between current smokers and nonsmokers in the chronic LBP group in the mean pain score (P = 0.025), total STarT Back score (P = 0.015), worst pain location (P = 0.020), most distal pain radiation (P = 0.042), and in the IASP neuropathic pain grade (P = 0.026). There was a significant difference in the mean Fagerström score between the four IASP neuropathic pain grades (P = 0.005). Current smoking yielded an odds ratio (OR) of 3.071 (P = 0.011) for developing chronic LBP and sciatica, and an OR of 4.028 (P = 0.002) for obtaining an IASP "definite/probable" neuropathic pain grade, for both cohorts. The likelihood for chronic LBP and sciatica increased by 40.9% (P = 0.007), while the likelihood for an IASP neuropathic grade of "definite/probable" increased by 50.8% (P = 0.002), for both cohorts, for every one unit increase in the Fagerström score. Conclusions: A current smoking status and higher nicotine dependence increase the odds for chronic LBP, sciatica and radicular neuropathic pain.

• Analytical Science and Technology
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• v.17 no.5
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• pp.410-415
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• 2004

In order to learn the emission characteristics of hazardous pollutants associated with environmental tobacco smoking (ETS), we measured the concentrations of major aromatic VOC and carbonyl compounds released from ETS. By acquiring the different smoke types of ETS, we were able to determine that the concentrations of those species range from ppb (normal exhaled air of smoker prior to smoking) to ppm levels (direct release of ETS without filter). Using these measurement data, we also evaluated the body-retaining rate of these compounds as the result of ETS. The results of our analysis indicated that predominant portion of them (e.g., > 99%) are retained as the result of cigarette smoking. To learn more about the potential impact of ETS, more extensive study may be required to assess the gross picture of pollutant deposition inside respiratory intake and their health-effects.

• Toxicological Research
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• v.22 no.3
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• pp.245-251
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• 2006

Nitric oxide(nitrogen monoxide, NO) plays important physiological roles, but excessive generation can be toxic. NO is present in cigarette smoke at up to 1,000 ppm, and probably represents one of the greatest exogenous sources of NO to which humans are exposed. We investigated whether cigarette smoking reduces the production of endogenous NO and whether it influences the action of lipopolysaccharide(LPS) to induce nitric oxide synthase activity in mouse brain. Mice(C57BL6/J) were exposed to cigarette smoke for 8 weeks. LPS was injected intraperitoneally in single or combination with the exposure to cigarette smoke. Six hours after the injection of LPS, mice were sacrificed and sera and brains were collected. Serum concentrations of nitrate and nitrite were not charged by 4-week smoke exposure, but were significantly increased by 6 and 8 weeks of smoke exposure. Interestingly, cigarette smoke reduced the elevation in serum nitrate and nitrite concentrations produced by LPS after 4-week smoking exposure. NO synthase(NOS) activity in brain was upregulated by LPS-administration. However, cigarette smoke exposure remarkably and consistently decreased the LPS-induced activity in mouse brain. This result suggests that cigarette smoking may affect against overproduction of the endogenous NO by LPS through the inhibition of NOS activity induced by LPS in brain or by modulation of the LPS action for the induction of NOS activity. We also suggest the possibility that the exogenous NO evolved in cigarette smoke enables feedback inhibition of NOS activity or other possibility that it attenuates the toxicity of endotoxin LPS in vivo by unknown mechanisms, which should be further studied.

• Journal of Preventive Medicine and Public Health
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• v.49 no.2
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• pp.80-96
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• 2016

Recently, a series of lawsuits were filed in Korea claiming tort liability against tobacco companies. The Supreme Court has already issued decisions in some cases, while others are still pending. The primary issue in these cases is whether the epidemiological evidence submitted by the plaintiffs clearly proves the causal relationship between smoking and disease as required by civil law. Proving causation is difficult in tobacco lawsuits because factors other than smoking are involved in the development of a disease, and also because of the lapse of time between smoking and the manifestation of the disease. The Supreme Court (Supreme Court Decision, 2011Da22092, April 10, 2014) has imposed some limitations on using epidemiological evidence to prove causation in tobacco lawsuits filed by smokers and their family members, but these limitations should be reconsidered. First, the Court stated that a disease can be categorized as specific or non-specific, and for each disease type, causation can be proven by different types of evidence. However, the concept of specific diseases is not compatible with multifactor theory, which is generally accepted in the field of public health. Second, when the epidemiological association between the disease and the risk factor is proven to be significant, imposing additional burdens of proof on the plaintiff may considerably limit the plaintiff's right to recovery, but the Court required the plaintiffs to provide additional information such as health condition and lifestyle. Third, the Supreme Court is not giving greater weight to the evidential value of epidemiological study results because the Court focuses on the fact that these studies were group-level, not individual-level. However, group-level studies could still offer valuable information about individual members of the group, e.g., probability of causation.

• Journal of dental hygiene science
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• v.10 no.3
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• pp.131-139
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• 2010

The purpose of this study was to evaluate smoking patterns, oral health behavior and perception of dental healthcare of military personnel in the South Korea Army. All 367 subjects were surveyed by the structured questionnaires with convenience sampling method. The questionnaires were consisting of 22 items. Depending on the conditions of military training, the distribution and differences of smoking patterns and oral behaviors were evaluated by frequency test, Weighted Kappa, Paired t-test and ANOVA. The differences of oral health perception on smoking were demonstrated by Mantel-Haenszel Chi-square test. In addition, Generalized Estimating Equation (GEE) was used to estimate the effects of oral behavior for the conditions of military training and smoking. The number of cigarette during military training period was similar to that during non-military training (p=0.109). The perception of smokers such as smoking effect on oral health, oral health and systemic health, and need of education for smoking cessation was significantly lower than non-smokers (p=0.0095, p=0.0007, and p<0.0001). The probability that toothbrush frequency per day was only one was associated with higher during military training period than non-military training (OR=9.29, 95% CI 5.05-17.07). Moreover, the probability that hours of toothbrush were less than one minute was associated with higher during military training than non-military training (OR=2.19, 95% CI 1.78-2.71). To improve knowledge, attitude, and behavior of oral health for the members, the army needs to develop oral health education and tobacco cessation programs. In particular, motivation and practice for oral health care are required to improve poor oral health behavior during the military training.

• Journal of dental hygiene science
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• v.13 no.1
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• pp.77-82
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• 2013

The purpose of this study was to examine the subjective awareness of smoker patients about the preparation of smoking cessation plans in an effort to lay the foundation for smoking cessation policy setting. The subjects were the selected patients at a dental clinic. A self-administered survey was conducted to grasp their personal characteristics, and the selected answer sheets from 236 respondents were analyzed. The findings of the study were as follows: 1. As for the extension of existing smoking cessation plans, the largest group (32.6%) preferred smoking cessation education, followed by smoking cessation counseling (28.8%), prescription of an smoking cessation aid (18.6%). 2. Concerning the necessity of a smoking cessation law, the men and the women respectively gave 2.37 and 3.00 to that, and the gender gap was significant. The patients had a significantly different opinion on the necessity of a rise in tobacco price according to their occupation and monthly mean household income, and their took a significantly different view of the necessity of smoking cessation counseling according to their residential area. 3. As a result of analyzing the correlation between their on effective smoking cessation policies and the related variables, all the variables had a statistically significant correlation to each other. 4. As a result of analyzing their opinions on what institution should be in charge of smoking cessation plans, the biggest group answered that dental clinics should be responsible for smoking cessation-aid prescription (50.0%), and the largest group replied that smoking cessation education and smoking cessation counseling should respectively be provided by public dental clinics (37.3%) and dental clinics (44.1%).The above-mentioned findings suggest that the preparation of new smoking cessation measures and the extension of existing smoking cessation plans are urgently required, and that dentists and dental hygienists should make a concerted effort to offer counseling and education to stimulate dental patients to abstain from smoking.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3173-3181
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• 2015

Background: It has been hypothesized that IL-18 (pro-) and IL-10 (anti-) inflammatory genetic variants at -607 C/A-137G/C and -819C/T,-592C/A, respectively, may generate susceptibility and severity risk with various modes of tobacco exposure in prostate carcinoma (PCa) patients. IL-18 is a pro-inflammatory cytokine expressed on various cells including prostate gland elements, and is a key mediator of immune responses with anti-cancerous properties. IL-10 is an anti-inflammatory cytokine that is associated with tumour malignancy which causes immune escape. Materials and Methods: The present study was conducted with 540 subjects, comprising 269 prostate carcinoma patients and 271 controls. Genotyping was performed by PCR-RFLP and confirmed by real time PCR probe-based methods. Results: The findings indicated that the mutant heterozygous and homozygous genotype CC and GC+CC showed significant negative associations (p=0.01, OR=0.21; 95% CI: 0.08-0.51 and p=0.011, OR=0.43; 95% CI: 0.22-0.81, respectively) thus, less chance to be diagnosed as cancer against GG genotype of tobacco smoking patients. In addition, a heterozygous GC genotype at the same locus of IL-18 pro-inflammatory cytokine may aggravate the severity (OR=2.82; 95%CI 1.09-7.29 :p=001) so that patients are more likely to be diagnosed in advanced stage than with the GG wild homozygous genotype. Our results also illustrated that anti-inflammatory cytokine (IL-10) genetic variants, although showing no significant association with susceptibility to cancer of the prostate, may gave profound effects on severity of the disease, as -819 TC (OR=4.60; 95%CI 1.35-15.73), and -592 AC (OR=5.04; 95%CI 1.08-25.43) of IL-10 in tobacco chewers and combined users (both chewers and smokers) respectively, are associated with diagnosis in more advanced stage than with other variants. Conclusions: We conclude that promoter genetic variants of IL-18 and IL-10 with various modes of tobacco exposure may affect not only susceptibility risk but also severity in prostate cancer.

• KDI Journal of Economic Policy
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• v.31 no.2
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• pp.127-153
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• 2009

There is a growing concern about potential harmful effect of second-hand or environmental tobacco smoking. As a result, smoking bans in workplace become more prevalent worldwide. In Korea, workplace smoking ban policy become more restrictive in 2003 when National health enhancing law was amended. The new law requires all office buildings larger than 3,000 square meters (multi-purpose buildings larger than 2,000 square meters) should be smoke free. Therefore, a lot of indoor office became non smoking area. Previous studies in other counties often found contradicting answers for the effects of workplace smoking ban on smoking behavior. In addition, there was no study in Korea yet that examines the causal impacts of smoking ban on smoking behavior. The situation in Korea might be different from other countries. Using 2001 and 2005 Korea National Health and Nutrition surveys which are representative for population in Korea we try to examine the impacts of law change on current smoker and cigarettes smoked per day. The amended law impacted the whole country at the same time and there was a declining trend in smoking rate even before the legislation update. So, the challenge here is to tease out the true impact only. We compare indoor working occupations which are constrained by the law change with outdoor working occupations which are less impacted. Since the data has been collected before (2001) and after (2005) the law change for treated (indoor working occupations) and control (outdoor working occupations) groups we will use difference in difference method. We restrict our sample to working age (between 20 and 65) since these are the relevant population by the workplace smoking ban policy. We also restrict the sample to indoor occupations (executive or administrative and administrative support) and outdoor occupations (sales and low skilled worker) after dropping unemployed and someone working for military since it is not clear whether these occupations are treated group or control group. This classification was supported when we examined the answers for workplace smoking ban policy existing only in 2005 survey. Sixty eight percent of indoor occupations reported having an office smoking ban policy compared to forty percent of outdoor occupation answering workplace smoking ban policy. The estimated impacts on current smoker are 4.1 percentage point decline and cigarettes per day show statistically significant decline of 2.5 cigarettes per day. Taking into account consumption of average sixteen cigarettes per day among smokers it is sixteen percent decline in smoking rate which is substantial. We tested robustness using the same sample across two surveys and also using tobit model. Our results are robust against both concerns. It is possible that our measure of treated and control group have measurement error which will lead to attenuation bias. However, we are finding statistically significant impacts which might be a lower bound of the true estimates. The magnitude of our finding is not much different from previous finding of significant impacts. For cigarettes per day previous estimates varied from 1.37 to 3.9 and for current smoker it showed between 1%p and 7.8%p.