Smokers In Korea Research Articles

Developing a Cost-Effectiveness Model of Digital Therapeutics for Smoking Cessation.

The purpose of this research was to construct a Markov model of digital therapeutics to predict the lifetime costs and consequences that would be incurred by a hypothetical group of adult smokers in Korea who only made a single attempt to stop smoking. To determine the efficacy of DTx, we created an annual cycle Markov model. The result shows that the NRT strategy is determined as the dominant strategy. Digital therapeutics acts as a complement to pharmacotherapy and is a low-cost option.

Association of smoking cessation with dynapenia among older lifetime smokers in Korea.

Muscle strength is known to play an important role in the health of older adults. The health burden of cigarette smoking among older adults remains significant. We investigated the association between smoking cessation and dynapenia among older lifetime smokers in Korea. This study is a secondary dataset analysis of cross-sectional data from theKorea National Health and Nutrition Examination Survey (KNHANES) 2016- 2019. We included 1450 participants aged 65-79 years, excluding those who had never smoked. Dynapenia was defined as grip strength <28 kg for men and <18 kg for women based on the Asian Working Group for Sarcopenia 2019 criteria. Multivariable logistic regression analysis evaluated the association between smoking cessation and dynapenia. Compared with current smokers, the adjusted odds ratio (AOR) of dynapenia in former smokers was 0.66 (95% CI: 0.44-0.99). The AORs for smoking cessation periods of ≤10 years, 10-20 years, 20-30 years, and >30 years were 0.67 (95% CI: 0.39-1.16), 0.61 (95% CI: 0.36-1.03), 0.65 (95% CI: 0.37-1.14), and 0.52 (95% CI: 0.25-1.06), respectively. The AOR for dynapenia significantly decreased with the years since smoking cessation (p for trend=0.043). Our findings suggest that smoking cessation can reduce the likelihood of dynapenia among older lifetime smokers, with a decreasing likelihood trend associated with longer cessation periods.

Developing Smoking Cessation Program for Female Smokers and Assessment of Its Impacts

Background: Female smokers find it challenging to quit smoking. The number of female smokers in Korea has not seen any decline. This study developed a smoking cessation program tailored for female smokers and evaluated its effectiveness.Methods: The treatment group, which was subjected to the smoking cessation program, was composed of seven adult female smokers and five female college students who smoked. The control group comprised 7 adult female smokers and 5 female college students who wanted to quit smoking.Results: Of the 12 participants in the control group, only 1 (8.3%) reported that she had maintained abstinence for 4 months and 1 week, while 5 (41.7%; 3 adults and 2 students) out of the 12 in the treatment group managed to abstain. For female smokers in this group, the motivation and empowerment to quit smoking increased significantly after participating in the program, and these positive effects were sustained for up to 3 months after the completion of the program.Conclusions: Female smokers who participated in the program that was developed as part of this study exhibited a significant abstinence rate, and their motivation and empowerment to quit smoking improved. These results indicate that this smoking cessation program can be clinically useful in helping female smokers quit smoking.

Health-Related Behavior and Psychosocial Characteristics of Adolescent Female Smokers in Korea, Compared with Adolescent Male Smokers.

This study aimed to investigate the relationship between health-related behavior and psychosocial characteristics among adolescent female smokers in South Korea using data from the 17th Korea Youth Risk Behavior Web-based Survey (KYRBWS) conducted in 2021. The analysis participants comprised 2407 adolescent smokers who were currently smoking, out of a sample of 54,835 participants. The characteristics of adolescent female smokers were examined by comparing them with those of adolescent male smokers. The results showed that male and female adolescent smokers accounted for 69.2% and 30.8% of the sample, respectively. Multiple logistic regression analysis identified school type, subjective socioeconomic status, physical activity, breakfast consumption, alcohol consumption, sexual experience, stress, generalized anxiety, and suicidal ideation as significant factors associated with adolescent female smokers. These findings provide important foundational data for the development of smoking-cessation programs and policies tailored specifically to adolescent female smokers.

Comparison of the Smoking Cessation of Heated Tobacco Product Users and Conventional Cigarette Smokers in Korea.

Since the introduction of heated tobacco products (HTPs) in Korea in 2017, their annual sales have increased. Several studies have investigated the perceptions of HTPs and smoking cessation behaviors. For the first time, In 2019, questions focused on HTP use were introduced in the Korea National Health and Nutrition Examination Survey (KNHNES). This study aimed to compare smoking cessation behaviors between HTP users and conventional cigarette smokers using KNHANES data. Data of 947 current adult smokers from the 8th KNHNES (2019) were analyzed. Current smokers were divided into conventional cigarette (CC)-only, HTP-only, and dual-use groups. The general characteristics of the three groups were investigated. Differences in current intention to quit smoking and past attempts to quit smoking among the three groups were analyzed using multivariate logistic regression analysis by IBM SPSS ver. 25.0. HTP-only users demonstrated fewer future smoking cessation plans (adjusted odds ratio [AOR], 0.398; 95% confidence interval [CI], 0.195-0.813; P=0.012) and fewer smoking cessation attempts in the past year (AOR, 0.533; 95% CI, 0.298-0.954; P=0.034) than CC-only smokers. However, there was no significant difference between dual-use (CC+HTP) and CC-only smokers. While dual-use and CC-only smokers showed similar smoking cessation behaviors, HTP-only users had fewer previous attempts to quit smoking and were less likely to be currently ready to quit smoking. These findings can be explained by a decrease in the need to quit smoking due to the convenience of HTP and the perception that HTPs are less harmful than CC.

Effects of Souvenirs on Smoking Cessation Success among Current and Former Adult Smokers in Korea

Effects of Souvenirs on Smoking Cessation Success among Current and Former Adult Smokers in Korea

Risk-based prediction model for selecting eligible population for lung cancer screening among ever smokers in Korea.

BackgroundThis study developed a new lung cancer risk prediction model for the Korean population and evaluated the performance, compared to the previously reported risk models developed in Western countries.MethodsAmong the 6,811,893 people who received health examinations from the Korean National Health Insurance Service, 969,351 ever-smokers (40–79 years) were included. Performance of Bach, Lung Cancer Risk Models for Screening, PLCOM2012, Pittsburgh, and Liverpool Lung Project models were evaluated. The ever-smokers were divided into the training and validation datasets by random sampling. The lung cancer risk model was developed and validated in the Korean population. The efficiency of model-based selection for lung cancer screening was compared with the eligible criteria of the National Lung Screening Trial (NLST).ResultsThe Korean lung cancer risk model showed the area under the curve and expected/observed (E/O) ratio of 0.816 and 0.983 in the training dataset and 0.816 and 0.988 in the validation dataset. The Korean lung cancer risk model included age-mean of age, square of age-mean of age, sex, square root of pack-years of smoking, years since cessation, physical activity, alcohol consumption, body mass index, and medical history of chronic pulmonary obstructive disease, emphysema, pneumoconiosis, and interstitial pulmonary disease. Compared with the NLST criteria, the Korean lung cancer risk model’s cut-off criteria (>2.1%) had more improved sensitivity (61.4% vs. 44.3%) and positive predictive value (4.1% vs. 2.9%). The Korean lung cancer risk model showed better discrimination and calibration than previously developed models in Western population.ConclusionsThe Korean lung cancer risk model can select eligible population for low-dose computed tomography screening among the Asian population. The efficiency of risk model-based selection for lung cancer screening is superior to that of fixed criteria-based selection.

Characteristics and Prevalence of Early Chronic Obstructive Pulmonary Disease in a Middle-Aged Population: Results from a Nationwide-Representative Sample.

IntroductionFew studies have examined the prevalence and associated factors of early chronic obstructive pulmonary disease (COPD) in Asians.ObjectiveTo evaluate the prevalence of early COPD and its associated factors among non-institutionalized middle-aged Korean adults.MethodsA total of 3195 participants aged 40–49 years from the 2016–2018 Korea National Health and Nutrition Examination Survey were included in this study. Patients (1) aged less than 50 years, (2) with a minimum of 10 pack-years of smoking, and (3) with forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) below the lower limit of normal were diagnosed with early COPD. The prevalence and odds ratio (OR) for early COPD were measured using multivariate logistic regression analysis, and the demographic data, anthropometric measurements, socioeconomic status, and lifestyle factors were considered covariates.ResultsThe overall prevalence of early COPD among the middle-aged Korean population was 2.4% (4.4% in men and 0.4% in women), while that in participants with ≥10 pack-years was 8.2% (8.1% in men and 11.3% in women). A multivariate logistic regression model showed that male sex, urban residence, chronic sputum production, and hypertriglyceridemia were associated with increased ORs for early COPD in middle-aged, non-institutionalized Korean adults.ConclusionEarly COPD is prevalent among middle-aged smokers in Korea. Efforts are needed to reduce the potential negative effects of early COPD on public health in Korea and other Asian countries.

Factors Associated with the 30-Day and 1-Year Smoking Abstinence of Women in Korea: The Effect of Nicotine Dependency, Self-Efficacy, and Mental Illness.

Despite the success of tobacco control efforts in reducing smoking rates during the past 50 years, data on the factors contributing to quitting success are still lacking. Smoking-related mortality among women has also not declined. Therefore, this study aimed to characterize sociodemographic features, smoking-related behaviors, mental illness, and smoking cessation in woman smokers in Korea who were registered in the Quitline program. Furthermore, factors associated with 30-day and 1-year successful smoking cessation after enrollment in the Quitline program were investigated. A total of 3360 adult woman Quitline users from 2007 to 2018 were included in the final analysis, with information on their age, education level, marital status, body mass index, frequency of alcohol consumption per month, nicotine dependency, self-efficacy for smoking cessation, presence of a smoking cessation supporter, and mental health history collected upon registration with the Quitline program in Korea. Their cessation outcome was investigated with a 1-year follow-up until the end of 2019. A multiple logistic regression analysis was conducted to identify factors associated with smoking cessation at the 30-day and 1-year follow-ups. The results of the multiple logistic regression analysis indicated that lower nicotine dependency, higher self-efficacy, and the presence of a smoking cessation supporter improved the odds of smoking cessation at the 30-day and 1-year follow-ups. In contrast, users with a mental health condition were less likely to achieve smoking cessation. Incorporating methods to increase self-efficacy in women who decide to quit smoking will contribute to facilitating more attempts to quit and achieving greater success in smoking cessation among woman smokers.

Nicotine Dependence and Stress Susceptibility in E-Cigarette Smokers: The Korea National Health and Nutrition Examination Survey 2013-2017.

BackgroundE-cigarettes are steadily gaining popularity in Korea. However, the characteristics of e-cigarette smokers, especially nicotine dependence and stress susceptibility, have not been evaluated in comparison to those of nonsmokers or combustible cigarette smokers in Korea.MethodsIn this study, 28,059 participants from the Korea National Health and Nutrition Examination Survey (2013–2017) were classified into the following three groups: non-smokers, smokers (current smokers and ex-smokers of combustible cigarettes only), and e-smokers (current smokers and ex-smokers of e-cigarettes regardless of combustible cigarette use).ResultsAmong the participants, 16,980 (60.5%), 9,247 (33.0%), and 1,832 (6.4%) subjects were non-smokers, smokers, and e-smokers, respectively. E-smokers were younger, more educated, and had a higher household income than nonsmokers or smokers. The number of e-smokers who smoked within 5 minutes of waking up (31.5% vs. 19.8%, p<0.001) and who planned to quit smoking within 6 months (39.1% vs. 35.7%, p<0.05) was greater than that of smokers. E-smokers perceived stress as “very much” (7.0% vs. 4.4%, p<0.001) and “a lot” (29.1% vs. 20.5%, p<0.001) compared to non-smokers. Suicidal ideation (6.5% vs. 4.7%, p<0.001), plans (2.4% vs. 1.3%, p<0.001), and attempts (1.1% vs. 0.5%, p<0.001) were higher in e-smokers than in non-smokers. Depressive episodes in 1 year (14.2% vs. 11.4%, p<0.05) and suicidal plans (2.4% vs. 1.8%, p<0.05) were more frequent among e-smokers than among smokers.ConclusionE-smokers were younger, more educated, and had a higher income, but they were more dependent on nicotine and susceptible to stress than non-smokers and smokers. Smoking cessation counseling should be tailored according to the characteristics of e-smokers.

Korean male active smokers: quantifying their smoking habits and the transformation factor among biomarkers in urine and blood

Objectives The aim of the study was to investigate the correlations within the levels of biomarkers in different biological matrices, along with smoking topography variables, among active male smokers in Korea. Accordingly, we defined a transformation factor to convert level of tobacco smoke exposure and impact biomarkers from different biometrics. Methods We examined smoking topography of recruited volunteers using a self-reporting survey. The level of tobacco smoke exposure and impact biomarkers in subjects’ urine and blood were analysed. Results were used to assess the correlations between the topography survey items with biomarkers in biological matrices. The relationship between the biomarkers in urine and blood was analysed. Accordingly, we defined a transformation factor as the ratio of different biomarkers in urine and blood matrices. Results Significant correlations among smoking topography variables and biomarkers were found. Besides, a strong significant association was found among urine and blood cotinine (ρ = 0.817) and NMR (ρ = 0.905). Urine vs blood cotinine and NMR transformation factors were calculated to be 6.17 L-Blood/g-Creatinine and 10.2, respectively. Conclusions The validated transformation factor connects epidemiological cohort studies with tobacco smoking exposure risk assessment. Hence, this study might be beneficial for further habit-based smoking risk assessments to obtain successful regional cession policies.

Experience with ‘National Smoking Cessation Services’ and Intention to Quit among Adult Smokers in Korea

Experience with ‘National Smoking Cessation Services’ and Intention to Quit among Adult Smokers in Korea

Air Pollution and Incidence of Lung Cancer by Histological Type in Korean Adults: A Korean National Health Insurance Service Health Examinee Cohort Study.

Studies have reported associations between long-term exposure to ambient air pollution and lung cancer. However, there have been inconsistent reports of such associations with lung cancer by histological type. Thus, the aim of this study was to assess the association of long-term exposure to particulate matter with an aerodynamic diameter up to 10 μm (PM10) and nitrogen dioxide (NO2) with lung cancer incidence by histological subtype in South Korea. This population-based cohort study included 6,567,909 cancer-free subjects from the Korean National Health Insurance Service (NHIS) database for 2006–2007. We linked population data to Korea Central Cancer Registry data to confirm lung cancer incidence for 2006–2013. Individual exposures to PM10 and NO2 were assessed as five-year average concentrations predicted at subjects’ district-specific home addresses for 2002–2007. We divided these exposures into two categories based on the 75th percentile. Cox proportional hazards models were used to estimate hazard ratios (HRs) of lung cancer incidence for the upper 25% exposure compared to the low 75% by histological subtypes at diagnosis after adjusting for potential confounders. A total of 27,518 lung cancer were found between 2006 to 2013. The incidence of lung cancer was higher in males, smokers, drinkers and subjects with chronic obstructive pulmonary disease. Overall, we did not find an increased risk of lung cancer with higher exposure to PM10 or NO2. However, high exposure to PM10 was associated with increased risk of adenocarcinoma in comparison with lower exposure in males and current smokers (HR, 1.14; 95% CI, 1.03–1.25). This study showed that long-term air pollution exposures were associated with an elevated risk of lung adenocarcinoma in male smokers in Korea.

4.48 Depressive Symptoms and Suicidal Behaviors of Adolescent Non-Daily Smokers in Korea: National Cross-Sectional Study

4.48 Depressive Symptoms and Suicidal Behaviors of Adolescent Non-Daily Smokers in Korea: National Cross-Sectional Study

Residential radon and environmental burden of disease among Non-smokers.

BackgroundLung cancer was the second highest absolute cancer incidence globally and the first cause of cancer mortality in 2014. Indoor radon is the second leading risk factor of lung cancer after cigarette smoking among ever smokers and the first among non-smokers. Environmental burden of disease (EBD) attributable to residential radon among non-smokers is critical for identifying threats to population health and planning health policy.MethodsTo identify and retrieve literatures describing environmental burden of lung cancer attributable to residential radon, we searched databases including Ovid-MEDLINE, -EMBASE from 1980 to 2016. Search terms included patient keywords using ‘lung’, ‘neoplasm’, exposure keywords using ‘residential’, ‘radon’, and outcomes keywords using ‘years of life lost’, ‘years of life lost due to disability’, ‘burden’. Searching through literatures identified 261 documents; further 9 documents were identified using manual searching. Two researchers independently assessed 271 abstracts eligible for inclusion at the abstract level. Full text reviews were conducted for selected publications after the first assessment. Ten studies were included in the final evaluation.ReviewGlobal disability‐adjusted life years (DALYs)(95 % uncertainty interval) for lung cancer were increased by 35.9 % from 23,850,000(18,835,000-29,845,000) in 1900 to 32,405,000(24,400,000-38,334,000) in 2000. DALYs attributable to residential radon were 2,114,000(273,000-4,660,000) DALYs in 2010. Lung cancer caused 34,732,900(33,042,600 ~ 36,328,100) DALYs in 2013. DALYs attributable to residential radon were 1,979,000(1,331,000-2,768,000) DALYs for in 2013. The number of attributable lung cancer cases was 70-900 and EBD for radon was 1,000-14,000 DALYs in Netherland. The years of life lost were 0.066 years among never-smokers and 0.198 years among ever-smoker population in Canada.ConclusionIn summary, estimated global EBD attributable to residential radon was 1,979,000 DALYs for both sexes in 2013. In Netherlands, EBD for radon was 1,000–14,000 DALYs. Smoking population lost three times more years than never-smokers in Canada. There was no study estimating EBD of residential radon among never smokers in Korea and Asian country. In addition, there were a few studies reflecting the age of building, though residential radon exposure level depends on the age of building. Further EBD study reflecting Korean disability weight and the age of building is required to estimate EBD precisely.Electronic supplementary materialThe online version of this article (doi:10.1186/s40557-016-0092-5) contains supplementary material, which is available to authorized users.

Awareness of COPD in a high risk Korean population.

PurposeIncreased awareness and understanding of chronic obstructive pulmonary disease (COPD) is an important aspect of disease management. The aim of this study was to explore COPD awareness among smokers participating in a smoking cessation program.Materials and MethodsFace-to-face interviews were conducted with 289 subjects in three smoking cessation clinics, using a structured questionnaire.ResultsA total of 68.2% of subjects had COPD-related symptoms, and 19.7% were in poor health. Only 1.0% of the subjects knew that COPD was a respiratory disease. A total of 2.4% of subjects had been diagnosed with COPD and received treatment. Television was the most common source of information about COPD, with 57.1% of the subjects receiving information in this way. After being informed about COPD, smoking-cessation willingness increased in 84.1% of the study group. It increased in 86.3% of the subjects without awareness of COPD and in 81.2% of subjects with COPD-related symptoms.ConclusionWe found that awareness of COPD is very poor among current smokers in Korea. Many smokers perceived their health status as good, despite the presence of COPD-related symptoms. As the level of smoking-cessation willingness was different between those with and without awareness of COPD or COPD-related symptoms, a personalized education program with various educational tools may be needed to enhance awareness of the disease and to motivate smokers to quit.

Factors Associated with Intention to Quit Smoking in Community-dwelling Male Adult Smokers

Purpose: This study was conducted to identify the factors associated with intention to quit smoking in community-dwelling male adult smokers in Korea. Methods: This study was cross-sectional research that used data of 4,010 male smokers. Data from the 2013 Community Health Survey were analyzed through multiple logistic regression. Results: Of the male adult smokers, 65.64% reported that they had an intention to quit smoking. In the logistic regression analysis, age, amount of smoking per day, previous attempts to quit smoking, exposure to smoking-quitting campaigns, and toothbrushing after lunch were significantly associated with intention to quit smoking. Conclusion: These factors should be considered in developing policies and population-based smoking cessation programs to increase smoking cessation among Korean men.

Mediating Effects of Self-Efficacy in the Transtheoretical Model Among Adolescent Male Smokers in Korea

This study examined the moderating and mediating effects of self-efficacy on the relationships between predictor variables (decisional balance and processes of change) and the outcome variable (stages of change) using the Transtheoretical Model. Cross-sectional data were collected from 147 current and former smokers at three vocational technical high schools in Korean metropolitan areas. The survey instruments included decisional balance, self-efficacy, processes of change (behavioral and experiential), and stages of change. Regression analyses were used to identify the mediating effects of self-efficacy. Self-efficacy mediated the relationships of decisional balance and behavioral processes with stages of change, but not that of experiential processes with stages of change. The study results will provide valuable information regarding how each predictor variable is connected and path through adoption of smoking cessation behavior. By understanding mechanisms of behavior change, health professionals could develop effective smoking cessation interventions with consideration of roles of self-efficacy in the smoking cessation behavior change. [Asian Nursing Research2009;3(1):15-23].

The Effect of Cigarette Price on Smoking Behavior in Korea

To determine the impact of cigarette prices on the decision to initiate and quit smoking by taking into account the interdependence of smoking and other behavioral risk factors. The study population consisted of 3,000 male Koreans aged > or =20. A survey by telephone interview was undertaken to collect information on cigarette price, smoking and other behavioral risk factors. A two-part model was used to examine separately the effect of price on the decision to be a smoker, and on the amount of cigarettes smoked. The overall price elasticity of cigarettes was estimated at -0.66, with a price elasticity of -0.02 for smoking participation and -0.64 for the amount of cigarettes consumed by smokers. The inclusion of other behavioral risk factors reduced the estimated price elasticity for smoking participation substantially, but had no effect on the conditional price elasticity for the quantity of cigarettes smoked. From the public health and financial perspectives, an increase in cigarette price would significantly reduce smoking prevalence as well as cigarette consumption by smokers in Korea.

An 18-month follow-up study on the influence of smoking on blood antioxidant status of teenage girls in comparison with adult male smokers in Korea

Objectives The influence of cigarette smoking on blood antioxidant status in teenage girls with a history of short-term smoking was followed over 18 mo. Methods Data obtained from female senior high school students (ages 14 to 18 y) in Korea were compared with data obtained from adult male smokers (ages 36 to 51 y) with a long history of smoking and living in the same geographic areas as the teenage subjects. A smoker was a person who had smoked at least three cigarettes a day for at least 1 y for teenagers ( n = 35) or at least 10 cigarettes a day for at least 13 y for adults ( n = 20). Serum, urine, and anthropometric data were obtained from teenagers every 6 mo over an 18-mo period. Samples were collected once from adults. Data were analyzed by Student's t test and Fisher's protected least significant difference test for comparing smokers and non-smokers and for analyzing period effects in each group. Results Serum nicotine and cotinine concentrations were higher in smokers than in non-smokers. Blood pressures were higher in teenage (at 0 and 12 mo) and adult smokers than in non-smokers. Extracellular superoxide dismutase activities and concentrations of serum vitamin C and folate were lower in smokers in the teenage (at 0, 12, or 18 mo) and adult groups. Serum ceruloplasmin activities and thiobarbituric acid-reactive substance production were not influenced by smoking. In adults, serum copper concentrations were higher in smokers than in non-smokers. This parameter for teenagers did not change consistently throughout the study. Conclusions Similar to adults, cigarette smoking by teenagers has a negative effect on oxidant defense systems.