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Trends in health behaviors over 20 years: findings from the 1998-2018 Korea National Health and Nutrition Examination Survey
Soyeon Kim, Sunhye Choi, Jihee Kim, Suyeon Park, Young-Taek Kim, Ok Park, Kyungwon Oh
Epidemiol Health. 2021;43:e2021026.   Published online April 19, 2021
DOI: https://doi.org/10.4178/epih.e2021026
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  • 352 Download
  • 20 Web of Science
  • 17 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to examine the trends in health behaviors in Korean population using data from the Korea National Health and Nutrition Examination Survey (KNHANES).
METHODS
The subjects were 96,408 adults aged 19 years or older who participated in the first (1998) through seventh (2016-2018) KNHANES health interview. The prevalence of health behaviors (cigarette smoking, alcohol drinking, and physical activity) and annual percent change (APC) were estimated using SAS and the Joinpoint program.
RESULTS
The prevalence of current cigarette smoking in men decreased by 2.8%p (APC= -2.8, p< 0.001) annually over the 20-year period, and the prevalence of exposure to secondhand smoke at home substantially decreased compared to 2005 (APC= -8.8, p< 0.001). Compared to 2005, the prevalence of current alcohol drinking in women, but not men, increased (APC= 2.0, p< 0.001), and the prevalence of binge drinking decreased in men (APC= -0.7, p< 0.001) and increased in women (APC= 2.4, p< 0.001). The prevalence of aerobic physical activity decreased from 2014 in both gendersd (p< 0.001). The prevalence of healthy behaviors practice (non-smoking, alcohol abstinence, and aerobic physical activity) was down-trending (APC= -5.3, p< 0.001), especially among women (APC= -6.4, p< 0.001).
CONCLUSIONS
Over the past 20 years, smoking behaviors improved. However, drinking behavior was unchanged and physical activity indicators markedly decreased. More active programs are necessary for improving health behaviors, which are major risk factors linked to chronic diseases.
Summary
Korean summary
국민건강영양조사(1998-2018) 자료를 활용하여 지난 20년간 성인의 건강행태를 분석한 결과 흡연율과 간접흡연 노출률은 지속적으로 감소하였고, 신체활동 실천율 또한 감소하였다. 월간음주율과 폭음률의 경우 남자는 큰 변화가 없었던 반면 여자는 모두 증가하였다.
Key Message
This study aimed to examine the trends in health behaviors in Korean population using data from the 1998-2018 Korea National Health and Nutrition Examination Survey (KNHANES). Over the past 20 years, the prevalence of cigarette smoking and exposure to secondhand smoke in Korean adults consistently decreased, as well as the prevalence of physical activity. There was no considerable change in men, whereas in women, the prevalence of alcohol drinking and binge drinking both increased.

Citations

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  • Variability in the association of smoking status with the prevalence of diabetes mellitus in the Korean population according to different definitions of smoking status: analysis based on the Korea National Health and Nutrition Examination Survey (2014-202
    Yechan Kyung, Young Sook Park, Mi Hyeon Jin, Hae Jeong Lee
    International Journal of Environmental Health Research.2024; : 1.     CrossRef
  • Relationship between Handgrip Strength and Incident Diabetes in Korean Adults According to Gender: A Population-Based Prospective Cohort Study
    Sung-Bum Lee, Min-Kyeung Jo, Ji-Eun Moon, Hui-Jeong Lee, Jong-Koo Kim
    Journal of Clinical Medicine.2024; 13(2): 627.     CrossRef
  • Adherence to Cancer Prevention Guidelines and Cancer Incidence and Mortality: A Population-Based Cohort Study
    Jin-Kyoung Oh, Minji Han, Byungmi Kim, Eun Young Park
    Cancer Research and Treatment.2023; 55(1): 15.     CrossRef
  • Ocular motility disorders following coronavirus disease-19 vaccination
    Kyung-Ah Park, Hyeshin Jeon, Dong Gyu Choi, Jae Ho Jung, Hyun-Jin Shin, Byung Joo Lee, Yeji Moon, Se-Youp Lee, Dong Cheol Lee, Soon Young Cho, Seong-Joon Kim, Sei Yeul Oh, Sunghyuk Moon, Shin Yeop Oh, Daye Diana Choi, Mi Young Choi, Won Jae Kim, Ungsoo Sa
    Graefe's Archive for Clinical and Experimental Ophthalmology.2023; 261(4): 1127.     CrossRef
  • Alcoholic liver disease in relation to cancer incidence and mortality: Findings from a large, matched cohort study in South Korea
    Thi Phuong Thao Tran, Minji Han, Ngoc Minh Luu, Jin‐Kyoung Oh
    Cancer Medicine.2023; 12(7): 8754.     CrossRef
  • Associations of dual use of tobacco cigarettes and e‐cigarettes, sleep duration, physical activity and depressive symptoms among middle‐aged and older Korean adults
    Mi‐Ae You, JiYeon Choi, Youn‐Jung Son
    Nursing Open.2023; 10(6): 4071.     CrossRef
  • Prevalence, Trend, and Risk Factors for Early Chronic Obstructive Pulmonary Disease: An Analysis of the Nationwide Population-Based Survey from 2010 to 2019 in South Korea
    Taeyun Kim, Hyunji Choi, Ju-il Seo, Seung-Jin Kim, Ji-Eun Choi, Minsu Yun, Jihun Kang
    COPD: Journal of Chronic Obstructive Pulmonary Disease.2023; 20(1): 153.     CrossRef
  • Trends in the Quality of Primary Care and Acute Care in Korea From 2008 to 2020: A Cross-sectional Study
    Yeong Geun Gwon, Seung Jin Han, Kyoung Hoon Kim
    Journal of Preventive Medicine and Public Health.2023; 56(3): 248.     CrossRef
  • Association of handgrip strength with new-onset CKD in Korean adults according to gender
    Sung-Bum Lee, Miryung Kim, Hui-Jeong Lee, Jong-Koo Kim
    Frontiers in Medicine.2023;[Epub]     CrossRef
  • Elevated Uric Acid Levels with Early Chronic Kidney Disease as an Indicator of New-Onset Ischemic Heart Disease: A Cohort of Koreans without Diabetes
    Sung-Bum Lee, Hui-Jeong Lee, Ha Eun Ryu, Byoungjin Park, Dong-Hyuk Jung
    Biomedicines.2023; 11(8): 2212.     CrossRef
  • Clinical and life style factors related to the nighttime blood pressure, nighttime dipping and their phenotypes in Korean hypertensive patients
    Byung Sik Kim, Ju Han Kim, Wan Kim, Woo Shik Kim, Sungha Park, Sang Jae Lee, Jang Young Kim, Eun Mi Lee, Sang Hyun Ihm, Wook Bum Pyun, Jeong-Hun Shin, Jinho Shin
    Clinical Hypertension.2023;[Epub]     CrossRef
  • Combinations of lifestyle behaviors and cancer risk among Korean adults
    Ngoc Minh Luu, Thi Tra Bui, Thi Phuong Thao Tran, Thi Huyen Trang Nguyen, Jin-Kyoung Oh
    Scientific Reports.2023;[Epub]     CrossRef
  • Risk for Esophageal Cancer Based on Lifestyle Factors–Smoking, Alcohol Consumption, and Body Mass Index: Insight from a South Korean Population Study in a Low-Incidence Area
    Mi Jung Kwon, Ho Suk Kang, Hyo Geun Choi, Joo-Hee Kim, Ji Hee Kim, Woo Jin Bang, Sung Kwang Hong, Nan Young Kim, Sangkyoon Hong, Hong Kyu Lee
    Journal of Clinical Medicine.2023; 12(22): 7086.     CrossRef
  • Association of Muscle Strength with Non-Alcoholic Fatty Liver Disease in Korean Adults
    Sung-Bum Lee, Yu-Jin Kwon, Dong-Hyuk Jung, Jong-Koo Kim
    International Journal of Environmental Research and Public Health.2022; 19(3): 1675.     CrossRef
  • Association of Handgrip Strength with Diabetes Mellitus in Korean Adults According to Sex
    Sung-Bum Lee, Ji-Eun Moon, Jong-Koo Kim
    Diagnostics.2022; 12(8): 1874.     CrossRef
  • Smoking trajectory and cancer risk: A population-based cohort study
    Minh Luu, Minji Han, Tra Bui, Phuong Thao Tran, Min-Kyung Lim, Jin Oh
    Tobacco Induced Diseases.2022; 20(August): 1.     CrossRef
  • Awareness of and practice toward cancer prevention recommendations: results of the Korean National Cancer Prevention Awareness and Practice Survey in 2021
    Jin-Kyoung Oh, Eunjung Park, Byungmi Kim, Yoon-Jung Choi, E Hwa Yun, Min Kyung Lim, Jeong-Soo Im, Eun Young Park
    Epidemiology and Health.2022; 44: e2022068.     CrossRef
The effect of demographic characteristics on the relationship between smoking and dry mouth in Iran: a cross-sectional, case-control study
Shahla Kakoei, Amir Hossein Nekouei, Sina Kakooei, Hamid Najafipour
Epidemiol Health. 2021;43:e2021017.   Published online February 28, 2021
DOI: https://doi.org/10.4178/epih.e2021017
  • 10,552 View
  • 350 Download
  • 4 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
The effect of age, sex, and other demographic factors on the relationship between smoking and dry mouth remains unknown. The aim of this study was to investigate the effects of demographic characteristics on the relationship between dry mouth, also known as xerostomia, and smoking.
METHODS
This case-control study included 5,640 randomly-selected subjects from the second phase of the Kerman Coronary Artery Disease Risk Factors Study, which observed 10,000 participants from 2014 to 2018. A checklist was used to record the participants’ demographic characteristics and smoking frequency. Each participant completed a six-item Fox questionnaire to measure dry mouth as a dependent variable. The interaction terms of daily cigarette smoking with sex, age, educational level, and marital status were entered into the model. Non-significant terms were removed using hierarchical model selection.
RESULTS
Of the sample, 3,429 (60.8%) did not have dry mouth and were analyzed as controls, whereas 2,211 (39.2%) had xerostomia and were deemed to be cases. Smokers were more likely to have dry mouth in all ages and both sexes (p < 0.001). As male became older, the chance of having dry mouth increased more rapidly than among female smokers (p < 0.001). In addition, female smokers were more likely to have dry mouth than male smokers (p < 0.001).
CONCLUSIONS
The likelihood of dry mouth among daily smokers depended on age and sex. Female smokers were more likely to have dry mouth, and its likelihood increased with age in daily smokers of both sexes, though more rapidly in males.
Summary
Key Message
The relationship between dry mouth as a distressing condition and smoking has been confirmed by many studies, but so far the severity and weakness of this relationship have not been studied in terms of demographic variables. We showed that the female smokers were more likely to have dry mouth. The chance of having dry mouth increase in a male smoker more than a female smoker as age increases.

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  • The prevalence of xerostomia among e-cigarette or combustible tobacco users: A systematic review and meta-analysis
    Xingtong Guo, Lili Hou, Xuepei Peng, Fuyou Tang
    Tobacco Induced Diseases.2023; 21(February): 1.     CrossRef
  • World Workshop on Oral Medicine VIII: Development of a core outcome set for dry mouth: a systematic review of outcome domains for xerostomia
    Paswach Wiriyakijja, Sven Eric Niklander, Alan Roger Santos-Silva, Michal Kuten Shorrer, Melanie Louise Simms, Alessandro Villa, Vidya Sankar, Alexander Ross Kerr, Richeal Ni Riordain, Siri Beier Jensen, Konstantina Delli
    Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology.2023; 135(6): 827.     CrossRef
  • Xerostomia as a key predictor of physical frailty among community-dwelling older adults in Japan: a five-year prospective cohort study from The Otassha Study
    Yuki Ohara, Masahori Iwasaki, Maki Shirobe, Hisashi Kawai, Ayako Edahiro, Keiko Motokawa, Yoshinori Fujiwara, Hunkyung Kim, Kazushige Ihara, Shuichi Obuchi, Yutaka Watanabe, Hirohiko Hirano
    Archives of Gerontology and Geriatrics.2022; 99: 104608.     CrossRef
  • Effect of vitamin E and supragingival scaling on salivary gland function in patients with differentiated thyroid cancer treated with 131I
    Yan Cheng, Huimin Tong, Xiaoqian Li, Xiaomin Zhang, Ju Fang, Rongli Yue, Nan Huang, Jing Tian, Feiyan Yu, Ying Gao
    Nuclear Medicine Communications.2022; 43(9): 995.     CrossRef
Relationship between happiness and tobacco smoking among high school students
Maryam Ataeiasl, Parvin Sarbakhsh, Hossein Dadashzadeh, Christoph Augner, Masoumeh Anbarlouei, Asghar Mohammadpoorasl
Epidemiol Health. 2018;40:e2018009.   Published online March 24, 2018
DOI: https://doi.org/10.4178/epih.e2018009
  • 13,088 View
  • 298 Download
  • 15 Web of Science
  • 14 Crossref
AbstractAbstract PDF
Abstract
OBJECTIVES
Recent research has described negative relationship between happiness and habitual smoking among adolescents. No study of this relationship has been conducted among Iranian adolescents. The aim of the present study was to characterize the relationship between happiness and cigarette or hookah smoking among a sample of high school students.
METHODS
A sample of 1,161 10th-grade students in Tabriz (northwest Iran) was selected by multi-stage proportional cluster sampling. Participants completed a self-administered multiple-choice questionnaire including information on cigarette smoking, hookah smoking, happiness score, substance abuse, self-injury, general risk-taking behavior, attitudes towards smoking, socioeconomic information, and demographic characteristics. An ordinal logistic regression model was used for data analysis.
RESULTS
It was found that 5.9 and 5.0% of students were regular cigarette smokers and regular hookah smokers, respectively. After controlling for potential confounders, higher happiness scores were found to protect students against more advanced stages of cigarette smoking (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.97 to 0.99; p=0.013). However, no significant relationship was found between happiness scores and hookah smoking status (OR, 1.01; 95% CI, 0.97 to 1.02; p=0.523).
CONCLUSIONS
Happiness scores were associated with less advanced stages of habitual cigarette smoking among high school students. Our findings underscore the necessity of conducting longitudinal or interventional studies aiming to determine the effects of enhancing happiness on preventing the transition through the stages of cigarette and hookah smoking.
Summary

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  • Geographic distribution and time trends of water-pipe use among Iranian youth and teenage students: A meta-analysis and systematic review
    Sima Afrashteh, Akram Ansarifar, Mohebat Vali, Leila Nami Nazari, Nasrin Keshtkar, Sara Memar, Elham Mohebbi, Maryam Hadji, Afshin Ostovar, Kazem Zendehdel, Maryam Marzban
    Journal of Ethnicity in Substance Abuse.2023; 22(2): 285.     CrossRef
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    Journal of Substance Use.2023; : 1.     CrossRef
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    Monica Licu, Claudiu G. Ionescu, Maria Suciu, Sorin Păun
    Romanian Journal of Military Medicine.2023; 126(4): 502.     CrossRef
  • Level of happiness among medical students in Bihar-An online survey
    Rajath Rao, BijayaNanda Naik, Saket Shekhar, SantoshKumar Nirala, CM Singh, Manisha Verma, Anuvarshini Ramalingam
    Journal of Education and Health Promotion.2023; 12(1): 305.     CrossRef
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    Children.2022; 9(2): 227.     CrossRef
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    The Clinical Respiratory Journal.2022; 16(6): 425.     CrossRef
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    Elham Ehsani-Chimeh, Haniye Sadat Sajadi, Meysam Behzadifar, Maryam Aghaei, Afsaneh Badrizadeh, Masoud Behzadifar, Nicola Luigi Bragazzi
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    Supa Pengpid, Karl Peltzer
    Journal of Psychology in Africa.2020; 30(4): 354.     CrossRef
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  • Testicular Toxicity of Water Pipe Smoke Exposure in Mice and the Effect of Treatment with Nootkatone Thereon
    Badreldin H. Ali, Suhail Al-Salam, Sirin A. Adham, Khalid Al Balushi, Mohammed Al Za'abi, Sumaya Beegam, Priya Yuvaraju, Priyadarsini Manoj, Abderrahim Nemmar
    Oxidative Medicine and Cellular Longevity.2019; 2019: 1.     CrossRef
  • Explaining the determinants of hookah consumption among women in southern Iran: a qualitative study
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Age-period-cohort analysis of smoking prevalence among young adults in Korea
Yong Ho Jee, Sung-il Cho
Epidemiol Health. 2016;38:e2016010.   Published online March 19, 2016
DOI: https://doi.org/10.4178/epih.e2016010
Correction in: Epidemiol Health 2016;38(0):e2016029
  • 18,432 View
  • 339 Download
  • 10 Web of Science
  • 6 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
Smoking prevalence among Korean men in their thirties is substantially high (approximately 50%). An in-depth analysis of smoking trends among young adults in their twenties is necessary to devise antismoking policies for the next 10 years. This study aimed to identify the contributions of age, period, and birth cohort effects on smoking prevalence in young adults.
METHODS
Subjects comprised 181,136 adults (83,947 men: 46.3%; 97,189 women: 53.7%) aged 19 to 30 years from the 2008-2013 Korea Community Health Survey. Smoking prevalence adjusted with reference to the 2008 population was applied to the age-period-cohort (APC) model to identify the independent effects of each factor.
RESULTS
For men, smoking prevalence rapidly escalated among subjects aged 19 to 22 years and slowed down among those aged 23 to 30 years, declined during 2008 to 2010 but stabilized during 2011 to 2013, and declined in birth cohorts prior to 1988 but stabilized in subjects born after 1988. However, in APC models, smoking prevalence increased with age in the 1988 to 1991 birth cohort. In this birth cohort, smoking prevalence at age 19 to 20 years was approximately 24% but increased to 40% when the subjects turned 23 to 24 years. For women, smoking prevalence was too low to generate consistent results.
CONCLUSIONS
Over the past six years and in recent birth cohorts, smoking prevalence in adults aged 19 to 30 years has declined and is stable. Smoking prevalence should be more closely followed as it remains susceptible to an increase depending on antismoking policies or social conditions.
Summary
Korean summary
우리나라 남자의 30대와 40대의 흡연율은 약 50% 수준으로 매우 높다. 앞으로 10년 뒤에 이들 연령대로 진입하는 20대와 30대 젊은 청년층의 흡연율의 추이를 심층 분석하는 것은 10년 뒤 금연정책 준비에 필요한 기초자료가 될 것이다. 이 연구의 목적은 젊은 청년의 흡연율의 변화추이에 영향을 주는 연령, 연도, 출생코호트 효과를 파악하고자 하였다. 지난 6년 동안 19-30세의 흡연율은 전체적으로 연도가 증가하고 최근 출생코호트로 올수록 감소하는 경향을 보였다. 그러나 최근 출생코호트의 흡연율은 앞으로 금연정책이나 사회적인 상황에 따라 여전히 증가할 여지가 있으므로 주의 깊은 관찰이 필요할 것으로 생각된다.

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    Magdalena Opazo Breton, Laura A. Gray
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    Chien Huey Teh, Sanjay Rampal, Kuang Hock Lim, Omar Azahadi, Aris Tahir
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    Magdalena Opazo Breton, Duncan Gillespie, Robert Pryce, Ilze Bogdanovica, Colin Angus, Monica Hernandez Alava, Alan Brennan, John Britton
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    Seung-Yeon Lee, Saemi Jung, Wanhyung Lee
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    Jin-Won Noh, Kyoung-Beom Kim, Jooyoung Cheon, Yejin Lee, Ki-Bong Yoo
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Health Statistics
Trends in cigarette smoking among adolescents and adults in South Korea
Sunhye Choi, Yoonjung Kim, Suyeon Park, Jihye Lee, Kyungwon Oh
Epidemiol Health. 2014;36:e2014023.   Published online October 28, 2014
DOI: https://doi.org/10.4178/epih/e2014023
  • 42,997 View
  • 390 Download
  • 46 Web of Science
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
This report is to examine changes in the smoking prevalence among adults and adolescents and provide basic data for national health policies. Korea National Health and Nutrition Examination Survey from 1998 to 2013 and Korea Youth Risk Behavior Web-based Survey from 2005 to 2013 were used to estimate national adults and adolescents smoking prevalence. In 2013, current cigarette smoking prevalence among male adults and female adults was 42.1% and 6.2%, decreasing by 1.6% points and 1.7% points, respectively compared to 2012. Among adolescents, current cigarette smoking prevalence was 14.4% for male and 4.6% for female students, decreasing by 1.9%points and 1.3%points, respectively compared to 2012. The highest current cigarette smoking prevalence was observed among adults of lower household income or lower education level and among middle and high school students of lower perceived household economic status or lower perceived academic records. Current cigarette smoking prevalence among male adults has decreased since 2011, whereas among female adults, there were no statistically significant annual changes. Among middle and high school students, the prevalence for male students decreased since 2011 and for female students decreased since 2006. But the smoking prevalence did not meet the Health Plan 2020 target.
Summary
Korean summary
국민건강영양조사(1998~2013)와 청소년건강행태온라인조사(2005~2013) 원시자료를 이용하여 분석한 결과, 2013년 현재흡연율은 성인의 경우 남자 42.1%, 여자 6.2%, 중고등학생은 남자 14.4%, 여자 4.6%이었다. 사회경제적요인별로는 성인의 경우 소득수준이 낮을수록, 교육수준이 낮을수록 현재흡연율이 높았고, 중고등학생은 주관적 가정의 경제적 상태가 낮을수록, 주관적 학업성적이 낮을수록 흡연율이 높았다.

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Original Article
Cigarette Smoking, Alcohol Consumption, and Breast Cancer in Korea.
Dae Hee Kang, Keun Young Yoo, Sue Kyung Park, Hye Won Koo, Jun Suk Suh, Young Chul Kim, Dong Young Noh, Kuk Jin Choe
Korean J Epidemiol. 1998;20(1):60-69.
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Abstract
A hospital-based case-control study was conducted to assess the relationship between cigarette smoking, alcohol consumption, and the risk of bgreast cancer in Korea. Histologically confirmed incident cases of breast cancer(n=146) were selected from the inpatients at the Department of Surgery, Seoul National University Hospital and Borame Hospital during 1994 to 1997. Women ithout self-reported past history of any malignandies were regarded as controls and selected at the same hospitals during the same period(n-153). Information on life-styles including cigarette smoking, alcohol drinking, and reproductive history were obtained by direct interview using standardixed questionnaire. Each case was matched with one control by 5-year age category(n=146). Adjusted odds ratios and 90% confidence intervals were estimated by unconditional linear logistic regression model. For smokers, age at first smoking was significantly associated with the breat cancer risk(adjusted OR=14.1, 90% CI=1.24-364.2). Particularly noteworthy was an increasing tendency of the breast cancer risk with the duration of alcohol consumtion in years aong alcohol drinkers(ptrend<0.1). These findings suggest that cigarette smoking at an earlier age and alcohol intake might contribute to the risk factor of breast cancer in Korean women. Further investigation on the association between genetic polymorphism of xenobiotic metabolism enxymes of environmental carcinogens and breast cancer should be needed.
Summary

Epidemiol Health : Epidemiology and Health