Epidemiology and Health

COVID-19: Original Article

The association between tobacco or nicotine product use behaviors and non-compliance with mask-wearing during the COVID-19 pandemic: a cross-sectional study in Korea: Da-eun Lee, Heewon Kang, Sung-il Cho; Epidemiol Health. 2022;44:e2022087. Published online October 7, 2022; DOI: https://doi.org/10.4178/epih.e2022087

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
It is necessary to investigate tobacco or nicotine product (TNP) use which acts as a risk factor for coronavirus disease 2019 (COVID-19) infection. Especially, wearing a mask is difficult to practice while using TNP. Therefore, this study aimed to examine the association between TNP use behaviors and non-compliance with mask-wearing during the COVID-19 pandemic.
METHODS
The samples of 208,618 Korean adults from 2020 Community Health Survey in Korea were used. As an independent variable, TNP use behaviors such as TNP use status, changes in TNP use after the COVID-19 outbreak, TNP types, and attempt to quit were analyzed. Logistic regression was performed on gender-stratified participants.
RESULTS
Among men, the odds ratio (OR) of current and former TNP users were 2.00 (95% confidence interval [CI], 1.66 to 2.40) and 1.32 (95% CI, 1.09 to 1.60), respectively, compared to never users. In women, OR was 1.50 (95% CI, 1.00 to 2.26) for former users. Cigarette use was more associated with not wearing a mask than non-cigarette tobacco or nicotine product (NCTNP) use (OR, 1.53; 95% CI, 1.12 to 2.08). Men whose TNP use decreased had lower non-compliance (OR, 0.52; 95% CI, 0.36 to 0.74); while women whose TNP use increased had lower non-compliance (OR, 0.13; 95% CI, 0.07 to 0.26).
CONCLUSIONS
Current and former users were less likely to wear masks. Cigarette use was more associated with not wearing a mask than NCTNP use. Changes in TNP use showed association for men and women; however, in the opposite direction. Therefore, more attention should be paid to TNP use prevention and cessation support during the epidemic of respiratory infectious diseases. Moreover, it is necessary to identify risk factors of cigarette users in compliance with mask-wearing.; Summary

Korean summary
담배 또는 니코틴 제품 (Tobacco or Nicotine Products, TNPs) 현재사용자와 과거사용자는 비사용자 대비 마스크 미착용 연관성이 높고, 비궐련 담배 또는 니코틴 제품 (Non-Cigarette Tobacco or Nicotine Products, NCTNPs) 사용자보다는 일반담배 사용자의 마스크 미착용 연관성이 높다. 남성에서는 코로나19 유행 이전 대비 TNPs 사용이 감소했을 때, 여성에서는 증가했을 때 마스크 미착용 연관성이 낮았다. 따라서 호흡기 감염병 유행 시기에는 더욱 TNPs 사용 예방과 금연 지원에 관심을 가질 것을 제안한다.

Key Message
During the epidemic of respiratory infectious diseases, more attention should be paid to tobacco or nicotine products (TNPs) use prevention and cessation support.

Original Articles

The risk of gastric cancer according to changes in smoking status among Korean men: Sung Keun Park, Min-Ho Kim, Chang-Mo Oh, Eunhee Ha, Eun Hye Yang, Woo Yeon Hwang, Ann Hee You, Jae-Hong Ryoo; Epidemiol Health. 2022;44:e2022086. Published online October 7, 2022; DOI: https://doi.org/10.4178/epih.e2022086

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Abstract Summary PDF: Abstract
OBJECTIVES
Smoking is a risk factor for gastric cancer. Studies have shown that the risk of gastric cancer can vary by smoking status and smoking amount at a single point in time. However, few data have been reported about the effect of changes in smoking status over time on the risk of gastric cancer.
METHODS
This study collected data from the National Health Insurance Corporation in Korea on 97,700 Korean men without gastric cancer who underwent health check-ups from 2002 to 2013. The smoking status (never smoked, quit smoking, and currently smoking) of study participants was assessed in 2003-2004 and 2009, and the results were categorized into 7 groups: never-never, never-quit, never-current, quit-quit, quit-current, current-quit, and current-current. Participants were followed until 2013 to identify incident gastric cancer. A multivariate Cox proportional hazard model was used to calculate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) for incident gastric cancer according to changes in smoking status and smoking amount (pack-years).
RESULTS
Compared with group 1 (never-never), participants currently smoking in 2009 (never-current, quit-current, and current-current) had higher HRs for gastric cancer (never-quit: 1.077; 95% CI, 0.887 to 1.306, never-current: 1.347; 95% CI, 0.983 to1.846, quit-quit: 1.086; 95% CI, 0.863 to 1.366, quit-current: 1.538; 95% CI, 1.042 to 2.269, current-quit: 1.339; 95% CI, 1.077 to 1.666, and current-current: 1.589; 95% CI, 1.355 to 1.864, respectively). The risk for gastric cancer was highest in heavy smokers, followed by moderate smokers.
CONCLUSIONS
In all categories of smoking status, current smoking was associated with the highest risk of gastric cancer. Heavy smoking was associated with an increased risk of gastric cancer, even in former smokers.; Summary

Korean summary
현재 흡연자의 경우 과거 흡연여부와 관계 없이 위암의 위험성이 가장 증가한다. 과거 흡연자의 경우에는 흡연량이 많은 경우에는 위암의 위험성이 증가한다. 이런 결과는 금연이나 흡연량을 줄이는 것이 위암의 위험성을 감소시키는데 매우 중요한 요인이란 것을 확인할 수 있다.

Key Message
Current smoking was associated with an increased risk of gastric cancer, regardless of previous smoking status. Although former smoking was not associated with an increased risk of gastric cancer, former smokers with a history of heavy smoking had an increased risk of gastric cancer. These results suggest that smoking cessation and reducing smoking amounts are both important factors in reducing the risk of gastric cancer.

The associations of the national health and productivity management program with corporate profits in Japan: Yuichiro Yano, Hiroshi Kanegae, Koichi Node, Atsushi Mizuno, Akira Nishiyama, Hiromi Rakugi, Hiroshi Itoh, Kaori Kitaoka, Naoki Kashihara, Fumiaki Ikeno, Ichiro Tsuji, Kunio Okada; Epidemiol Health. 2022;44:e2022080. Published online September 23, 2022; DOI: https://doi.org/10.4178/epih.e2022080

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Using a dataset from a survey on national health and productivity management, we identified health and productivity factors associated with organizational profitability.
METHODS
The Ministry of Economy, Trade and Industry conducted an annual survey on Health and Productivity Management between 2014 and 2021. We assessed the associations of organizational health and productivity management using survey questions collected in 2017 and 2018, with the rate of change in profits from 2017 and 2018 to 2020. We identified factors associated with organizational profitability using eXtreme Gradient Boosting, and calculated SHapley Additive exPlanation (SHAP) values for each factor.
RESULTS
Among 1,593 companies (n= 4,359,834 employees), the mean age of employees at baseline was 40.3 years and the proportion of women was 25.8%. A confusion matrix for evaluating model performance had an accuracy of 0.997, precision of 0.993, recall of 0.997, and area under the precision-recall curve of 0.999. The most important factors related to an increase in corporate profits were the percentage of current smokers (SHAP value, 0.121), per-employee cost of health services (0.084) and medical services (0.050); the percentage of full-time employees working in sales departments (0.074) and distribution or customer service departments (0.054); the percentage of employees who slept well (0.055); and the percentage of employees within a company who regularly exercised (0.043).
CONCLUSIONS
Employees’ lifestyle-related health risk factors and organizations’ management systems were associated with organizational profitability. Lifestyle medicine professionals may demonstrate a significant return on investment by creating a healthier and more productive workforce.; Summary

Key Message
Lifestyle medicine professionals may demonstrate a significant return on investment by creating a healthier and more productive workforce

Prediction of cancer survivors’ mortality risk in Korea: a 25-year nationwide prospective cohort study: Yeun Soo Yang, Heejin Kimm, Keum Ji Jung, Seulji Moon, Sunmi Lee, Sun Ha Jee; Epidemiol Health. 2022;44:e2022075. Published online September 13, 2022; DOI: https://doi.org/10.4178/epih.e2022075

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
This study aimed to investigate the factors affecting cancer survival and develop a mortality prediction model for Korean cancer survivors. Our study identified lifestyle and mortality risk factors and attempted to determine whether health-promoting lifestyles affect mortality.
METHODS
Among the 1,637,287 participants in the Korean Cancer Prevention Study (KCPS) cohort, 200,834 cancer survivors who were alive after cancer diagnosis were analyzed. Discrimination and calibration for predicting the 10-year mortality risk were evaluated. A prediction model was derived using the Cox model coefficients, mean risk factor values, and mean mortality from the cancer survivors in the KCPS cohort.
RESULTS
During the 21.6-year follow-up, the all-cause mortality rates of cancer survivors were 57.2% and 39.4% in men and women, respectively. Men, older age, current smoking, and a history of diabetes were high-risk factors for mortality, while exercise habits and a family history of cancer were associated with reduced risk. The prediction model discrimination in the validation dataset for both KCPS all-cause mortality and KCPS cancer mortality was shown by C-statistics of 0.69 and 0.68, respectively. Based on the constructed prediction models, when we modified exercise status and smoking status, as modifiable factors, the cancer survivors’ risk of mortality decreased linearly.
CONCLUSIONS
A mortality prediction model for cancer survivors was developed that may be helpful in supporting a healthy life. Lifestyle modifications in cancer survivors may affect their risk of mortality in the future.; Summary

Korean summary
현재 암 생존자의 사망 위험을 평가하는 데 유용한 한국형 암 생존자 사망률 예측 모델은 없습니다. 본 연구에서는 고령, 남성, 현재 흡연, 당뇨병 병력을 포함한 생활양식 요인이 사망의 고위험 요인인 반면, 운동 습관 및 암의 가족력은 사망 위험을 감소시키는 것으로 나타났습니다. 현재 흡연과 운동 습관은 사망 위험에 영향을 미치는 수정 가능한 두 가지 요소로써, 이러한 생활습관 요인으로 구성된 예측모형은 생활습관 교정을 통해 우리나라 암 생존자의 사망률을 낮출 수 있음을 시사합니다.

Key Message
Currently, there is no Korean mortality prediction model for cancer survivors that would be useful in evaluating their risk of mortality. The present study showed that lifestyle factors, including older age, male sex, current smoking, and history of diabetes were high-risk factors for mortality, while exercise habits and a family history of cancer reduced the risk of mortality. Current smoking and exercise habits are the two modifiable factors that affected the risk of mortality. The prediction model comprising these lifestyle factors implies that the risk of mortality of cancer survivors in Korea can be reduced through lifestyle modification.

COVID-19: Special Article

Smoking, drinking, and physical activity among Korean adults before and during the COVID-19 pandemic: a special report of the 2020 Korea National Health and Nutrition Examination Survey: Sunhye Choi, Jinwook Bahk, Suyeon Park, Kyungwon Oh, Kyunghee Jung-Choi; Epidemiol Health. 2022;44:e2022043. Published online April 25, 2022; DOI: https://doi.org/10.4178/epih.e2022043

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
This study aimed to describe trends in health behaviours between 2011 and 2020 and compare the changes in these behaviours between the 2020 COVID-19 pandemic and previous periods according to socio-demographic variables.

METHODS

This study used data from the 2011 to 2020 Korea National Health and Nutrition Examination Survey. Current cigarette smoking, high-risk drinking, and inadequate physical activity levels were used as health behaviour indicators. The age-standardized prevalence, differences in prevalence between the periods, and the annual percentage change (APC) were calculated.

RESULTS

Current cigarette smoking showed a decreasing trend (APC, -2.6), high-risk drinking remained unchanged, and inadequate physical activity levels increased (APC, 3.5) during 2011-2020. There were significant differences in high-risk drinking (3.1%p; 95% confidence interval [CI], 0.3 to 5.9) and inadequate physical activity levels (4.3%p; 95% CI, 0.4 to 8.1) between 2019 and 2020 in men. Among men, increased high-risk drinking was found in those aged 40-49 years, non-single households, urban residents, and the middle and highest income groups between 2019 and 2020. The low educational group and manual workers among men aged 30-59 years also showed an increased proportion of high-risk drinking. Inadequate physical activity levels also increased among men between 2019 and 2020 in those aged 30-39 years, non-single households, urban residents, and the upper-middle-income group.

CONCLUSIONS

In the first year of the COVID-19 pandemic, Korean men’s high-risk drinking and inadequate physical activity levels increased. In addition to social efforts to reduce the spread of infectious diseases, active measures to positively change health behaviour are needed.

Summary

Korean summary
코로나 대유행 첫 해인 2020년, 한국 남성에서 고위험음주와 부적절한 신체 활동 수준이 증가하였다. 감염성 질환 대유행 시기, 확산을 차단하기 위한 사회적 노력과 더불어 건강행태에 부정적인 여파가 미치지 않도록 적극적인 대책이 필요함을 시사한다.

Key Message
In the first year of the COVID-19 pandemic, Korean men’s high-risk drinking and inadequate physical activity levels increased. Despite Korea's positive performance in various indicators during the COVID-19 pandemic, the socioeconomic and cultural effects of COVID-19 have affected people's health behaviour. In addition to social efforts to reduce the spread of infectious diseases, active measures to positively change health behaviour are needed.

Citations

Citations to this article as recorded by

Changes in food and nutrient intakes in Korean adults before and during the coronavirus disease 2019 pandemic : data from the 2011-2020 Korea National Health and Nutrition Examination Survey
Kyungwon Oh, Suyeon Park, Sihyun Park, Sungha Yun, Hongseok Choi, Eun Kyeong Jeong
Epidemiology and Health.2023;[Epub] CrossRef
Factors affecting decreased physical activity during the COVID-19 pandemic: an age-, gender-, and body mass index-matched study
Jhin-Yi Shin, Jaemoo Lee, Jung-Min Lee, Nam Yoon Ho
Frontiers in Public Health.2023;[Epub] CrossRef
The serotype-specific prevalence of pneumococci in hospitalized pneumonia patients with COPD: a prospective, multi-center, cohort study
Jae Yeol Kim, Jae-Woo Jung, Min-Jong Kang, Deog Kyeom Kim, Hayoung Choi, Young-Jae Cho, Seung Hun Jang, Chang-Hoon Lee, Yeon Mok Oh, Ji Sook Park
The Korean Journal of Internal Medicine.2023;[Epub] CrossRef
Current status of health promotion in Korea
Soo Young Kim
Journal of the Korean Medical Association.2022; 65(12): 776. CrossRef
Changes in the prevalence of metabolic syndrome in Korean adults after the COVID-19 outbreak
Ji-Young Kwon, Sang-Wook Song
Epidemiology and Health.2022; 44: e2022101. CrossRef

Original Articles

The association of pancreatic cancer incidence with smoking status and smoking amount in Korean men: Do Jin Nam, Chang-Mo Oh, Eunhee Ha, Min-Ho Kim, Eun Hye Yang, Hyo Choon Lee, Soon Su Shin, Woo Yeon Hwang, Ann Hee You, Jae-Hong Ryoo; Epidemiol Health. 2022;44:e2022040. Published online April 21, 2022; DOI: https://doi.org/10.4178/epih.e2022040

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2 Citations

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Our study examined the dose-response relationship between smoking amounts (pack-years) and the risk of developing pancreatic cancer in Korean men.

METHODS

Of 125,743 participants who underwent medical health checkups in 2009, 121,408 were included in the final analysis and observed for the development of pancreatic cancer. We evaluated the associations between smoking amounts and incident pancreatic cancer in 4 groups classified by pack-year amounts. Cox proportional hazards models were used to estimate the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) of incident pancreatic cancer by comparing groups 2 (<20 pack-year smokers), 3 (20-≤40 pack-year smokers), and 4 (>40 pack-year smokers) with group 1 (never smokers).

RESULTS

During 527,974.5 person-years of follow-up, 245 incident cases of pancreatic cancer developed between 2009 and 2013. The multivariate-adjusted HRs (95% CIs) for incident pancreatic cancer in groups 2, 3, and 4 were 1.05 (0.76 to 1.45), 1.28 (0.91 to 1.80), and 1.57 (1.00 to 2.46), respectively (p for trend=0.025). The HR (95% CI) of former smokers showed a dose-response relationship in the unadjusted model, but did not show a statistically significant association in the multivariate-adjusted model. The HR (95% CI) of current smokers showed a dose-response relationship in both the unadjusted (p for trend=0.020) and multivariate-adjusted models (p for trend=0.050).

CONCLUSIONS

The risk of developing pancreatic cancer was higher in current smokers status than in former smokers among Korean men, indicating that smoking cessation may have a protective effect.

Summary

Korean summary
본 연구에서는 대한민국 남성을 대상으로 흡연양 및 흡연상태에 따른 췌장암 발병을 분석하였다. 흡연양이 많을수록, 현재 흡연상태일수록 췌장암 발병이 높았고, 금연한 경우 췌장암의 발병이 낮은 것을 확인할 수 있었다.

Key Message
As a result of analyzing the incidence of pancreatic cancer according to the amount of smoking and smoking status among Korean men, it was confirmed that the more smoked and the current smoking status, the higher the incidence of pancreatic cancer, and the lower the incidence of pancreatic cancer when quitting smoking.

Citations

Citations to this article as recorded by

Associations between smoking status and infertility: a cross-sectional analysis among USA women aged 18-45 years
Sijie He, Li Wan
Frontiers in Endocrinology.2023;[Epub] CrossRef
Modifiable Pancreatic Ductal Adenocarcinoma (PDAC) Risk Factors
Natalia Michalak, Ewa Małecka-Wojciesko
Journal of Clinical Medicine.2023; 12(13): 4318. CrossRef

The relationship between poor sleep quality measured by the Pittsburgh Sleep Quality Index and smoking status according to sex and age: an analysis of the 2018 Korean Community Health Survey: Jun Hyun Hwang, Soon-Woo Park; Epidemiol Health. 2022;44:e2022022. Published online February 14, 2022; DOI: https://doi.org/10.4178/epih.e2022022

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Multiple studies have found that cigarette smokers are more likely to experience sleep disturbances than non-smokers. This study aimed to examine various associations between smoking and sleep quality according to sex and age, which have yet to be sufficiently examined in prior studies.

METHODS

Data analysis was conducted using a nationally representative sample of 224,986 Korean adults who participated in the 2018 Korea Community Health Survey. Sleep quality, as the dependent variable, was measured using the Pittsburgh Sleep Quality Index (PSQI), with PSQI scores indicating either good (≤4 points) or poor (>5 points) sleep quality. Multiple logistic regression analysis was performed considering socio-demographic factors, health behaviors, comorbidities, and psychological factors as covariates.

RESULTS

The overall weighted prevalence of poor sleep quality was 39.4% (95% confidence interval, 39.1 to 39.7). In the multivariate model that excluded psychological factors, poor sleep quality positively correlated to smoking for both sexes and all age groups except for male aged ≥65 years. However, in the full model that included psychological factors, statistically significant odds ratios (approximately 1.5) for poor sleep quality according to smoking status were only observed for female under 65 years of age.

CONCLUSIONS

The relationship between poor sleep quality and smoking status differed according to sex and age. In order to improve the quality of sleep, it is necessary to intervene smoking cessation along with solving psychological problems, especially female in middle age and younger.

Summary

Korean summary
한국 성인의 39.4%는 수면의 질(피츠버그 수면의 질 지수(PSQI) 기준)이 낮았다. 성별 및 연령에 따라 흡연과 수면의 질 사이의 관련성은 다르게 나타났다. 구체적으로는 65세 이하의 여성에서 흡연은 수면의 질 악화와 관련성이 있었으나, 남성 또는 65세 이상 여성에서는 흡연과 수면의 질 간 유의한 관련성을 보이지 않았다.

Key Message
In order to improve the quality of sleep, it is necessary to intervene smoking cessation along with solving psychological problems, especially female in middle age and younger.

Citations

Citations to this article as recorded by

The associations between working conditions and subjective sleep quality among female migrant care workers
I-Ming Chen, Tzu-Yun Lin, Yi-Ling Chien, Jennifer Yi-Ying Chen, Jen-Hui Chan, Shih-Cheng Liao, Po-Hsiu Kuo, Hsi-Chung Chen
Frontiers in Public Health.2023;[Epub] CrossRef

Social competence, leisure time activities, and smoking trajectories among adolescent boys: data from the Korean Children & Youth Panel Survey: Eunjung Park, Min Kyung Lim, Jinju Park, Tran Thi Phuong Thao, Sukyung Jeong, Eun Young Park, Jin-Kyoung Oh; Epidemiol Health. 2021;43:e2021066. Published online September 9, 2021; DOI: https://doi.org/10.4178/epih.e2021066

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
The purpose of this study was to identify the trajectories and potential predictors of tobacco use during adolescence in Korea and to develop appropriate strategies for the implementation of tobacco use prevention programs.
METHODS
The trajectory of tobacco use and associated predictors were analyzed for 1,169 male students from grade 6 (age 11-12) to grade 10 (age 15-16) in the Korean Children & Youth Panel Survey from 2012 to 2016.
RESULTS
Three trajectories of smoking experience were identified: non-smokers (class 1: n=775, 82.3%), temporary users (class 2: n=32, 3.4%), and regular users (class 3: n=135, 14.3%). When compared to non-smokers, temporary users had a higher likelihood of living with a single parent, dissatisfaction with grades, having a girlfriend, having been victimized at least once, and having at least 1 delinquent friend in grade 7 (when smoking experimentation was at its peak). Significant factors associated with regular use included having a girlfriend, committing at least 1 type of delinquent behavior, and being a non-reader. Committing at least 1 type of delinquent behavior and having at least 1 delinquent friend were associated with regular users, distinguishing them from temporary users.
CONCLUSIONS
Understanding why adolescents exhibit different trajectories of tobacco use by identifying the factors associated with each trajectory can contribute to the development of tailored prevention strategies and early cessation programs for adolescents.; Summary

Korean summary
2010-2016년 한국아동청소년패널에 포함된 남학생 흡연경험 분석을 통해 3개의 주요 흡연유형이 확인되었다 (비흡연자 82.3%, 일시 흡연자 3.4%, 지속 흡연자 14.3%). 한부모 가정, 학업성적에 대한 불만족, 이성친구를 사귀는 경우, 또래로부터 괴롭힘을 당한 경험, 1명 이상의 비행 친구가 있는 경우 일시 흡연자가 될 가능성이 높고, 비행 경험이 있는 경우, 이성 친구를 사귀는 경우, 독서를 하지 않는 경우 지속 흡연자가 될 가능성이 높았다. 청소년기 성장단계에 따른 흡연유형의 변화와 관련 요인에 대한 분석 결과는 청소년 대상 맞춤형 흡연예방 및 금연 프로그램 마련에 기여할 수 있을 것이다.

Key Message
In adolescence, significant life changes such as increasing academic workloads and various societal influences combined with growing recognition can affect their interest in trying smoking. The current study suggested that societal influence such as living with a single parent, dissatisfaction with grades, having been victimized at least once, and having at least 1 delinquent friend initiates smoking experimentation. Adolescents having a girlfriend, committing at least 1 type of delinquent behavior, and never reading have a greater possibility of smoking continuation for regular use. These findings might contribute to development of tailored prevention and early cessation programs for adolescents.

Effect of tobacco outlet density on quit attempts in Korea: a multi-level analysis of the 2015 Korean Community Health Survey: Jaehyung Kong, Sung-il Cho; Epidemiol Health. 2021;43:e2021048. Published online August 3, 2021; DOI: https://doi.org/10.4178/epih.e2021048

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Abstract Summary PDF: Abstract
OBJECTIVES
This study aimed to examine whether the regional density of tobacco outlets in Korea was associated with the likelihood of attempting to quit among smokers
METHODS
This study was designed as a secondary data analysis of a cross-sectional study. Data from the 2015 Korean Community Health Survey and tobacco outlet registrations in 17 metropolitan cities and provinces with 254 communities in Korea were used for the analysis. In total, 41,013 current smokers (≥19 years of age) were included. Multi-level logistic regression analysis was conducted to investigate regional differences associated with smokers’ attempts to quit and to evaluate the effects of individual and regional characteristics on quit attempts.
RESULTS
Higher tobacco outlet density was associated with lower odds of attempting to quit. Smokers who resided in districts with the highest tobacco outlet density were 18% less likely to attempt quitting (odds ratio, 0.82; 95% confidence interval, 0.70 to 0.98) than smokers who resided in the regions with the lowest tobacco outlet density (intraclass correlation coefficient, 0.030).
CONCLUSIONS
This study showed that quit attempts were related to community-level factors, such as tobacco outlet density, as well as other individual factors. These findings support the implementation of national policies restricting the number of tobacco outlets within communities or zones and limiting tobacco marketing in tobacco outlets.; Summary

Korean summary
본 연구는 2015년 지역사회건강조사에 응답한 19세 이상 현재 흡연자 41,013명을 대상으로 금연 시도와 관련된 개인 수준의 요인과 지역 수준의 요인을 파악하기 위하여 다수준 분석을 실시하였다. 분석결과, 개인 수준의 요인뿐만 아니라 거주하는 지역의 담배소매점 밀집도가 흡연자의 금연 시도와 유의한 관계가 있는 것으로 확인되었다. 흡연조장환경 개선을 위한 담배 공급 감소 노력의 일환으로 지역사회 수준의 담배소매점 관리 정책이 필요하다.

Key Message
This study aimed to investigate whether the environment related to tobacco retailers impacts adult smokers’ attempts to quit smoking, for the first time in South Korea, using nationwide data on tobacco retailers and current smokers. Smokers who resided in districts with the highest tobacco outlet density were 18% less likely to attempt quitting (odds ratio, 0.82; 95% confidence interval, 0.70-0.98) than smokers who resided in the regions with the lowest tobacco outlet density. These findings support the implementation of national policies restricting the number of tobacco outlets within communities or zones and limiting tobacco marketing in tobacco outlets.

Patterns and predictors of smoking relapse among inpatient smoking intervention participants: a 1-year follow-up study in Korea: Seung Eun Lee, Chul-Woung Kim, Hyo-Bin Im, Myungwha Jang; Epidemiol Health. 2021;43:e2021043. Published online June 9, 2021; DOI: https://doi.org/10.4178/epih.e2021043

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Abstract Summary PDF

Abstract

OBJECTIVES
This study aimed to identify relapse patterns in smokers who participated in an inpatient treatment program and to investigate factors related to relapse.

METHODS

The participants comprised 463 smokers who participated in an inpatient treatment operated by the Daejeon Tobacco Control Center from 2015 to 2018. Participants received high-intensity smoking cessation intervention for 5 consecutive days, including pharmacotherapy and behavioral support, and continued with follow-up for 1 year to determine whether they maintained smoking cessation after discharge from inpatient treatment. Kaplan-Meier and Cox proportional hazard models were used in the analysis.

RESULTS

Participants’ relapse rate within 1 year was 72.8%, and 59.8% of participants smoked again within 6 months after participation. A higher number of counseling sessions was significantly associated with a lower risk of relapse (hazard ratio [HR], 0.23; 95% confidence interval [CI], 0.17 to 0.32 for ≥9 vs. ≤5 counseling sessions). Conversely, higher relapse rates were significantly associated with the use of nicotine replacement therapy (NRT) (HR, 1.91; 95% CI, 1.43 to 2.55 for use vs. no use), and higher levels of baseline expired carbon monoxide (CO) (HR, 1.58; 95% CI, 1.21 to 2.06 for expired CO concentrations of 10-19 ppm vs. expired CO concentrations <10 ppm).

CONCLUSIONS

High-intensity smoking cessation interventions in hospital settings can be effective for smoking cessation in smokers with high nicotine dependence. In addition, the results suggest that for quitters to maintain long-term abstinence, they should receive regular follow-up counseling for 1 year after completing a high-intensity smoking cessation intervention.

Summary

Korean summary
• 한국은 국가금연정책의 일환으로 중증고도흡연자를 위해 고강도의 입원형 금연 중재 프로그램을 운영하고 있다. • 고강도 금연 중재를 받은 후 첫 6개월은 재흡연이 가장 빈번히 일어나는 시기였다. • 장기 금연을 유지하기 위해서는 고강도 금연 중재 후에도 1년간 지속적인 추후 상담이 이루어져야 한다.

Key Message
• South Korea operates a high-intensity inpatient treatment program for heavy smokers. • Relapse typically occurred in the first 6 months after completing the intervention. • Continuous 1 year follow-up counseling is important for long-term abstinence.

Citations

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Attitudes and influencing factors associated with smoking cessation: An online cross-sectional survey in China
Jian-Hua Wang, Yu-Feng Yang, Shi-Lei Zhao, Hai-Tao Liu, Lei Xiao, Li Sun, Xi Wu, Dong-Chao Yuan, Li-Yao Ma, Bao-Zhao Ju, Jian-Ping Liu
Tobacco Induced Diseases.2023; 21(June): 1. CrossRef
Factors associated with long-term smoking relapse in those who succeeded in smoking cessation using regional smoking cessation programs
Seung Hun Lee, Yu Hyeon Yi, Young In Lee, Hyo Young Lee, Kyoung-Min Lim
Medicine.2022; 101(31): e29595. CrossRef

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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14 Citations

Abstract Summary PDF Supplementary 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.

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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
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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
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

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4 Citations

Abstract Summary 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

An age-period-cohort analysis of the difference in smoking prevalence between urban and non-urban areas in Japan (2004–2019): Tasuku Okui; Epidemiol Health. 2020;42:e2020072. Published online December 1, 2020; DOI: https://doi.org/10.4178/epih.e2020072

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10 Citations

Abstract PDF Supplementary Material

Abstract

OBJECTIVES
This study aimed to conduct an age-period-cohort (APC) analysis of smoking prevalence trends in urban and non-urban areas in Japan.

METHODS

Data on smoking prevalence from 2004 to 2019 were extracted from the Comprehensive Survey of Living Conditions in Japan. Government ordinance-designated cities and special wards in Tokyo were defined as urban areas. The respondents ranged from 20 years to 79 years old, and were grouped in 5-year intervals. Cohorts were defined for each age group of each year, and those born between 1925-1929 and 1995-1999 were examined. We calculated the estimated smoking prevalence for each age, period, and cohort, as well as the smoking prevalence ratio of non-urban areas compared with urban areas from the APC analysis results.

RESULTS

The magnitude of the decrease in the period effect on smoking prevalence was larger in urban areas than in non-urban areas for both men and women. The smoking prevalence ratio for non-urban areas compared with that of urban areas was above 1 for men at most time points, except in the older age groups. In addition, the prevalence ratio between the areas decreased, particularly as age increased. For women, the smoking prevalence ratio in non-urban areas compared to urban areas was below 1 until cohorts born in the 1970s, but the trend reversed thereafter.

CONCLUSIONS

The results of this study suggest that further smoking control and cessation measures are necessary, particularly for older cohorts in urban women and for younger ages in non-urban men.

Summary

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Wenkai Jiang, Caifei Xiang, Yan Du, Xin Li, Wence Zhou
International Journal of Environmental Research and Public Health.2023; 20(2): 1552. CrossRef
The Usefulness of a Smartphone App–Based Smoking Cessation Program for Conventional Cigarette Users, Heated Tobacco Product Users, and Dual Users: Retrospective Study
Yuko Noda, Ryuhei So, Misaki Sonoda, Takahiro Tabuchi, Akihiro Nomura
Journal of Medical Internet Research.2023; 25: e42776. CrossRef
Pancreatic Cancer and its Attributable Risk Factors in East Asia, Now and Future
Kuiwu Ren, Chunlong Liu, Ziqiang He, Panpan Wu, Jian Zhang, Rui Yang, Tao Cui, Kun Song, Di Cheng, Kui He, Jiangtao Yu
The Oncologist.2023;[Epub] CrossRef
Regional Differences in the Prevalence of Atopic Dermatitis among Schoolchildren in Japan and Its Associated Factors from 2006 to 2018
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Association of Esophageal Cancer Mortality with Municipal Socioeconomic Deprivation Level in Japan, 2013–2017: An Ecological Study Using Nationwide Data
Tasuku Okui, Akie Hirata, Naoki Nakashima
International Journal of Environmental Research and Public Health.2022; 19(9): 5483. CrossRef
Trends in Deaths Attributable to Smoking in China, Japan, United Kingdom, and United States From 1990 to 2019
Haoyu Wen, Cong Xie, Fang Shi, Yan Liu, Xiaoxue Liu, Chuanhua Yu
International Journal of Public Health.2022;[Epub] CrossRef
Decreased head circumference at birth associated with maternal tobacco smoke exposure during pregnancy on the Japanese prospective birth cohort study
Tadashi Shiohama, Aya Hisada, Midori Yamamoto, Kenichi Sakurai, Rieko Takatani, Katsunori Fujii, Naoki Shimojo, Chisato Mori, Michihiro Kamijima, Shin Yamazaki, Yukihiro Ohya, Reiko Kishi, Nobuo Yaegashi, Koichi Hashimoto, Chisato Mori, Shuichi Ito, Zenta
Scientific Reports.2021;[Epub] CrossRef
An analysis of health inequalities depending on educational level using nationally representative survey data in Japan, 2019
Tasuku Okui
BMC Public Health.2021;[Epub] CrossRef
Geographical Differences and Their Associated Factors in Chronic Obstructive Pulmonary Disease Mortality in Japan: An Ecological Study Using Nationwide Data
Tasuku Okui, Jinsang Park
International Journal of Environmental Research and Public Health.2021; 18(24): 13393. CrossRef
Trend of asthma prevalence among children based on regional urbanization level in Japan; 2006–2019
Tasuku Okui
Environmental Analysis Health and Toxicology.2021; 36(4): e2021027. CrossRef

Factors associated with indoor smoking at home by adults across Korea: a focus on socioeconomic status: Bomgyeol Kim, Yejin Lee, Young Dae Kwon, Tae Hyun Kim, Jin Won Noh; Epidemiol Health. 2020;42:e2020067. Published online October 28, 2020; DOI: https://doi.org/10.4178/epih.e2020067

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
Secondhand smoke is an issue that cannot be ignored due to its various negative effects. Especially, secondhand smoke inside the household is an area where health policy must pay attention as it can affect all age groups. This study aims to identify the factors associated with smoking inside the household focusing on socioeconomic status in Korea.
METHODS
We used data from the Community Health Survey of 2017 and a total of 33,462 participated in the study. Data were analyzed through IBM SPSS version 25.0 to conduct binary logistic regression analysis.
RESULTS
Results indicated that indoor smoking had a significant association with socioeconomic status. This association was more marked in those participants who had low household income or those with elementary school education level or less. Furthermore, the study indicates that when the smoker is a woman, older, has higher stress, and is a heavier smoker, the probability of her smoking inside the house is higher.
CONCLUSIONS
Based on the results, it is meaningful that this study has found the factors of smoking inside household. The result identify the factors associated with indoor smoking at home, and it can be used as baseline data for developing new smoking cessation policies.; Summary

Korean summary
이 연구는 가정 실내 흡연과 관련된 다양한 요인들을 파악하였으며, 소득, 교육수준과 같은 사회경제적 요인과 가정 실내 흡연의 연관성을 확인하였다. 이를 통해 가정 실내 흡연 감소를 위한 금연 정책의 근거자료로 활용될 수 있을 것으로 기대된다.

Relationship between smoking status and muscle strength in the United States older adults: R. Constance Wiener, Patricia A. Findley, Chan Shen, Nilanjana Dwibedi, Usha Sambamoorthi; Epidemiol Health. 2020;42:e2020055. Published online July 28, 2020; DOI: https://doi.org/10.4178/epih.e2020055

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3 Citations

Abstract PDF

Abstract

OBJECTIVES
Muscle strength in older adults is associated with greater physical ability. Identifying interventions to maintain muscle strength can therefore improve quality of life. The purpose of this study was to evaluate whether current or former smoking status is associated with a decrease in muscle strength in older adults.

METHODS

Data from the Health and Retirement Study from 2012-2014 were analyzed with regard to maximum dominant hand grip strength, maximum overall hand grip strength, and smoking status (current, former, or never). Unadjusted linear regression was conducted. Other factors known to be related to strength were included in the adjusted linear regression analyses.

RESULTS

For maximum grip strength, the regression coefficient was 4.91 for current smoking (standard error [SE], 0.58; p<0.001), 3.58 for former smoking (SE, 0.43; p<0.001), and 28.12 for never smoking (SE, 0.34). Fully adjusted linear regression on the relationship between dominant hand grip strength and smoking did not yield a significant result. The factors significantly associated with dominant hand grip strength were male sex, younger age, a race/ethnicity of non-Hispanic White or non-Hispanic Black, higher income, morbidity of ≤1 condition, no pain, and moderate or vigorous exercise more than once a week.

CONCLUSIONS

Muscle strength in older adults was not associated with smoking status in the adjusted analysis.

Summary

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