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Original Articles

Factors associated with intention to quit smoking in Indonesia: findings from a cross-sectional Global Adult Tobacco Survey
Dea Anita Ariani Kurniasih, Bunga Astria Paramashanti, Wahyu Pudji Nugraheni, Tities Puspita, Basuki Rachmat, Debri Rizki Faisal
Received January 17, 2025  Accepted June 27, 2025  Published online November 18, 2025  
DOI: https://doi.org/10.4082/kjfm.25.0016    [Epub ahead of print]
Background
Smoking affects human health and healthcare systems worldwide, particularly in Indonesia. We used secondary data from the 2021 Global Adult Tobacco Survey (GATS) to analyze Indonesian smoking cessation determinants.
Methods
We analyzed data from 2,877 individuals aged 15 years and older from the 2021 GATS Indonesia, selected through multistage clustering. We used multiple logistic regression analysis adjusted for the complex survey in STATA 17.0 to examine Indonesian smokers’ intention to quit including age, sex, education, occupation, household wealth, place of residence, perceptions that smoking causes serious illness, efforts to stop smoking in the past, abstinence days in the past, health-related reason, social reason, environmental reason, and financial reason).
Results
Weighted adult intention to quit smoking within 12 months was 17.8%. Factors associated with intention to quit smoking among current smokers in Indonesia included adults age 45 years or older (adjusted odds ratio [AOR], 1.69; 95% confidence interval [CI], 1.12–2.54), completed higher education (AOR, 1.85; 95% CI, 1.01–3.42), working status (AOR, 0.72; 95% CI, 0.55–0.96), perception that smoking causes serious illness (AOR, 2.88; 95% CI, 1.96–4.22), abstinence days in the past >30 days (AOR, 3.10; 95% CI, 2.18–4.41), social reason (AOR, 1.48; 95% CI, 1.05–2.09), and environmental reason (AOR, 1.67; 95% CI, 1.23–2.28).
Conclusion
Intention to quit smoking depends on several factors. Smoking cessation guidelines must be widely and often implemented, especially for high-risk smokers. Pharmacological and non-pharmacological smoking cessation strategies require cooperation among healthcare providers, public health actors, and the government.
  • 510 View
  • 34 Download
The effectiveness of online smoking prevention program for adolescents in South Korea: a comparative analysis with traditional education
HyoRim Ju, EunKyo Kang, Cheol Min Lee, Yooseock Cheong
Received February 6, 2025  Accepted May 2, 2025  Published online October 31, 2025  
DOI: https://doi.org/10.4082/kjfm.25.0030    [Epub ahead of print]
Background
This study aimed to evaluate the effectiveness and engagement of an interactive simulation-based online smoking prevention program compared to a traditional offline program for Korean adolescents.
Methods
A total of 1,008 adolescents from elementary, middle, high, and alternative schools in Chungcheongnam-do Province, South Korea participated in this study from October 1 to 31, 2021. The offline program consisted of 2-hour lectures by teachers, whereas the online program included six interactive peer-oriented video modules. The evaluation compared and analyzed the survey results measuring changes in smoking-related knowledge and attitudes before and after each program, as well as the level of interest in and satisfaction with education.
Results
When comparing the pre- and post-intervention scores between the two groups, no statistically significant differences were found except for a decreased belief that smoking helps relieve stress (F=12.125, P=0.001). However, withingroup comparisons revealed that the online smoking prevention program led to positive changes in most smokingrelated knowledge and attitude items, including reduced beliefs about smoking as a stress reliever (P<0.001) and lower misconceptions about the harm of e-cigarettes (P<0.001). In terms of engagement and satisfaction, the online program received significantly higher scores for interest (P<0.001), knowledge improvement (P<0.001), and program recommendations (P=0.021).
Conclusion
The online smoking prevention program was as effective as the traditional offline approach in enhancing smoking-related knowledge and attitudes. Moreover, its superior engagement and time efficiency highlight its strong potential as an effective alternative or complementary strategy to conventional school-based programs.
  • 520 View
  • 17 Download
The association between urine cotinine level and hemoglobin and hematocrit levels: a cross-sectional study using the Korea National Health and Nutrition Examination Survey VIII (2019–2021)
Jaehyun An, Yaeji Lee, Ehn-Young Kim, Yu-Jin Kwon, Ji-Won Lee
Received August 28, 2024  Accepted February 6, 2025  Published online June 30, 2025  
DOI: https://doi.org/10.4082/kjfm.24.0212    [Epub ahead of print]
Background
Smoking is a global health risk known to elevate hemoglobin (HB) levels through its effects on hematopoiesis. Urine cotinine, a metabolite strongly correlated with serum cotinine, serves as an effective biomarker for assessing smoking status. This study aimed to explore the relationship between urinary cotinine levels and both HB and hematocrit (HCT) levels in a Korean population.
Methods
The study analyzed 4,454 healthy participants, categorized into three groups based on urine cotinine tertiles. Steiger’s Z tests were used to assess correlations between HB, HCT levels, and urine cotinine. After adjusting for clinical variables, multiple linear regression was employed to evaluate the relationship between urine cotinine levels and HB/HCT. Receiver operating characteristic curves helped determine the cut-off values for urine cotinine in relation to HB and HCT levels.
Results
After adjusting for covariates, a positive correlation was found between urine cotinine and both HB and HCT levels. HB levels were 18% higher in the second tertile and 23% higher in the highest tertile than the lowest. Similarly, HCT levels increased by 44% in the second tertile and 50% in the highest tertile. The highest tertiles of HB and HCT had values of 504.650 and 202.950, respectively, with area under the curve values of 0.634 for HB and 0.616 for HCT.
Conclusion
This study demonstrates a significant correlation between urine cotinine levels and elevated HB and HCT levels in a representative Korean population. Clinicians should consider urine cotinine levels when assessing anemia in smokers or individuals exposed to secondhand smoke. Further research is needed to validate these findings.
  • 1,266 View
  • 27 Download
Background
The use of heated tobacco products (HTPs) among Korean adults has been steadily increasing since they were first introduced in 2017. It is known that smoking combustible cigarettes (CCs) adversely affects the serum lipid profile and increases the risk of cardiovascular disease. However, the health impacts of HTPs remain under- researched. This study, therefore, aims to explore the effects of HTP use on serum lipid levels.
Methods
This study involved 10,309 participants, selected from the Korea National Health and Nutrition Examination Survey VII-1 and VIII conducted between 2018 and 2021. Participants were categorized based on their smoking status: “HTPs ever user” included dual, triple, and past HTP users; “current HTPs only user” for those exclusively using HTPs; “current CCs only user” for those exclusively smoking CCs; and “never smoker.” Logistic regression analysis was used to assess the impact of smoking type on serum lipid concentrations.
Results
The analysis revealed that the “HTPs ever user” group had a higher odds ratio (OR) for elevated total cholesterol compared to the “never smoker” group (OR, 1.40; 95% confidence interval [CI], 1.03–1.92). The likelihood of having high low-density lipoprotein (LDL)-cholesterol was greatest in the “current HTPs only user” group when compared to “never smokers” (OR, 1.71; 95% CI, 1.01–2.89).
Conclusion
The findings indicate that exclusive use of HTPs is linked to an increased level of serum LDL-cholesterol. Further longitudinal studies are necessary to fully determine the health risks associated with HTPs.

Citations

Citations to this article as recorded by  
  • The chemical profile and toxicological impact of heated tobacco products
    M. Davigo, F. J. van Schooten, A. Opperhuizen, A. H. V. Remels, R. Talhout
    Inhalation Toxicology.2026; : 1.     CrossRef
  • Unveiling the risks of noncombustible nicotine or tobacco products
    Su-Min Jeong
    Korean Journal of Family Medicine.2025; 46(5): 297.     CrossRef
  • 9,054 View
  • 137 Download
  • 1 Web of Science
  • 2 Crossref
Effect of electronic cigarettes on the change of Fagerstrom Test for Nicotine Dependence scores during 1-year follow-up
Saksorn Meelarp, Pantitra Singkheaw, Thanin Chattrapiban
Korean J Fam Med 2025;46(6):409-417.   Published online November 13, 2024
DOI: https://doi.org/10.4082/kjfm.24.0038
Background
The use of e-cigarettes is increasing globally, particularly among young adults. Although several use them to quit smoking, their effects are controversial. The Fagerstrom Test for Nicotine Dependence (FTND) was used to assess nicotine dependence in the smoking cessation process. This study examined changes in FTND scores among young adults using different types of cigarettes over a 1-year period.
Methods
Prospective cohort data were collected from cigarette users at higher education institutions in the lower northern region of Thailand to analyze changes in FTND scores over a 1-year period. E-cigarette users and combined users were compared with conventional cigarette users. A marginal structural model (MSM) with an inverse probability of weighting (IPW) was used to adjust for time-dependent and time-independent confounders.
Results
Of the 133 participants, 58 were e-cigarette users (43.6%), 33 were combined cigarette users (24.8%), and 42 were conventional cigarette users (31.6%). The results revealed that when both time-dependent and time-independent confounders were adjusted using MSM with IPW, e-cigarette users had a 0.20 decrease in the mean FTND score, and combined users had a 0.47 decrease in the mean FTND score compared to conventional cigarette users. However, the difference was not statistically significant.
Conclusion
The use of e-cigarettes or combined cigarettes did not significantly affect nicotine dependence levels in young adults over a 1-year period. Consequently, e-cigarettes should not be recommended to reduce nicotine dependence among young adult cigarette users. Further studies are required to determine whether e-cigarettes affect smoking cessation rates.

Citations

Citations to this article as recorded by  
  • A year of significant progress for the Korean Journal of Family Medicine
    Seung-Won Oh
    Korean Journal of Family Medicine.2026; 47(1): 1.     CrossRef
  • 4,711 View
  • 105 Download
  • 1 Crossref
Tobacco cessation: screening and interventions
Yoo-Bin Seo, Sang-Wook Song, Sung-Goo Kang, Soo Young Kim
Korean J Fam Med 2025;46(1):12-19.   Published online October 29, 2024
DOI: https://doi.org/10.4082/kjfm.24.0034
Background
Tobacco use has been the leading cause of disease and death in South Korea. Early detection of tobacco use and evidence-based interventions play pivotal roles in facilitating tobacco cessation.
Methods
In accordance with the earlier iterations of the Lifetime Health Maintenance Program (2009) and recent recommendations from the United States Preventive Services Task Force (USPSTF; 2021), two themes were chosen for investigation: the identification of and intervention for tobacco use. The USPSTF recommendations were formulated by conducting an overview of reviews. In this study, literature searches and quality assessments of reviews were conducted.
Results
The findings highlighted the efficacy of physician-led identification and advising in promoting tobacco cessation, with robust evidence supporting the implementation of behavioral and pharmacological interventions. These interventions significantly increased the likelihood of successful cessation compared with usual care. Digital interventions, such as internet- or mobile-based interventions, showed additive effects for quitting.
Conclusion
Identification and targeted interventions are essential for tobacco cessation. By leveraging evidencebased strategies and enhancing access to resources, healthcare providers can empower individuals to achieve successful tobacco cessation and improve overall health outcomes.

Citations

Citations to this article as recorded by  
  • A year of significant progress for the Korean Journal of Family Medicine
    Seung-Won Oh
    Korean Journal of Family Medicine.2026; 47(1): 1.     CrossRef
  • 4,445 View
  • 120 Download
  • 1 Crossref
Association between use of combustible cigarettes and noncombustible nicotine or tobacco products and health-related quality of life in Korean men: a nationwide population-based study
Chae-Won Baek, Joo-Hyun Park, Do-Hoon Kim, Hyun-Jin Kim, An-Na Lee, Jung-Hwa Shin, Sung-Kwon Cho, Hye-In Kim, Ye-Ram Choi
Korean J Fam Med 2025;46(5):359-368.   Published online September 11, 2024
DOI: https://doi.org/10.4082/kjfm.23.0179
Background
Although the association between smoking and health-related quality of life (HRQoL) has been established, the effects of tobacco products, including combustible cigarettes (CCs) and non-combustible nicotine or tobacco products (NNTPs), on HRQoL remain unclear. This study examined the association between tobacco use and HRQoL in Korean men.
Methods
Data from the Korea National Health and Nutrition Examination Survey conducted between 2013 and 2020 were analyzed. A total of 16,429 male participants aged ≥19 years completed the European Quality of Life-5 Dimensions (EQ-5D). Impaired HRQoL was defined as scoring in the lowest 20% of the EQ-5D index and having some or extreme problems in the following five domains of the EQ-5D: mobility, self-care, usual activities, pain/ discomfort, and anxiety/depression. Multiple logistic regression was conducted to evaluate the risk of impaired HRQoL in current tobacco users.
Results
Current tobacco users exhibited a significantly higher risk of impaired HRQoL compared with never users (odds ratio [OR], 1.42; 95% confidence interval [CI], 1.05–1.92). Compared to never users, current tobacco users reported more problems with mobility and pain/discomfort (all P<0.05). Moreover, compared with former tobacco users, current tobacco users had a higher risk of impaired HRQoL (OR, 1.60; 95% CI, 1.18–2.17). Compared to former tobacco users, current tobacco users reported more problems with mobility and pain/discomfort (all P<0.05).
Conclusion
Use of CCs and NNTPs is associated with impaired HRQoL in Korean men. Therefore, further interventions for lifestyle modification and smoking cessation treatments are required to reduce the risk of impaired HRQoL among current tobacco users.

Citations

Citations to this article as recorded by  
  • A year of significant progress for the Korean Journal of Family Medicine
    Seung-Won Oh
    Korean Journal of Family Medicine.2026; 47(1): 1.     CrossRef
  • Unveiling the risks of noncombustible nicotine or tobacco products
    Su-Min Jeong
    Korean Journal of Family Medicine.2025; 46(5): 297.     CrossRef
  • 3,297 View
  • 86 Download
  • 1 Web of Science
  • 2 Crossref
Association between e-cigarette smoking and insulin resistance using the triglyceride-glucose index in Korean adults: Korea National Health and Nutrition Examination Survey
Dahae Lim, Jung In Choi, Ryuk Jun Kwon, Sang Yeoup Lee, Young Hye Cho, Eun Ju Park, Youngin Lee, Sae Rom Lee, Soo Min Son, Yun Jin Kim, Jeong Gyu Lee, Yu Hyeon Yi, Young Jin Tak, Seung Hun Lee, Gyu Lee Kim, Young Jin Ra
Korean J Fam Med 2025;46(5):327-332.   Published online August 20, 2024
DOI: https://doi.org/10.4082/kjfm.23.0141
Background
Insulin resistance contributes to the development of cardiovascular disease and type 2 diabetes mellitus. Smoking leads to an increase in triglyceride levels, which, in turn, increases insulin resistance. Although the number of e-cigarette users has increased in recent years, few studies have investigated the association between ecigarette use and insulin resistance. Therefore, this study aimed to determine the association between e-cigarette use and insulin resistance using the triglyceride-glucose (TyG) index in Korean adults.
Methods
This study included 4,404 healthy adults aged ≥20 years who participated in the Korea National Health and Nutrition Examination Survey between 2019 and 2020. Participants were categorized as never-smokers or ecigarette users, and the TyG index was categorized into low- and high-TyG index groups according to the median value (9.22). A logistic regression analysis was performed to determine the association between e-cigarette smoking and insulin resistance.
Results
E-cigarette users had a higher TyG index than never smokers (e-cigarette: mean=9.35; never: mean=9.18; P<0.001). The ecigarette users had a higher risk of being in the high TyG index group than never-smokers (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.03–1.84). In the subgroup analysis stratified by sex, age, and body mass index, a higher OR for a high TyG index was observed in men (OR, 1.46; 95% CI, 1.03–2.08) and individuals aged 60 years or older (OR, 3.74; 95% CI, 1.14–12.30).
Conclusion
Our findings suggest that e-cigarette use is significantly associated with insulin resistance.

Citations

Citations to this article as recorded by  
  • Association Between Electronic Cigarette Use and Risk of Obstructive Sleep Apnea Among Korean Adults: A Cross-Sectional Nationwide Population-Based Study
    Wonseok Jeong, Min Ji Song, Ji Hye Shin, Ji Hyun Kim
    Journal of Clinical Medicine.2025; 14(11): 3616.     CrossRef
  • Unveiling the risks of noncombustible nicotine or tobacco products
    Su-Min Jeong
    Korean Journal of Family Medicine.2025; 46(5): 297.     CrossRef
  • 10,772 View
  • 153 Download
  • 3 Web of Science
  • 2 Crossref
Background
Noncombustible nicotine or tobacco product (NNTP) use, and cigarette smoking are associated with a high likelihood of unhealthy weight control behaviors (UWCBs) among adolescents. However, no study has addressed the differences in UWCBs among non-users, single users of combustible cigarettes (CCs) or NNTPs and dual users. This study compared the frequencies of weight control behaviors according to the status of CC and NNTP use among Korean adolescents.
Methods
This was a cross-sectional study of 25,094 adolescents who had attempted to reduce or maintain their body weight during the past 30 days, using data from the 15th Korea Youth Risk Behavior Survey, 2019. Data on the status of CC and NNTP use, weight status, and weight control behaviors were obtained using self-report questionnaires. Subjects were categorized into four groups: non-users, cigarette-only users, NNTP-only users, and dual users.
Results
Among boys and girls, current smokers and NNTP users were 8.9%±0.3% and 5.5%±0.3%, and 4.2%±0.2% and 1.7%±0.1%, respectively. Among boys, NNTP-only users were more likely to engage in extreme weight control behaviors than non-users. Among girls, users of either CCs or NNTPs were more likely to engage in extreme weight control behaviors and less extreme weight control behaviors than non-users.
Conclusion
This study shows that users of either CCs or NNTPs are more likely to engage in UWCBs, and NNTP-only users are the most likely to do so.

Citations

Citations to this article as recorded by  
  • Reflecting on progress and challenges: the Korean Journal of Family Medicine in 2024
    Seung-Won Oh
    Korean Journal of Family Medicine.2025; 46(2): 55.     CrossRef
  • Longitudinal Associations between Adolescent Electronic Cigarette Use and Eating Behaviors
    Saira Sarwar, W. Alex Mason, Jennifer Mize Nelson, Kimberly Andrews Espy, Timothy D. Nelson
    Substance Use & Misuse.2025; 60(14): 2144.     CrossRef
  • The Interconnected Nature of Smoking, Depression, and Obesity in Behavioral Medicine
    Joung Sik Son
    Korean Journal of Family Medicine.2024; 45(4): 181.     CrossRef
  • 4,366 View
  • 64 Download
  • 3 Web of Science
  • 3 Crossref

Review Article

Evidence-Based Guideline for the Treatment of Smoking Cessation Provided by the National Health Insurance Service in Korea
Cheol Min Lee, Yoo-Bin Seo, Yu-Jin Paek, Eon Sook Lee, Hye Seon Kang, Soo Young Kim, Sungwon Roh, Dong Won Park, Yoo Suk An, Sang-Ho Jo, The Guideline Development Group for Developing the Korean Clinical Practice Guideline for Tobacco Cessation
Korean J Fam Med 2024;45(2):69-81.   Published online February 28, 2024
DOI: https://doi.org/10.4082/kjfm.23.0142
Although major countries, such as South Korea, have developed and disseminated national smoking cessation guidelines, these efforts have been limited to developing individual societies or specialized institution-based recommendations. Therefore, evidence-based clinical guidelines are essential for developing smoking cessation interventions and promoting effective smoking cessation treatments. This guideline targets frontline clinical practitioners involved in a smoking cessation treatment support program implemented in 2015 with the support of the National Health Insurance Service. The Guideline Development Group of 10 multidisciplinary smoking cessation experts employed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE)-ADOLOPMENT approach to review recent domestic and international research and guidelines and to determine evidence levels using the GRADE methodology. The guideline panel formulated six strong recommendations and one conditional recommendation regarding pharmacotherapy choices among general and special populations (mental disorders and chronic obstructive lung disease [COPD]). Strong recommendations favor varenicline rather than a nicotine patch or bupropion, using varenicline even if they are not ready to quit, using extended pharmacotherapy (>12 weeks) rather than standard treatment (8–12 weeks), or using pharmacotherapy for individuals with mental disorders or COPD. The conditional recommendation suggests combining varenicline with a nicotine patch instead of using varenicline alone. Aligned with the Korean Society of Medicine’s clinical guideline development process, this is South Korea’s first domestic smoking cessation treatment guideline that follows standardized guidelines. Primarily focusing on pharmacotherapy, it can serve as a foundation for comprehensive future smoking cessation clinical guidelines, encompassing broader treatment topics beyond medications.

Citations

Citations to this article as recorded by  
  • Korean Clinical Practice Guideline of Korean Society for Research on Nicotine and Tobacco (KSRNT) and National Evidence-Based Healthcare Collaborating Agency (NECA) on Treatment of Tobacco Use 2024
    Yoo-Bin Seo, Haine Lee, Yu-Jin Paek, Hyeon-Jeong Lee, Cheol Min Lee, Eon Sook Lee, Heejin Kimm, Hye-Ji An, Eun-Jung Bae, Ji Soo Kim, Sungwon Roh, Yoo Suk An, Sang-Ho Jo, Seo Young Kang, Yun Hee Kim, Kyung Hyun Suh, Sang Hwa Shin, Jin-Kyoung Oh, Dong Won P
    Journal of Korean Medical Science.2025;[Epub]     CrossRef
  • 13,173 View
  • 135 Download
  • 1 Web of Science
  • 1 Crossref

Original Articles

Tobacco Use among School-Age Adolescents in Indonesia: Findings from the 2015 Indonesia Global School-Based Student Health Survey
Zulfikar Ihyauddin, Dwi Astuti Dharma Putri, Jeslyn Tengkawan, Fitriana Murriya Ekawati, Mei Neni Sitaresmi
Korean J Fam Med 2023;44(6):327-334.   Published online August 31, 2023
DOI: https://doi.org/10.4082/kjfm.23.0010
Background
Although Indonesia has a considerable proportion of adolescent smokers, nationally representative studies of its determinants remain limited. The 2015 Indonesian Global School-Based Student Health Survey (GSHS) was conducted with school-age adolescents and provided information about smoking behavior. This study aimed to examine the prevalence, determinants, and correlates of tobacco use among adolescents in Indonesia using the GSHS survey.
Methods
A secondary data analysis of a cross-sectional study was conducted using data from the 2015 Indonesian GSHS. Multivariate logistic regression was used to assess the determinants and correlates of tobacco use.
Results
Our analysis showed that 9.1% of school-age adolescents had used tobacco products in the past 30 days. Most were 13–15 years (61.7%) and had attempted to stop smoking (92.4%). After adjusting for covariates, significant risk factors associated with tobacco smoking were older age groups (prevalence odds ratio [POR], 3.01–9.40; 95% confidence interval [CI], 1.71–23.1), male (POR, 13.7; 95% CI, 8.71–21.5), psychological distress (POR, 1.41; 95% CI, 1.05–1.90), smoking exposure (POR, 1.98–2.15; 95% CI, 1.35–3.42), and when both parents smoked (POR, 2.96; 95% CI, 1.78–4.94). In addition, tobacco use was associated with other risky behaviors, including sex with multiple partners, using drugs, drinking alcohol, and being involved in physical fights.
Conclusion
Tobacco use is high among Indonesian adolescents. This prevalence highlights the need for a more stringent tobacco control policy and tailored cessation programs for adolescents by considering important modifiable determinants of tobacco use among adolescents, including risky smoking-related behaviors.

Citations

Citations to this article as recorded by  
  • Associação entre consumo de álcool, tabagismo e atividade física em adolescentes escolares sul-americanos
    José Ywgne, André Oliveira Werneck, Bruno Bizzozero-Peroni, Diego Giulliano Destro Christófaro, Fernanda Castro Monteiro, Ingrid Kelly Alves dos Santos Pinheiro, Kabir Prem Sadarangani, Rafael Miranda Tassitano, Danilo Rodrigues Pereira da Silva
    Revista Brasileira de Atividade Física & Saúde.2025; 29: 1.     CrossRef
  • Correlation between religiosity, family functioning, and factors associated with substance use among secondary school students in high-risk areas
    Noor Adnin Ab Aziz, Suzaily Wahab, Rosnah Sutan, Muhammad Adib Baharom, Amirul Danial Azmi, Siti Azirah Asmai, Gerard Hutchinson
    PLOS One.2025; 20(7): e0308192.     CrossRef
  • Predictor of smoking cessation among school-going adolescents in Indonesia: a secondary analysis based on the transtheoretical model of behavioral change
    Omid Dadras
    Frontiers in Psychiatry.2024;[Epub]     CrossRef
  • Pharmacotherapy guidelines for smoking cessation in primary healthcare clinics
    Cheol Min Lee, Yu Jin Paek, Yoo Bin Seo, Eon Sook Lee
    Journal of the Korean Medical Association.2024; 67(4): 230.     CrossRef
  • Exploring Behavioral and Pharmacological Interventions against Excessive Tobacco Use
    Dalmacito A. Cordero
    Korean Journal of Family Medicine.2024; 45(4): 231.     CrossRef
  • 5,131 View
  • 116 Download
  • 5 Web of Science
  • 5 Crossref
Background
Smoking can reduce taste sensitivity, the ability to sense various tastes, and diet quality and can increase the incidence of diseases such as hypertension. This study aimed to analyze the association between the smoking amount, subjective salt preference, and salt-related eating behaviors.
Methods
Data of more than 16 million individuals from the Korean Community Health Survey were used. Forest plots were drawn to compare the cumulative odds ratios of salt taste preference and salt-related eating behaviors, adjusted for sex, age, body mass index, education level, household income, marital status, and drinking status at various smoking levels.
Results
Subjective salt preference and salt-related eating behaviors increased with smoking amount; the adjusted odds ratios (AORs) for smoking >20 cigarettes were higher than those for smoking <20 cigarettes. For daily smokers, the AOR was 1.27 (95% confidence interval [CI], 1.22–1.31) for 1–5 cigarettes per day and 1.68 (95% CI, 1.65–1.71) for 16–20 cigarettes per day (P<0.001). Smokers were more likely to have more frequent salt-related eating behaviors than nonsmokers.
Conclusion
The subjective salt preference of smokers was higher than that of nonsmokers. Additionally, smokers used salt or soy sauce and dipped fried food in soy sauce more frequently than nonsmokers, which was also related to smoking amount.

Citations

Citations to this article as recorded by  
  • Effects of opioid blockade on taste perception across smoking status: an analysis of detection thresholds, intensity, and pleasantness
    Justin J. Anker, Mustafa al’Absi
    Journal of Neural Transmission.2025; 132(9): 1411.     CrossRef
  • Cross sectional study on the prevalence and associated factors of iodine status in the population of Lausanne
    Pauline Ducraux, Aurélien Thomas, Maïwenn Perrais, Julien Vaucher, Pedro Marques-Vidal
    Scientific Reports.2025;[Epub]     CrossRef
  • Trend analysis and projection of gastric cancer burden linked to high sodium intake in China, Japan, Republic of Korea, and Mongolia (1990–2021): A comprehensive assessment based on the 2021 global burden of disease study
    Xiaohuang Yang, Shaoxing Chen, Canmei Zhong, Yadong Lai, Fenglin Chen, Ricardas Radisauskas
    PLOS One.2025; 20(12): e0338030.     CrossRef
  • 4,956 View
  • 68 Download
  • 4 Web of Science
  • 3 Crossref
Associations of Alcohol Consumption and Smoking Behaviors with Depressed Mood According to Gender in Korean Young Adults
Jung Won Hwang, Youngmi Eun, Chan-Hee Song
Korean J Fam Med 2023;44(5):274-280.   Published online July 7, 2023
DOI: https://doi.org/10.4082/kjfm.22.0146
Background
Recent studies have reported that chronic mental health problems often emerge in young adulthood. This study elucidated the independent effects of smoking and drinking on depressed mood in young adults by sex.
Methods
We used Data from the Korea National Health and Nutrition Examination Surveys conducted in 2014, 2016, and 2018. A total of 3,391 participants aged 19–35 years, without serious chronic diseases, were recruited for this study. Depression was evaluated using the Patient Health Questionnaire (PHQ-9).
Results
Smoking behavior, current smoking, and number of days smoked were significantly associated with higher PHQ-9 scores in both men and women (all P<0.05). However, past and ever smoking were positively associated with PHQ-9 scores only in women (all P<0.001). Regarding alcohol consumption, the age at which drinking first began was negatively associated with PHQ-9 scores in both men and women (all P<0.001), but the amount of alcohol consumed at 1 time was positively associated with PHQ-9 scores only in women (P=0.013). Men who drank 2–4 times a month and women who had not drunk during the past year had the lowest PHQ-9 scores.
Conclusion
Smoking and alcohol consumption were independently associated with depressed mood in young Korean adults, which was more pronounced in women, and exhibited sex-specific characteristics.

Citations

Citations to this article as recorded by  
  • Articles published in Korean Journal of Family Medicine: impact of COVID-19 on study trends
    Byung Ho Kong, Jae Kyung Choi, San-Sung Lee, Ji Young Kim
    Korean Journal of Family Medicine.2025; 46(5): 316.     CrossRef
  • Comparison of Depression-related Factors among Young Adults Pre- and Post-COVID-19: Focusing on the Early Pandemic Period
    So Hyun Kim
    Journal of Health Informatics and Statistics.2025; 50(4): 370.     CrossRef
  • Women’s Health and Primary Care
    Seung-Won Oh
    Korean Journal of Family Medicine.2024; 45(1): 1.     CrossRef
  • Pharmacotherapy guidelines for smoking cessation in primary healthcare clinics
    Cheol Min Lee, Yu Jin Paek, Yoo Bin Seo, Eon Sook Lee
    Journal of the Korean Medical Association.2024; 67(4): 230.     CrossRef
  • 5,547 View
  • 118 Download
  • 3 Web of Science
  • 4 Crossref
Comparison of the Smoking Cessation of Heated Tobacco Product Users and Conventional Cigarette Smokers in Korea
Doyeon Won, Wonyoung Jung, Dongwook Shin
Korean J Fam Med 2023;44(3):151-157.   Published online May 20, 2023
DOI: https://doi.org/10.4082/kjfm.22.0142
Background
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.
Methods
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.
Results
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.
Conclusion
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.

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  • 6 Web of Science
  • 9 Crossref
Background
After the advent of heated tobacco products (HTPs) in 2017, domestic cigarette sales declined until 2019, but have increased in South Korea since 2020. This study aimed to analyze tobacco use and cessation behavior among HTP users compared with conventional cigarette (CC) users.
Methods
We analyzed data from the eighth Korea National Health and Nutrition Examination Survey (2019). Of 6,188 study participants, 1,181 were current tobacco product users (single, dual, and triple), including all combinations of CCs, HTPs, and electronic cigarettes (ECs). Tobacco use and cessation behaviors among single and dual users of CCs and HTPs were assessed using various categorical methods.
Results
In 2019, proportions of HTP use in men and women aged ≥19 years in South Korea were 8.8% and 1.5%, respectively, and those of single, dual, and triple users were 23.6%, 58.0%, and 18.4%, respectively. Dual users had more tobacco use than CC only and HTP only users (all P<0.001). Each daily user accounted for a lower percentage of attempt and preparation stages for cessation than intermittent users (all P<0.001, except for dual users).
Conclusion
In this study, we analyzed the differences in tobacco use and cessation behavior among CC and HTP users in various populations in South Korea. Additionally, we found that all novel tobacco product users had already experienced CCs in adulthood. Further studies that address HTP’s harmful effects in humans are necessary.

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    Cheol Min Lee
    Journal of the Korean Medical Association.2022; 65(12): 789.     CrossRef
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Exposure to Secondhand Smoke and a Tobacco-Specific Carcinogen in Non-Smokers
Jae-woo Lee, Woojung Yang, Ye-Seul Kim, Yonghwan Kim, Hyo-Sun Yoo, Hee-Taik Kang
Korean J Fam Med 2022;43(2):117-124.   Published online March 17, 2022
DOI: https://doi.org/10.4082/kjfm.21.0073
Background
The International Agency for Research on Cancer classifies 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol (NNAL) as a known carcinogen. This study aimed to investigate the association between exposure to secondhand smoke (SHS) and NNAL concentrations in non-smokers.
Methods
This was a cross-sectional study based on data from the 2016 to 2018 Korea National Health and Nutrition Examination Survey. Urine NNAL concentrations were categorized into tertiles of 3,615 study participants who were non-smokers. All sampling and weight variables were stratified, and analyses to account for the complex sampling design were conducted.
Results
The overall, male, and female percentages of SHS exposure among non-smokers were 22.4%, 29.2%, and 20.4%, respectively. The geometric means of urine NNAL concentrations were 1.896±0.098 pg/mL and 1.094±0.028 pg/mL in the SHS exposure and non-exposure groups, respectively. After adjusting for confounding variables, in the total group, the geometric mean of urine NNAL concentrations was significantly higher in the SHS exposure group than in the SHS non-exposure group (adjusted P-value <0.001). Compared with the non-exposure group, the adjusted odds ratios (95% confidence intervals) for the highest NNAL tertile group of overall SHS exposure in the total, men, and women groups were 2.44 (1.95–3.05), 1.65 (1.08–2.53), and 2.73 (2.11–3.52), respectively, after full adjustment.
Conclusion
The urine NNAL concentration in the SHS exposure group was significantly higher than that in the non-exposure group. Exposure to SHS was associated with a higher risk of elevated urine NNAL concentrations in non-smokers.

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Effect of Patient Empowerment Model on Smoking Cessation: Randomized Controlled Trial
Ghada M. Khafagy, Mervat M. Mahmoud, Saeed S. A. Soliman
Korean J Fam Med 2021;42(5):369-375.   Published online September 20, 2021
DOI: https://doi.org/10.4082/kjfm.20.0212
Background
Smoking is a preventable cause of chronic morbidity. Patient empowerment is a process through which people establish greater control over their health-related decisions and actions. To assess the effect of patient empowerment versus health education on the nicotine dependence score and progress of patients under different stages of smoking cessation.
Methods
This was a single-blinded randomized controlled clinical trial that included 76 smokers attending family medicine clinics. Participants were divided into two groups: empowerment and health education groups. Their nicotine-dependence score and smoking cessation stage were identified. All study participants were subjected to five health education sessions with a 3-month follow-up period.
Results
The mean nicotine-dependence score decreased significantly in both groups after the intervention. This decrease was slightly higher in the empowerment group; however, the difference was not statistically significant. After the intervention, 16.7% of the health education and 30.0% of the empowerment group transitioned from stage 1 to stages 2–4 of smoking cessation, with the change being statistically significant only in the empowerment group. There was no statistically significant difference in the number of study participants who stopped smoking between the health education and empowerment groups.
Conclusion
Both the empowerment model and traditional health education have similar positive effects on decreasing the nicotine-dependence level. There was a significant improvement in the stage of change for patients under the empowerment model, although there was no statistically significant difference between the groups regarding the number of participants who stopped smoking.

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    Soo Young Kim
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    Soo Young Kim
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Factors that Predict Smoking Cessation among Older Koreans: Based on the Korea National Health and Nutrition Examination Survey 2016–2018
Han Kyul Lim, Yong Soon Park, Jeong Hyeon Kim, Jeong Hyun Kim
Korean J Fam Med 2021;42(5):363-368.   Published online September 20, 2021
DOI: https://doi.org/10.4082/kjfm.20.0203
Background
Tobacco smoking is associated with several diseases and deaths in older Koreans. This study aimed to evaluate the factors associated with smoking cessation in older Koreans.
Methods
We selected 579 subjects who started smoking before the age of 65 years from the Korea National Health and Nutrition Examination Survey 2016–2018. We excluded the subjects who quit smoking before the age of 65 years, and then categorized the rest of subjects into those who stopped smoking after the age of 65 years and those who are constant smokers. Multivariable logistic analysis was performed to evaluate the factors related to smoking cessation among older Koreans.
Results
Among the participants, 66.1% were persistent smokers. After multivariable analysis, the factors significantly associated with smoking cessation were as follows: being in the age group of 75–79 years (adjusted odds ratio [aOR], 4.07; 95% confidence interval [CI], 2.12–7.83), being in the age group of 70–74 years (aOR, 3.10; 95% CI, 1.72–5.61), a family history of ischemic heart disease (aOR, 3.36; 95% CI, 1.09–10.35), and having had no cancer screening (aOR, 0.36; 95% CI, 0.18–0.70).
Conclusion
Further efforts to identify the factors related to smoking cessation will help formulate a smoking cessation policy.

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  • Current status of health promotion in Korea
    Soo Young Kim
    Journal of the Korean Medical Association.2022; 65(12): 776.     CrossRef
  • 5,544 View
  • 93 Download
  • 1 Web of Science
  • 1 Crossref
Background
This study aimed to investigate trends in the prevalence of current smokers and motivation to quit among Korean male cancer survivors.
Methods
Out of 20,012 men who participated in the Korea National Health and Nutrition Examination Survey V (2010–2012), VI (2013–2015), and VII (2016–2017), 742 cancer survivors were included. A cancer survivor was defined as a person who concurred to the item, “The cancer has been diagnosed by a doctor” in the health questionnaire. Smoking status was classified as current, former, and never smokers. Regarding motivation to quit smoking, we defined those who had a willingness to quit within 6 months as the willing group. Logistic regression analysis was conducted to examine trends in the prevalence of current smokers and the proportion of the willing group among current smokers.
Results
Overall, 3.7% of Korean men who participated in the study were cancer survivors. Current smokers constituted 19.5%, 19.1%, and 15.3% of cancer survivors in phases V, VI, and VII respectively which did not show significant changes (P for trend=0.33). However, the proportion of current smokers in the non-cancer group was significantly reduced to 46.6%, 41.2%, and 38.9% in phases V, VI, and VII, respectively (P for trend <0.001). The proportion of those with a motivation to quit smoking did not show a significant trend in the cancer survivors (P for trend=0.964) and non-cancer group (P for trend=0.884).
Conclusion
Prevalence of current smokers and motivation to quit in Korean male cancer survivors did not show significant trends.

Citations

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  • Current status of health promotion in Korea
    Soo Young Kim
    Journal of the Korean Medical Association.2022; 65(12): 776.     CrossRef
  • Smoking Cessation in Cancer Survivors
    Young Gyu Cho
    Korean Journal of Family Medicine.2021; 42(4): 258.     CrossRef
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  • 86 Download
  • 2 Web of Science
  • 2 Crossref
Background
Many people use both combustible cigarette (CC) and electronic cigarette (EC). We compared nicotine dependence among CC, EC, and dual users using questionnaires and urinary cotinine levels.
Methods
Data from the Korea National Health and Nutrition Examination Survey (2014–2017) databases were analyzed; 3,917 CC, EC, and dual users were administered the urinary cotinine test, and 1,045 current CC and dual users completed the Heaviness of Smoking Index (HSI) questionnaires. Weighted geometric means of urine cotinine levels were compared between exclusive CC, exclusive EC, and dual users. The distribution rate, based on time to first cigarette (TTFC), cigarettes per day (CPD), and the HSI was analyzed in two weighted groups, exclusive CC and dual users.
Results
Among those who currently use any type of cigarette, 89.4%, 1.4%, and 9.2% were exclusive CC, exclusive EC, and dual users, respectively. Weighted geometric means of urine cotinine were highest in dual users (1,356.4 ng/mL), followed by exclusive CC (1,270.3 ng/mL), and exclusive EC (867.7 ng/mL) with significant differences between all three groups (P<0.05). There were no statistically significant differences in CPD between exclusive CC and dual users (P=0.626). The proportion of TTFC ≤5 minutes was 21.5% and 29.5% in the two groups, respectively (P=0.010); however, HSI differences in the two groups was marginal (P=0.557).
Conclusion
In this study, the urinary cotinine value could distinguish the three groups, CC, EC, and dual users, but the questionnaire using HSI could not distinguish the three groups.

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    Journal of the Korean Medical Association.2022; 65(12): 776.     CrossRef
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Review Article

The Impact of Heated Tobacco Products on Smoking Cessation, Tobacco Use, and Tobacco Sales in South Korea
Cheol Min Lee
Korean J Fam Med 2020;41(5):273-281.   Published online September 18, 2020
DOI: https://doi.org/10.4082/kjfm.20.0140
Heated tobacco products (HTPs), a hybrid between conventional and electronic cigarettes, were first launched in South Korea in June 2017. Owing to advertisements stating that HTPs are odorless, tar-free, and less harmful to health, the sales of HTPs have grown quickly enough to account for about 10% of the total tobacco market in a year. HTP use by young, highly educated, and high-income groups had a significant impact on both the overall tobacco market over the past 3 years and the smoking and quitting behaviors of smokers. Based on national smoking rate statistics, tobacco sales trends, and the number of visitors to smoking cessation clinics, the following changes have been identified: (1) The decline in current smoking rates has slowed or rose in some groups. (2) The decline in total cigarette sales has slowed but rose again in the first quarter of 2020. (3) The number of visitors to smoking cessation clinics decreased just after the advent of HTPs. These results may be due to the insufficient support of tobacco regulation policies but also coincide chronologically with the appearance of HTPs in South Korea. It is necessary to investigate the usage rate of various tobacco products, including HTPs and e-cigarettes, to examine the health risks of novel tobacco products and provide accurate information to users and policymakers. Finally, tobacco companies are continuously developing new product concepts to escape the regulation of existing cigarettes; thus, comprehensive management measures for all nicotine-containing products are needed.

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    Makoto Aoike, Yukihiro Mori, Kiyoshi Hotta, Yukihiro Shigeno, Yuka Aoyama, Mamoru Tanaka, Hana Kouzai, Hatsumi Kawamura, Masato Tsurudome, Morihiro Ito
    Drug Discoveries & Therapeutics.2022; 16(3): 118.     CrossRef
  • Factors Associated with Quit Intentions among Adult Smokers in South Korea: Findings from the 2020 ITC Korea Survey
    Minjung Han, Donghee Seo, Yeol Kim, Hong Gwan Seo, Sung-il Cho, Sungkyu Lee, Sujin Lim, Susan C. Kaai, Anne C. K. Quah, Mi Yan, Steve S. Xu, Geoffrey T. Fong
    International Journal of Environmental Research and Public Health.2022; 19(17): 10839.     CrossRef
  • Comparison of Tobacco Use and Cessation Behavior between Conventional Cigarette and Heated Tobacco Product Users: Based on the Analyses of the Eighth Korea National Health and Nutrition Examination Survey 2019
    Hyeree Yu, Cheol Min Lee
    Korean Journal of Family Medicine.2022; 43(5): 296.     CrossRef
  • Acute Eosinophilic Pneumonia after Combined Use of Conventional and Heat-Not-Burn Cigarettes: A Case Report
    Bo Hyoung Kang, Dong Hyun Lee, Mee Sook Roh, Soo-Jung Um, Insu Kim
    Medicina.2022; 58(11): 1527.     CrossRef
  • Current status of tobacco use, cessation and control policy in Korea
    Cheol Min Lee
    Journal of the Korean Medical Association.2022; 65(12): 789.     CrossRef
  • Prevalence and predictors of heated tobacco products use among male ever smokers: results from a Korean longitudinal study
    Jeeeun Yi, Cheol Min Lee, Seung-sik Hwang, Sung-il Cho
    BMC Public Health.2021;[Epub]     CrossRef
  • Nicotine Dependence of Electronic Cigarette, Dual Combustible and Electronic Cigarette Users
    Jungun Lee
    Korean Journal of Family Medicine.2021; 42(3): 189.     CrossRef
  • Prevalence and reasons for use of Heated Tobacco Products (HTP) in Europe: an analysis of Eurobarometer data in 28 countries
    Anthony A. Laverty, Constantine I. Vardavas, Filippos T. Filippidis
    The Lancet Regional Health - Europe.2021; 8: 100159.     CrossRef
  • Combined Associations of Changes in Noncombustible Nicotine or Tobacco Product and Combustible Cigarette Use Habits With Subsequent Short-Term Cardiovascular Disease Risk Among South Korean Men: A Nationwide Cohort Study
    Seulggie Choi, Kiheon Lee, Sang Min Park
    Circulation.2021; 144(19): 1528.     CrossRef
  • Bibliometric Analysis of Publications Related to Heated Tobacco Products Reported over the Period 2015-2020
    Min Joo Jeon, Su Mi Lee, Kiheon Lee, Eunbyul Cho, Joo Young Kim, Woo Kyung Bae, Jong Soo Han, Hyejin Lee, Se Young Jung
    Journal of the Korean Society for Research on Nicotine and Tobacco.2021; 12(2): 74.     CrossRef
  • Reasons for Using Heated Tobacco Products among South Korean Adults
    Ji Min Kim, Hong-Jun Cho
    Journal of the Korean Society for Research on Nicotine and Tobacco.2021; 12(2): 53.     CrossRef
  • Are Heated Tobacco Product Users Less Likely to Quit than Cigarette Smokers? Findings from THINK (Tobacco and Health IN Korea) Study
    Cheol Min Lee, Choon-Young Kim, Kiheon Lee, Sungroul Kim
    International Journal of Environmental Research and Public Health.2020; 17(22): 8622.     CrossRef
  • The Change of Tobacco Use Pattern among Adolescents after the Introduction of Novel Tobacco Products
    Cheol Min Lee
    Journal of the Korean Society for Research on Nicotine and Tobacco.2020; 11(2): 84.     CrossRef
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  • 31 Web of Science
  • 35 Crossref

Original Articles

Association between Time to First Cigarette and Health-Related Quality of Life of Middle-Aged Male Current Smokers: A Nationwide Representative Study in Korea
Sung Eun Jo, Hye Rim Hwang, Yun Jin Kim, Sang Yeoup Lee, Jeong Gyu Lee, Yu Hyeon Yi, Young Hye Cho, Young Jin Tak, Seung Hun Lee, Eun Ju Park, Youngin Lee
Korean J Fam Med 2021;42(3):225-231.   Published online August 4, 2020
DOI: https://doi.org/10.4082/kjfm.19.0103
Background
Although many studies have demonstrated that the first cigarette in the morning increases the prevalence of smoking-related morbidity, limited studies have examined the impact of time to first cigarette (TTFC) on the health-related quality of life (HRQoL). Thus, we assessed this relationship using nationally-representative data from the Korea National Health and Nutrition Examination Survey VII-1 (2016).
Methods
We conducted a cross-sectional study using data from 577 current male smokers aged 30–59 years, after excluding those with a certain disease. Participants were divided into four categories according to TTFC (≤5 min, 6–30 min, 31–60 min, >60 min). HRQoL was measured using self-reported EuroQol-5 (EQ-5D). The relationship between TTFC and EQ-5D index was analyzed using a multivariate-adjusted generalized linear model to assess how HRQoL varies according to TTFC. After adjusting for confounders, a multivariate-adjusted logistic regression analysis was performed to identify which of the five dimensions of the EQ-5D affected the HRQoL according to TTFC.
Results
The generalized linear analysis indicated that as TTFC decreased (6–30 min, 31–60 min vs. >60 min), the EQ-5D index score decreased significantly (P=0.037). Shorter TTFC (≤5 min vs. >60 min) was associated with higher pain/discomfort (odds ratio [OR], 3.82; 95% confidence interval [CI], 1.39–10.48) and anxiety/depression (OR, 7.58; 95% CI, 1.75–32.88).
Conclusion
Higher nicotine dependence was associated with impaired HRQoL. These results may be used to improve smoking cessation treatment outcomes.

Citations

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  • Current status of tobacco use, cessation and control policy in Korea
    Cheol Min Lee
    Journal of the Korean Medical Association.2022; 65(12): 789.     CrossRef
  • 6,132 View
  • 113 Download
  • 1 Web of Science
  • 1 Crossref
Associations between Living Alone and Smoking and Alcohol Consumption in Korean Adults
Sang-Woo Lee, Byoungduck Han, Sung Jung Cho, Seung Jin Jung, Youn Huh, Junghun Kim, Do Hyun Eum, Taeryoon Kim, Soon-Hong Min, Woohyun Lee, Jinhee Cho, Min Hee Kwon, Ga Eun Nam
Korean J Fam Med 2020;41(5):306-311.   Published online May 26, 2020
DOI: https://doi.org/10.4082/kjfm.18.0148
Background
Recently, single-person households have increased in Korea and this trend may have potential public health implications and affect various health behaviors. This study investigated the associations between living alone and health behaviors such as smoking and alcohol consumption among Korean adults.
Methods
We used data from the 6th Korea National Health and Nutrition Examination Survey between 2013 and 2015 and a total of 17,088 adults were included. We performed a multivariable logistic regression analysis and calculated odds ratios (ORs) with 95% confidence intervals (CIs).
Results
Single-person households accounted for about 10% of the total participants. The proportions of currently smoking and heavy alcohol consumption were higher among individuals living alone than those living together among younger women and middle-aged and elderly men and women. In the multivariable logistic regression analysis, living alone was associated with increased odds of currently smoking compared to living together among middle-aged men and women (OR, 7.37; 95% CI, 2.33–23.32 in men and OR, 2.36; 95% CI, 1.04–5.36 in women) after adjusting for confounding variables.
Conclusion
From this nationwide, population-based study, we found that living alone is associated with increased odds of currently smoking, especially in middle-aged people. Public health concerns may be warranted for middle-aged single-person households to reduce health risks related to smoking.

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    Nan-He Yoon, Dong Ha Kim, Seunghyun Yoo
    Korean Journal of Health Education and Promotion.2025; 42(3): 35.     CrossRef
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    Hong-Ying Yang, Lian Li, Lu-Jie Yu, Guo-Lin Bian
    World Journal of Psychiatry.2025;[Epub]     CrossRef
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    Jinbo Zhao, Yongchao Hou, Yuan Chu, Min He, Renting Xie, Hui Liu, Yahui Wang, Li Li
    European Journal of Cardiovascular Nursing.2025; 24(6): 936.     CrossRef
  • Community Health Perspectives on Middle-aged Adults Living Alone: A Scoping Review
    Jaehee Yoon, Hyun-Ju Seo, Youjin Jung, Eun Jung Bae, Joohyun Chung, Sangsuk Kim, Heesook Son
    Journal of Community Health.2025;[Epub]     CrossRef
  • Longitudinal Associations between Living Alone and Mental Health and Mortality in Ageing Adults in South Africa
    Supa Pengpid, Karl Peltzer
    Ageing International.2025;[Epub]     CrossRef
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    Jimin Lee*+, Youngmee Kim*+, Won-Kyung Cho
    Tobacco Induced Diseases.2025; 23(November): 1.     CrossRef
  • Living alone and cancer mortality by race/ethnicity and socioeconomic status among US working‐age adults
    Hyunjung Lee, Gopal K. Singh, Ahmedin Jemal, Farhad Islami
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  • Association between living alone and all-cause mortality of young and middle-aged patients with acute myocardial infarction: analysis of the China Acute Myocardial Infarction (CAMI) registry
    Yu Jiang, Jin-Gang Yang, Hai-Yan Qian, Yue-Jin Yang
    BMC Public Health.2024;[Epub]     CrossRef
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    Kimiko Tomioka, Midori Shima, Keigo Saeki
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    Supa Pengpid, Karl Peltzer, Dararatt Anantanasuwong, Wasin Kaewchankha
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    Shiming Li, Yue Wu, Queping Yang, Ying Jiang, Haohao Zhu
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  • Determinants of Problem Drinking by Regional Variation among Adult Males in Single-Person Households: Geographically Weighted Regression Model Analysis
    Junggeun Ahn, Heeseung Choi, Jiu Kim
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  • Six-year mortality associated with living alone and loneliness in Swedish men and women born in 1930
    Masuma Novak, Margda Waern, Lena Johansson, Anna Zettergren, Lina Ryden, Hanna Wetterberg, Therese Rydberg Sterner, Madeleine Mellqvist Fässberg, Pia Gudmundsson, Ingmar Skoog
    BMC Geriatrics.2023;[Epub]     CrossRef
  • Association between Increasing Social Capital and Decreasing Prevalence of Smoking at the Municipality Level: Repeated Cross-Sectional Study from the JAGES
    Hiroki Takeuchi, Kazushige Ide, Ryota Watanabe, Yasuhiro Miyaguni, Katsunori Kondo
    International Journal of Environmental Research and Public Health.2022; 19(8): 4472.     CrossRef
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    Zhaowei Zhu, Zhenyu Peng, Zhenhua Xing
    Frontiers in Public Health.2022;[Epub]     CrossRef
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    Yunli Zhao, Gordon Guyatt, Ya Gao, Qiukui Hao, Ream Abdullah, John Basmaji, Farid Foroutan
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    Soo Young Kim
    Journal of the Korean Medical Association.2022; 65(12): 776.     CrossRef
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  • 16 Web of Science
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Effect of Increasing Tobacco Prices on Stages of Smoking Cessation: A Korean Nationwide Data Analysis
Jihye Kwon, Hyunji Kim, Hyoeun Kim, Sunmi Yoo, Seung Guk Park
Korean J Fam Med 2021;42(1):17-23.   Published online May 19, 2020
DOI: https://doi.org/10.4082/kjfm.19.0135
Background
In 2015, tobacco prices significantly increased in Korea as part of the government’s smoking cessation policy. This study examined the changes in the stages of smoking cessation among Korean male smokers before and after the implementation of the tobacco price policy, and identified the predictors of such changes.
Methods
The study population comprised 3,533 male current smokers (age ≥19 years) who participated in the Korea National Health and Nutrition Survey in 2012, 2013, 2015, and 2016. Current smokers were defined as persons who had smoked ≥100 cigarettes during their lifetime and are continuing to smoke. In accordance with the transtheoretical model, smokers were classified into the precontemplation stage (no plan to quit), contemplation stage, and preparation stage (planning to quit within 6 months). We examined the changes in the smoking cessation stages before and after the implementation of the policy. Multivariate logistic regression analysis was conducted to identify factors related to the likelihood of continuing smoking, after adjustments for potential confounders.
Results
Immediately after the policy implementation, the percentage of smokers in the precontemplation stage decreased from 65.6% to 60.8% (P=0.014). However, this effect was temporary. Significant risk factors for remaining in the precontemplation stage were older age (odds ratio [OR], 1.010; 95% confidence interval [CI], 1.002–1.018; P=0.004), being in the lowest income quartile (OR, 1.226; 95% CI, 1.001–1.502; P=0.049), and manual worker or unemployed status (OR, 1.256; 95% CI, 1.036–1523; P=0.020).
Conclusion
Increasing tobacco prices only temporarily change the stage of smoking cessation among Korean male smokers.

Citations

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  • Risk of Mortality Associated With Substance Use Disorder in Korea: A National Population-Based Study
    Seyoung Kim, Jee Hoon Sohn, Seung-sik Hwang
    Journal of Korean Medical Science.2026;[Epub]     CrossRef
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    Sujin Lee, Jae Ho Chung
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  • Current status of tobacco use, cessation and control policy in Korea
    Cheol Min Lee
    Journal of the Korean Medical Association.2022; 65(12): 789.     CrossRef
  • Current status of health promotion in Korea
    Soo Young Kim
    Journal of the Korean Medical Association.2022; 65(12): 776.     CrossRef
  • Public Health Intervention for Smoking Cessation
    Soo Young Kim
    Korean Journal of Family Medicine.2021; 42(5): 343.     CrossRef
  • 6,199 View
  • 124 Download
  • 4 Web of Science
  • 5 Crossref
Factors Associated with the Intention to Quit Smoking in Elderly Korean Men: The Korea National Health and Nutrition Examination Survey 2010-2015
Inho Lee, Yong Soon Park, Jeong Hyeon Kim, Seung Hyeok Han
Korean J Fam Med 2020;41(4):237-242.   Published online April 24, 2020
DOI: https://doi.org/10.4082/kjfm.18.0124
Background
Tobacco smoking is the most preventable cause of diseases and death in older adults. This study aimed to evaluate the factors associated with the intention to quit smoking in elderly Korean men.
Methods
We investigated 813 male smokers aged 65 years or more from the 5th and 6th Korea National Health and Nutrition Examination Survey 2010–2015. Multiple logistic regression analysis was performed to identify factors related with smoking cessation intention.
Results
Of the respondents, 26.3% had the intention to quit smoking. After adjustment for confounding factors, the intention to quit smoking was significantly associated with a history of ischemic heart disease (adjusted odds ratio, 1.88; 95% confidence interval, 1.02–3.48).
Conclusion
Identifying the factors related to the intention to quit smoking among older adults can help in developing effective smoking cessation strategies for this section of the population.

Citations

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  • Factors Associated with Quit Intentions among Adult Smokers in South Korea: Findings from the 2020 ITC Korea Survey
    Minjung Han, Donghee Seo, Yeol Kim, Hong Gwan Seo, Sung-il Cho, Sungkyu Lee, Sujin Lim, Susan C. Kaai, Anne C. K. Quah, Mi Yan, Steve S. Xu, Geoffrey T. Fong
    International Journal of Environmental Research and Public Health.2022; 19(17): 10839.     CrossRef
  • Factors that Predict Smoking Cessation among Older Koreans: Based on the Korea National Health and Nutrition Examination Survey 2016–2018
    Han Kyul Lim, Yong Soon Park, Jeong Hyeon Kim, Jeong Hyun Kim
    Korean Journal of Family Medicine.2021; 42(5): 363.     CrossRef
  • 5,792 View
  • 99 Download
  • 2 Web of Science
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Short-Term Success Rates of Smoking Cessation Support Programs and Factors Predicting Smoking Relapse: Using Data from a Smoking Cessation Clinic in a Hospital
Seung-Hyun Yu, Myeong-Jun Kim, Jin Jeon, Hoon-Ki Park, Hwan-Sik Hwang, Kye-Yeung Park
Korean J Fam Med 2019;40(6):373-379.   Published online November 20, 2019
DOI: https://doi.org/10.4082/kjfm.18.0094
Background
Although the number of medical institutions running a smoking cessation clinic is on the rise, there remains a paucity of research on the long- and short-term success rates of smoking cessation programs, as well as on smoking relapse rates, before and after project implementation. This study assessed the general characteristics of patients visiting the smoking cessation clinic, success rate of smoking cessation in the short term, and risks of relapse.
Methods
Medical records from March 2015 to April 2017 were analyzed and telephone surveys were conducted with 151 smokers who visited a hospital smoking cessation clinic from March 2015 to April 2017.
Results
Of the 139 smokers who were eligible for follow-up, 22 (15.8%) failed to quit smoking initially. The clinic’s 6-month success rate of smoking cessation was 64.83%. Those with higher medication compliance had a lower risk of primary failure (odds ratio, 0.056; 95% confidence interval, 0.005–0.609), whereas those with higher age (hazard ratio [HR], 0.128; P=0.0252) and a greater number of visits to the clinic (HR, 0.274; P=0.0124) had a lower risk of relapsing.
Conclusion
The risk of primary failure to quit was higher with low medication compliance, and that of relapsing was higher with lower age and fewer number of clinic visits. Various evaluation and analysis methods can be carried out in the future based on the accumulated data for maintenance of smoking cessation and relapse prevention.

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    Asia Pacific Journal of Public Health.2024; 36(4): 329.     CrossRef
  • Associations between Nicotine Dependence, Smartphone Usage Patterns, and Expected Compliance with a Smoking Cessation Application among Smokers
    Oh Beom Kwon, Chihoon Jung, Auk Kim, Sang Won Park, Gihwan Byeon, Seung-Joon Lee, Woo Jin Kim
    Healthcare Informatics Research.2024; 30(3): 224.     CrossRef
  • The Current Status and Challenges of National Smoking Cessation Support Program in Korea
    Seung-Won Oh
    Korean Journal of Family Medicine.2019; 40(6): 351.     CrossRef
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  • 107 Download
  • 3 Web of Science
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Review Article

Cigarette Smoking in South Korea: A Narrative Review
Rebekah Gunter, Edwin Szeto, Se-Hoon Jeong, Sooyeon (Aly) Suh, Andrew J. Waters
Korean J Fam Med 2020;41(1):3-13.   Published online June 13, 2019
DOI: https://doi.org/10.4082/kjfm.18.0015
Although the prevalence of cigarette smoking has declined in Western countries over the past few decades, a comparable decline among males has not been observed in Asian countries, especially in South Korea, where approximately 40%–50% of men and 4%–8% of women have been identified as smokers, and there is a pressing need to understand the background of cigarette smoking in these populations. The present study is a narrative review of the research literature on cigarette smoking in South Korea. First, we describe the social, economic, and cultural factors that impact cigarette smoking in South Korea. The paper also reviews the available peer-reviewed literature comprising observational studies and interventional studies, including randomized controlled trials. The extant literature on smoking in Korean Americans is also reviewed. Cigarette smoking in South Korea has been relatively understudied, and this review identifies priority areas for future research, including the use of mobile interventions.

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Original Article

Association between Cigarette Smoking and Sarcopenia according to Obesity in the Middle-Aged and Elderly Korean Population: The Korea National Health and Nutrition Examination Survey (2008–2011)
Yoonjoo Jo, John Alderman Linton, Junho Choi, Junghae Moon, Jungeun Kim, Jiyoung Lee, Sinae Oh
Korean J Fam Med 2019;40(2):87-92.   Published online March 20, 2019
DOI: https://doi.org/10.4082/kjfm.17.0078
Background
The definition of sarcopenia focuses on muscle mass and function. Sarcopenic obesity is the relative excess of fat tissue with decreased muscle mass. We examined the association between cigarette smoking and sarcopenia according to obesity in middle-aged and elderly Koreans.
Methods
We conducted a cross-sectional study of 9,385 subjects (age ≥50 years) based on data from the fourth and fifth Korea National Health and Nutrition Examination Surveys (2008–2011). Smoking groups were categorized by smoking status and the number of cigarettes smoked daily. Sarcopenia was defined as weight-adjusted appendicular skeletal muscle mass of 2 standard deviations below the sex-specific mean for young adults. Obesity was defined as fat mass ≥30% for men and ≥40% for women. Subjects were categorized into three groups: sarcopenic obese (SO), sarcopenic non-obese (SNO), and normal. Multiple logistic regression analysis was performed to assess the association between smoking and SNO and SO.
Results
Among men, current smokers were more associated with SNO than never-smokers (adjusted odds ratio [OR], 3.34; 95% confidence interval [CI], 1.09–10.26). However, there was no significant association between smoking status and SNO in women or SO in either sex. Among current smokers, moderate smokers (11–20 cigarettes/d) were more likely to be SNO (adjusted OR, 5.81; 95% CI, 1.12–30.31) and heavy smokers (>20 cigarettes/d) were more likely to be SO (adjusted OR, 9.53; 95% CI, 1.65–55.01) than light smokers (<11 cigarettes/d).
Conclusion
In men, smoking was positively associated with SNO, and heavy smokers were more likely to be SO than light smokers.

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Brief Communication

Serum Cadmium Level Is Positively Associated with Unruptured Intracranial Aneurysm Incidence
Bich Nae Ri Yoon, Jun Beom Lee, Ga Heon Jin, Won Yong Kim
Korean J Fam Med 2019;40(4):273-277.   Published online February 7, 2019
DOI: https://doi.org/10.4082/kjfm.17.0140
Background
Cadmium is a toxic element in cigarette smoke associated with ischemic vascular disease. Its association with cerebral aneurysm is unknown.
Methods
We retrospectively analyzed the medical records of patients with headache who underwent imaging studies between March 2014 and August 2016. An unruptured intracranial aneurysm (UIA) was confirmed by brain magnetic resonance angiography or computed tomography angiography. A control group included age- and sexmatched patients without an UIA. Whole blood and random urine tests were used for detection of cadmium and arsenic levels, respectively. Student t-test was used to compare subject characteristics, mean cadmium and arsenic levels between groups, and differences between groups with small (<4-mm) and large (≥4-mm) UIAs. Multivariate regression analysis was used to identify risk factors for aneurysm incidence.
Results
Of 238 patients, 25 had an UIA. Those with an UIA had more pack-years of smoking (19.5±3.8 vs. 12.5±6.8, P=0.044) and higher mean serum cadmium levels (1.77±0.19 vs. 0.87±0.21 µg/L, P=0.027). Arsenic levels showed no difference between groups. (67.4±23.5 vs. 62.2±18.3 µg/L, P=0.458). There were no significantly different demographic, clinical, or laboratory characteristics between small and large aneurysm groups. According to multivariate analysis, smoking (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.06–2.33; P=0.047) and serum cadmium >2.0 mcg/L (OR, 1.39; 95% CI, 1.15–1.84; P=0.043) were associated with aneurysm incidence.
Conclusion
UIA incidence was associated with pack-years of smoking and serum cadmium level, but aneurysm size was not associated with serum cadmium level.

Citations

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Original Articles
The Relationship between Electronic Cigarette Use with or without Cigarette Smoking and Alcohol Use among Adolescents: Finding from the 11th Korea Youth Risk Behavior Web-based Survey
Kwang Ho Oh, Cheol Min Lee, Bumjo Oh, Seung-Won Oh, Hee-Kyung Joh, Ho Chun Choi, Seung Jae Kim, Sho Rry Lea
Korean J Fam Med 2019;40(4):241-247.   Published online January 14, 2019
DOI: https://doi.org/10.4082/kjfm.17.0094
Background
Electronic cigarette (EC) consumption (‘vaping’) is rapidly increasing, not only in adults but also in adolescents. Little is known about the association between vaping and problem behaviors such as drinking.
Methods
We used data from the 11th Korea Youth Risk Behavior Web-based Survey, which was conducted in 2015 and included 68,043 participants who were Korean middle and high school students. The survey assessed EC, cigarette, and alcohol use. Multiple regression analysis was used to examine risk of current drinking and problem drinking across the following categories of users: never user (never used either product), former user (use of EC or cigarettes in the past, but not currently), vaping only, smoking only, and dual user (current use of both products).
Results
EC only users were 1.2% in males, and 0.3% in females. Dual user of both conventional cigarettes and ECs were 5.1% in males, and 1.2% in females. Drinking frequency, drinking quantity per once, and problem drinking were higher among vapers than non-vapers and former-vapers, moreover, were higher among daily vapers than intermittent vapers. Compared to never users, EC only users were higher on risk of current drink and problem drink. The dual users were highest on risk of current drink.
Conclusion
Vaping is independently associated with alcohol use problems in Korean students, even those not currently smoking. Moreover, dual use of cigarettes and ECs is strongly associated with alcohol use problems. Therefore, vaping students should be concerned about their hidden alcohol use problems.

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    Chang-Mo Oh, Yangha Kim, Jieun Yang, Sunhye Choi, Kyungwon Oh
    Epidemiology and Health.2023; 45: e2023018.     CrossRef
  • Addiction-Related Outcomes of Nicotine and Alcohol Co-use: New Insights Following the Rise in Vaping
    Jude A Frie, Caitlin J Nolan, Jennifer E Murray, Jibran Y Khokhar
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    Chelsey DeGomez, Jennifer Feirstein
    JAAPA.2022; 35(9): 25.     CrossRef
  • Comparison of Tobacco Use and Cessation Behavior between Conventional Cigarette and Heated Tobacco Product Users: Based on the Analyses of the Eighth Korea National Health and Nutrition Examination Survey 2019
    Hyeree Yu, Cheol Min Lee
    Korean Journal of Family Medicine.2022; 43(5): 296.     CrossRef
  • Prevalence of Vaping and Behavioral Associations of Vaping Among a Community of College Students in the United States
    Ogbebor E. Omoike, Kiana R. Johnson
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  • Use of Single, Dual, and Poly Tobacco Products in Korean Adolescents
    Min Kwon, Sophia J. Chung, Jinhwa Lee
    Asia Pacific Journal of Public Health.2021; 33(5): 571.     CrossRef
  • Association between preference for using alcohol beverage-named e-liquids and alcohol use among high school youth
    Asti Jackson, Ran Wu, Grace Kong, Deepa R. Camenga, Meghan Morean, Patricia Simon, Krysten W. Bold, Angela M. Haeny, Suchitra Krishnan-Sarin
    Drug and Alcohol Dependence.2020; 209: 107903.     CrossRef
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  • Prevalence and Correlates of the Dual Use of Conventional and Electronic Cigarettes among Korean Adolescents: 2016-2018 Korean Youth Risk Behavior Survey
    Eon Sook Lee, Yu Jin Paek
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  • Electronic and Conventional Cigarette Use and Drinking Behaviors in Korean Adolescents
    Young Gyu Cho
    Korean Journal of Family Medicine.2019; 40(4): 201.     CrossRef
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Relationship between Smoking and Abdominal Aorta Calcification on Computed Tomography
Jin-Gyu Jung, Li-Tzy Wu, Jong-Sung Kim, Eung-Du Kim, Seok-Joon Yoon
Korean J Fam Med 2019;40(4):248-253.   Published online January 4, 2019
DOI: https://doi.org/10.4082/kjfm.17.0098
Background
Cigarette smoking increases the risk of atherosclerosis, which often develops as vascular calcification on radiologic examinations. This study evaluated the relationship between smoking-related factors and incidental abdominal aorta calcification (AAC) detected by computed tomography (CT) among middle-aged and elderly men.
Methods
We assessed the abdominal CT findings of 218 men aged 40 to 81 years who underwent health checkups. The associations between smoking factors and AAC were analyzed using logistic regression analysis to adjust for confounding variables such as age, lifestyle factors, and chronic diseases.
Results
Adjusting for confounding variables, the risk of AAC was significantly increased in association with smoking for at least 20 years (adjusted odds ratio [AOR], 5.22; 95% confidence interval [CI], 1.82–14.93), smoking 10+ pack-years (10–20 pack-years: AOR, 4.54; 95% CI, 1.07–5.68; >20 pack-years: AOR, 5.28; 95% CI, 2.10–13.31), and a history of smoking (former smoker: AOR, 2.10; 95% CI, 1.07–5.68; current smoker: AOR, 5.05; 95% CI, 2.08–12.26). In terms of the daily smoking amount, even a low smoking level increased the risk of AAC.
Conclusion
These findings suggest that smoking for 20+ years, smoking 10+ pack-years, and even a low level of smoking daily increases the likelihood of developing AAC. Clinicians should recommend that patients quit smoking and stress the importance of smoking duration when promoting health in middle-aged and elderly patients.

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Association between Possibility of Purchasing Cigarettes and E-cigarette Experience among Korean Adolescent Smokers
Jae-Hyun Kim, Jin-Won Noh, Sun-Jung Kim, Jeoung A Kwon, Young Choi, Ki-Bong Yoo
Korean J Fam Med 2018;39(4):225-232.   Published online July 6, 2018
DOI: https://doi.org/10.4082/kjfm.17.0014
Background
To aim of this study was to examine the association between perceived possibility of purchasing cigarettes and e-cigarette experience among adolescents who currently smoke cigarettes.
Methods
Data were derived from the Korea Youth Risk Behavior Web-Based Survey; a total of 29,169 current smokers participated. The dependent variable was e-cigarette experience in the previous month. Analyses included χ2 test and survey logistic regression.
Results
A perceived easy possibility of purchasing cigarettes increased the odds of e-cigarette experience (odds ratio, 1.19; 95% confidence interval, 1.07–1.33) compared to when it was perceived as impossible. An easy possibility of purchasing cigarettes increased the odds of e-cigarettes experience among males aged 12–15 or 17 years compared to when it was impossible to purchase cigarettes.
Conclusion
A perceived easy possibility of purchasing cigarettes was more likely to increase e-cigarette experience among adolescents. Laws restricting adolescents’ access to e-cigarettes must be strengthened.

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  • Vaping—An Emerging Threat to Youngsters of Pakistan
    Nazish Jaffar, Hafiza Tooba Siddiqui, Huda Amin, Md Ariful Haque
    Addiction Biology.2025;[Epub]     CrossRef
  • Underage E-Cigarette Purchasing and Vaping Progression Among Young Adults
    Alyssa F. Harlow, Rob S. McConnell, Jessica L. Barrington-Trimis
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  • The Impact of Heated Tobacco Products on Smoking Cessation, Tobacco Use, and Tobacco Sales in South Korea
    Cheol Min Lee
    Korean Journal of Family Medicine.2020; 41(5): 273.     CrossRef
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  • 129 Download
  • 3 Web of Science
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The Association between Smoking Status and Influenza Vaccination Coverage Rate in Korean Adults: Analysis of the 2010–2012 Korea National Health and Nutrition Examination Survey
Jung Keun Park, Soo Lee, Ji Eun Lee, Kyung-Do Han, Ji Hyun Kim, Jin Hee Yoon, Suk Won Park, Yang-Hyun Kim, Kyung-Hwan Cho
Korean J Fam Med 2018;39(2):90-95.   Published online March 22, 2018
DOI: https://doi.org/10.4082/kjfm.2018.39.2.90
Background

Globally, smoking is one of the biggest challenges in public health and is a known cause of several important diseases. Influenza is preventable via annual vaccination, which is the most effective and cost-beneficial method of prevention. However, subjects who smoke have some unhealthy behaviours such as alcohol, low physical activity, and low vaccination rate. In this study, we analyzed the relationship between smoking status and factors potentially related to the influenza vaccination coverage rate in the South Korean adult population.

Methods

The study included 13,565 participants aged >19 years, from 2010 to 2012 from the Korea National Health and Nutrition Examination Survey data. Univariate analyses were conducted to examine the association between influenza coverage rate and related factors. Multivariate analysis was obtained after adjusting for variables that were statistically significant.

Results

The overall vaccination rate was 27.3% (n=3,703). Older individuals (P<0.0001), women (P<0.0001), non-smokers (P<0.0001), light alcohol drinkers (P<0.0001), the unemployed (P<0.0001), and subjects with diabetes mellitus (P<0.0001), hypercholesterolemia (P<0.0001), and metabolic syndrome (P<0.0001) had higher influenza vaccination coverage than the others. In multivariate analyses, current smokers and heavy smokers showed lower vaccination rates (odds ratio, 0.734; 95% confidence interval, 0.63–0.854).

Conclusion

In the current study, smokers and individuals with inadequate health-promoting behaviors had lower vaccination rates than the others did.

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  • Smoking and serological response to influenza vaccine
    Won Suk Choi, Mary Patricia Nowalk, Krissy Moehling Geffel, Michael Susick, Sean Saul, Chyongchiou Jeng Lin, Ted M. Ross, Richard K. Zimmerman
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  • Determining the intention of receiving the influenza vaccine: a cross-sectional survey among international and domestic college students in the USA
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    Brandon M Imp, Tory Levine, Derek D Satre, Jacek Skarbinski, Mitchell N Luu, Stacy A Sterling, Michael J Silverberg
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    Paolo Montuori, Immanuela Gentile, Claudio Fiorilla, Michele Sorrentino, Benedetto Schiavone, Valerio Fattore, Fabio Coscetta, Alessandra Riccardi, Antonio Villani, Ugo Trama, Francesca Pennino, Maria Triassi, Antonio Nardone
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  • Secular trends and determinants of influenza vaccination uptake among patients with cardiovascular disease in Korea: Analysis using a nationwide database
    Min Kim, Bumhee Yang, Seonhye Gu, Eung-Gook Kim, So Rae Kim, Kyeong Seok Oh, Woong-Su Yoon, Dae-Hwan Bae, Ju Hee Lee, Sang Min Kim, Woong Gil Choi, Jang-Whan Bae, Kyung-Kuk Hwang, Dong-Woon Kim, Myeong-Chan Cho, Hyun Lee, Dae-In Lee
    Frontiers in Cardiovascular Medicine.2022;[Epub]     CrossRef
  • Factors Associated with Annual Influenza Vaccination Uptake in U.S. Older Adults from 2019 to 2020
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    Hyun Ju Chae, MiJong Kim
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  • 61 Download
  • 9 Web of Science
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Association of Time to First Morning Cigarette and Chronic Obstructive Pulmonary Disease Measured by Spirometry in Current Smokers
Geonhyeok Kim, Hongji Song, Kyunghee Park, Hyemi Noh, Eunyoung Lee, Hyoeun Lee, Hayoon Kim, Yujin Paek
Korean J Fam Med 2018;39(2):67-73.   Published online March 22, 2018
DOI: https://doi.org/10.4082/kjfm.2018.39.2.67
Background

Time to first cigarette after waking is an indicator of nicotine dependence. We aimed to identify the association between time to first cigarette and spirometry-proven obstructive respiratory impairment, especially chronic obstructive pulmonary disease, in current smokers.

Methods

We included 392 subjects who visited the comprehensive medical examination center of Hallym University Sacred Heart Hospital between July 2014 and September 2015. Subjects with lung disease or anemia were excluded. Obstructive pulmonary impairment was defined as <70% of the predicted value of forced expiratory volume in 1 second/forced vital capacity. Subjects were classified into the early (≤30 minutes) and late (>30 minutes) groups based on the time to first cigarette. Logistic regression and linear regression analyses were used for data analysis.

Results

Ninety-eight subjects (25%) were classified into the early group. After adjusting for smoking behaviors (cigarettes per day and smoking duration), socioeconomic status (education and income), age, and physical activity, an early time to first cigarette was found to be associated with an increased risk of obstructive pulmonary impairment measured using spirometry (adjusted odds ratio, 2.84; 95% confidence interval, 1.22–6.61).

Conclusion

Compared to current smokers with a late time to first cigarette, those with an early time to first cigarette had a higher risk of obstructive pulmonary impairment, especially chronic obstructive pulmonary disease. Classifying smoking-related behaviors, especially time to first cigarette, may help target clinical screening for chronic obstructive pulmonary disease.

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  • Time from waking to first cigarette, genetic susceptibility, and the risk of COPD: A Prospective cohort study from UK Biobank
    Liu Qiqi, Liu Haoxiang, Wu Chuansha, Sun Xiaojie, Xiong Longzhu, Kong Chunxue, Ma Jixuan, Zhou Ting
    Heart & Lung.2026; 76: 9.     CrossRef
  • Alcohol and Nicotine Dependence and Time to Death in a General Adult Population: A Mortality Cohort Study
    Ulrich John, Hans-Jürgen Rumpf, Monika Hanke, Christian Meyer
    European Addiction Research.2023; 29(6): 394.     CrossRef
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    Arash Toghyani, Somayeh Sadeghi
    Journal of Research in Medical Sciences.2022; 27(1): 18.     CrossRef
  • Association between Time to First Cigarette and Health-Related Quality of Life of Middle-Aged Male Current Smokers: A Nationwide Representative Study in Korea
    Sung Eun Jo, Hye Rim Hwang, Yun Jin Kim, Sang Yeoup Lee, Jeong Gyu Lee, Yu Hyeon Yi, Young Hye Cho, Young Jin Tak, Seung Hun Lee, Eun Ju Park, Youngin Lee
    Korean Journal of Family Medicine.2021; 42(3): 225.     CrossRef
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    Baksun Sung
    Tobacco Use Insights.2019;[Epub]     CrossRef
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    Rui Zhang, Ling Chen, Lei Cao, Kang-jie Li, Yao Huang, Xiao-qian Luan, Ge Li
    RESPIRATORY RESEARCH.2018;[Epub]     CrossRef
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  • 60 Download
  • 6 Web of Science
  • 6 Crossref
Background

The prevalence of metabolic syndrome (MetS) has risen rapidly worldwide, including in South Korea. Factors related to lifestyle are closely associated with the development of MetS. The aim of this study was to investigate the association between MetS and a number of factors positively influencing health, namely non-smoking, low-risk drinking, sufficient sleep, regular exercise, and the habit of reading food labels, among Korean men.

Methods

This cross-sectional study included 3,869 men from the 2007–2009 Korean National Health and Nutrition Examination Survey. Information on five factors positively influencing their health was obtained using a self-reported questionnaire. We categorized subjects into four groups, depending on the number of positive factors reported (group I, 0–1 factor; group II, 2 factors; group III, 3 factors; group IV, 4–5 factors).

Results

Men who reported a greater number of positive health factors had better laboratory and anthropometric values than men who reported fewer positive health factors. The prevalence of MetS was 29.1, 27.2, 20.7, and 14.6% in groups I to IV, respectively. Compared to group I, odds ratios (95% confidence intervals) for MetS were 0.96 (0.78–1.19) in group II, 0.67 (0.52–0.87) in group III, and 0.52 (0.35–0.76) in group IV, after adjusting for confounding factors. Odds ratios for abdominal obesity, glucose intolerance, and hypertriglyceridemia were statistically significant.

Conclusion

A greater number of positive lifestyle factors influencing health were associated with a lower risk of developing MetS, in a nationally representative sample of Korean men.

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  • Association between Use of Nutritional Labeling and the Metabolic Syndrome and Its Components
    Hyung-sub Jin, Eun-bee Choi, Minseo Kim, Sarah Soyeon Oh, Sung-In Jang
    International Journal of Environmental Research and Public Health.2019; 16(22): 4486.     CrossRef
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  • 42 Download
  • 1 Web of Science
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Association between Weight Changes after Smoking Cessation and Cardiovascular Disease among the Korean Population
Eun Ha Kim, Hyejin Lee, Dong Wook Shin, Jae Moon Yun, Jung-Hyun Shin, Yoo Kyoung Lim, Hye Yeon Koo, Miso Jang
Korean J Fam Med 2017;38(3):122-129.   Published online May 23, 2017
DOI: https://doi.org/10.4082/kjfm.2017.38.3.122
Background

Cigarette smoking is a risk factor for cardiovascular disease (CVD) and has both beneficial and harmful effects in CVD. We hypothesized that weight gain following smoking cessation does not attenuate the CVD mortality of smoking cessation in the general Korean population.

Methods

Study subjects comprised 2.2% randomly selected patients from the Korean National Health Insurance Corporation, between 2002 and 2013. We identified 61,055 subjects who were classified as current smokers in 2003–2004. After excluding 21,956 subjects for missing data, we studied 30,004 subjects. We divided the 9,095 ex-smokers into two groups: those who gained over 2 kg (2,714), and those who did not gain over 2 kg (6,381, including weight loss), after smoking cessation. Cox proportional hazards regression models were used to estimate the association between weight gain following smoking cessation and CVD mortality.

Results

In the primary analysis, the hazard ratios of all-cause deaths and CVD deaths were assessed in the three groups. The CVD risk factors and Charlson comorbidity index adjusted hazard ratios (aHRs) for CVD deaths were 0.80 (95% confidence interval [CI], 0.37 to 1.75) for ex-smokers with weight gain and 0.80 (95% CI, 0.50 to 1.27) for ex-smokers with no weight gain, compared to one for sustained smokers. The associations were stronger for events other than mortality. The aHRs for CVD events were 0.69 (95% CI, 0.54 to 0.88) and 0.81 (95% CI, 0.70 to 0.94) for the ex-smokers with and without weight gain, respectively.

Conclusion

Although smoking cessation leads to weight gain, it does not increase the risk of CVD death.

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    Heajung Lee, Jaeyong Shin, Jae Woo Choi
    Frontiers in Endocrinology.2024;[Epub]     CrossRef
  • Lifelong smoking status, weight gain, and subsequent risk of major adverse cardiovascular events: Long‐term follow‐up of a middle‐aged Chinese population
    Lirong Liang, Changwei Li, Xiaoqing Liu, Long Zhou, Shuilian Chu, Ruiyuan Zhang, Jinzhuang Mai, Adrianna Westbrook, Jiachen Li, Di Zhang, Liancheng Zhao, Yangfeng Wu
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The Association Between Shift Work and Health Behavior: Findings from the Korean National Health and Nutrition Examination Survey
Myung-Ji Bae, Yun-Mi Song, Jin-Young Shin, Bo-Young Choi, Jung-Hyun Keum, Eun-Ae Lee
Korean J Fam Med 2017;38(2):86-92.   Published online March 22, 2017
DOI: https://doi.org/10.4082/kjfm.2017.38.2.86
Background

Shift workers are increasing worldwide, and various negative health effects of shift work have been reported. This study aimed to evaluate the relationship between shift work and health behavior.

Methods

This cross-sectional study included a total of 11,680 Korean adults (6,061 men and 5,619 women) aged ≥20 years old who participated in the Fifth Korean National Health and Nutrition Examination Survey, 2010–2012. Multiple logistic regression analysis was performed to evaluate the association between shift work and health behavior after adjusting for covariates.

Results

In men, shift work was associated with an increased risk of inadequate sleep (odds ratio [OR], 1.18; 95% confidence interval [CI], 1.00 to 1.40) compared to day work. In women, shift work was associated with an increased risk of smoking (OR, 1.73; 95% CI, 1.34 to 2.22) and inadequate sleep (OR, 1.24; 95% CI, 1.05 to 1.47) compared to day work. In an age-stratified subgroup analysis, female shift workers aged ≥50 years old demonstrated an increased risk of smoking (OR, 5.55; 95% CI, 3.60 to 8.55), alcohol consumption (OR, 2.22; 95% CI, 1.53 to 3.23), and inadequate sleep (OR, 1.50; 95% CI, 1.10 to 2.05) compared to female day workers.

Conclusion

Shift work is associated with worse health behavior, and this is most evident in women aged ≥50 years. Targeted strategies to reduce the negative health effects of shift work should be implemented, with consideration of shift workers' demographic characteristics.

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Joint Effect of Cigarette Smoking and Body Mass Index on White Blood Cell Count in Korean Adults
A-Ra Cho, Won-Jun Choi, Shin-Hye Kim, Jae-Yong Shim, Yong-Jae Lee
Korean J Fam Med 2017;38(2):75-80.   Published online March 22, 2017
DOI: https://doi.org/10.4082/kjfm.2017.38.2.75
Background

White blood cell count is an independent risk factor for cardiovascular disease. Several lifestyle and metabolic factors such as cigarette smoking and obesity are known to be associated with an elevated white blood cell count. However, the joint effect of cigarette smoking and obesity on white blood cell count has not yet been fully described.

Methods

We explored the joint effect of cigarette smoking and obesity on white blood cell count using multiple logistic regression analyses after adjusting for confounding variables in a population-based, cross-sectional study of 416,065 Korean adults.

Results

Cigarette smoking and body mass index have a dose-response relationship with a higher white blood cell count, but no synergistic interaction is observed between them (men, P for interaction=0.797; women, P for interaction=0.311). Cigarette smoking and body mass index might have an additive combination effect on high white blood cell count. Obese male smokers were 2.36 times more likely and obese female smokers 2.35 times more likely to have a high white blood cell count when compared with normal body mass index non-smokers.

Conclusion

Cigarette smoking and body mass index are independently associated with an elevated white blood cell count in both men and women.

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  • The association between smoking profile, leukocyte count, and inflammatory indices in males: a cross-sectional analysis of the TABARI cohort study at enrollment phase
    Erfan Ghadirzadeh, Mahmood Moosazadeh, Motahareh Kheradmand, Masoumeh Bagheri-Nesami, Sajad Ghafari-Cherati, Mobina Gheibi, Amirsaeed Hosseini
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  • Dose-Dependent Toxic Effect of Cotinine-Verified Tobacco Smoking on Systemic Inflammation in Apparently Healthy Men and Women: A Nationwide Population-Based Study
    Won-Jun Choi, Ji-Won Lee, A Ra Cho, Yong-Jae Lee
    International Journal of Environmental Research and Public Health.2019; 16(3): 503.     CrossRef
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Association Between the Awareness of Dyslipidemia and Health Behavior for Control of Lipid Levels Among Korean Adults with Dyslipidemia
In Young Cho, Hwa Yeon Park, Kiheon Lee, Woo Kyung Bae, Se Young Jung, Hye Jin Ju, Jae Kyeong Song, Jong Soo Han
Korean J Fam Med 2017;38(2):64-74.   Published online March 22, 2017
DOI: https://doi.org/10.4082/kjfm.2017.38.2.64
Background

Dyslipidemia is a major risk factor contributing to cardiovascular disease and its prevalence is steadily rising. Although screening tests are readily accessible, dyslipidemia remains undertreated. Evaluating health behavior patterns after diagnosis may help improve lifestyle interventions for the management of dyslipidemia.

Methods

Data from the fifth Korean National Health and Nutrition Examination Survey 2010–2012 were used. A total of 6,624 dyslipidemia patients over 20 years old were included according to National Cholesterol Education Program-Adult Treatment Panel III guidelines. Logistic regression analysis was completed using a weighted method to determine whether awareness of dyslipidemia was associated with health behavior. Health behavior was divided into two categories: behavioral factors (smoking, alcohol consumption, exercise) and nutritional factors (adequate intake of fiber, carbohydrate, fat, protein).

Results

There were no significant differences in health behavior among dyslipidemia patients according to awareness after adjustment for covariates, diabetes and hypertension. Awareness in women was associated with decreased smoking (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.32 to 0.94), but when adjusted for diabetes and hypertension the result was not significant (OR, 0.61; 95% CI, 0.35 to 1.06). The same pattern applied to intake of carbohydrate in men (OR, 1.28; 95% CI, 0.99 to 1.67) and protein in women (OR, 1.22; 95% CI, 0.98 to 1.50). In subgroup analysis, awareness of dyslipidemia in men without hypertension or diabetes was associated with adequate intake of carbohydrate (OR, 1.70; 95% CI, 1.06 to 2.72).

Conclusion

Increasing awareness alone may not be enough to improve healthy behavior in patients with dyslipidemia. Efforts including patient education and counseling through a multi-team approach may be required.

Citations

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    Ji Hyung Nam, Jaeyong Shin, Sung-In Jang, Ji Hyun Kim, Kyu-Tae Han, Jun Kyu Lee, Yun Jeong Lim, Eun-Cheol Park
    BMJ Open.2019; 9(3): e024731.     CrossRef
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Discrepancy between Self-Reported and Urine-Cotinine Verified Smoking Status among Korean Male Adults: Analysis of Health Check-Up Data from a Single Private Hospital
Youngju Kim, Yoon-Jung Choi, Seung-Won Oh, Hee-Kyung Joh, Hyuktae Kwon, Yoo-Jin Um, Sang Hyun Ahn, Hyun Joo Kim, Cheol Min Lee
Korean J Fam Med 2016;37(3):171-176.   Published online May 26, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.3.171
Background

Enquiry into smoking status and recommendations for smoking cessation is an essential preventive service. However, there are few studies comparing self-reported (SR) and cotinine-verified (CV) smoking statuses, using medical check-up data. The rates of discrepancy and under-reporting are unknown.

Methods

We performed a cross-sectional study using health examination data from Healthcare System Gangnam Center, Seoul National University Hospital in 2013. We analyzed SR and CV smoking statuses and discrepancies between the two in relation to sociodemographic variables. We also attempted to ascertain the factors associated with a discrepant smoking status among current smokers.

Results

In the sample of 3,477 men, CV smoking rate was 11.1% higher than the SR rate. About 1 in 3 participants either omitted the smoking questionnaire or gave a false reply. The ratio of CV to SR smoking rates was 1.49 (95% confidence interval [CI], 1.38–1.61). After adjusting for confounding factors, older adults (≥60 years) showed an increased adjusted odds ratio (aOR) for discrepancy between SR and CV when compared to those in their twenties and thirties (aOR, 5.43; 95% CI, 2.69–10.96). Educational levels of high school graduation or lower (aOR, 2.33; 95% CI, 1.36–4.01), repeated health check-ups (aOR, 1.45; 95% CI, 1.03–2.06), and low cotinine levels of <500 ng/mL (aOR, 2.03; 95% CI, 1.33–3.09), were also associated with discordance between SR and CV smoking status.

Conclusion

Omissions and false responses impede the accurate assessment of smoking status in health check-up participants. In order to improve accuracy, it is suggested that researcher pay attention to participants with greater discrepancy between SR and CV smoking status, and formulate interventions to improve response rates.

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    World Journal of Gastroenterology.2023; 29(24): 3843.     CrossRef
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    Cheol Min Lee
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    Cheolmin Lee, Hyeji Shin, Sunghee Kim, Kiheon Lee, Yongjin Cho, Yoo Seock Cheong, Sungroul Kim
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    Surendra Kumar Sharma, Alladi Mohan, Achintya Dinesh Singh, Hridesh Mishra, Sonali Jhanjee, Ravindra Mohan Pandey, Binit Kumar Singh, Rohini Sharma, Prakash Babu Pallipamu, Madhukar Pai, Keertan Dheda
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Compliance and Effectiveness of Smoking Cessation Program Started on Hospitalized Patients
Gun Hee Shin, Sung Won Yi, Yoo Seock Cheong, Eal Whan Park, Eun Young Choi
Korean J Fam Med 2016;37(3):149-155.   Published online May 26, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.3.149
Background

Varenicline is now very useful medication for cessation; however, there is only little result of researches with varenicline for cessation of hospitalized patients. This research attempted to analyze the cessation effect of medication and compliance of hospitalized patients.

Methods

This research included data for 52 patients who were prescribed varenicline among 280 patients who were consulted for cessation during their admission period. This research checked whether smoking was stopped or not after six months and analyzed their compliance, the factors for succeeding in smoking cessation.

Results

One hundred and ninety hospitalized patients participated in smoking cessation counseling among 280 patients who included consultation from their admission departments. And varenicline was prescribed for only 80 patients after counseling. Nineteen smokers were successful in smoking cessation among 52 final participants representing the rating of success of 36.5%. The linkage between compliance of varenicline and rate of smoking successful has no statistical significance. The factors for succeeding in smoking of hospitalized patients are admission departments, diseases, and economic states.

Conclusion

Smoking cessation program has low inpatient compliance. Cooperation of each departments is very important for better compliance. Success rate of cessation was relatively high (36.5%). Cessation attempt during hospitalization is very effective strategy.

Citations

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  • The Effect of Varenicline on Smoking Cessation in Hospitalized Patients: A Systematic Review and Meta-Analysis
    Mahshid Aryanpur, Raheb Ghorbani, Sajjad Rashno, Gholamreza Heydari, Mehdi Kazempour-Dizaji, Zahra Hessami, Narges Ghorbani
    Addiction and Health.2024; 16(2): 122.     CrossRef
  • Public Health Intervention for Smoking Cessation
    Soo Young Kim
    Korean Journal of Family Medicine.2021; 42(5): 343.     CrossRef
  • The effect of a multidisciplinary approach for smoking cessation in patients with Crohn’s disease: Results from an observational cohort study
    Pierachille Santus, Dejan Radovanovic, Davide Raiteri, Stefano Pini, Giuseppe Spagnolo, Giovanni Maconi, Maurizio Rizzi
    Tobacco Induced Diseases.2020;[Epub]     CrossRef
  • Using Lean Quality Improvement Tools to Increase Delivery of Evidence-Based Tobacco Use Treatment in Hospitalized Neurosurgical Patients
    Laurel Sisler, Oluwaseun Omofoye, Karina Paci, Eldad Hadar, Adam O. Goldstein, Carol Ripley-Moffitt
    The Joint Commission Journal on Quality and Patient Safety.2017; 43(12): 633.     CrossRef
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  • 4 Web of Science
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Predictors of Successful Smoking Cessation after Inpatient Intervention for Stroke Patients
Eugene Ha, Jun-Yong Jo, Ah-Leum Ahn, Eun-Jung Oh, Jae-Kyung Choi, Dong-Yung Cho, Hyuk-Jung Kweon
Korean J Fam Med 2016;37(2):85-90.   Published online March 25, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.2.85
Background

Smoking is a well-known risk factor of cancer, chronic disease, and cerebrovascular disease. Hospital admission is a good time to quit smoking but patients have little opportunity to take part in an intensive smoking cessation intervention. The purpose of this study was to identify the factors of successful smoking cessation among stroke patients who undergo an intensive cessation intervention during the hospitalization period.

Methods

Thirty-nine male smokers who were admitted with stroke were enrolled in the study. They participated in a smoking cessation intervention during hospitalization. Smoking status was followed up by telephone 3 months later. Nicotine dependence, sociodemographic factors, and other clinical characteristics were assessed.

Results

After 3 months post-intervention, the number of patients who stopped smoking was 27 (69.2%). In addition, there was no significant difference in nicotine dependence, sociodemographic factors, and clinical characteristics. Only the stages of readiness for smoking cessation were a significant predictor (odds ratio, 18.86; 95% confidence interval, 1.59–223.22).

Conclusion

This study shows that a patient's willingness to quit is the most significant predictor of stopping smoking after Inpatient cessation Intervention for stroke Patients.

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  • Association between post-stroke smoking and stroke recurrence in first-ever ischemic stroke survivors: based on a 10-year prospective cohort
    Qiang Yao, Bai-Yang Zhang, Yi-Die Lin, Mei-Jing Hu, Min Jiang, Mu-Ke Zhou, Cai-Rong Zhu
    Neurological Sciences.2023; 44(10): 3595.     CrossRef
  • Rates, Predictors, and Impact of Smoking Cessation after Stroke or Transient Ischemic Attack: A Systematic Review and Meta-Analysis
    Jean Jacques Noubiap, John L. Fitzgerald, Celine Gallagher, Gijo Thomas, Melissa E. Middeldorp, Prashanthan Sanders
    Journal of Stroke and Cerebrovascular Diseases.2021; 30(10): 106012.     CrossRef
  • Analysis of Factors Affecting the Intention to Quit Smoking in Stroke Patients
    Junghee Youn, Mee Kyung Shin
    The Korean Journal of Rehabilitation Nursing.2021; 24(1): 78.     CrossRef
  • Public Health Intervention for Smoking Cessation
    Soo Young Kim
    Korean Journal of Family Medicine.2021; 42(5): 343.     CrossRef
  • Intervenção para cessação do tabagismo em pacientes internados por AVC
    Daniella Porfírio Nunes, Marcos Christiano Lange, Luiza Moschetta Zimmermann, Élcio Juliato Piovesan, Isabel Cristina Scarinci
    Revista Psicologia e Saúde.2021; : 33.     CrossRef
  • Assessing motivation to smoking cessation in hospitalized patients
    Juana María Sepúlveda-Sánchez, José Carlos Canca-Sánchez, Francisco Rivas-Ruiz, Mónica Martín-García, Celia Lorente Márquez, Eva María Timonet-Andreu
    Enfermería Clínica (English Edition).2018; 28(1): 13.     CrossRef
  • Evaluación de la motivación para la cesación tabáquica en pacientes hospitalizados
    Juana María Sepúlveda-Sánchez, José Carlos Canca-Sánchez, Francisco Rivas-Ruiz, Mónica Martín-García, Celia Lorente Márquez, Eva María Timonet-Andreu
    Enfermería Clínica.2018; 28(1): 13.     CrossRef
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    Vladimir Levshin, Nina Slepchenko
    Tobacco Prevention & Cessation.2017;[Epub]     CrossRef
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Association between Smoking and Periodontal Disease in Korean Adults: The Fifth Korea National Health and Nutrition Examination Survey (2010 and 2012)
Ah-Young Jang, Jung-Kwon Lee, Jin-Young Shin, Hae-Young Lee
Korean J Fam Med 2016;37(2):117-122.   Published online March 25, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.2.117
Background

This study aimed to evaluate an association between smoking, smoking cessation, and periodontal disease in Korean adults.

Methods

The data were collected from 8,336 participants, aged between 20 and 64 years, who participated in the fifth Korea National Health and Nutrition Examination (2010 and 2012). Smoking status was assessed using self-administered questionnaires. Periodontal disease was defined as a community periodontal index ≥3 points. Logistic regression analysis was used to evaluate an association between smoking, smoking cessation, and periodontal disease after adjusting for age, sex, education, monthly income, diabetes, obesity, alcohol intake, and frequency of tooth brushing.

Results

The risk of periodontal disease was higher among current smokers (odds ratio [OR], 1.49; 95% confidence interval [CI], 1.21-1.83) than never smokers. Among current smokers, the risk of periodontal disease was increased in smokers of ≥10 cigarettes/d, ≥20 years duration, and >10 pack-years compared with never smokers (P<0.05). Among former smokers, the risk of periodontal disease after 10 years since cessation declined to 0.56 (95% CI, 0.42-0.75) compared with current smokers and was indistinguishable statistically from never smokers.

Conclusion

Periodontal disease is significantly associated with smoking status in Korean adults.

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    Jing Kang, Jianhua Wu, Vishal. R. Aggarwal, David Shiers, Tim Doran, Jasper Palmier-Claus
    Dentistry Journal.2024; 12(7): 191.     CrossRef
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    Hyang-Ah Park, Ah-ran Pae, Yong-Dae Kwon, Seoung-Jin Hong, Kun-Chul Lee, Jae-In Ryu
    The Journal of The Korean Dental Association.2024; 62(10): 619.     CrossRef
  • Association between Smoking and Periodontal Disease in South Korean Adults
    Ka-Yun Sim, Yun Seo Jang, Ye Seul Jang, Nataliya Nerobkova, Eun-Cheol Park
    International Journal of Environmental Research and Public Health.2023; 20(5): 4423.     CrossRef
  • Impact of Smoking Cessation on Periodontal Tissues
    Poliana Mendes Duarte, Cristiana Fernandes Plutarco Nogueira, Sarah Monique Silva, Cláudio Mendes Pannuti, Karin C. Schey, Tamires Szeremeske Miranda
    International Dental Journal.2022; 72(1): 31.     CrossRef
  • Adrenal incidentaloma as a novel independent predictive factor for periodontitis
    M. O. Rodrigues, A. B. Moraes, M. P. de Paula, V. A. Pereira, A. T. T. Leão, L. Vieira Neto
    Journal of Endocrinological Investigation.2021; 44(11): 2455.     CrossRef
  • Effect of smoking on periodontal health and validation of self-reported smoking status with serum cotinine levels
    Shweta Goswami, Pekka Ylöstalo, Sohaib Khan, Matti Knuuttila, Eduardo Bernabe, Anna Liisa Suominen
    Acta Odontologica Scandinavica.2021; 79(8): 573.     CrossRef
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    Haoyun Sun, Minquan Du, Baojun Tai, Shuli Chang, Yixuan Wang, Han Jiang
    Clinical Oral Investigations.2020; 24(12): 4403.     CrossRef
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    Ahu Dikilitas¸, Fatih Karaaslan, Umut Yig˘it
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  • Self-Reported Exposure to ETS (Environmental Tobacco Smoke), Urinary Cotinine, and Oxidative Stress Parameters in Pregnant Women—The Pilot Study
    Lubica Argalasova, Ingrid Zitnanova, Diana Vondrova, Monika Dvorakova, Lucia Laubertova, Jana Jurkovicova, Juraj Stofko, Michael Weitzman, Iveta Waczulikova, Martin Simko
    International Journal of Environmental Research and Public Health.2019; 16(9): 1656.     CrossRef
  • The Influence ofTLR4,CD14,OPG, andRANKLPolymorphisms in Periodontitis: A Case-Control Study
    Joana Maira Valentini Zacarias, Josiane Bazzo de Alencar, Patrícia Yumeko Tsuneto, Victor Hugo de Souza, Cléverson O. Silva, Jeane Eliete Laguila Visentainer, Ana Maria Sell
    Mediators of Inflammation.2019; 2019: 1.     CrossRef
  • Smoking and Periodontal Health
    S. Selva Süme Keşir, H. Ebru Olgun
    Current Oral Health Reports.2018; 5(1): 50.     CrossRef
  • The association of dietary vitamin C intake with periodontitis among Korean adults: Results from KNHANES Ⅳ
    Jung-Hoo Lee, Myung-Seop Shin, Eun-Jeong Kim, Yoo-Been Ahn, Hyun-Duck Kim, Binnaz Leblebicioglu
    PLOS ONE.2017; 12(5): e0177074.     CrossRef
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    Nimali Wellapuli, Lilani Ekanayake
    BMC Research Notes.2017;[Epub]     CrossRef
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    Mario Romandini, Gioele Gioco, Giorgio Perfetti, Giorgio Deli, Edoardo Staderini, Andreina Laforì
    Journal of Clinical Periodontology.2017; 44(5): 490.     CrossRef
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The Relationship between Smoking and Unhealthy Weight Control Behaviors among Korean Adolescents: The Tenth Korea Youth Risk Behavior Web-Based Survey, 2014
Won Yong Sim, Young Gyu Cho, Jae Heon Kang, Hyun Ah Park, Kyoung Woo Kim, Yang Im Hur, Koh Eun Shin, Gyeong Ran Byeon
Korean J Fam Med 2017;38(1):28-33.   Published online January 18, 2016
DOI: https://doi.org/10.4082/kjfm.2017.38.1.28
Background

Adolescent smoking is positively related to weight control attempts, especially by unhealthy methods. The co-occurrence of smoking and unhealthy weight control behaviors may cause serious health problems in adolescents. This study examined the relationship of smoking with unhealthy weight control behaviors among Korean adolescents.

Methods

This cross-sectional study involved 31,090 students of grades 7 to 12, who had tried to reduce or maintain their weight during the 30 days prior to The Tenth Korea Youth Risk Behavior Web-based Survey, 2014. Data on height, weight, weight control methods, smoking, alcohol intake, living with one's family, and perceived economic status were obtained through self-report questionnaires. ‘Unhealthy weight control behaviors’ were subcategorized into ‘extreme weight control behaviors’ and ‘less extreme weight control behaviors.’

Results

The smoking rates were 13.3%±0.4% in boys and 3.8%±0.2% in girls. Current smokers were more likely to engage in extreme weight control behaviors (odds ratio [OR], 1.47; 95% confidence interval [CI], 1.09 to 2.00 in boys, and OR, 2.05; 95% CI, 1.59 to 2.65 in girls) and less extreme weight control behaviors (OR, 1.23; 95% CI, 1.07 to 1.40 in boys, and OR, 1.47; 95% CI, 1.22 to 1.76 in girls) compared to non-smokers among both boys and girls.

Conclusion

Current smoking is independently related to a high likelihood of engaging in unhealthy weight control behaviors among Korean adolescents. This relationship is stronger for girls than for boys. Extreme weight control behaviors have a stronger relationship with current smoking than less extreme weight control behaviors.

Citations

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  • Association between weight gain following smoking cessation and development of hypertension in the future
    Yuichi Ninomiya, Shin Kawasoe, Takuro Kubozono, Akihiro Tokushige, Hitoshi Ichiki, Anwar Ahmed Salim, Yoshiyuki Ikeda, Hironori Miyahara, Koichi Tokushige, Mitsuru Ohishi
    Hypertension Research.2024; 47(5): 1167.     CrossRef
  • Unhealthy Weight Control Behaviors according to the Status of Combustible Cigarette and Noncombustible Nicotine or Tobacco Product Use among Korean Adolescents with Experience Attempting to Reduce or Maintain Their Body Weight: The 15th Korea Youth Risk B
    A Ra Bong, Young Gyu Cho, Hyun Ah Park, Kyo Woon Kim
    Korean Journal of Family Medicine.2024; 45(4): 223.     CrossRef
  • Unhealthy weight control behaviors and related factors by gender and weight status: Results from a nationally representative sample of Korean adolescents
    Eun Jung Bae, Ju Young Yoon
    Archives of Psychiatric Nursing.2023; 42: 75.     CrossRef
  • Factors Associated With Unhealthy Weight Control Behaviors Among a Representative Sample of U.S. High School Students
    Chung-Bang Weng, Jiunn-Jye Sheu, Huey-Shys Chen
    The Journal of School Nursing.2022; 38(6): 533.     CrossRef
  • Latent Class Analysis of Obesogenic Behaviors among Korean Adolescents: Associations with Weight-Related Outcomes
    Haein Lee, In-Seo La
    International Journal of Environmental Research and Public Health.2021; 18(21): 11059.     CrossRef
  • Smoking as a weight control strategy of Serbian adolescents
    Biljana Kilibarda, Jelena Gudelj Rakic, Sonja Mitov Scekic, Srmena Krstev
    International Journal of Public Health.2020; 65(8): 1319.     CrossRef
  • Relationship between unhealthy weight control behaviors and substance use patterns among Korean adolescents: results from the 2017 national youth risk behavior survey
    Yeji Lee, Kang-Sook Lee
    Public Health.2019; 174: 56.     CrossRef
  • Associations between History of Hospitalization for Violence Victimization and Substance-Use Patterns among Adolescents: A 2017 Korean National Representative Survey
    Yeji Lee, Kang-Sook Lee
    International Journal of Environmental Research and Public Health.2018; 15(7): 1543.     CrossRef
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  • 9 Web of Science
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Time to First Cigarette and Hypertension in Korean Male Smokers
Saerom Lee, Miae Jang, Hye-Mi Noh, Hye-Young Oh, Hong Ji Song, Kyung Hee Park, Yu-Jin Paek
Korean J Fam Med 2015;36(5):221-226.   Published online September 18, 2015
DOI: https://doi.org/10.4082/kjfm.2015.36.5.221
Background

Morning blood pressure surge affects to cardiovascular disease risk. Short time to first cigarette (TTFC) after waking can enhance morning blood pressure surge, and accelerate atherosclerosis

Methods

We investigated that the relationship between TTFC and blood pressure. The study subjects included male current smokers (n=211) who had health check-up in Hallym University Sacred Heart Hospital from July to September, 2014. We categorized the subjects into 2 groups according to TTFC; early TTFC (TTFC <30 minutes) and late TTFC (TTFC ≥30 minutes), and the subjects who were taking antihypertensive medications or had a high blood pressure (>140 mm Hg or 90 mm Hg) were defined as hypertensive group. Multivariate logistic regression was performed to estimate the odds ratio and 95% confidence interval to investigate the association between TTFC and hypertensive group.

Results

Compared with late TTFC, early TTFC had higher odds (odds ratio [OR], 3.87; 95% confidence interval [CI], 1.89-7.94) for hypertensive group. After adjusting confounding factors, early TTFC was significantly associated with an increased risk of hypertension (OR, 4.43; 95% CI, 1.84-10.70).

Conclusion

early TTFC after waking is associated with hypertension. It suggests delaying TTFC might help to control of blood pressure among the current smokers who are not ready to immediately quit smoking.

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    Rui Tang, Ying Hu, Jian Zhou, Xuan Wang, Xiang Li, Yoriko Heianza, Lu Qi
    American Journal of Kidney Diseases.2024; 84(5): 593.     CrossRef
  • Time from waking to the first cigarette and mortality and incident cardiovascular disease
    Yanzhi Li, Wenjian Lai, Hao Zhao, Xiali Zhong, Lan Guo
    Journal of Public Health.2024; 46(4): 487.     CrossRef
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    Ulrich John, Hans-Jürgen Rumpf, Monika Hanke, Christian Meyer
    European Addiction Research.2023; 29(6): 394.     CrossRef
  • Time to First Cigarette and the Risk of Hypertension: A Nationwide Representative Study in Korea
    Jinok Bae, Yu Hyeon Yi, Yun Jin Kim, Jeong Gyu Lee, Young Jin Tak, Seung Hoon Lee, Hye Rim Hwang, Sang Yeoup Lee, Young Hye Cho, Ei Jin Ro
    American Journal of Hypertension.2019; 32(2): 202.     CrossRef
  • Comments on Statistical Issues in November 2015
    Kyung Do Han, Yong Gyu Park
    Korean Journal of Family Medicine.2015; 36(6): 357.     CrossRef
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  • 28 Download
  • 5 Web of Science
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Weight Control Methods Related to Cotinine-Verified Smoking among Korean Adult Women: Korea National Health and Nutrition Examination Survey, 2008-2011
Young Kyun Kim, Young Gyu Cho, Jae Heon Kang, Hyun Ah Park, Kyoung Woo Kim, Yang Im Hur, Yeon Gak Yoo, Jiyoung An
Korean J Fam Med 2015;36(2):72-81.   Published online March 23, 2015
DOI: https://doi.org/10.4082/kjfm.2015.36.2.72
Background

Korean women are known to have a very low smoking rate. However, the actual smoking rate among Korean women is higher than 10% and may continue to increase gradually. In addition, some Korean women use extreme weight control methods that have potentially harmful effects. This study was conducted to elucidate weight control methods related to cotinine-verified smoking among Korean adult women.

Methods

This cross-sectional study involved 4,189 women aged ≥19 years who had attempted weight control during the past 1 year from the Korea National Health and Nutrition Examination Survey, 2008-2011. Smoking status was assessed using both self-report questionnaires and assays of urinary cotinine, and weight control methods were investigated using self-report questionnaires.

Results

The smoking rate based on the measurement of urinary cotinine was 12.4% ± 0.8% among Korean women. Cotinine-verified smokers were more likely to attempt fasting (odds ratio, 2.19; 95% confidence intervals, 1.03 to 4.67), taking prescription diet-pills (odds ratio, 2.37; 95% confidence intervals, 1.47 to 3.82), and taking nonprescription diet-pills (odds ratio, 3.46; 95% confidence intervals, 1.71 to 6.98), and were less likely to attempt eating less food or modifying dietary patterns (odds ratio, 0.71; 95% confidence intervals, 0.51 to 0.99) compared to non-smokers.

Conclusion

Korean adult women's smoking is independently related to a high likelihood of using weight control methods with potentially harmful effects, such as fasting and taking diet-pills, and a low likelihood of choosing weight control methods, including dietary modification, that require constant effort for a prolonged time.

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  • The Relationship between Body Mass Index and Smoking Cessation Plans in Korean Adults
    Ji Young Lee, Seon Mee Kim, Yoon Seon Choi, Yong Gyu Park, E Yeon Kim, So Jung Yoon, Jin Wook Kim, Jung Hwan Yoon, Man Kim, Hye Ran Jeon
    Journal of Obesity & Metabolic Syndrome.2017; 26(4): 281.     CrossRef
  • Factors Affecting Smoking Cessation Intention of Female Workers: Using Community Health Survey, 2014
    Hye-Young Jang, Song Yi Han
    Korean Journal of Occupational Health Nursing.2016; 25(4): 352.     CrossRef
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  • 26 Download
  • 2 Crossref
Results of an Inpatient Smoking Cessation Program: 3-Month Cessation Rate and Predictors of Success
Sun-Hee Kim, Jung-Ah Lee, Kye-Un Kim, Hong-Jun Cho
Korean J Fam Med 2015;36(2):50-59.   Published online March 23, 2015
DOI: https://doi.org/10.4082/kjfm.2015.36.2.50
Background

Hospitalization presents smokers with an opportunity to initiate smoking cessation. We studied the effect of inpatient counseling and follow-up after discharge on smoking cessation and assessed predictors of successful cessation.

Methods

This study included a total of 125 patients (118 male and 7 female) who were admitted to departments of neurology, cardiology, and pulmonology. They were referred to the smoking cessation clinic, and participated between September 2011 and February 2013. A counseling service lasting about thirty minutes was provided by the third-year family medicine residents during hospitalization. The follow-up counseling services, which were either by telephone or in-person physician counseling were provided at 1 week, 4 weeks, and 3 months. Smoking habits and nicotine dependency data were gathered using questionnaires, and patient information was collected from electronic medical records.

Results

The average age in the study was 57.9 ± 10.2 years and duration of smoking was 35.9 ± 11.7 years. Daily tobacco consumption was 23.5 ± 13.2 cigarettes. The smoking cessation rate after 3 months was 42.4%. The only differences between patients in the successful cessation and failed groups were cause of admission (P = 0.039) and total number of counseling sessions after discharge (P < 0.001). In a multivariate analysis, smoking cessation was more likely when patients experienced more instances of follow-up after discharge (1-2 visits: odds ratio [OR], 8.186; 95% confidence interval [CI], 1.060 to 63.239; ≥3 visits: OR, 121.873; 95% CI, 14.462 to 1,027.055).

Conclusion

Smoking cessation counseling during hospitalization and further follow-up by telephone or outpatient counseling after discharge contributed to an increased smoking cessation rate. The smoking cessation rate also tended to increase with total counseling numbers.

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    Hersh Trivedi, Hannah Kay, Katy Reines, Julie Hartzell, Eiman Newcomer, Shannon Myers, Richard S. Matulewicz, Adam O. Goldstein, Kimberly A. Shoenbill, Marc A. Bjurlin
    Clinical Genitourinary Cancer.2025; 23(1): 102252.     CrossRef
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    Po-Hsun Yang, Yuan-Shan Chien, Dih-Ling Luh
    Archives of Public Health.2024;[Epub]     CrossRef
  • Smoking History and Nicotine Dependence Alter Sleep Features in Patients with Obstructive Sleep Apnea-Hypopnea Syndrome
    Ioanna Grigoriou, Serafeim-Chrysovalantis Kotoulas, Konstantinos Porpodis, Dionysios Spyratos, Ioanna Papagiouvanni, Alexandros Tsantos, Anastasia Michailidou, Constantinos Mourelatos, Christina Mouratidou, Ioannis Alevroudis, Kalliopi Tsakiri, Vasiliki D
    Healthcare.2024; 13(1): 49.     CrossRef
  • Smoking-Induced Disturbed Sleep. A Distinct Sleep-Related Disorder Pattern?
    Ioanna Grigoriou, Paschalia Skalisti, Ioanna Papagiouvanni, Anastasia Michailidou, Konstantinos Charalampidis, Serafeim-Chrysovalantis Kotoulas, Konstantinos Porpodis, Dionysios Spyratos, Athanasia Pataka
    Healthcare.2023; 11(2): 205.     CrossRef
  • Smoking cessation programme in hospitalised patients due to acute respiratory disease
    Sónia Isabel Silva Guerra, Jorge Marques Vale, Rui Dias Nunes
    Internal Medicine Journal.2022; 52(12): 2130.     CrossRef
  • A Comparative Analysis of Machine Learning Methods for Class Imbalance in a Smoking Cessation Intervention
    Khishigsuren Davagdorj, Jong Seol Lee, Van Huy Pham, Keun Ho Ryu
    Applied Sciences.2020; 10(9): 3307.     CrossRef
  • Comparison of the Effect of Group and Individual Training on Smoking Cessation Motivation in Coronary Artery Disease Patients
    A Badrooh, N Mozaffari, A Barikani, B Dadkhah
    Journal of Health and Care.2019; 21(2): 99.     CrossRef
  • Smoking behaviours of Hong Kong Chinese hospitalised patients and predictors of smoking abstinence after discharge: a cross-sectional study
    Ka Yan Ho, William Ho Cheung Li, Katherine Ka Wai Lam, Man Ping Wang, Wei Xia, Lok Yin Ho, Kathryn Choon Beng Tan, Hubert Kit Man Sin, Elaine Cheung, Maisy Pik Hung Mok, Tai Hing Lam
    BMJ Open.2018; 8(12): e023965.     CrossRef
  • The Abstinence Rate of the Inpatient Smoking Cessation Program
    Jae-Hang Cho, Seock-Hwan Lee, Jung-Woo Sohn, Hye-Young Yang
    Journal of the Korean Society for Research on Nicotine and Tobacco.2017; 8(2): 88.     CrossRef
  • Factors Associated with Six Month Quit Rate of in-hospital Smoking Program
    Hyeyoung Shin, Yunjoo Lee, Sunhee Kim, Hong-Jun Cho
    Journal of the Korean Society for Research on Nicotine and Tobacco.2016; 7(2): 66.     CrossRef
  • Hospitalization as a Teachable Moment for Cigarette Smoking Cessation
    Ki Young Son
    Korean Journal of Family Medicine.2015; 36(2): 44.     CrossRef
  • Comments on Statistical Issues in May 2015
    Yong Gyu Park
    Korean Journal of Family Medicine.2015; 36(3): 154.     CrossRef
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The Relationship between Smoking Level and Metabolic Syndrome in Male Health Check-up Examinees over 40 Years of Age
Gwang-Yul Hwang, Yoon-Jeong Cho, Rae-Ho Chung, Sung-Hi Kim
Korean J Fam Med 2014;35(5):219-226.   Published online September 24, 2014
DOI: https://doi.org/10.4082/kjfm.2014.35.5.219
Background

The objective of this study was to investigate the relationship between smoking and metabolic syndrome in men.

Methods

This cross-sectional study included 1,852 men over age 40 who underwent health screening from April 2009 to December 2010. We classified them into three smoking levels as non-, intermediate-, and heavy-smoker, considering their smoking status (non, ex, current) and amount (0, 1-29, ≥30 pack year [PYR]). The relationship between smoking level and metabolic syndrome was analyzed by logistic regression analysis, after covariates (age, body mass index, education, house income, alcohol intake, and physical activity) were controlled.

Results

The proportions of non-, intermediate-, and heavy-smokers were 31.8%, 56.2%, and 12.0%, respectively. Odds ratios (ORs) and 95% confidence intervals (95% CIs) for metabolic syndrome were 1.0, 1.58 (1.09-2.23), 1.92 (1.29-2.81) in non-, intermediate-, and heavy-smokers, respectively. For heavy-smokers compared with non-smokers, ORs and 95% CIs of a lower high density lipoprotein cholesterol, higher triglyceride, and higher fasting glucose were 2.47 (1.63-3.74), 1.71 (1.17-2.52), and 1.43 (1.02-2.00), respectively. In current-smokers, we divided into three subgroups according to PYR, and compared with 1-19 PYR, ORs and 95% CIs of 20-29 PYR and ≥30 PYR for metabolic syndrome were 2.07 (1.14-3.74) and 3.06 (1.66-5.62), respectively.

Conclusion

This study showed a positive dose-response relationship between smoking level and metabolic syndrome in men.

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    Ya-Hui Chang, Chung-Yi Li, Hon-Ping Ma, Chien-Yuan Wu, Yann-Yuh Jou, Chiachi Bonnie Lee
    JMIR Public Health and Surveillance.2025; 11: e73114.     CrossRef
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The Association of Lung Age with Smoking Status in Korean Men
Hye Young Oh, Hong Soo Lee, Sang Wha Lee, Kyung Won Shim, Hyejin Chun, Joo Yeon Kim
Korean J Fam Med 2014;35(1):35-41.   Published online January 23, 2014
DOI: https://doi.org/10.4082/kjfm.2014.35.1.35
Background

Lung age, calculated from sex, forced expiratory volume in one second (FEV1), and height, was developed to illustrate premature changes to the lungs and could be used to motivate smoking cessation. However, this method has not been tested in association with smoking in Korea. The purpose of this study was to investigate the association of lung age with smoking and other factors in Korean males.

Methods

We reviewed the records of 1,100 healthy men who visited a health promotion center at Ewha Womans University Medical Center from January 2008 to June 2009. Lung age was calculated from FEV1 and normal predictive values of spirometry according to age in the Korean population. The difference between lung age and chronological age was evaluated in relation to smoking status, weight, body mass index, waist, muscle mass, fat mass, and exercise.

Results

The age difference was significantly higher in current smokers than in non-smokers (12.47 ± 19.90 vs. 7.30 ± 19.52, P < 0.001). Additionally, the age difference was positively correlated with life time pack-year (β = 0.223; P < 0.001) and fat mass (β = 0.462; P < 0.001). Lung age increased 1 year for 4.48 pack-year increase or for 2.16% increase in fat mass.

Conclusion

We found a significant relationship between lung age and both smoking status and fat mass in healthy Korean males. Lung age may be a useful tool for motivating cessation of cigarette smoking and management of risk factors related to obesity.

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Background

Previous studies have shown that self-reports tend to underestimate smoking status, especially among women in Korea. We therefore assessed the characteristics of Korean women smokers who falsely described themselves as non-smokers.

Methods

The subjects were 4,135 adult women aged ≥19 years who participated in the 2008 Korean National Health and Nutrition Examination Survey. Of these, 3,151 subjects answered questions about their smoking status on self-reported questionnaires and underwent assays of urinary cotinine concentration. Subgroups of false respondents (n = 131) and true respondents (n = 198) regarding smoking were determined by comparing their responses on questionnaires with their urinary cotinine levels.

Results

Among adult Korean women, the self-reported smoking rate was 7.4% (95% confidence interval [CI], 6.4% to 8.4%); however, using urinary cotinine >100 ng/mL as a marker of smoking, the smoking rate was 11.8% (95% CI, 10.5% to 13.3%). In multivariate analysis, after adjusting for type of household, family income, and suicidal ideation, the odds ratios (ORs) of false respondents were 3.49 (95% CI, 1.41 to 8.63) for college-educated women and 2.47 (95% CI, 1.22 to 5.01) for women with high school education, relative to women with elementary school education. Married women with living spouses (OR, 2.80; 95% CI, 1.33 to 5.90) were more likely to respond falsely than unmarried women. Women who reported trying to reduce weight within 1 year (OR, 2.70; 95% CI, 1.47 to 4.93) and those who reported being less stressed (OR, 1.82; 95% CI, 1.08 to 3.07) were more likely to be false respondents.

Conclusion

The smoking rate determined using urinary cotinine concentration was higher than the self-reported rate among Korean women. Among smokers, those who were more educated, married, living with a husband, trying to reduce weight, and less stressed tended to describe themselves falsely as non-smokers.

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