Background Adolescence is an essential stage of a child’s development, transitioning them into adulthood. During this time, they are vulnerable to various social issues, such as experimenting with alcohol, among others. Although alcohol consumption was proven to be detrimental to physical and cognitive development toward adulthood, and almost one in 10 Malaysian adolescents aged 13 years and above are current drinkers, studies concerning the driving factors are still scarce. This cross-sectional study aimed to determine alcohol use among 244 adolescents in Nabawan, Sabah.
Methods This study assessed the associations between alcohol use and three potential factors: demographic, environmental, and psychological. Respondents who were selected through stratified proportionate random sampling answered a set of assessment tools.
Results Results showed that 30.7% (95% confidence interval [CI], 24.91–36.48) of Nabawan adolescents use alcohol. Analysis revealed that older age adolescents 18 years and 19 years, respectively (adjusted odds ratio [aOR], 3.93; P=0.021; aOR, 5.38; P=0.003), having parents (aOR, 4.11; P=0.001) and peers (aOR, 11.57; P<0.001) who consume alcohol were significantly associated with alcohol use. Unexpectedly, good parental monitoring (aOR, 2.46; P=0.019) and discussing serious problems with parents (aOR, 3.86; P=0.001) were significantly associated with alcohol use.
Conclusion Conclusively, policies on alcohol-related harm reduction and prevention should be developed, especially school-based programs, programs addressing family functioning, and parent-child communication, among others, should be further looked into. Future research on the school environment, adolescents’ drinking motives, and the development of practical adolescent-friendly alcohol screening tools are recommendations for improvements.
Background Increasing cigarette tax is known to be effective in stopping smoking and preventing initiation of smoking in adolescents. This study was designed to investigate the change of smoking attitudes in high school students after increase in cigarette tax in 2004. Methods: A self-questionnaire study was performed in high school students in Seoul and Chungnam province in June, 2004. The number of respondents was 1,424 consisting of 883 males and 541 females. The factors related to smoking cessation or reduction of smoking amount after increase in cigarette tax were analysed. Results: Among the total 1,424 subjects, 199 (14.0%) students smoked before the increase in cigarette tax. The smoking rate of males and females were 19.5% and 5.0%, respectively. Thirty nine percent of smokers quit smoking or reduced the smoking amount after increase in tax, among them 28.6% of the smokers (27.9% and 33.0% for males and females, respectively) reported quitting smoking. Female smokers and smokers in preparation stage of Prochaska model reported quitting smoking or reducing the smoking amount than male smokers and smokers in pre-consideration stage (OR 6.85:95% CI=1.78∼26.33, OR 6.62:95% CI= 2.20∼19.95, respectively). Conclusion: Increase of cigarette tax was effective in quitting the smoking and reducing the smoking amount in adolescents in Korea. (J Korean Acad Fam Med 2007;28: 256-262)
Background : As the metabolic syndrome represents a constellation of cardiovascular risk factors,its prevention is very important. Especially, child and adolescent obesity and metabolic abnormalities track into adulthood and it may promote the development of the metabolic syndrome in adults. however, in Korea there are only few studies about the metabolic syndrome of children and adolescents. Therefore, the objective of this study was to determine the prevalence and distribution of the metabolic syndrome in Korean children and adolescents.
Methods : The Korean National Health and Nutrition Survey (KNHNS) 2001 was a nation representative survey with a stratified multistage sampling design. Data from a comprehensive questionnaire, physical examination, and blood sample were obtained from 1,090 Korean children and adolescents (567 boys, 523 girls), aged 10 to 19 years. The metabolic syndrome was determined by using the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII) definition modified for age.
Results : The prevalence of the metabolic syndrome in Korean children and adolescents was 7.1% (9.2% in boys, 4.8% in girls). The syndrome was present in 36.6% of overweight children and adolescents (body mass index [BMI] ≥ 95th percentile) compared with 11.2% of at-risk children and adolescents (BMI 85th to ＜95th percentile) and 2.5% of those with a BMI below the 85th percentile (P＜0.001). A multivariate logistic regression model showed a significant increase in risk of the metabolic syndrome in association with gender and BMI.
Conclusion : Overall, 7.1% of children and adolescents and 36.6% of overweight children and adolescents in Korea met the criteria for the metabolic syndrome. These findings emphasize the need for both public health and clinical interventions to improve the detection, prevention, and treatment of the metabolic syndrome, especially in obese children and adolescents.
Smoking and tobacco addiction are serious public health problems worldwide. New research reveals that addiction to tobacco can begin very early, with very low levels of smoking. Family physicians are in a unique position to prevent smoking initiation by youths and to diagnose and treat tobacco addiction in young smokers. In this paper we discuss the factors that prompt youths to try smoking, how quickly addiction to tobacco begins after the onset of smoking, how a family physician can determine whether a young patient is addicted, and what the physician can do to prevent adolescent patients from beginning to smoke or to assist them to quit if they already smoke.
Background : In comparison to the decreasing smoking rate of adults, the smoking rate in adolescents and women is still increasing worldwide including Korea. Previous studies on the smoking rate of adolescents were done by questionnaires allowing bias in their response because of smoking ban among adolescents in Korea. In order to know the actual smoking rate of Korean adolescents, we performed an objective study using urine nicotine detection.
Methods : From April to July 2002, 306 boy's high school students and 325 girl's high school students in Seoul were included for this study. We obtained self-reported questionnaire from them and assessed urine nicotine level by NicCheck I Test Strip to check their actual smoking status.
Results : The current smoking rate of male students by self-reported questionnaire was 14.9%, 20.4%, 22.5%, respectively and that by detection of urine nicotine was 26.6%, 38.0%, 29.6%, respectively, in the 1st, 2nd and 3rd grade. The current smoking rate of female students by self-reported questionnaire was 22.6%, 23.9%, respectively and that by detection of urine nicotine was 46.6%, 35.4%, respectively in the 2nd and 3rd grade. The Kappa index of the questionnaire results was 0.27, 0.46, 0.75, respectively in the 1st, 2nd and 3rd grade male students and 0.33, 0.44, respectively in the 2nd and 3rd grade female students respectively.
Conclusion : The smoking rate of students by detection of urine nicotine was higher than that of the self-reported questionnaire results. The validity of the questionnaire results was more accurate in males than females, and higher grade than lower grade. The self-reported questionnaire was an insufficient tool for evaluation of adolescents' smoking status, especially in female students and lower grade students.
Background : Obesity in adolescents has been shown to be significantly associated with long-term mortality and morbidity. Leptin serceted by adipose tissue regulates body weight, and obese people show high leptin levels as well as as leptinresistance. The objective of this study was to ex-amine the relationships of leptin concentration with various indices of obesity, cardiovascular risk factors, and diet in adolescents.
Methods : We conducted cross sectional study with sixty-eight obese (28 male and 40 female)and 80 normal weight adolescents (40 male and 40 female), aged 12-18y, from and urban area in South Korea. Weight, height, body fat, waist and hip circumference, blood pressure, and fasting serum glucose, total, LDL, and HDL-cholesterol, triglyceride, and leptin were measured, and a 24 dietary recall obtained.
Results : Females had, on average, two-times higher leptin concentrations per fat mass than males. Circulating leptin was strongly associated with body fat (male:r=0.69, p<0.01; female:r=0.67, p<0.01), and waist circumference (male:r=0.65, p<0.01; female:r=0.64, p<0.01). The correlations between log.leptin and some cardiovascular risk factors were weakly positive. None of the association between log.leptin and nutrient intakes were significant. In a multiple regression model, body fat, gender, and waist circumference were found to be significant independent determinants of leptin concentration.
Conclusion : These results show that female adolescents have higher leptin levels compared to male adolescents, independent of the concomitant variation in total body fat mass. Although leptin concentration did not have direct association with intakes, there was significant correlations with obesity and several cardiovascualr risk factors in Korean adolescents.
Background : Recently in Korea, the rate of addictive drug abuse is rapidly increasing in men on salary, housewives, and even in adolescents, who have been considered to be free from drugs, which presents a serious problem to the society. Especially, the habituation to gateway drug, such as cigarettes and alcohol, before 15 years old, would lead to the increased possibility of other drug abuse, including illicit drugs. Thereupon in this study, we intended to review the effect of adolescents' smoking on the drug abuse and deviated behaviors.
Methods : On September, 1997, randomly selected were 12 classes, on the basis of 2 classes per grade, from the two schools which was located each in Seoul and Bucheon. And survey was done on 610 students with non-nominal, self-reported questionnaire.
Results : The rate of adolescent smoking was 28.1% in male students and had increasing tendency of "the higher the grades, the higher the smoking rate"(17.0% in the 1st grade, 31.5% in the 2nd grade, 35.9% in the 3rd grade). The smoking rate of female students was 12.3%. From the 2nd grade of middle school to the 2nd grade of high school was the critical period when the smoking habit was initiated in almost 90% of the students. The experiencing rates of drug abuse in studied subjects were as follows : drinking(79.0%), stimulants(4.8%), sedatives(4.1%), hypnotics(3.1%), glue sniffing(1.5%), butane gas(0.7%), marijuana/hemp(0.2%). They were higher in the smoking group than in the nonsmoking group, showing statistical significances in most items except hypnotics and marijuana/hemp. Also similar results were shown in deviated behaviors between the groups.
Conclusion : With the concerted efforts of family, school, society and nation, we as family physicians should make efforts to delay and prevent adolescents' smoking, which is a gateway to drug abuse and deviated behaviors, and to increase people's recognition of health risks caused by smoking, and to provide proper program for adolescents to stop smoking.
Background : Despite the declining tendency of the prevalence of tuberculosis in Korea, pulmonary tuberculosis is still considered to be such an important disease in Korea that tuberculosis of patients have been screened by mass miniature radiography(MMR). Although the prevalence of tuberculosis increases with age, screening of it has been done on students and young workers. There hasn't been any study about the prevalence of tuberculosis in adolescents recently.
Methods : MMR were performed on high school freshmen in Seoul from March to September, 1995. Patients with abnormal MMR were further evaluated on history taking and standard chest X-ray, Their results were classified as normal, active tuberculosis, activity-undetermined tuberculosis, healed tuberculosis, and other diseases. The prevalence of active tuberculosis by this screening method was estimated.
Results : Among 194,102 high school freshmen, 388 were suspected to have pulmonary tuberculosis by MMR. The prevalence of tuberculosis in high school freshmen in Seoul was 0.20%, male 0.18%, female 0.23% by MMR respectively, There was significant difference between the prevalences of both sexes. History taking and standard X-ray was taken for 94 students and among them 68 students were found to have active tuberculosis(72.3%), 14 normal(14.9%), 3 other diseases(3.2%), 9 healed or activity-undetermined tuberculosis(9.6%). Newly-diagnosed patients in active tuberculosis were 59(82.9%). There were family history in 31 out of 94 students(33.0%) and 29 out of 68 students(37.1%) with active pulmonary tuberculosis had family history of tuberculosis.
Conclusion : The prevalence of pulmonary tuberculosis in high school freshmen in Seoul was 0.20% by MMR. Positive predictive value of MMR was 72.3% in follow-up students by standard chest X-ray. Therefore estimated prevalence of active pulmonary tuberculosis by standard chest X-ray after MMR was 0.14%.
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