KJC Korea
Journal Central

Korean Society for Research on Nicotine and Tobacco (KSRNT Chairman: Baek Yoo-jin, a professor at Hallym University Medical School), had encountered the U.S. Centers for Disease Control and Prevention’s epidemiological report on the epidemics of an E-cig related lung disease(Sept. 17), and we are very concerned about the promotion of e-cigarettes (including devices) and reckless advertising activities in the blind spots and the increase in number of e-cigarette users (especially in the young population, including adolescents). We strongly urge the National Assembly and the government to come up with effective policies to strengthen the regulation of tobacco products, including e-cigarettes (including devices).

Background: Smoking cessation clinic service is provided in public health center since 2005 in Korea, and it has been included in the National Health Insurance Service since 2015. This cross-sectional study investigated factors affecting satisfaction with the service and differences in satisfaction rates between smokers who were successful and unsuccessful in quitting smoking. Methods: A satisfaction survey was administered to 1,500 participants in 2016; of these, 1,418 answered all the satisfaction items. The success and failure of smoking cessation were defined as whether the individual had smoked during the week before taking the questionnaire. Chi-square test was used to evaluate differences in the respondents’ satisfaction with the smoking cessation support services and with the treatment received from physicians. Logistic regression analysis was used to determine the factors associated with the satisfaction rate. Results: Of the 1,418 respondents, 644 successfully quit smoking and 774 failed to quit. The satisfaction rates for the support services and treatment were significantly higher in the success group. Multivariate analysis showed that successful smoking cessation was an independent factor that increased satisfaction with both the support services (odds ratio, 3.70; 95% confidence interval, 2.45–5.59) and treatment by the physician (odds ratio, 2.06; 95% confidence interval, 1.44–2.96). Conclusion: Successful smoking cessation was an independent factor related to satisfaction with the support service and treatment by the physician. Satisfaction rates differed with age, sex, and hypertension. To increase satisfaction rates, medical staff should provide targeted treatments considering each individual’s characteristics.

Background: Few studies have been performed on electronic cigarette (e-cigarette) use among Korean adults with no history of combustible cigarette (CC) use. Methods: We used data from the Korea Community Health Survey (2014–2017) to analyze factors associated with e-cigarette ever use among adults with no history of CC use. Multivariate logistic regression analysis was performed to evaluate the relationship between ever use of e-cigarettes and never use of CCs after adjusting for sociodemographic and health behavior factors. Results: Among 579,815 participants with never use of CCs, 971 (0.2%) had ever used e-cigarettes. The odds ratios (ORs) for ever use of e-cigarettes were higher in individuals at a younger age [OR for age 19–34 years was 9.53 than that for age ≥ 65 years, 95% confidence interval (CI) 4.11–22.12], heavy alcohol consumers (OR 1.94, 95% CI 1.54–2.46), those with depressive symptoms (OR 2.36, 95% CI 1.62–3.44), those with poor general health (OR 1.39, 95% CI 1.10–1.75), and those with diabetes (OR 2.27, 95% CI 1.36–3.80). However, the ORs for ever use of e-cigarettes were lower in females (OR 0.11, 95% CI 0.08–0.14), those with low physical activity (OR 0.73, 95% CI 0.56–0.95), and those with hypertension (OR 0.59, 95% CI 0.39–0.89). Conclusions: Ever use of e-cigarette was not common among never users of CCs. However, it was more prevalent in younger individuals, males, and those with poor health and health habits. These factors must be considered while establishing tobacco control policies.

Background: Some previous studies have claimed that electronic cigarette (e-cigarette) use is helpful in quitting smoking. However, this role of e-cigarettes remains uncertain because several current smokers use e-cigarettes as an alternative to tobacco smoking. The present study aimed to compare the quitting behaviors of dual users and cigarette-only smokers. Methods: Data of 5,179 current smokers from the sixth and seventh Korea National Health and Nutrition Examination Surveys (2013–2017) were analyzed. Current smokers were divided into dual users and cigarette-only smokers based on e-cigarette use in the past month. Factors influencing e-cigarette use were investigated. Differences in the quitting behaviors between both groups were assessed using multivariate logistic regression analysis with STATA 11.0. Results: Young age (＜40 years) and smoking amount (＞20 cigarettes/day) were associated with e-cigarette use. Nicotine replacement therapy (NRT) use in the past 5 days was associated with e-cigarette use [odds ratio (OR), 5.328; 95% confidence interval (CI), 2.377-11.941]. Dual users demonstrated higher quit attempts in the past year (OR, 1.600; 95% CI, 1.113-2.301). There was no difference between dual users and cigarette-only smokers in choosing an evidence-based quit method such as using a quit line or visiting a smoking cessation clinic. However, dual use was associated with use of NRT over the counter NRT use. Conclusion: There are no differences in employing an evidence-based smoking cessation method between dual users and cigarette-only smokers, despite the higher quit attempts in dual users. Further evaluation of the effect of NRT use as a quitting method on dual users is warranted.

Background: Even a small smoking amount can increase the risk of lung cancer and cardiovascular diseases. The association between low-intensity smoking [<1/1–10 cigarettes per day (CPD)] and metabolic syndrome (MS) remains unknown. Methods: Overall, 4,130 men aged >18 years were recruited from the 2015-2016 Korea National Health and Nutrition Examination Survey and divided by smoking history into never smoker, former smoker, intermittent smoker (<1 CPD), light smoker (1–10 CPD), moderate smoker (11–19 CPD), and heavy smoker (≥20 CPD). We investigated the association between current smoking amount, cigarette smoking duration, and pack-year and MS and its components. The association between smoking status and MS was evaluated with logistic regression analysis after adjusting for age, body mass index, house income, marital status, alcohol consumption, physical activity, and comorbidity. Results: Multivariate analysis revealed a dose–response association with smoking intensity and abdominal obesity, low high-density lipoprotein (HDL) cholesterol, high triglycerides, and MS but not with high blood pressure and high fasting glucose. The smoking amount that increased the risk was different for each component but significant for intermittent smoking (high triglycerides), light smoking (low HDL cholesterol), moderate smoking (MS), and heavy smoking (abdominal obesity). Similar dose–response association was observed between pack-year and MS. Conclusions: Smoking has a dose–response association with MS but this association is inconsistent among its components. The risk of high triglycerides and low HDL cholesterol may increase even with low-intensity smoking, but the association between smoking and high blood pressure and glucose is not definite.

Introduction: Work schedules and working hours are known to affect the incidence of cancer, heart disease, and cardiovascular disease and are associated with unhealthy behaviors. This study evaluated the association between smoking rates in Korean adult workers and their work schedules and working hours. Methods: The analysis included data of 15,904 workers aged ≥19 years obtained from the Korea National Health and Nutrition Examination Survey (2013–2017). The work schedule was categorized as day, evening, night, or shift work, and the working hours per week as ≤40 h, 40–50 h, 50–60 h, or >60 h. Associations were assessed using multivariate logistic regression analysis. Results: Current smokers accounted for 27.4% of the included subjects. Women who worked in the evening or at night had significantly higher smoking rates than those who worked during the day [evening work: odds ratio (OR), 1.797; 95% confidence interval (CI), 1.306–2.471; night work: OR, 6.835; 95% CI, 4.075–11.461]. Smoking rates were significantly higher in both men and women who worked >60 h per week (men: OR, 1.328; 95% CI, 1.117–1.578; women: OR, 1.835; 95% CI, 1.247–2.701). Conclusion: The work schedule and working hours of adult workers in Korea influenced their smoking rates. Tobacco control policies for employees should consider the employees’ work schedules and working hours.

Background: Although there has been a sharp increase in the use of heated tobacco products (HTPs) in Korea, its accuracy has not been verified. Methods: In total, 121 participants who used any type of tobacco [conventional cigarette (CC), electronic cigarettes (EC), and/or HTP] and completed an online survey in June 2019 were recruited. They were interviewed and classified into seven categories according to their combination. Results: Discordance between self-reported and interviewer-rated tobacco use patterns was 39.7% (48/121). Between these, large differences were observed in the prevalence of HTP alone (0% vs. 24.8%), triple use (18.2% vs. 4.1%), and dual use of CC/HTP (22.3% vs. 14.0), but relatively small differences were observed in the prevalence of CC alone (41.3% vs. 42.1%), EC alone (7.4% vs. 9.1%), and dual use of CC/EC (10.7% vs. 5.8%). Conclusion: There was a large difference between self-reported and interviewer-related tobacco use patterns, especially among those who currently used HTP regardless of CC or EC use.

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