Trends of smoking and passive smoking in residents in Shaanxi province: an analysis on results of four cross-sectional surveys, 2007-2015 / 中华流行病学杂志

Objective@#To understand the trends of smoking and passive smoking exposure in adults in Shaanxi province from 2007 to 2015.@*Methods@#Data was from China Chronic Disease and Risk Factor Surveillance in 2007, 2010, 2013 and 2015 to calculate the rates of smoking, smoking cessation and passive smoking exposure, as well as the amount of smoking of smokers indicated by each surveillance. Cochran-Armitage test was used to assess the trends across survey periods. The weighting rate was calculated by using sampling weight and data from the 6th national census in 2010. Sensitivity analysis was done to test the trends as well.@*Results@#The results of the surveillance indicated that the smoking rate in 2007 was 38.26%, highest in the results of four surveys, it decreased to 30.95% in 2013 and then increased to 34.11% in 2015 (Cochran-Armitage test: Z=2.46, P=0.014). The amount of smoking increased from 16.90 cigarettes per day in 2007 to 17.76 cigarettes per day in 2015. The overall rate of smoking cessation was 11.02% in 2007 and 16.95% in 2015 (Cochran- Armitage test: Z=-4.18, P<0.01). We observed the passive smoking exposure rate was 48.10% in 2010 and 63.88% in 2015 (Cochran-Armitage test: Z=-10.60, P<0.01). We found no difference in trends by sensitivity analysis.@*Conclusions@#The smoking rate and amount of cigarettes smoked in adults in Shaanxi remained stable and at a high level. The rate of smoking cessation increased gradually, while the passive smoking exposure rate increased rapidly.

Outcomes Of A Two-Year Smoke-Free University And Organizational Policy Management

@#This study aimed to evaluate the outcomes of the implementation of a smoke-free university policy after two years and to analyze predictors for organizational policy management and smoke-free university. A cross-sectional survey study was designed and undertaken as a baseline in 2014 and as an evaluation in 2016 in a government university within 2 campuses in the Northeast of Thailand. Students and staff/personnel returned questionnaires at a university. There were 891 and 960 people enrolled in to the study in 2014 and 2016, respectively. Outcomes were smoke-free environment, smoking rate, quit rate and variables affecting a smoke-free university. After two years, the smoke-free environment was improved significantly (p<0.001). The smoking rate was not a statistically significant increase, (6.73% in 2014 and 8.42% in 2016, p>0.05). Of this increase, the rate for regular smoking was lower than its expected value by 7.6%. The quit rate significantly increased from 8.33% to 33.96% (p<0.05). Law and organizational support were significant predictors of organizational policy management (adjusted R2 = 19%, p<0.001). Organizational policy management was a significant predictor for being smoke-free university (adjusted R2= 41%, p<0.001). Two years’ experience of implementing a smoke-free university policy showed significant improvements. The organizational policy management directly strengthened these improvements.

An investigation on smoke-free environment and smoking statusat or below county-level governments / 预防医学

Objective To learn the smoke-free environment and smoking status at or below county-level governments of Zhejiang Province, and to promote a smoke-free government.Methods By multi-stage random sampling method, 4 cities were selected in Zhejiang Province, then 4 counties were selected in 4 cities, finally12 governments were selected in 4 counties.With the methods of field observation,interview and questionnaire survey,smoke-free environment and smoking behavior , tobacco related knowledge of civil servants were investigated.Results A total of 12 governments and 405 civil servants were investigated.The smoke-free environment of 12 governments were relatively well.The total smoking rate of civil servants was 17.78%, and the highest was 26.67% in Jiande City, and the lowest were 9.00% in Zhuji City.For the civil servants ,male(26.62%), aged 50-(40.74%),divorced or widowed(40.00%),graduation of technical secondary school (33.33%),cadre of section rank(57.14%),above 20 years' work(28.81%),smoking anywhere at home(50.00%), smoking in certain areas at work(22.95%)were significantly higher.The rate of cognition on the hazards of smoking was lower among the smokers than that of non-smokers (P<0.05).The rate of agreement on MPOWER tobacco control strategies and smoking bans in public places were lower among the smokers than that of non-smokers (P<0.05).Non-conditional logistic regression analysis showed that age of 30-39(OR=9.87,95%CI:1.45-67.29),50-(OR=9.87,95%CI:1.45-67.29), smoking anywhere at home(OR=12.28,95%CI:2.95-51.18),and smoking in certain areas at home(OR=6.57,95%CI:3.07-14.08) may be the risk factors about smoking behavior.Conclusion The situation of smoking control at or below county-level governments in Zhejiang Province was good, and smoking rates has declined.But tobacco related knowledge and behavior of civil servants were relatively insufficient.Aiming at the problems found in the investigation, it is necessary to strengthen education on smoking control among civil servants, and to promote a smoke-free government.

Impact of Increased Tobacco Price on Adult Smoking Rate in South Korea / 보건행정학회지

BACKGROUND: The purpose of this study is to investigate impact of increased tobacco price in 2015 on the adult smoking rate in South Korea. METHODS: This study used 6th Korea National Health and Nutrition Examination Survey from 2013 to 2015. Total 14,860 adults were included in the analysis. The chi-square test, univariate- and multivariate survey logistic regressions, and subgroup analysis were conducted. RESULTS: Results show that adult smoking rate before price increase were 19.08% and after price increase were 16.69%. Adjusted by variables associated with smoking behavior and others, multivariate survey logistic regressions revealed that smoking rate decreased after introduction of increased tobacco price policy (odds ratio [OR], 0.745; 95% confidence interval [CI], 0.575 to 0.967) and the impact was different by various social status (male: OR, 0.688; 95% CI, 0.523 to 0.905; age over 60: OR, 0.487; 95% CI, 0.315 to 0.754; rural area: OR, 0.531; 95% CI, 0.309 to 0.912; household income Q1: OR, 0.593; 95% CI, 0.352 to 0.999; household income Q4, OR, 0.616; 95% CI, 0.386 to 0.983). CONCLUSION: The study revealed decreased smoking rate after increased tobacco price policy and different trend depending on various social characteristics. We recommend that government agencies and policy makers should pursue tobacco price control policy continuously and population specific manner and concurrently non-price policy should be implemented as well.

Impact of Increased Tobacco Price on Adult Smoking Rate in South Korea / 보건행정학회지

BACKGROUND: The purpose of this study is to investigate impact of increased tobacco price in 2015 on the adult smoking rate in South Korea. METHODS: This study used 6th Korea National Health and Nutrition Examination Survey from 2013 to 2015. Total 14,860 adults were included in the analysis. The chi-square test, univariate- and multivariate survey logistic regressions, and subgroup analysis were conducted. RESULTS: Results show that adult smoking rate before price increase were 19.08% and after price increase were 16.69%. Adjusted by variables associated with smoking behavior and others, multivariate survey logistic regressions revealed that smoking rate decreased after introduction of increased tobacco price policy (odds ratio [OR], 0.745; 95% confidence interval [CI], 0.575 to 0.967) and the impact was different by various social status (male: OR, 0.688; 95% CI, 0.523 to 0.905; age over 60: OR, 0.487; 95% CI, 0.315 to 0.754; rural area: OR, 0.531; 95% CI, 0.309 to 0.912; household income Q1: OR, 0.593; 95% CI, 0.352 to 0.999; household income Q4, OR, 0.616; 95% CI, 0.386 to 0.983). CONCLUSION: The study revealed decreased smoking rate after increased tobacco price policy and different trend depending on various social characteristics. We recommend that government agencies and policy makers should pursue tobacco price control policy continuously and population specific manner and concurrently non-price policy should be implemented as well.

Impact of village-based health education of tobacco control on the current smoking rate in Chinese rural areas / 华中科技大学学报（医学）（英德文版）

The number of smokers in Chinese rural areas is more than 200 million, which is twice that in cities. It is very significant to carry out tobacco control interventions in rural areas. We performed this community intervention study to evaluate the efficacy of village-based health education of tobacco control on the male current smoking rate in rural areas. The population of this study was the males above 15 years old from 6 villages in rural areas. The villages were randomly assigned to intervention group or control group (3 villages in each group). Self-designed smoking questionnaire was applied. The intervention group received the village-based health education of tobacco control for one year. The primary outcome measurement was the male current smoking rate. In the baseline investigation, completed surveys were returned by 814 male residents from the control group and 831 male residents from the intervention group. The male current smoking rate in the control group and the intervention group was 61.2% and 58.5%, respectively, before intervention. There was no significant difference between these two groups (P>0.05). After one-year intervention, the current smoking rate in the intervention group (51.2%) was significantly lower than that in the control group (62.8%) (P<0.001). Our study suggested that the village-based health education of tobacco control was effective in lowering the male current smoking rate in rural areas, which could be a suitable and feasible way for tobacco control in the Chinese rural areas.

The Characteristics of False Respondents on a Self-reported Smoking Survey of Korean Women: Korean National Health and Nutrition Examination Survey, 2008 / 가정의학회지

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 > or =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.

Tobacco consumption and behavior of the smokers in Jiangxi province / 中华流行病学杂志

Objective To explore the behaviors of smokers as well as the tobacco consumption in Jiangxi province.Impact regarding the increases of tobacco retail price on the smoking behaviors among cigarette consumers was also studied.Data was provided for further development on measurements including legislation,taxing and increasing the retail price on tobacco.Methods 805 residents above 15 year-olds were chosen through random clustered sampling,and face to face interviewed,in Shangrao and Yichun of Jiangxi province.A chart was drawn to show the relationship between the change of smoking behavior and the increase of sales price of tobacco.Results The average rate of smoking was 27.08％ (46.62％ for males and 3.05％ for females).16.06％ (35/218) of the smokers had ever tried to quit smoking but failed.The years of smoking ranged from 1 year to 50 years,with 96.33％ of the smokers purchased cigarettes on their own.Price of the cigarette ranged from 15 to 30 RMB per package,and smokers usually spent on average 192 RMB which accounted 13％ of their monthly income,per month.According to the chart,if the cigarette price had a 50％ increase,it would lead to 45％ of the smokers reduce the number of cigarette consumption with another 5％ of the smokers attempt to quit smoking.If cigarette price had an increase by 2 times,50％ of the smokers would attempt to quit smoking.So the chart could be used to estimate the percentage of smokers' behavior change according to the increase of tobacco's sales price.Conclusion The cconomy burden of tobacco consumption among cigarette smokers was huge,suggesting that the Chinese smokers did need to change their smoking behavior.Chinese government should develop tobacco-related legislations and laws and set proper cigarette tax,hopefully this could reduce the number of smokers in a long run.

A descriptive study on the smoking pattern among general population in Xuzhou,2008 / 中华流行病学杂志

Objective To understand the prevalence of smoking in different sub-populations in Xuzhou area so as to develop effective tobacco control policies. Methods Through multi-stage randomized cluster sampling,a face-to-face study with standard questionnaire was carried out among residents aged above 15 years,from June to December 2008,with descriptive nature. Results Totally,44 686 people,with 21 524 males and 23 162 females at age 15 and over were investigated,including 34 391 of them from rural areas and 10 295 from the urban population. Data regarding rates on ever smoked and current smoking,regular smoking,heavy smoking,and average numbers of cigarettes smoked per day,types of tobacco products smoked,rates on quitting smoking successfully,relapse,passive smoke exposure etc.,were 22.45%,21.40%,15.49%,9.49%,15.09/d,4.68%,5.91% and 14.12% respectively. There were no significant differences in the rates of overall smoking,current smoking and regular smoking among urban and rural residents (P>0.05). However,rates of successfully quitting smoking and passive smoke exposure in the urban areas were higher than those in the rural areas (P<0.05). Rates regarding relapse,heavy smoking and average numbers of cigarettes smoked per day in the rural areas were higher than those in the urban areas(P<0.05). Rates on smoking,current smoking,regular smoking,heavy smoking,relapse and average numbers of cigarettes smoked per day were higher in males than those in females (P<0.05). Rates of quitting smoking successfully and passive smoke exposure were higher in females than those in males (P< 0.05). The major types of tobacco products smoked by people aged 15 years old and above were cigarettes (85.17%),and Chinese pipes (3.24%). Conclusion Smoking was quite common in people from Xuzhou. Our data suggested that health education should be strengthened and sustainable intervention measures be developed and implemented to control the tobacco use in the area.

Behavior, attitude and influencing factors of smoking among residents aged 15 to 69 years in Hongkou District of Shanghai / 上海交通大学学报（医学版）

Objective To investigate the prevalence and attitude of smoking and its influencing factors among residents in Hongkou District of Shanghai, so as to provide evidence for tobacco control. Methods Nine hundred and sixty residents in Hongkou District of Shanghai aged 15 to 69 years were selected by multi-level random sampling, among whom 958 completed the investigations on smoking status. Results The smoking rate and standardized smoking rate were 20. 04% and 18. 73%, respectively. The smoking rate and standardized smoking rate of males were 41.05% and 30.07%, and those of females were 0. 80% and 1. 70% , respectively. The smoking rate of males was higher than that of females (RR = 0.02, 95% CI: 0.01 -0.03). The smoking rates of age groups of 25 years old and over were higher than those of 15 to 24 years old, and the smoking rate of subjects with or above junior college education was lower than that of subjects with or below middle school education (RR=0.45, 95% CI: 0.25 -0.79). Subjects who drank alcohol smoked more than those did not (RR = 2. 68, 95% CI: 1. 76 - 4.09). Lower annual per capita income and higher knowledge on smoking hazard led to more tendance to object to smoking and agree with anti-smoking. Conclusion The prevalence of smoking of residents aged 15 to 69 years in Hongkou District of Shanghai was relatively lower. Age, gender, education status and alcohol drinking were influencing factors of smoking. Education on tobacco control among subjects aged more than 35 years should be strengthened, and more attention should be paid to those with lower education. Besides, education on alcohol control should be managed together with tobacco control.

Smoking Prevalence and Habits of Physicians in Korea: a Mail Questionnaire Survey Conducted in 2000

BACKGROUND: Nationwide evaluation of physicians' smoking rate may be helpful to predict future trend of smoking in a general population. Thus, we investigated physicians' smoking rate and their habits in Korea. METHODS: Ten percent of physicians among the registered members of the Korean Medical Association were chosen by stratified random sampling and a mail questionnaire survey was conducted in 2000. Of the 2,977 physicians to whom the questionnaires were delivered, 1,248 (41.9%) responded. RESULTS: Overall smoking rate among Korean doctors was 29.9%. Smoking rate of males was 34.9% and that of females was 2.3%. In the current smokers, the most frequently reported age when they had begun smoking were 15~20 years (60.3%), the majority of daily smoking amount was less than or equal to 1 pack (92.5%), and those who were planning to quit smoking within 1 month were 11.9%. In the ex-smokers, the most frequently reported age when they had begun smoking were in their 20s (67.7%) and the most frequently reported age when they had stopped smoking were in their 30s (38.0%). CONCLUSION: The smoking rate of Korean physicians was estimated to be less than that of the general Korean population, but higher than that of physicians in major developed countries. More efforts to lower smoking rate of physicians and regular follow up is needed.

Change of Smoking Attitude in High School Students of Korea after Increase in Cigarette Tax

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.

Change of Smoking Attitude in High School Students of Korea after Increase in Cigarette Tax

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.

Behavior,attitude and influencing factors of smoking among residents aged 15 to 69 years in Hongkou District of Shanghai / 上海第二医科大学学报

Objective To investigate the prevalence and attitude of smoking and its influencing factors among residents in Hongkou District of Shanghai,so as to provide evidence for tobacco control. Methods Nine hundred and sixty residents in Hongkou District of Shanghai aged 15 to 69 years were selected by multi-level random sampling,among whom 958 completed the investigations on smoking status. Results The smoking rate and standardized smoking rate were 20.04% and 18.73%,respectively.The smoking rate and standardized smoking rate of males were 41.05% and 30.07%,and those of females were 0.80% and 1.70%,respectively.The smoking rate of males was higher than that of females(RR=0.02,95%CI: 0.01-0.03).The smoking rates of age groups of 25 years old and over were higher than those of 15 to 24 years old,and the smoking rate of subjects with or above junior college education was lower than that of subjects with or below middle school education(RR=0.45,95%CI: 0.25-0.79).Subjects who drank alcohol smoked more than those did not(RR=2.68,95%CI: 1.76-4.09).Lower annual per capita income and higher knowledge on smoking hazard led to more tendance to object to smoking and agree with anti-smoking. Conclusion The prevalence of smoking of residents aged 15 to 69 years in Hongkou District of Shanghai was relatively lower.Age,gender,education status and alcohol drinking were influencing factors of smoking.Education on tobacco control among subjects aged more than 35 years should be strengthened,and more attention should be paid to those with lower education.Besides,education on alcohol control should be managed together with tobacco control.

The Difference of Smoking Rates before and after Hospital Admission

BACKGROUND: The harmfulness of smoking is well known, but the smoking rate of adult males in Korea is still high. Therefore, we wanted to find out the factors related to smoking cessation among patients who had been admitted to hospital and to make an effective smoking cessation program. METHODS: We reviewed the medical records of patients who had been admitted to the department of internal medicine or orthopedic surgery of an hospital from January 25, 2005 to June 15, 2005. We enrolled 104 male patients who were smokers and gave them telephone interviews. Among them, 74 patients answered (71.2%). RESULTS: Among the subjects, 10 patients quit smoking and 64 smoked continuously. Age, duration and amount of smoking, past experiences of smoking cessation were not significantly different between the two groups. The patients who were admitted to the department of internal medicine (P=0.047) and advised from doctors to quit smoking (P=0.010) showed a high smoking cessation rate. The patients who were advised by doctors showed a higher rate of planning for smoking cessation, even though they were still smoking (P=0.001). CONCLUSION: For smoking cessation in admission patient's, doctor's advice to quit smoking was important.

Investigation of Smoking Rate, Habits and Attitudes towards Smoking in Lawyers of Korea

BACKGROUND: It is well-known that a decline in the prevalence of smoking among physicians has preceded a decline in the general population. For the purpose of finding out the reason for lower smoking rate in Korean medical doctors than that of general population whether it is due to knowledge of toxicity related to smoking perceived as health professionals or as the only leader group in society this study was investigated. We selected lawyers as a representative of other professional groups. We investigated smoking rate, habits and attitudes towards smoking in Korean lawyers and compared the smoking rate and attitudes to wards smoking in lawyers with those of medical doctors. METHODS: This study investigates smoking rate, habits and attitudes towards smoking in Korean lawyers. An anonymous self-administered postal survey was used. One-third of registered lawyers were sampled according to stratified random sampling. Among 1,401 target population, 463 (38.3%) responded. RESULTS: Among male lawyers, 38.0% were current smokers, 38.9% were ex-smokers and 23.1% were non-smokers, while 7.7% were ex-smokers and 92.3% were non-smokers among female lawyers. The direct age-adjusted smoking rate among Korean male lawyers was 42.1%. CONCLUSION: In comparison of the direct age-adjusted smoking rate among male lawyers, medical doctors and general population in Korea, the rate in lawyers was 42.1%, medical doctors 34.9%, and general population 67.6%. The smoking rate of lawyers was found to be higher than that of medical doctors, but considerably lower than that of general population. In comparison of the attitudes towards smoking between lawyers and medical doctors, the lawyers were found to have a lower level of support in questions of the knowledge about the harmful effects of smoking and smoking bans on health than medical doctors.

The Validity of a Questionnaire on Juvenile Smoking Status through Urine Nicotine Detection

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.

Adolescents' Smoking Status and Effectiveness of Smoking Cessation Education in Chonan Area

BACKGROUND: In spite of worldwide recognition of the hazardous effects of smoking, the adolescent smoking rate in Korea continues to increase. This study was performed to determine the smoking statistics for the Chonan area, and to evaluate the effectiveness of mass smoking cessation education based on Prochaska's trans-theoretical model in adolescents. METHODS: To obtain the smoking statistics, an on-site questionnaire survey was performed on 7,373 students from 5 middle and 6 high schools in the Chonan area from May to July, 2001. A logistic regression analysis was done on the variables in order to determine the factors related to smoking. Immediately after completing smoking cessation education, the second questionnaire, which included questions on the effectiveness and satisfaction of the education, was conducted in one high school. RESULTS: The smoking rates were 18.0% in males, 8.8% in females; 4.3% in middle school students, and 21.1% in high school students. The smoking rate in vocational high schools (30.7%) was higher than in general high schools (11.9%)(P<0.001). Multiple logistic regression analyses indicated that the smoking rate increased in males (OR= 2.28), father's smoking status (OR=1.55), mother's smoking status (OR=2.98), and sibling's smoking status (OR=3.57). Approximately 47% of smokers answered that "curiosity" was their most important motivational factor; 29.1% of smokers started smoking in second grade of middle school. The pre-education survey on the trans-theoretical stage of smoking cessation revealed that 38.1% fell into pre-contemplation stage, 36.8% into contemplation stage, and 25.1% into preparation stage. The post-education survey showed remarkable change to 20.8% of pre-contemplations stage, 47.6% of contemplation stage, and 31.6% of preparation stage. CONCLUSION: The mass smoking cessation education run by doctors did have an impact on the motivational stage of smoking cessation. Therefore, to improve adolescents' health, an active non-smoking campaign and education should be continued in various ways.

Smoking Status and Related Factors of Korean Middle School Students in 2002

BACKGROUND: According to recent studies of smoking rates among adolescents, the age at which young people begin to smoke is decreasing. The present study reports the results of a survey, conducted by the Korean National Tuberculosis Association (KNTA) in 2002, of the smoking status of Korean middle school students. METHODS: From April to November 2002, the KNTA surveyed the present smoking status of middle school students (total 14,296: boys-8,697, girls-5,599) according to sex and grade in 125 schools in 12 provinces during a smoking cessation education program. RESULTS: The survey showed that 18.4% of the males (7th grade-15.8%, 8th grade-17.6%, 9th grade-21.8%) and 8.3% of the females (7th grade-6.2%, 8th grade-9.3%, 9th grade-9.5%) had smoking experience. Approximately 2.5% of the males (7th grade-1.2%, 8th grade-1.8%, 9th grade-4.6%) and 1.0% of the females (7th grade- 0.3%, 8th grade-1.2%, 9th grade-1.5%) smoked regularly. The boys' smoking rate was higher than that of the girls in all grades. Smoking rates varied among the provinces, with Chungbuk having the highest rate (2.8%) and Jeonbuk having the lowest (0.9%). The time when most smokers began to smoke was in 6th grade of elementary school for the boys (15.9%) and 7th grade of middle school for the girls (28.6%). Approximately 69.4% of smokers answered that "curiosity" was the most important motivational factor. Statistical analysis indicated that smoking rates were positively correlated with alcohol use and height of students, but were negatively correlated with parents' level of education. At the end of the smoking cessation education program, the number of smokers had reduced for the boys (from 2.6% to 2.2%), but had increased for the girls (from 1.8% to 2.0%). The pre- program survey on the trans-theoretical stage of smoking cessation revealed that 34.2% fell into a pre- contemplation stage, 34.2% into a contemplation stage, and 31.6% into a preparation stage. The post-education survey showed remarkable changes: 24.0% were in the pre-contemplations stage, 40.0% in the contemplation stage, and 36.0% were in the preparation stage. CONCLUSION: This study reports the results of a survey, conducted by the KNTA in 2002, concerning the national smoking status of middle school students, relating factors, and levels of motivation for quitting smoking. The smoking cessation education program run by the KNTA had an impact on the motivational stage of smoking cessation.

The Smoking Rate Among Doctors and Its Various Implications

The most common disease in Korea is smoking and the number of the sufferers is about twelve million. The prevalence of smoking among doctors may indicate the likelihood of success of population-based anti-tobacco campaigns. It has been established that the decline in the prevalence of smoking among physicians has preceded the decline in the general population according to the Kunz's two-phase model in smoking epidemic. There is also evidence that physicians who smoke are less likely to counsel patients about the hazards of smoking. For these three reasons it is important to understand the current smoking status among medical doctors. The smoking rate was reported to be 34.9% among Korean doctors in male and 2.3% in female in 2000. In the same period it has been reported to be 67.6% in male and 3% in female in the general population. According to Kunz, Korea is a mature country in terms of smoking epidemic. All the doctors should be well aware that there are effective and scientific ways of smoking cessation. But the proportion of doctors who have never been educated for smoking cessation was 97.9%. Undergraduate and continuous medical education for smoking cessation should be reinforced. The drop smoking rate among Korean medical doctors is mandatory.