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Smoking Cessation Intervention in Rural Kerala, India: Findings of a Randomised Controlled Trial

  • Jayakrishnan, Radhakrishnan;Uutela, Antti;Mathew, Aleyamma;Auvinen, Anssi;Mathew, Preethi Sara;Sebastian, Paul
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6797-6802
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    • 2013
  • Background: Prevalence of tobacco use is higher in the rural than urban areas of India. Unlike tobacco cessation clinics located in urban areas, community-based smoking cessation intervention has the potential to reach a wider section of the community to assist in smoking cessation in the rural setting. The present study aimed to assess the effectiveness of a cessation intervention in rural Kerala state, India. Materials and Methods: Current daily smoking resident males in the age group 18-60 years from four community development blocks in rural Kerala were randomly allocated to intervention and control groups. The intervention group received multiple approaches in which priority was given to face-to-face interviews and telephone counselling. Initially educational materials on tobacco hazards were distributed. Further, four rounds of counselling sessions were conducted which included a group counselling with a medical camp as well as individual counselling by trained medical social workers. The control group received general awareness training on tobacco hazards along with an anti-tobacco leaflet. Self-reported smoking status was assessed after 6 and 12 months. Factors associated with tobacco cessation were estimated using binomial regression method. Results: Overall prevalence of smoking abstinence was 14.7% in the intervention and 6.8% in the control group (Relative risk: 1.85, 95% CI: 1.05, 3.25). A total of 41.3% subjects in the intervention area and 13.6% in the control area had reduced smoking by 50% or more at the end of 12 months. Lower number of cigarettes/ bidi used, low nicotine dependence and consultation with a doctor for a medical ailment were the statistically significant predictors for smoking cessation. Conclusions: Rigorous approaches for smoking cessation programmes can enhance quit rates in smoking in rural areas of India.

The Status and Future Challenges of Tobacco Control Policy in Korea

  • Cho, Hong-Jun
    • Journal of Preventive Medicine and Public Health
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    • v.47 no.3
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    • pp.129-135
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    • 2014
  • Tobacco use is the most important preventable risk factor for premature death. The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC), the first international public health treaty, came into force in 2005. This paper reviews the present status of tobacco control policies in Korea according to the WHO FCTC recommendations. In Korea, cigarette use is high among adult males (48.2% in 2010), and cigarette prices are the lowest among the Organization for Economic Cooperation and Development countries with no tax increases since 2004. Smoke-free policies have shown incremental progress since 1995, but smoking is still permitted in many indoor public places. More than 30% of non-smoking adults and adolescents are exposed to second-hand smoke. Public education on the harmful effects of tobacco is currently insufficient and the current policies have not been adequately evaluated. There is no comprehensive ban on tobacco advertising, promotion, or sponsorship in Korea. Cigarette packages have text health warnings on only 30% of the main packaging area, and misleading terms such as "mild" and "light" are permitted. There are nationwide smoking cessation clinics and a Quitline service, but cessation services are not covered by public insurance schemes and there are no national treatment guidelines. The sale of tobacco to minors is prohibited by law, but is poorly enforced. The socioeconomic inequality of smoking prevalence has widened, although the government considers inequality reduction to be a national goal. The tobacco control policies in Korea have faltered recently and priority should be given to the development of comprehensive tobacco control policies.

Doctor's Failure to Provide Effective Treatments for Smokers and the Legal Responsibility of Medical Malpractice (의사의 금연 건강지도의무와 의료과오책임)

  • Kim, Un-Mook
    • The Korean Society of Law and Medicine
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    • v.9 no.2
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    • pp.231-267
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    • 2008
  • Tobacco has become the world's leading cause of deaths and diseases. And !be tobacco use and dependence itself is a kind of diseases, so-called "mental and be-havioural disorders due to use of tobacco" in "International Statistical Classification of Diseases and Related Health Problems(ICD-10)" and "Korean Standard Classification of Diseases". The tobacco use and dependence is a chronic disease that requires repeated clinical interventions and multiple attempts to quit. But effective treatments to the tobacco use and dependence are developed and exist that can significantly increase the rate of long-tenn smoking abstinence. So the physicians should warn smoking patients about the dangers of smoking to the health and the life, and the clinicians ought to provide one of more of the treatments which have been proven effective in helping smokers quit to smoke. It has been concluded that if a doctor failed to provide effective treatment for smokers, and the smokers subsequently died of the smokers-related conditions(tobaccosis) or became incapacitated by the tobaccosis the smokers were considered in the medical malpractice. Thus the smokers could sue the physician for medical malpractice, claiming that the doctor's legal responsibility of appropriate treatments including smoking-cessation which the physician deliberately or negligently breached.

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Analysis of Related Factors on Middle School Student Smoking in Korea (우리나라 중학생의 흡연실태와 관련 요인 분석)

  • Jang, Jin-Yeong
    • Journal of the Korean Society of School Health
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    • v.19 no.2
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    • pp.75-88
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    • 2006
  • Purpose : This study are the secondary data of Global Youth Tobacco Survey(GYTS) developed by the WHO and United State Center for Disease Control(CDC) and Prevention to trace tobacco use among youth in youth in countries across the world. This study was carried out to serve for a basis for antismoking campaigns and to prevent adolescents from smoking by analyzing the smoking by analyzing the smoking realities factors. Methods : This study is a cross-sectional school-based survey, which employed a two-stage cluster sample design to produce a nationally representative sample of middle school students aged 13 to 15 years olds. Seventy-five schools were selected. All schools containing grade 1, 2 and 3 that contained 40 or students were included in the sampling frame. Results : The results of this study were as follows ; 1. The proportion of smoking students in middle school was 6.4% and the rate of smoking in male students(7.4%) was higher than it of in female students(5.5%). 2. 26.5% of all respondent had a experience to try smoke and the results showed that the rate of trying smoking in male students was increased by grade more than female students. 3. According to test of significance in regression analysis, the independent variables such as sex, school grade, smoking parents, friends distinction, pocket money and others showed statistical significance. 4. There was a statistical significance between smokers and nonsmokers in proportion to the completing the preventive education for nonsmoking(p=0.0023) and the acquirement of knowledge on smoking(p<.0001). 5. Finally there was a statistical significance between the exposure to anti-smoking campaign(p=0.0053) and tobacco advertisement in the mass media and the smoking(p=0.0036). Conclusion : All things considered, the health education for tobacco control in school need to be developed from an elementary school. I suggest that prevent smoking program in school need to be revitalized and be made more accessible for everyone who wish to quit. And the government should develop the regulation on total banning promoting cigarette advertising and smoking scene in the movie for young people.

Rethinking Anti-tobacco Health Education in an Eastern Mediterranean Country with Growing Tobacco Use

  • Obeidat, NA;Ayub, HS;Shtaiwi, AS;Hawari, FI
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.2
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    • pp.527-533
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    • 2016
  • Background: In Jordan, a developing country with a high tobacco burden and where roughly 40% of cancers are tobacco-related, limited knowledge exists on public awareness regarding tobacco. This is a hindrance for experts seeking to strengthen anti-tobacco health promotion and counter growing tobacco use. We sought to evaluate public awareness regarding tobacco; to gauge exposure to anti-tobacco public messages; and to draw attention to the lay public's informational needs. Materials and Methods: A cross-sectional survey of lay public in the capital, Amman, capturing knowledge regarding tobacco harms and anti-tobacco laws, perceptions regarding tobacco use and control, and exposure to and recall of anti-tobacco messages, was conducted. Statistics on perceptions were generated and analyzed by smoking status and sociodemographic factors. Multivariate regression was performed to estimate independent associations of smoking and sociodemographic factors with knowledge. Results: Of 1,169 respondents, 17.8% could recall specific anti-tobacco messages. With regard to knowledge, despite high proportions of respondents exhibiting knowledge for individual statements regarding tobacco health harms, variables capturing breadth of knowledge showed that much lower proportions could correctly identify all the listed health harms of tobacco, and all listed Jordanian anti-tobacco regulations (47.5% and 36.2%, respectively). On multivariate analysis, breadth of knowledge varied by smoking status, age and educational level. Conclusions: There is need for more salient, evocative and multi-faceted anti-tobacco messages in Jordan, tailored to subgroups, given detected variability in knowledge across smoking status and sociodemographic characteristics.

Influences of Tobacco-Related Knowledge on Awareness and Behavior towards Smoking

  • Park, Jinju;Lim, Min Kyung;Yun, E Hwa;Oh, Jin-Kyoung;Jeong, Bo Yoon;Cheon, Yejin;Lim, Sujin
    • Journal of Korean Medical Science
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    • v.33 no.47
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    • pp.302.1-303.10
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    • 2018
  • Background: A considerable amount of research has shown that knowledge and appropriate awareness are essential for encouraging positive behaviors and promoting health. In Korea, the roles that behavioral changes play in the prevention of cancer have been an important issue since the introduction of the 10 codes for cancer prevention in 2006. Thus, the present study investigated the associations of tobacco-related knowledge with awareness and attitudes towards positive smoking-cessation behaviors. Methods: The present study analyzed data from the 2010 national questionnaire survey (n = 1,006). This study evaluated sociodemographic characteristics, smoking status, self-rated health status, health-related interests, and the accuracy of 12 tobacco-related statements to determine knowledge level and to investigate its impact on awareness and behaviors related to smoking. These parameters were examined and staged using the Precaution Adoption Process Model. Results: A higher level of tobacco-related knowledge was significantly associated with a positive attitude towards smoking cessation (5-8 correct answers: odds ratio [OR], 2.53; 95% confidence interval [CI], 1.57-4.08; ${\geq}9$ correct answers: OR, 3.90; 95% CI, 2.22-6.82; reference: ${\leq}4$ correct answers). Interestingly, among current smokers, only those who correctly responded to ${\geq}9$ of 12 tobacco-related statements were significantly associated with a positive attitude towards smoking cessation. Conclusion: This study found that having a higher level of tobacco-related knowledge had a significant impact on positive attitudes towards smoking cessation. This suggests that there is a need to disseminate appropriate knowledge to the general population to encourage positive attitudes and promote healthful behaviors in terms of smoking.

A Cross-Country Comparison of Knowledge, Attitudes and Practices about Tobacco Use: Findings from the Global Adult Tobacco Survey

  • Gupta, Bhawna;Kumar, Narinder
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.12
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    • pp.5035-5042
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    • 2014
  • Background: Knowledge and individual perceptions about adverse effects of all forms of tobacco exert direct influence on the level of tobacco consumption in various socio-demographic groups. The objective of this study was to determine the nature, extent and demographic correlates of knowledge, attitudes and perceptions of use of tobacco among adults in low and middle income countries. Materials and Methods: The Global Adult Tobacco Survey, conducted in fourteen different countries from 2008-2010, was sourced for the data analyzed in this study. Descriptive statistical analyses were conducted to determine the prevalent knowledge and individual perceptions amongst adults about all forms of tobacco consumption. Results: There was relatively high awareness about the harmful effects of smoking tobacco with main awareness being about its relationship with lung cancer (>90% in most countries). In contrast, there was relatively low awareness about harmful effects of smokeless tobacco (< 90% in all countries except India and Bangladesh), and observed correlation of smoking tobacco with heart attack (40.6% in China, 65.1% in India) and stroke (28.2% in China, 50.5% in India). Conclusions: A large proportion of adults living in low and middle income countries possess adequate knowledge about smoking tobacco but have inadequate awareness as well as false perceptions about smokeless forms of tobacco. Popular beliefs of inverse relationships of tobacco consumption with knowledge, attitudes and perception of populations towards tobacco are challenged by the findings of this study.

Smoking and Health Control (흡연과 건강관리)

  • 박선섭
    • Korean Journal of Health Education and Promotion
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    • v.6 no.2
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    • pp.66-75
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    • 1989
  • About smoking and health control by theorize of common with various records investigation prevent an injury from smoking Further, should be contribute for the national health improvement for application of guide to health education. The results of investigation are as follows; 1) Tobacco be transmitted the first year of KwangHea's(reign) from GeeRu(the year of GeeRu), before sixth year of KwangHea's GapIn. 2) By reason of smoking an extreme poison ingerdients is Nicotine, Co, Tar etc three kinds. 3) The number of chemicalcompound in the tobacco smoking. Nicotine play an important part of it makes continue to smoking act. 4) Co, Not only injury vascular in the cell wall but also influence in ardiac muscular tissue. 5) Tar, is play an important part tl determine taste of tobacco or fragrace(a sweet smell). 6) Be demaged in the body with harmful objects of tobacco is first lung cancer, next heart disease, and chronic lung disease etc. 7) Passive smoke(indirect smoke)is first smoker's when have smoking and blow smoke from cigarette take smoking. On second when take smoking as it is burning cagar to end. 8) Female smoker are no good and bring many trouble to the mother's body and fetal body(an unborn child). 9) Nicotine also, like drug and alcohol break out reliance, introspection, poisonous or obstinence syndrome 10) A counterplan about smoke should be settlement with propriety control of smoking and an antismoking(non-smoker).

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Predictors of Tobacco Use among Youth in India: GATS 2009-2010 Survey

  • Sharma, Shailja;Singh, Mitasha;Lal, Pranay;Goel, Sonu
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7535-7540
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    • 2015
  • Background: Early initiation of smoking and chewing of diverse forms of tobacco among youth in India is a significant driver for tobacco epidemic in India. Several socio-demographic factors are predictors of tobacco use in populations, especially among youth. Interventions which address these socio-demographic factors can help policy makers to curb new initiations and avert morbidity and mortality due to tobacco use. Objective: To study the various sociodemographic variables associated with tobacco use among youth in India. Materials and Methods: Secondary analysis of data from the Global Adult Tobacco Survey-India 2009-10 for the age group of 15-24 years was performed and predictors of smoking and smokeless tobacco were analyzed using data on occupation, education, and other sociodemographic factors. Results: In India there are a total of 51.3 million (22.1%) youth (15-24 years) tobacco users. Of these 35.1 million consumes chewable tobacco (15.1%), 16.2 million smoke (7%) and 1.6 million are dual users (3.1%). Males, urban, less educated, un-employed and those belonging to middle class preferred smoking over chewing; whereas, females, rural, students and those belonging to low socio-economic class are predictors of smokeless tobacco use. The major determinants of dual users are male sex, poor socio-economic strata and student class. The overall tobacco use was higher among males, rural populations, lower socioeconomic strata and un-employed class. Conclusions: India's youth is more susceptible to the tobacco addiction, especially of smokeless tobacco. Youth from rural India especially students, girls and those from poor socio-economic strata prefer to use smokeless tobacco products whereas urban, male and those less educated prefer smoking tobacco products. More population-based and region-focused research is needed to understand initiation patterns into tobacco use among youth so as to inform policymakers to devise new policy measures to curb the growing epidemic.

Social Determinants of Health and Tobacco Use in Five Low - and Middle-Income Countries - Results from the Global Adult Tobacco Survey (GATS), 2011 - 2012

  • Tee, Guat Hiong;Aris, Tahir;Rarick, James;Irimie, Sorina
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.3
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    • pp.1269-1276
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    • 2016
  • Background: Tobacco consumption continues to be the leading cause of preventable deaths globally. The objective of this study was to examine the associaton of selected socio-demographic variables with current tobacco use in five countries that participated in the Phase II Global Adult Tobacco Survey in 2011 - 2012. Materials and Methods: We analysed internationally comparable representative household survey data from 33,482 respondents aged ${\geq}15years$ in Indonesia, Malaysia, Romania, Argentina and Nigeria for determinants of tobacco use within each country. Socio-demographic variables analysed included gender, age, residency, education, wealth index and awareness of smoking health consequences. Current tobacco use was defined as smoking or use of smokeless tobacco daily or occasionally. Results: The overall prevalence of tobacco use varied from 5.5% in Nigeria to 35.7% in Indonesia and was significantly higher among males than females in all five countries. Odds ratios for current tobacco use were significantly higher among males for all countries [with the greatest odds among Indonesian men (OR=67.4, 95% CI: 51.2-88.7)] and among urban dwellers in Romania. The odds of current tobacco use decreased as age increased for all countries except Nigeria where. The reverse was true for Argentina and Nigeria. Significant trends for decreasing tobacco use with increasing educational levels and wealth index were seen in Indonesia, Malaysia and Romania. Significant negative associations between current tobacco use and awareness of adverse health consequences of smoking were found in all countries except Argentina. Conclusions: Males and the socially and economically disadvantaged populations are at the greatest risk of tobacco use. Tobacco control interventions maybe tailored to this segment of population and incorporate educational interventions to increase knowledge of adverse health consequences of smoking.