• Journal of Korean Academy of Nursing
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• v.47 no.2
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• pp.211-221
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• 2017

Purpose: This study was done to develop and test a structural model on smoking cessation intention in technical high school men. The conceptual model was based on the theory of reasoned action and health promotion model. Methods: From May 29 to April 13, 2015, 413 technical high school students who smoked completed a structured questionnaire. Data were analyzed to calculate the direct and indirect effects of factors affecting smoking cessation intention. The SPSS WIN 20.0 and AMOS 21.0 programs were used. Results: The hypothetical model was a good fit for the data. The model fit indices were $x^2/df=2.36$, GFI=.95, AGFI=.92, NFI=0.97, and RMSEA=.05. Self-esteem had direct and indirect effects on smoking cessation intention. Attitude, subjective norm, and self-efficacy had direct effects on smoking cessation intention. Smoking knowledge and environmental factor had indirect effects on smoking cessation intention. This model explained 87.0% of the variance in smoking cessation intention. Conclusion: These results indicate that technical high school students' intention to stop smoking can be improved through an increase in self-esteem, negative environmental factors, attitude toward smoking cessation, subjective norm about smoking cessation, and self-efficacy for smoking cessation.

• Journal of Preventive Medicine and Public Health
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• v.45 no.2
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• pp.105-112
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• 2012

Objectives: Cigarette smoking is a modifiable risk factor for cardiovascular disease. Bilirubin is a potent antioxidant and its concentration decreases in smokers. However, studies about the association between cigarette smoking and bilirubin are scarce and most are limited to total bilirubin. Additionally, bilirubin is highly related to hemoglobin. Therefore, this study evaluates the association between bilirubin subtypes and cigarette smoking in healthy Korean men independently of hemoglobin. Methods: This study included 48 040 Korean men aged 30 to 87 years who visited the Korea Medical Institute for routine health examinations from January to December, 2007. The association of smoking with total, direct, and indirect bilirubin was assessed by logistic regression analysis taking into consideration differences in subjects and smoking characteristics. Results: Current smokers had lower bilirubin concentrations than never-smokers and ex-smokers. Smoking amount and duration were inversely significantly associated with total, direct, and indirect bilirubin. In a multivariable adjusted model, compared to never-smokers, the odds ratios (ORs) and 95% confidence intervals (CIs) of current smokers with the highest number of pack-years were 1.7 (1.6 to 1.9) for total, 1.5 (1.4 to 1.6) for direct, and 1.7 (1.6 to 1.9) for indirect bilirubin. After further adjustment for hemoglobin, this association became stronger (OR [95% CI], 2.1 [1.9 to 2.2] for total; 1.9 [1.8 to 2.0] for direct; 2.0 [1.9 to 2.2] for indirect bilirubin). Conclusions: In this study, bilirubin subtypes are inversely associated with smoking status, smoking amount, and smoking duration in healthy Korean men independently of hemoglobin. Further studies are needed to investigate this association in healthy Korean women.

• Journal of Preventive Medicine and Public Health
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• v.34 no.3
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• pp.269-276
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• 2001

Objectives : To evaluate the internal burden and hazardous effects associated with smoking in middle and high school students. Methods : We analysed urinary cotinine(U-cotinine) concentrations and the frequency of Sister Chromatid Exchanges (SCE). A comparison was done of U-cotinine concentrations and the frequency of SCE in peripheral lymphocytes across school levels (middle vs. high) and smoking types (direct: daily & occasional smoking, indirect; usual indirect & non-smoking), in 122 males. Results : The middle school student group comprised 6.8% daily smokers, 15.9% occasional smokers, 40.9% daily indirect smokers, and 35.4% nonsmokers, while the high school student group comprised 18.0%, 20.5%, 35.7%, and 21.8%, respectively. The U-cotinine concentration and the frequency of SCE among the middle school students were $79.11{\mu}g/l$ and 2.0 per cell, respectively, which were significantly lower than the $146.85{\mu}g/l$ (p=0.078) and 2.6 per cell (p=0.005) of the high school students. Among the 40 direct smokers, these two biomarkers were $236.66{\mu}g/l$ and 2.59 per cell, significantly higher than the $67.33{\mu}g/l$ (p=0.0001) and 2.1 per cell (p=0.003) among indirect smoking groups. The variation in individual U-cotinine concentration ranged widely in both the indirect and direct smoking groups. Conclusion : Urinary cotinine concentrations and the frequency of Sister Chromatid Exchange seem to objectively and effectively evaluate student exposure whether it was direct or indirect smoking. Consequently, these biomarkers may be useful in monitoring the objective efficacy of anti-smoking programs in adolescent populations.

• Journal of Korean Academy of Nursing
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• v.29 no.6
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• pp.1192-1207
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• 1999

The purpose of this study was to clarify the dynamic relationships among risk factors of arteriosclerosis and to develop and examine a model which could explain this relationship clearly. Data were collected from medical records of 400 male clients who visited a university hospital located in Inchon for physical examinations, from May 1996 to December 1996. Data were analyzed using the LISREL (Linear Structural Relationship) 8 program. To test the fitness of the hypothesized model, chi-square, RMSR (root mean square residual), GFI (goodness of fit index), CN (critical number) and Q-plot were used. Most of the fitness measurements, except the chi-square showed that the hypothesized model complimented the real data. According to the results, there were trends that obesity and hyperlipidemia were prevalent in heavier smokers, higher alcohol intakers, and groups who excercised less. Also, hypertension was more prevalent in older age, higher alcohol intaker, and higher serum lipid level groups. In contrast to the hypothesis, alcohol intake did not significantly affect serum lipid levels. This might be due to the serum lipid measurements (total cholesterol and trigryceride) used in this study to estimate hyperlipidemia. The direct effect of smoking on hypertension was not significant. However, the total effect of smoking on the hypertension was significant since indirect effects of smoking on hypertension, such as obesity and hyperlipidemia, were significant. The total effect of obesity on hypertension was significant since the indirect effect of obesity on hypertension via hyperlipidemia was significant, although the direct effect of smoking on hypertension was not significant. The degree of explaining hyperlipidemia with smoking, exercise, and obesity was high (60%), however, the degree of explaining obesity with age, smoking, alcohol intake, and exercise was very low (7%). On the basis of these results, high risk factors of arteriosclerosis such as hypertension, hyperlipidemia, or obesity are either directly or indirectly correlated each other. Therefore, it is difficult to predict outcomes for increasing or decreasing the risk factors by simply modulating a factor. Smoking, alcohol, and exercise both directly and indirectly affected major risk factors of arteriosclerosis. Therefore, correcting these variables is required to decrease risk factors. Finally, the relationship among other risk factors which have been known to be related with arteriosclerosis (diet, stress or hereditary) should be clarified in further studies.

• Korean Journal of Health Education and Promotion
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• v.19 no.3
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• pp.13-34
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• 2002

This study examined smoking behavior of Korean female college students by applying the Ajzen's Theory of Planned Behavior, and tried to uncover the factors influencing smoking behavior. The main findings are as follows: First, the attitude toward smoking behavior and the perceived behavioral control were statistically significant in predicting smoking intention. The smoking intention was also significant in predicting smoking behavior. Thus, in order to promote to stop smoking, smoking prevention education emphasizing to reduce smoking intention, to lower the positive attitude toward smoking behavior and to enhance the capacity for perceived behavioral control seems to be helpful. Second, the smoking intention influenced significantly over the smoking behavior in all situations. But the influences of the attitude toward smoking behavior, the subjective norms, and the perceived behavioral control over the smoking intention varied from not significant in one situation to significant in the other situation. Thus, different prevention programs according to the characteristics of individuals need to be developed. Third, in a path analysis, the grade and the degree of satisfaction with college life had the indirect influence, and the growth place had the direct influence over the attitude toward smoking behavior and smoking intention. Thus the smoking prevention program focusing on the students who are the first grade, less satisfied with college life, and growing up in small cities should be developed.

• Research in Community and Public Health Nursing
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• v.9 no.1
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• pp.117-127
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• 1998

The Theory of Planned Behavior has been shown to yield great explanatory power in health behavior as well as social behavior. This study was conducted to test the Theory of Planned Behavior in the prediction and intention of smoking cessation behavior in university student smokers. We conveniently sampled 204 university student smokers and investigated using questionaries, analyzing the data with the Pearson product-moment correlation, and multiple regression. The results are as follows : 1. There are significant correlations in direct and indirect measures of attitude toward smoking cessation behavior, subjective norm, and perceived behavioral control. 2. Behavior belief is significant in predicting attitudes toward smoking cessation behavior. Normative belief is significant in predicting the subjective norm. Control belief is significant in predicting perceived behavioral control. 3. Attitude toward smoking cessation behavior, subjective norm are significant in predicting intention of smoking cessation behavior. In conclusion, this study demonstrated strong support for the Theory of the Planned Behavior and its use to predict smoking cessation behavior in university students smokers. But, as perceived behavioral control is not significant in predicting smoking cessation behavior, indepth research is needed to evaluate the usefullness of the Theory of Planned Behavior and Reasoned Action Theory.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.23 no.2
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• pp.41-49
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• 2013

Objectives: The purpose of this study was to clarify the association between serum carcinoembryonic antigen (CEA) and type of work in the shipbuilding industry. Methods: 1,072 final study subjects were admitted to a general hospital from April through July 2010 for the purpose of medical examination. Data on general characteristics such as age, smoking history, alcohol history and exercise habits was gathered through structured self-administered questionnaires. Information on job factors was collected from a medical examination, by interview and through company personnel data. Serum CEA levels were measured after eight hours' fasting and were analyzed by a radioimmunoassay. Results: On univariate analysis, the mean serum CEA level was significantly higher among married (p=0.02), older age (p<0.01), longer work time (p<0.01), smokers (p<0.01), lower education (p<0.01), and indirect and direct exposure groups (p<0.01). On multiple regression analysis, serum CEA level was influenced by smoking (p=0.001), duration of work (p=0.019), and direct exposure group (p<0.001). However, among the direct exposure group, serum CEA level was not significantly different between welding, mounting, electro-device constructive work, grinding and cleaning, and painting. Conclusions: The goal of this research was to determine if there were differences between serum CEA levels according to occupational role among shipyard workers. The direct exposure group of shipyard workers had a relatively higher level of serum CEA than did the indirect exposure group and office workers, most likely due to occupational exposure.

• Journal of the Korean Society of School Health
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• v.14 no.2
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• pp.207-213
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• 2001

Objectives: We surveyed the prevalence of smoking among the adolescent population and analysed the correlation of the two exposure biomarkers-concentration of blood cadmium and urinary cotinine-to the smoking status. Methods: Subjects were 193 middle and high school students in Chungnam province. Blood cadmium and urinary cotinine were compared by sex and smoking status. Smoking status were classified by either the concentration of urinary cotinine or subjective answering as a smoker in the questionnaire. Results: Smoking prevalence was 24.6%, 36.2% and 6.7% among all subjects, male and female subjects, respectively. Average smoking amount was 17.5 and 1.5 cigarettes per month among the male subjects and female subjects, respectively. Mean concentration of urinary cotinine among the male subjects was $135.57{\mu}g/{\ell}$, and that of female subjects was $116.59{\mu}g/$. Direct smokers showed higher concentration of urinary cotinine than those of indirect smokers, and subjects with higher urinary concentration showed higher prevalence of smoking, too. Mean concentration of blood cadmium was $0.0572{\mu}g/d{\ell}$ among the male subjects, and $0.0693{\mu}g/d{\ell}$ among the female subjects. Among the male subjects, both exposure biomarkers showed significant correlation to the smoking status, but among the female subjects urinary cotinine did not show significant correlation to the smoking status. Conclusion: Concentrations of these two biomarkers suggested that this population had significantly high evironmental tobacco smoking(ETS) and efficient stop-smoking programs to reduce ETS should be directed to this population.

• Journal of Preventive Medicine and Public Health
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• v.34 no.3
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• pp.183-190
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• 2001

Objective : To estimate the annual economic costs attributable to cigarette smoking in Korea. Methods : The costs were classified as being direct medical and non-medical costs, indirect costs and others. We focused on those costs related that are incurred in the treatment of selected diseases (cardiovascular diseases, respiratory diseases, and cancers), which have been proven to be caused by smoking. In addition to the basic costs of treatment, the additional amount of costs occurred due to smoking was obtained by computing the population attributable risk (PAR%) caused by smoking. To compute the PAR%, relative risks of smoking to the number of outpatient visits, hospitalizations, and the death were estimated using the Cox proportional hazard model, respectively. Our major data source was the 'Korea Medical Insurance Corporation (KMIC) cohort study,' which was composed of a total of 115,682 male and 67,932 female beneficiaries who had complete records of their smoking histories in the year of 1992. Results : The annual costs that could be attributable to smoking were estimated to be in the range of 2,847,500 million Won to 3,959,100 million Won. The maximum estimate of 3,959,100 million Won includes 233,100 million Won for medical costs, 5,100 million Won for transportation costs, 27,600 million Won for care giver's economic costs, 69,100 million Won in productivity loss, 3,435,000 million Won lost because of premature death, 172,100 million Won in costs resulting from passive smoke inhalation and 17,100 million Won for costs that resulted from fires that were caused by careless smoking. Conclusion : Our study confirms that the magnitude of the economic burden of smoking to Korean society is substantial. Therefore, this study provides strong evidence that there is a strong need for a national policy of tobacco control in Korea.

• Korean Public Health Research
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• v.44 no.4
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• pp.15-24
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• 2018

Objective : This study explores whether and how the amount of smoking differs by economic status and perception among the men in working age. Methods : The study utilized the 4th wave of KoWEPS containing the items on perception of economic conditions. Analysis was conducted on ever-married men aged 30-54, who have capacity to work. It used 2 stage regression model methods to examine the mediation effect of perception on economic status. Results : The results shows that the negative perception on economic status has a positive effect on smoking. Disposable income affects smoking only through the perception of economic status. Employment status exerts both direct and indirect effect on smoking. Conclusions : These findings imply that less privileged economic status is related to smoking through anxiety or stress for the negative perception on it.