• Korea Journal of Hospital Management
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• v.22 no.4
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• pp.16-23
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• 2017

Purposes: Despite the positive health effects of both smokers and non-smokers, the non-smoking area policy is being negatively evaluated because of the vague fears of declining restaurant sales. The purpose of this study is to analyze the changes in sales of general restaurants(including liquor stores) and other restaurants that are considered to have the most applications of smoking cessation policy among the smoking facilities, and to examine the economic impact of the designation and expansion policies of non-smoking areas. Methodology: This study used the wholesale and retail trade survey data of the Korea National Statistical Office from 2011 to 2014 and analyzed 31,577 restaurants excluding missing values. For statistical analysis, t-test, ANOVA and Difference-in-differences(DID) models were used and the interaction term of area and year was entered. Findings: As the non-smoking area policy had been designated and expanded from December 2012 to December 31 2013, high restaurant sales in 2012 declined sharply in 2013. However, despite the expanding of the no-smoking area from January 1 2014 through December 31 2014, restaurant sales slightly recovered in 2014. In the case of other restaurants, there is no significant change in sales since the start of the policy in 2013. Practical Implications: The decline in restaurant sales due to the designation and expansion of non-smoking areas is temporary and can not be sustained over the long term. This result can be used to positively suggest negative perceptions of the designation and expansion policy of non-smoking areas. Also, this result can contribute to health promotion and smoking cessation policies by protecting non-smokers from the risk of secondhand smoking exposure and inducing smokers to decrease smoking rate and smoking amount.

• Journal of Environmental Health Sciences
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• v.47 no.1
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• pp.78-86
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• 2021

Objectives: The purposes of this study were to investigate the installation rates and status of indoor smoking rooms in public facilities and to determine the level of compliance level with smoke-free policies in accordance with the National Health Promotion Act. Methods: A visiting survey was conducted on 1,206 public facilities in the Seoul Metropolitan Area and the Daegu and Gyeongsangbuk-do Province area. Researchers selected public facilities such as bars, coffee houses, and internet cafes using convenient sampling. They visited without prior notice, checked the existence of indoor smoking rooms, and recorded their status. Results: Internet cafes (110/116) had the highest installation rate of indoor smoking rooms, followed by bowling clubs (17/19) and billiard rooms (87/100). Depending on the type of business, 50-88% of smoking rooms were not completely enclosed. Coin karaoke rooms showed the least inadequacy in this regard. In addition, out of 512 smoking rooms, in 33% (n = 169) smoking indoors was observed in non-smoking areas. Only 9% of public facilities were in full compliance with the indoor smoke-free regulation. Conclusions: It was found that most of the public facilities with indoor smoking rooms did not comply with the smoke-free policy, and smoking was still observed inside some facilities. Therefore, there is a need for a policy that prohibits indoor smoking rooms completely.

• Korean Journal of Health Education and Promotion
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• v.18 no.3
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• pp.1-10
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• 2001

The purposes of this study were to identify patients' perceptions toward regulations of smoking in general hospitals and hazards caused by smoking. Moreover this study also identified smoking behaviors and punishment experience due to in-hospital smoking and education experiences of smoking in general hospitals. Around 88.0％ of all respondents regardless of either smokers or non-smokers knew that hospitals are non-smoking area. However, 71.6％ of smokers smoked during their hospital visits. For their smoking, only 51.0％ of smokers utilized smoking rooms or areas for their smoking. Only 55.1％ of smokers experienced punishments or notifications of warning due to their smoking. Around 93.0％ of inpatients and outpatients acknowledged hazards toward their health caused by smoking. However, smokers did not realize the dangerous effects of passive smoking to other persons. Only 38.1％ of smokers said that passive smoking causes hazard of others' health. 63.8％ of smokers hoped for secession of smoking but only 42.8％ of them sustained their non-smoking periods over 5 moths. Based on these results, this study insists that a more enforced smoking policy in general hospitals be desperately needed for protecting patients' health and controlling smoking at unapproved areas. Moreover hospitals should take proactive actions to prevent smoking in hospitals. A health education program in hospitals should promote patients' self-efficacy to stop smoking and patients' understanding of the hazardous effects of passive smoking in hospitals.

• Health Policy and Management
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• v.27 no.3
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• pp.219-228
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• 2017

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.

• 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.

• Journal of Society of Preventive Korean Medicine
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• v.12 no.3
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• pp.185-197
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• 2008

Purpose : To know the smoking status of regional residents and to contribute the development of smoking education program by analyzing the related characteristics and affecting variables. by convenience sampling of total 1,300 regional residents in Daegu. Method : The investigation was conducted with 1,204 residents in mid to small urban area of Gyeongsangbukdo. for 3 months from April 1, to June 30, 2007. Results : 1) The current smoking rate of test subjects was 19.3% and 63% responded as non smoker, and 17.1% of test subjects responded as currently stopped smoking. 2) The smokers' age that habitually started smoking resulted to show the highest distribution at their age of $20{\sim}29$ by including 49.3% in 446 smokers, and 39.6% in ages younger than 19 years old. 3) The subjective health status of test subjects was found to be healthy in 65.1% of nonsmokers. 4) The increase of stress along with the increase of depression significantly had large effects on smoking rate. 5) When the regression analyses were conducted, test subjects' sex, age, religion, current residing area, occupation, the level of health status, the level of stress and the level of depression found to have significant effects, and the influence of these variables was 27.4% by showing an overall significance. Conclusion : Primarily, the average smoking rate of regional residents was slightly decreased, but the smoking rate in juveniles, university students, professional workers, office workers, labor workers and women were found to be increased. Therefore smoking prevention and stop smoking policies have to be enforced with the development of more effective education programs. Secondly, the health status especially the increase of stress along with the increase of depression significantly had large effects on smoking rate. So, it is considered that the responsible government, related organizations and experts should make efforts not only for the improvement of health and but also for the establishment of stress and depression solving measures. Thirdly, the supports and willingness of government and local government for substantial practicing the development of smoking prevention and stop smoking enforcement policy education programs have to be advanced with the systematic backup as the first step of improving health of national peoples.

• Health Policy and Management
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• v.26 no.1
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• pp.12-23
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• 2016

Background: Many studies have explained regional disparities in health by socioeconomic status and healthcare resources, focusing on differences between urban and rural area. However some cities in Korea have the highest cardiovascular mortality, even though they have sufficient healthcare resources. So this study aims to confirm three hypotheses. (1) There are also regional health disparities between cities not only between urban and rural area. (2) It has different regional risk factors affecting cardiovascular mortality whether it is urban or rural area. (3) Besides socioeconomic and healthcare resources factors, there are remnant factors that affect regional cardiovascular mortality such as health behavior and physical environment. Methods: The subject of this study is 227 local authorities (si, gun, and gu). They were categorized into city (gu and si consisting of urban area) and non-city (gun consisting of rural area), and the city group was subdivided into 3 parts to reflect relative different city status: city 1 (Seoul, Gyeonggi cities), city 2 (Gwangyeoksi cities), and city 3 (other cities). We compared their mortalities among four groups by using analysis of variance analysis. And we explored what had contributed to it in whole authorities, city and non-city group by using multiple regression analysis. Results: Cardiovascular mortality is highest in city 2 group, lowest in city 1 group and middle in non-city group. Socioeconomic status and current smoking significantly increase mortality regardless of group. Other than those things, in city, there are some factors associated with cardiovascular mortality: walking practice(-), weight control attempt(-), deficiency of sports facilities(+), and high rate of factory lot(+). In non-city, there are other factors different from those of city: obesity prevalence(+), self-perceiving obesity(-), number of public health institutions(-), and road ratio(-). Conclusion: To reduce cardiovascular mortality and it's regional disparities, we need to consider differentiated approach, respecting regional character and different risk factors. Also, it is crucial to strengthen local government's capacity for practicing community health policy.

• The Journal of Korean Society for School & Community Health Education
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• v.9 no.1
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• pp.143-156
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• 2008

Objectives: This study was performed to examine the effective health education measures and health education programs for college students and also investigated the demands of restriction on drinking and smoking behavior in public area at the school level. Methods: The data were collected from 446 students of five universities located in Seoul and analyzed with SPSS WIN 10.0 program. Results: 1) Current drinkers were average 87.7% (male 90.1%, female 85.3%) and binge drinker was 68.4% (male 76.5%, female 60.2%). Among all drinkers, 19.4% drank more than eight times per month. As for the rate of smoking, 50.9% among the male student, and 12.1% among females were smokers. Among all smokers. the largest group (41.5%) smoked between >$11{\sim}20$ cigarettes per day. Many of the students started smoking in their middle schools (male 29.8%, female 51.5%). It implies that smoking prevention programs need to be emphasized in these schools. 2) The analysis of the correlation between drinking and smoking shows that no smoking students who drank were 66.2%, but abstainer who is smoker were only 5.7%(p=0.004). Alcohol consumption frequency and amount of smokers were higher than those of nonsmokers (p=0.000). The rate of attempts to reduce drinking was 38.1%, mainly for health reason. More than 34.5% of smoking student had made attempts to quit smoking, but succeeded only 16.9%. 3) As for the needs of moderate drinking and smoking cessation education, 67.8% among female students and 53.6% among male demand special education programs. About effective health education measures on drinking and smoking, 49.3% of drinkers and 35.2% of smokers had an inclination for health educator, and the next were video, campaign and pamphlet. 4) The largest group (45.0%) of respondents had agreed to regulate on drinking behavior, and especially 74.5% of them wants to ban the practice in most public area in school. 35.7% among female students and 27.0% among male desired to extend the non-smoking area on whole campus. The health policy for college students, through various ways, such as education, counseling service, and special program on orientation, should be employed. For public health perspectives, university and college community had to institute the detailed enforcement regulation on drinking and smoking.

• KDI Journal of Economic Policy
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• v.31 no.2
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• pp.127-153
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• 2009

There is a growing concern about potential harmful effect of second-hand or environmental tobacco smoking. As a result, smoking bans in workplace become more prevalent worldwide. In Korea, workplace smoking ban policy become more restrictive in 2003 when National health enhancing law was amended. The new law requires all office buildings larger than 3,000 square meters (multi-purpose buildings larger than 2,000 square meters) should be smoke free. Therefore, a lot of indoor office became non smoking area. Previous studies in other counties often found contradicting answers for the effects of workplace smoking ban on smoking behavior. In addition, there was no study in Korea yet that examines the causal impacts of smoking ban on smoking behavior. The situation in Korea might be different from other countries. Using 2001 and 2005 Korea National Health and Nutrition surveys which are representative for population in Korea we try to examine the impacts of law change on current smoker and cigarettes smoked per day. The amended law impacted the whole country at the same time and there was a declining trend in smoking rate even before the legislation update. So, the challenge here is to tease out the true impact only. We compare indoor working occupations which are constrained by the law change with outdoor working occupations which are less impacted. Since the data has been collected before (2001) and after (2005) the law change for treated (indoor working occupations) and control (outdoor working occupations) groups we will use difference in difference method. We restrict our sample to working age (between 20 and 65) since these are the relevant population by the workplace smoking ban policy. We also restrict the sample to indoor occupations (executive or administrative and administrative support) and outdoor occupations (sales and low skilled worker) after dropping unemployed and someone working for military since it is not clear whether these occupations are treated group or control group. This classification was supported when we examined the answers for workplace smoking ban policy existing only in 2005 survey. Sixty eight percent of indoor occupations reported having an office smoking ban policy compared to forty percent of outdoor occupation answering workplace smoking ban policy. The estimated impacts on current smoker are 4.1 percentage point decline and cigarettes per day show statistically significant decline of 2.5 cigarettes per day. Taking into account consumption of average sixteen cigarettes per day among smokers it is sixteen percent decline in smoking rate which is substantial. We tested robustness using the same sample across two surveys and also using tobit model. Our results are robust against both concerns. It is possible that our measure of treated and control group have measurement error which will lead to attenuation bias. However, we are finding statistically significant impacts which might be a lower bound of the true estimates. The magnitude of our finding is not much different from previous finding of significant impacts. For cigarettes per day previous estimates varied from 1.37 to 3.9 and for current smoker it showed between 1%p and 7.8%p.

• Health Policy and Management
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• v.29 no.4
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• pp.399-411
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• 2019

Background: This study aimed to explore the associations of social-demographic, health-behavioral, and woman-specific factors with the non-screening status of the cervical cancer screening test in Korean adult women. Methods: This study was a cross-sectional analysis of 9,698 Korean adult women aged 20 years or more who participated in the Korea National Health and Nutrition Examination Surveys V (2010-2012). Rao-Scott chi-square tests and survey logistic regression analyses were employed respectively to analyze the difference in the non-screening status of the cervical cancer screening test by each characteristic and to explore the factors related to the non-screening status. Results: The rate of the non-screening status of the cervical cancer screening test was 53.5% over the previous 2 years. In the survey logistics regression analysis, age, marital status, educational levels, income levels, residential area, occupation, private health insurance, smoking, alcohol, obesity, menstrual status, pregnancy experience, and hormone replacement therapy were significantly associated with the non-screening status of the cervical cancer screening test. Conclusion: On the basis of the results of this study, some social-demographic, health-behavioral, and woman-specific characteristics of Korean adult women seem to affect the non-screening status of the cervical cancer screening test. Therefore, appropriate health policies need to be designed, implemented, monitored, and evaluated to reduce the non-screening status of the cervical cancer screening test of them.