• Asian Pacific Journal of Cancer Prevention
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• v.13 no.6
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• pp.2663-2667
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• 2012

Objectives: An attempt was made to understand the nicotine dependence of smokers selected for an ongoing smoking cessation intervention programme in rural Kerala, India. Methods: Data were collected from resident males in the age group of 18 to 60 years from 4 randomly allocated community development blocks of rural Thiruvananthapuram district (2 intervention and 2 control groups). Trained accredited social health activist workers were utilised to collect data from all groups through face to face interview. Nicotine dependence among participants was assessed by means of the six-item Fagerstrom Test for Nicotine Dependence (FTND) translated into the local language. The internal consistency of FTND was computed using Cronbach's alpha coefficient. Criterion validity (concurrent) was assessed by correlations of nicotine dependence scores with age at initiation of smoking and cumulative smoking volume in pack-years. Results: Among the 928 smokers identified, 474 subjects were in the intervention area (mean age = 44.6 years, SD = 9.66 years) and 454 in the control area (mean age = 44.5 years, SD = 10.30 years). The overall FTND score among current daily smokers was 5.04 (SD: 5.05). FTND scores in the control and intervention areas were 4.75 (SD: 2.57) and 4.92 (SD: 2.51) respectively. The FTND scores increased with age and decreased with higher literacy and socioeconomic status. The average FTND score was high among smokers using both bidi and cigarettes (mean 6.10, SD 2.17). Internal consistency analysis yielded a Cronbach's alpha coefficient of 0.70 in a subsample of 150 subjects, a moderate result. The association of the scale was strongest, with the number of pack-years smoked (rho = 0.677, p < 0.001). Conclusion: A moderate level of nicotine dependence was observed among smokers in the current study. Tobacco cessation strategies could be made more cost effective and productive if a baseline assessment of nicotine dependence is completed before any intervention.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4639-4643
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• 2012

The burden of lung cancer in terms of mortality is the highest among all types of cancers globally. The present study aimed to evaluate lifestyle related habits, clinico-pathological profile and treatment details of lung cancer patients who were registered at Malabar Cancer Centre (MCC), Kerala, during the calendar year 2010. A retrospective evaluation was made from medical records to gather data from 281 registered lung cancer cases in 241 males and 40 females, with a male to female ratio of 6.03: 1. Approximately 89% of the cases were above 50 years of age. Among males about 91% of the cases were smokers and 62% of them had a chronic smoking habit. Adenocarcinomas, squamous cell carcinomas, non-small cell carcinomas and small cell cancers accounted for 10.7, 13.9, 17.0 and 5.7% respectively. Out of 281 cases around 67% were diagnosed with distant metastasis and the remainder had regional lymph node involvement. However, no statistically significant difference was observed for secondary site of tumor according to gender. As majority of the cases reported at MCC were in an advanced stage of the disease, histology of the secondary site from supraclavicular lymph nodes or liver was taken for diagnosis. Initiation of population based screening for early detection of cancer, and primary and secondary prevention strategies for reducing the prevalence of tobacco consumption are high priorities to reduce the lung cancer burden in Kerala.

• Health Policy and Management
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• v.24 no.4
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• pp.342-348
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• 2014

Background: Due to lack of regular and systematic evaluation tool, Korea's tobacco control policy has not been examined its overall process of implementation including efficiency and adequacy of the policies. This study developed policy monitoring and evaluation model to assess policy implementation and effectiveness of tobacco control in Korea. Methods: Based on World Health Organization operational manual for assessment, MPOWER (monitor tobacco use and prevention policies, protect from tobacco smoke, offer help to quit tobacco use, warn about the dangers of tobacco, enforce bans on tobacco advertising promotion and sponsorship, and raise taxes on tobacco) related policies were reviewed by rating policy efforts, programme management, people (human resources and their development), provision of organization, provision of fund and partnerships (range, 0 to 5). Results: As a result of the experts' assessment, overall Korean tobacco control policies scored 2.61 points, which is poor. In relation to each 'MPOWER' policies, 'W' scored the highest points (2.93), followed by 'O' (2.91), 'M' (2.87), 'P' (2.86), and 'E' (2.23). 'R' scored the lowest points of 1.87, meaning government efforts in tobacco price policy is insufficient. Conclusion: This study concludes that Korean tobacco control policy should strengthen tax and price measures, while programme infrastructure, people, and funds for policy enforcement should be secured. Furthermore, rather than focusing on one specific measure, a balanced approach reflecting various aspects of tobacco controls should be considered in order to decrease smoking rates and prevent smoking initiation.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.10
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• pp.4973-4977
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• 2012

Introduction: Tobacco use is a global health care problem. Repetitive exposure to nicotine produces neuroadaptation resulting in nicotine dependence. Smoking is associated with a range of diseases, causing high levels of morbidity and mortality and is one of the leading causes of preventable deaths, with more than 4.6 million smokers worldwide dying each year from smoking related illnesses. Stopping smoking has major health benefits. Quitting at any age provides both short and long term benefits. Materials and methods: 45 patients attending the outpatient department at the Oxford Dental College, Bangalore, were randomly allocated to three groups of interventions namely placebo, counseling and nicotine replacement therapy (NRT). Initially each one was assessed for carbon monoxide levels using a breath analyser (pico smokerlyser bedfont UK). They were followed up for six months and the carbon monoxide levels were again assessed using the same instrument. The paired t test was used to compare the results before and after the intervention. Results: The scores before the initiation of intervention and after treatment were compared and all three interventions were found to be statistically significant after six months. It was noticed that patients with very low or low dependence followed by high dependence had good response in the placebo group (68% and 47.6% respectively), in the counseling group maximum response was seen in the medium followed by the very low group (61% and 59% respectively), and maximum response was seen in very high followed by the very low group with NRT (78.7% and 60.5% respectively). Conclusion: The inference that can be drawn from the present study is that non-invasive, non pharmacological methods like placebo and counseling are effective in low to medium groups, and NRT is effective with higher nicotine dependence.

• Korean Journal of Health Education and Promotion
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• v.16 no.2
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• pp.157-171
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• 1999

This paper analyzed health practices of students in an university in Chollabukdo Province. It attempted to study how many university students had what kinds of health practices. Furthermore, it tried to find out what are the major problems in health practice among university students. To study health practices of university students, this study sampled 1,469 students randomly. Many of the students had poor practices of teeth care. In tooth-brushing, many students (35.8%) brushed their teeth before breakfast in the morning. Most of the students (95% or more) visit dental clinic only when they had problem(s) in their teeth. For weights, there exists a great gap between perception and BMI (Body Mass Index), especially among female students. Among the female students who perceived their weights were above average, 96.4% of them were normal according to BMI. Many of the students were drinking greater amount of alcohol than safe amount suggested by the National Health and Medical Research Council of Australia. The proportion of the students drinking harmful or hazardous amount of alcohol were 79.5% of the male students and 74.9% of the female students. It suggests that health promotion fund or tax need to be levied on alcohol to frustrate unhealthful drinking. More than half (59.0%) of the male students and about 6.0% of the female students were smoking cigarettes. The smoking initiation ages were 17.8 for male and 18.2 for female students. It means that many of the students started smoking in their junior high or high schools. It implies that smoking prevention and smoking cessation programs need to be emphasized in these schools. For perception on sex, 27.8% of the male students and 60.9% of the female students thought to keep their virginity before their marriage. The female students were more conservative in perception on sex. The average number of sexual intercourses per year of male students was 17.0 times with their lovers, 7.9 times with prostitutes, and 7.0 times with maids. The female students had sexual intercourses 5.0 times with their lovers and 4.0 times with waiters per year. The proportion of students who had experience of sexual intercourse with homosexual partners was 1.0%. The finding this study was that the university students were vulnerable to poor health practices. It is suggested that public health intervention program be provided for university students to keep them in good healthy lifestyle.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.11
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• pp.5371-5374
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• 2012

The present study was conducted to assess the prevalence and type of tobacco use among adolescents and also the reasons for the initiation of tobacco use amongst them. It was conducted in ten randomly selected schools in the Kannur district of Kerala state, India. A total of 3,000 school children participated. The study observed an overall prevalence of 5.5%. The prevalence observed among boys was 12% and none of the girls were tobacco users. Association between father's and friend's tobacco habits were observed.

• Tuberculosis and Respiratory Diseases
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• v.85 no.2
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• pp.155-164
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• 2022

Background: The remarkable efficacy of osimertinib in non-small cell lung cancer (NSCLC) with acquired T790M mutation has been widely documented in clinical trials and real-world practice. However, some patients show primary resistance to this drug. Even patients who initially show a favorable response have inconsistent clinical outcomes later. Therefore, the aim of this study was to identify additional clinical predictive factors for osimertinib efficacy. Methods: A prospective cohort of patients with acquired T790M positive stage IV lung adenocarcinoma treated with osimertinib salvage therapy in Hallym University Medical Center were analyzed. Results: Sixty-one eligible patients were analyzed, including 38 (62%) women and 39 (64%) who never smoked. Their mean age was 63.3 years. The median follow-up after treatment with epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) was 36.0 months (interquartile range, 24.7-50.2 months). The majority (n=45, 74%) of patients were deceased. Based on univariate analysis, low baseline neutrophil-to-lymphocyte ratios (NLR), age ≥50 years, never-smoking history, stage IVA at osimertinib initiation, and prolonged response to previous TKIs (≥10 months) were associated with a significantly longer progression-free survival (PFS). Multivariate analysis showed that never-smoking status (hazard ratio [HR], 0.54; 95% confidence interval [CI], 0.30-0.98; p=0.041) and a baseline NLR less than or equal to 3.5 (HR, 0.23; 95% CI, 0.12-0.45; p<0.001) were independently associated with a prolonged PFS with osimertinib. Conclusion: Smoking history and high NLR were independent negative predictors of osimertinib PFS in patients with advanced NSCLC developing EGFR T790M resistance after the initial EGFR-TKI treatment.

• Korean Journal of Health Education and Promotion
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• v.33 no.5
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• pp.71-81
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• 2016

Objectives: Tobacco marketing encourages smoking initiation of non-smokers, especially adolescents, and it hinders quit intention of those who smoke or who attempt to quit smoking. Article 13 of the WHO Framework Convention on Tobacco Control(WHO FCTC) requests a comprehensive ban on tobacco advertising, promotion and sponsorship(TAPS). Ratified the Convention in 2005, Korea has partially implemented the provisions. However, online marketing regulations are still insufficient. Methods: Based on relevant national and international regulations, this research designed monitoring mechanism for online tobacco marketing and studied 1,404 websites to identify current situation of online sales and advertisement of tobacco in Korea. Results: This study found that online trade of tobacco products are overtly conducted, while tobacco advertising with flavoring and misleading descriptors are also prevalent. Also, online tobacco marketing facilitate adolescents' access to tobacco product and that advertising and promotion activities lead to tobacco purchase without difficulties. Conclusions: Fundamental solution to prevent online tobacco advertisement and promotion is banning online sales of tobacco and conducting a regular monitoring for compliance. Korean government should consider establishing an official surveillance system for online tobacco advertisement, followed by a comprehensive ban on TAPS to fulfill its obligation as a Party to the FCTC.

• Journal of Nutrition and Health
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• v.39 no.1
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• pp.18-27
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• 2006

Smoking is well known to be associated with increased indices of tree radical-mediated damage of DNA, indicating that smoking may exacerbate the initiation and propagation of oxidative stresses, which are potential underlying processes in the pathogenesis of many diseases. The purpose of this study was to evaluate whether a daily regimen of green vegetable drink supplementation to smokers can be protective against endogenous lymphocytic DNA damage and whether it could enhance other antioxidant status. Twenty nonsmokers and nineteen smokers aged 23-60 were given 240 ml of green vegetable drink every day for 8 weeks in addition to their normal diet, and blood samples were drawn before and after the intervention. The 8 weeks of green vegetable drink consumption resulted in a significant decrease (p = 0.000, by paired t-test) in lymphocyte DNA damage expressed by TL (before: $63.13{\pm}1.05$ vs after: $37.86{\pm}10.83$, before: $66.73{\pm}1.24$ vs after: $36.51{\pm}1.13$), TM (before: $14.55{\pm}0.61$ vs after: $6.61{\pm}0.25$, before: $15.36{\pm}0.45$ vs after: $6.65{\pm}0.38$) and $\%$ DNA in tail (before: $19.7{\pm}0.41$ vs after: $16.6{\pm}0.37$, before: $20.6{\pm}0.31$ vs after: $17.1{\pm}0.5$) in both nonsmokers and smokers respectively. Vitamin C and TRAP level was not significantly changed after the supplementation. In conclusion, these results support the hypothesis that green vegetable drink exert a cancer-protective effect partially via a decrease in oxidative damage to DNA.

• Journal of Korean Academy of Nursing
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• v.54 no.2
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• pp.193-210
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• 2024

Purpose: The objective of this study was to develop a predictive model for the sexual experiences of adolescents using the random forest method and to identify the "variable importance." Methods: The study utilized data from the 2019 to 2021 Korea Youth Risk Behavior Web-based Survey, which included 86,595 man and 80,504 woman participants. The number of independent variables stood at 44. SPSS was used to conduct Rao-Scott χ² tests and complex sample t-tests. Modeling was performed using the random forest algorithm in Python. Performance evaluation of each model included assessments of precision, recall, F1-score, receiver operating characteristics curve, and area under the curve calculations derived from the confusion matrix. Results: The prevalence of sexual experiences initially decreased during the COVID-19 pandemic, but later increased. "Variable importance" for predicting sexual experiences, ranked in the top six, included week and weekday sedentary time and internet usage time, followed by ease of cigarette purchase, age at first alcohol consumption, smoking initiation, breakfast consumption, and difficulty purchasing alcohol. Conclusion: Education and support programs for promoting adolescent sexual health, based on the top-ranking important variables, should be integrated with health behavior intervention programs addressing internet usage, smoking, and alcohol consumption. We recommend active utilization of the random forest analysis method to develop high-performance predictive models for effective disease prevention, treatment, and nursing care.