• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7277-7281
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• 2013

Background: Globally, there have been important changes in trends amongst gender, histology and smoking patterns of lung cancer cases. Materials and Methods: This retrospective study was conducted on 466 patients with lung cancer who were registered in Regional Cancer Center, Regional Institute of Medical Sciences, Manipur from January 2008 to December 2012. Results: Most were more than 60 years of age (67.8%) with a male: female ratio of 1.09:1. Some 78.8% of patients were chronic smokers with male smoker to female smoker ratio of 1.43:1. Consumption of alcohol was found in 29.4%, both smoking and alcohol in 27.5%, betel nut chewing in 37.9% and tobacco chewing in 25.3%. A history of tuberculosis was present in 16.3% of patients. The most frequent symptom was coughing (36.6%) and most common radiological presentation was a mass lesion (70%). Most of the patients had primary lung cancer in the right lung (60.3%). The most common histological subtype was squamous cell carcinoma (49.1%), also in the 40-60 year age group (45.9%), more than 60 year age group (51.6%), males (58.1%) and females (41.8%). As many as 91.9% of squamous cell carcinoma patients had a history of smoking. About 32.5% of patients had distant metastasis at presentation with brain (23.8%) and positive malignant cells in pleural effusions (23.1%) as common sites. The majority of patients were in stage III (34.4%), stage IV (32.5%) and stage II (30.2%). Conclusions: Our analysis suggests that the gender gap has been narrowed such that about half of the patients diagnosed with lung cancer are women in this part of India. This alarming rise in female incidence is mainly attributed to an increased smoking pattern. Squamous cell carcinoma still remains the commonest histological subtype. Most of the patients were elderly aged and presented at locally or distantly advanced stages.

• 보건교육건강증진학회지
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• 제33권2호
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• pp.57-66
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• 2016

Objectives: This study investigated the relationship between smoking status and depressive symptoms among Korean adults. Methods: We used the data of 17,871 adults aged 19 years or older from the fifth Korea National Health and Nutrition Examination Survey(2010-2012). The subjects were classified as nonsmokers, former smokers, and current smokers by gender. Logistic regression analysis was used to calculate the odds ratios(ORs) and the 95% confidence intervals(CIs) for the effects of smoking status on depressive symptoms, and depression diagnosed by a doctor. Results: Compared to nonsmokers, the ORs of depressive symptoms for current smokers were 1.11(95% CI, 1.11-1.12) among males, and 1.64(95% CI, 1.63-1.64) among females. Compared to former smokers, the ORs of depressive symptoms for current smokers were 1.05(95% CI, 1.05-1.05) among males, and 1.89(95% CI 1.88-1.90) among females. Compared to nonsmokers, the ORs of depression for current smokers were 0.94(95% CI, 0.94-0.95) among males, and 1.40(95% CI, 1.39-1.41) among females. Compared to former smokers, the ORs of depression for current smokers were 1.09(95% CI, 1.09-1.10) among males, and 0.99(95% CI, 0.99-1.00) among females. Conclusions: Smoking is associated with depressive symptoms among Korean adults. Therefore, it is necessary to consider depressive symptoms with the management of tobacco control policies.

• Asian Pacific Journal of Cancer Prevention
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• 제16권7호
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• pp.3029-3034
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• 2015

Background: While the perinatal outcomes of active maternal smoking are well documented, results of the effects of environmental tobacco smoke (ETS) exposure during pregnancy are inconsistent. We aimed to examine the effect of ETS exposure, assessed by maternal hair nicotine levels at $35^{th}$ week of gestation, on birth weight and the risk of small for gestational age (SGA) and low birth weight (LBW). Materials and Methods: A total of 871 non-smoking healthy pregnant women were recruited by one Korean hospital between 1 October 2006 and 31 July 2007. Hair samples were collected and anthropometric questionnaires administered at $35^{th}$ week of gestation. The primary outcome was birth weight and secondary outcomes were the risk of babies being SGA and LBW. Results: Log-transformed hair nicotine concentrations were inversely related with birth weight after adjusting for confounding variables (${\beta}=-0.077$, p=0.037). After stratifying hair nicotine levels by tertiles (T1, low [0.0-0.28 ng/mg]; T2, medium [0.29-0.62 ng/mg]; and T3, high [0.63-5.99 ng/mg]), the mean birth weight in each groups were 3,342g (T1) 3,296g (T2) and 3,290 g (T3), respectively. However the difference between groups was not statistically significant by analysis of co-variance (ANCOVA) adjusting for covariates (p=0.062). In logistic regression analysis, the risk of SGA was higher in the T3 (OR=1.59, 95%CI 1.05-2.42) than in the reference group (T1), after controlling for confounding variables. The risk of low birth weight (<2,500g, LBW) was not significantly higher (OR=1.44, 95%CI 0.95-2.19), but the risk of babies being below 3,000g birth weight was increased in the T3 group (OR=1.53, 95%CI 1.00-2.36) compared with that in the T1 group. Conclusions: Maternal ETS exposure during pregnancy was inversely related with birth weight. The risk of SGA increased in the highest ETS exposure group compared with in the low exposure group. To prevent ETS exposure during pregnancy, more comprehensive tobacco control policies are needed.

• 한국보건간호학회지
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• 제20권1호
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• pp.39-56
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• 2006

Objectives: To investigate the drinking and smoking habits among the community residents of a city. Methods: We surveyed 1.973 adults from October 1, 2005 to November 16, 2005. The data collected on alcohol drinking habits involved frequency, age of initiation, amount of alcohol consumed, number of attempts to reduce consumption and reasons for reducing it. The data collected on smoking habits involved amount, age of initiation, duration, situations, and the number of attempts to quit smoking. These were analyzed with frequency, percentage, mean, standard deviation, $x^2$-test, t-test and ANOVA. Results: The rate of drinking was 67.4%; 83.1% among males, and 52.5%among females. Among all drinkers, the largest group (29.8%) drank once or twice a week. The mean age of initiation was 21.2 years; 19.9 among males, and 22.8 among females. The average consumed amount was 5.8 glasses; males consumed 7.4 glasses, and females 3.3 glasses. The consumption was the highest among those in fifties. The rate of attempts to reduce drinking was 33.4%, mainly for health reasons. The rate of smoking was 38.0%; 72.4% among males, and 5.5% among females. Among all smokers, the largest group (44.1%) smoked between 11 and 20 cigarettes per day. The mean of the age of initiation was 20.7 years; 20.3 among males, 25.6 among females. The mean smoking duration was 20.9 years; 21.3 years among males, and 16.2 years among females. The main reason for the initial attempt was curiosity. The most common situation for smoking was after dinner. The rate of attempts to quit smoking was 77.1%, mainly out of concern for one's health. Alcohol consumption among smokers was higher than among any other group of nonsmokers. Also, the age of drinking initiation among smokers was lower than among any other group of nonsmokers. Conclusion: This study highlighted the actual data on drinking and smoking habits among community residents. The study can be utilized for creating programs aiming at reducing the consumption of alcohol and tobacco or stopping it altogether. Therefore, it is now possible to assess the indicators for interventions in each population group. Finally, the groups of heavy drinkers and smokers are expected to be given priority for intervention program.

• 한국보건간호학회지
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• 제13권1호
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• pp.97-113
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• 1999

To investigate the actual condition of the adult-smoking in Chinan County. I used self-reporting questionnaires among 923 residents living in nine districts selected at random among the sites of eleven eup-myons from December 28. 1998 to January 6. 1999. collected data and analyized using SPSS. The smoking rate of adults in Chinan County was $36.9\%$. There was a significant difference in smoking rate according to the age. gender, education and job among general characteristics. The smoking rate in group of above 40s was about $40\%$ and that of the male took $55.5\%$ which was higher than that of female and the smoking rate of the people having high-school education was the highest$(46.2\%)$. With regard to the career. the smoking rate of the farmers ranked first$(46.1\%)$. Therefore anti-smoking business for smokers should be focused on above 40 years old, males. people having high school education and farmers. As the result of the survey of smoking habits of 340 people who smoke currently, the average smoking begining age was 21.8 and $81.5\%$ among them was between 16-25 years old. $4.4\%$ was under 15. during around the elementary school. Most motives to smoke were as followed; curiosity or taste$(33.6\%)$, relief of stress $(31.2\%)$, peer presure$(26.5\%)$ And considering the amount of the cigarette which is smoked per day, the case which is less than a pack of cigarettes was highest as $75.5\%$ and the people who smoke over one pack of cigarettes took $24.5\%$. As for the kind of tobacco which is smoked, how to smoke and the desire for the smoking, most case was toxin was moderate$(47.8\%)$ or mild$(46.9\%)$. shallowly$(49.0\%)$ or deeply$(46.3\%)$ and under stress$(33.4\%)$. after meals$(27.8\%)$, during drink$(15.7\%)$ and so on. The highest point marked among the factors of smoking motives was 'the reduce of negative emotion' $(3.27\pm1.00)$. followed by 'uncomfortable habits' $(2.87\pm1.02)$, 'addiction' $(2.84\pm1.06)$. 'habit' $(2.74\pm1.12)$. 'pleasure' $(2.70\pm1.04)$. 'stimulus' $(2.59\pm.90)$, 'sensation-exercise satisfaction' $(2.42\pm.97)$. Smokers smoke to reduce the negative emotions when angry in most common case. depressed. anxious. uncomfortable. lone. ashamed or embarrased. and intend to solve the certain problem. etc. Other motives are uncomfortable habit. addiction. habit. pleasure and the pursuit of stimulus. The level of nicotine dependence of adults m Chinan County was 10.57 which amount to 'high' wholly. As the resulf of the level of nicotine dependence score. the people who are low in the level of nicotine was $33.5\%$. the people who are high was $48.2\%$. very high was $18.4\%$. The approach for anti-smoking for smokers should be conducted differently according to the level of the nicotine. For the people who are in low level of nicotin dependence the prohibition of the smoking should be guided through the approach to foster strong will. for those who are in 'high' by acquiring proper method for the prohibition of smoking. and for those who are 'very high' the anti-smoking should be induced by providing proper program because of the possibility of the suffer from abstinence syndrome. The difference of the level of nicotine with the general characteristics of the objects had not statistically significant difference. The difference of the level of nicotine dependence accompanied by smoking habit had statistically significant difference according to the amount of smoke, the kind of tobacos. smoke inhale habit. In other words, the group of heavy smokers had higher level of the nicotine dependence than that of the light smokers relatively and the group which smoke strong taboaco has higher level of nicotine than that of which smoke mild or moderate. And the group of smokers who smoke deeply has higher level of nicotine than that who smoke shallowly or nonswallow. Aa a result of the analysis of the correlation between smoking motive factors and the level of nicotine, there was the indication that people who smoke for the decrease of the negative emotion. habit, pleasure. stimulus. sensation-exercise satisfaction had high level of the nicotine dependence. As the result of the anti-smoking will of smokers. $65.0\%$ of them had prohibition of smoking will. $29.3\%$ had no will to quit smoke. The most important reason for anti-smoking was health. $67.9\%$ had experience to try to quit smoke and the biggest reason to fail to quit smoking was the lack of the will power to keep anti-smoking. $52.8\%$ of them were advised to stop smoking from their spouses or children. only $2.8\%$ were by medical. The people who have the opinion to need anti-smoking education were $69.6\%$. Therefore when the business for the hygine of the mouth for adult is set. it should be centered on the people who have intention of prohibition of the smoking and help to quit smoking by way of other affirmative counter-program not smoking under stress.

• Asian Pacific Journal of Cancer Prevention
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• 제15권17호
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• pp.7021-7027
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• 2014

Background: The problem of cancer, especially lung cancer, is very acute in Bangladesh. The present study was conducted to evaluate the risk of lung cancer among Bangladeshi people based on hereditary, socio-economic and demographic factors. Materials and Methods: This study was carried out in 208 people (patients-104, controls-104) from January 2012 to September 2013 using a structured questionnaire containing details of lung cancer risk factors including smoking, secondhand smoke, tobacco leaf intake, age, gender, family history, chronic lung diseases, radiotherapy in the chest area, diet, obesity, physical activity, alcohol consumption, occupation, education, and income. Descriptive statistics and testing of hypotheses were used for the analysis using SPSS software (version 20). Results: According to this study, lung cancer was more prevalent in males than females. Smoking was the highest risk factor (OR=9.707; RR=3.924; sensitivity=0.8872 and P<0.0001) followed by previous lung disease (asthma, tuberculosis etc.) (OR=7.095; RR=1.508; sensitivity=0.316 and P<0.0001)) for male patients. Highly cooked food (OR=2.485; RR=1.126; sensitivity=0.418 and P=0.004)) and also genetic inheritance (OR=1.93; RR=1.335; sensitivity=0.163 and P=0.138) demonstrated significant correlation with lung cancer as risk factors after these two and alcohol consumption was not prevalent. On the other hand, for female patients, tobacco leaf intake represented the highest risk (OR=2.00; RR=1.429; sensitivity= 0.667 and P=0.5603) while genetic inheritance and highly cooked food also correlate with lung cancer but not so significantly. Socioeconomic status and education level also play important roles in causing lung cancer. Some 78.5% male and 83.3% of female cancer patients were rural residents, while 58.2% lived at the margin or below the poverty line. Most male (39.8%) and female (50.0%) patients had completed only primary level education, and 27.6% male and 33.3% female patients were illiterate. Smoking was found to be more prevalent among the less educated persons. Conclusions: The results obtained in this study indicate the importance of creating awareness about lung cancer risk factors among Bangladeshi people and making appropriate access to health services for the illiterate, poor, rural people.

• Asian Pacific Journal of Cancer Prevention
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• 제15권24호
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• pp.10937-10941
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• 2015

Pathogenesis of lung cancer is a complicated biological process including multiple genetic and epigenetic changes. Since cigarette smoking is confirmed as the most main risk factor of non-small cell lung cancer (NSCLC), the aim of this study was to determine whether tobacco exposure plays a role in gene methylation. Methylation of the RAR-${\beta}$ gene were detected using methylation-specific polymerase chain reaction in DNA from 167 newly diagnosed cases with NSCLC and corresponding 105 controls. A significant statistical association was found in the detection rate of the promoter methylation of RAR-${\beta}$ gene between NSCLC and controls ($x^2$=166.01; p<0.01), and hypermethylation of the RAR-${\beta}$ gene was significantly associated with smoking status (p=0.038, p<0.05). No relationship was found between RAR-${\beta}$ gene methylation and pathologic staging including clinical stage, cell type, gender and drinking (p>0.05), and the methylation of RAR-${\beta}$ gene rate of NSCLC was slightly higher in stages III+IV (80.0%) than in I+II (70.8%). Similar results were obtained for methylation of the RAR-${\beta}$ gene between squamous cell carcinoma (77.9%) and other cell type lung cancer (73.9%). These results showed that the frequency of methylation increased gradually with the development of clinical stage in smoking-associated lung cancer patients, and tobacco smoke may be play a potential role in RAR-${\beta}$ gene methylation in the early pathogenesis and process in lung cancer, particularly squamous cell carcinoma. Aberrant promoter methylation is considered to be a promising marker of previous carcinogen exposure and cancer risk.

• Journal of Preventive Medicine and Public Health
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• 제52권6호
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• pp.427-432
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• 2019

Objectives: In Indonesia, 61 million adults smoked in 2018, and 59 million were exposed to secondhand smoke at offices or restaurants in 2011. The Presidential Decree 109/2012 encouraged local governments to implement a smoke-free policy (SFP), and the city of Jayapura enacted a local bill (1/2015) to that effect in 2015. This study aimed to evaluate compliance with this bill and to explore challenges in implementing it. Methods: We conducted a mixed-methods study. Quantitatively, we assessed compliance of facilities with 6 criteria (per the bill): the presence of signage, the lack of smoking activity, the lack of sale of tobacco, the lack of tobacco advertisements, the lack of cigarette smoke, and the lack of ashtrays. We surveyed 192 facilities, including health facilities, educational facilities, places of worship, government offices, and indoor and outdoor public facilities. Qualitatively, we explored challenges in implementation by interviewing 19 informants (government officers, students, and community members). Results: The rate of compliance with all 6 criteria was 17% overall, ranging from 0% at outdoor public facilities to 50% at health facilities. Spatial patterning was absent, as shown by similar compliance rates for SFP facilities within a 1-km boundary around the provincial and city health offices compared to those outside the boundary. Implementation challenges included (1) a limited budget for enforcement, (2) a lack of support from local non-governmental organizations and universities, (3) a lack of public awareness at the facilities themselves, and (4) a lack of examples set by local leaders. Conclusions: Overall compliance was low in Jayapura due to many challenges. This information provides lessons regarding tobacco control policy in underdeveloped areas far from the central government.

• 환경위생공학
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• 제15권3호
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• pp.1-7
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• 2000

There is increasing evidence suggestion that passive smoking increases the risk of lung cancer and other disease, though the potential health effects of exposure to environmental tobacco smoke (ETS) is a controversial subject. Since smoking in restaurant is prevalent in Korea, the concern on passive smoking exposure of non-smoking service-workers has been requested. ETS exposure of non-smoking service-workers at restaurant was assessed because they hare spent their times in restaurant indoors. The purpose of this study was feasibility of nitrogen dioxide($NO_2$) as exposure marker of ETS. The results of the study were as follows; 1. Average $NO_2$ concentrations in indoor and outdoor t restaurants were 57.1ppb(${\pm}12.4$) and 54.29ppb(${\pm}9.54$), respectively. Comparing office-workers, service-workers at restaurants were exposured highly. 2. The personal $NO_2$ measurement as exposure marker of ETS could cause the exposure error because $NO_2$ can be generated by combustion appliances in indoor. 3. Service-workers spent their most time(86.6%) in indoor. Mean time spent at restaurant indoors and at home was 9.4 hours and 10.9 hours, respectively. 4. Personal $NO_2$ levels correlated with indoor $NO_2$ concentrations of restaurant (r=0.70) and of their home (r=0.52) rather than of outdoor $NO_2$ concentration of restaurant (r=0.35). The cause of personal $NO_2$ exposure of non-smoking service-workers were considered as smoking of guests and combustion appliance indoors. 5. personal $NO_2$ exposures were estimated using Monte-Carlo simulation and time-weighted model. Estimated personal $NO_2$ level was 47.25ppb(${\pm}8.3$).

• 치위생과학회지
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• 제14권4호
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• pp.525-536
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• 2014

2009년 9월부터 2010년 2월까지 대전 서구보건소, 서구 관저보건지소, 건양대학교 금연클리닉에 자발적으로 참여하고 연구에 동의한 금연대상자들을 기초시점, 2주차, 2개월, 4개월, 6개월, 12개월 시점에 추구조사하고, MMP-8, MMP-9, IL-$1{\beta}$의 농도를 ELISA법을 사용하여 측정하였다. 그 중 1년간 금연에 성공한 11명의 치은열구액내 변화사례를 관찰한 결과, 1. 각 대상자의 치은열구액내 MMP-8, MMP-9, IL-$1{\beta}$ 변화는 대상자에 따라 각기 다른 파동성을 보였다. 2. 금연기간 동안 치은열구액 내 MMP-8의 변화 경향은 5명의 대상자가 감소하였고 2명의 대상자가 증가하였으며, 4명의 대상자가 유지되었다. MMP-9의 변화 경향은 6명의 대상자가 감소, 2명의 대상자가 증가, 3명의 대상자가 유지되었다. IL-$1{\beta}$의 변화 경향은 5명의 대상자가 감소하였고 3명의 대상자가 증가하였고, 3명의 대상자가 유지되었다. MMP-8과 9이 증가되는 경향을 보이는 2명의 대상자는 다른 대상자에 비해 기초시점부터 각 바이오마커의 농도가 상당히 낮은 대상자였으며 증가폭은 다른 대상자에 비해 그 양이 적었다. 본 사례연구를 통해 금연은 치주에 관한 다른 처치 없이도 치은열구액 내 MMP-8, MMP-9, IL-$1{\beta}$ 농도를 감소시키거나 유지시킬 수 있는 가능성이 있다고 판단되었으나, 연구대상자수의 충분한 확보와 금연 성공률의 향상을 통해 통계분석이 가능한 추가적인 연구가 필요하다.