• Asian Pacific Journal of Cancer Prevention
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• v.16 no.18
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• pp.8365-8370
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• 2016

Background: Shammah is a traditional form of snuff dipping tobacco (a smokeless tobacco form) that is commonly used in Yemen. Oral mucosal changes due to the use of shammah can usually be observed in the mucosal surfaces that the product touches. The aim of this study was to determine the association between shammah use and oral leukoplakia-like lesions. Other associated factors were also determined. Materials and Methods: A cross sectional study was conducted on 346 randomly selected adult males. Multi-stage random sampling was used to select the study location. After completing the structured questionnaire interviews, all the participants underwent clinical exanimation for screening of oral leukoplakia-like lesions Clinical features of oral leukoplakia-like lesion were characterized based on the grades of $Ax{\acute{e}}ll$ et al (1976). Univariable logistic regression and multivariable logistic regression were used to assess the potential associated factors. Results: Out of 346 male participants aged 18 years and older, 68 (19.7%) reported being current shammah users. The multivariable analysis revealed that age, non-formal or primary level of education, former shammah user, current shammah user, and frequency of shammah use per day were statistically associated with the presence of oral leukoplakia-like lesions [Adjusted odds ratio (AOR) = 1.03; 95% confidence interval (CI) : 1.01, 1.06; P=0.006], (AOR=8.65; 95% CI: 2.81, 26.57; P=0.001), (AOR=3.65; 95% CI: 1.40, 9.50; P=0.008), (AOR=12.99; 95% CI: 6.34, 26.59; P=0.001), and (AOR=1.17; 95% CI: 1.02, 1.36; P=0.026), respectively. Conclusions: The results revealed oral leukoplakia-like lesions to be significantly associated with shammah use. Therefore, it is important to develop comprehensive shammah prevention programs in Yemen.

• Journal of Preventive Medicine and Public Health
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• v.56 no.5
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• pp.485-486
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• 2023

• Journal of Preventive Medicine and Public Health
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• v.43 no.6
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• pp.459-471
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• 2010

The main behavioural and environmental risk factors for cancer mortality in the world are related to diet and physical inactivity, use of addictive substances, sexual and reproductive health, exposure to air pollution and use of contaminated needles. The population attributable fraction for all cancer sites worldwide considering the joint effect of these factors is about 35% (34 % for low- and middle-income countries and 37% for high-income countries). Seventy-one percent of lung cancer deaths are caused by tobacco use (lung cancer is the leading cause of cancer death globally). The combined effects of tobacco use, low fruit and vegetable intake, urban air pollution, and indoor smoke from household use of solid fuels cause 76% of lung cancer deaths. Exposure to these behavioural and environmental factors is preventable; modifications in lifestyle could have a large impact in reducing the cancer burden worldwide. The evidence of association between lifestyle factors and cancer, as well as the main international recommendations for prevention are briefly reviewed and commented upon here.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.16
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• pp.6883-6888
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• 2015

Background: Tobacco smoking is a major cause of preventable disease and death worldwide. Kreteks are clove-flavored cigarettes made from a combination of tobacco and ground-clove mixed with a sauce, smoked widely in Indonesia. Because health and social consequences of kretek smoking are potentially as great as those of traditional cigarettes, this study examines the prevalence of kretek smoking in Indonesia and associated risk factors. Materials and Methods: The study used nationally representative Indonesia Global Adult Tobacco Survey data. Multiple logistic regression analysis was employed to identify correlates of kretek smoking. Results: One-third of Indonesian adults smoked tobacco of which about 90.0% smoked kreteks. Prevalence of kretek smoking among men (60.9%) was more than 25 times the rate among women (2.3%). Overall, the highest prevalence of kretek use was in the age group 45-54 years (36.5%), followed by 34-44 (35.1%), 25-34 (34.2 %), and 55-64 years (32.8%). By wealth index, prevalence of kreteks smoking among those in the middle index was almost 50% above the rate for the wealthiest group (36.4% vs 24.8% respectively). Logistic regression results showed that being male, being older, having less education, and being less wealthy were significant predictors of kretek smoking, while urban vs rural residence was not. Conclusions: Kretek smoking is common in Indonesia and is entrenched in the sociocultural fabric of the country. However, potential consequences of kretek smoking, particularly as risks for noncommunicable diseases, underscore the importance of a comprehensive approach to tobacco control as outlined in the World Health Organization's MPOWER strategies.

• Proceedings of The Korean Society of Health Promotion Conference
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• 2001.09a
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• pp.91-111
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• 2001

Background: Alcohol and tobacco use are two major behavioral risk factors implicated in increased morbidity and mortality. Since both substances are widely used in Korea, a concerted effort is currently underway to reduce the use of tobacco and alcohol in Korea. Objectives: Efforts directed toward educating health promotion planners and health educators from local health departments to organize and implement health education programs to reduce the proportion of people smoking and excessive drinking in the community. Methods: A training guide on prevention of smoking and excessive drinking has been developed. Comprehensive multi-media health promotion materials were developed based on health behavior theories and strategies for effective health behavioral interventions. To better control of behavioral risk and promote health enhancement, the materials were developed to introduce a user-oriented developmental approach by making messages more persuasive and organizing content in a user-friendly manner. Sections of the report explain theoretical background of the intervention, choosing goals and a target population, specific program activities to include in an intervention, development, organization, methods of making program content vivid and persuasive, and evaluation,. Implications for Practitioners: The process followed in developing the health intervention materials is described in detail to assist practitioners who need to develop effective programs to reduce the use of tobacco and excessive alcohol. Health educators from all local health departments in the country were trained in the use of the materials, to enable them to develop community interventions to reduce smoking and excessive drinking.

• The Korean Journal of Health Service Management
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• v.6 no.4
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• pp.13-25
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• 2012

There is growing evidence that substance use such as tobacco or alcohol consumption influences health disparity among adolescents. Previous research papers have shown an inconsistency in the relationship between socio-economic status (SES) and substance use in adolescents. However, little is known about socio-economic differences in unhealthy behaviors among Korean adolescents. The purpose of the present study is to explore associations between SES and substance use in Korean adolescents. The analysis was performed using data from the 2009 Korean Youth Risk Behavior Web-based Survey (YRBS), which included a nationally representative sample of middle and high school students. Drinking/heavy drinking and smoking/daily smoking behavior indices were used for dependent variables, and perceived economic status, family affluence score, parents' education were used for independent variables. Chi-square test were used to compare tobacco and alcohol consumption among 3 SES groups. Logistic regression models were used to identify statistically significant socio-economic factors after adjusting other covariates. Higher perceived economic status and higher family affluence were associated with higher rates of smoking, daily smoking, drinking, and heavy drinking, while lower level of parents' education was related to higher use of tobacco and alcohol. Socio-economic status significantly influences health behaviors in adolescents, and it may consequently affect health disparity in their adulthood. Therefore, there is a need of continuous monitoring and follow-up research of health disparity among adolescents.

• Journal of Korean Academy of Nursing
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• v.33 no.2
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• pp.256-264
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• 2003

Purpose: The purpose of this research was to find out tobacco control education taught graduate, baccalaureate and associate degree-nursing programs in Korea. Method: A valid and reliable questionnaire previously used to assess tobacco use in medical and nursing schools in the United States was translated and revalidated. Surveys were sent out to all the graduate, baccalaureate and associate nursing programs in Korea. All 6-tobacco curricula content areas recommended by the United States National Cancer Institute and the Agency for Health Care Policy and Research was included. Result: Majority of BSN (93.2%-75%) and AD (92.3%-64.1%) programs were teaching health hazards, cancer risk, health effects of tobacco, effects of ETS, contents of cigarette, withdrawal symptoms and high risk groups of smoking as a part of required courses. However, 87.5% (14/16) of graduate, 50.0% (22/44) in baccalaureate, 53.8% (21/39) in associate degree programs were not teaching about the 5 A's. Of those who reported teaching smoking cessation strategies, they were covered most frequently in Community Nursing (50%), Adult Health Nursing (43.8%) on the graduate level, and in Community Nursing (65.9%-BSN, 76.9%-AD) and Adult Health (54.5%-BSN, 74.4%-AD) on the undergraduate level. 31.1% (5/16) in Graduate, 18.2%(8/44) in BSN, 10.3% (4/39) in Associate Degree programs reported that there are no smoking students in their schools and rest of the schools reported either do not know or they have 1 to more than 21% of students smoking. Conclusion: The study results identifies the quantity and level of tobacco control content in three different nursing programs and will help in developing curricular guidelines in the future. Further survey needs to be done on nursing students' knowledge, attitude and belief on smoking and smoking cessation.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.sup1
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• pp.43-47
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• 2016

Second-hand tobacco smoke (SHS) exposure at home, especially among children, is a serious issue in Viet Nam. During the past decade, much effort has been taken for tobacco control in the country, including various prgorammes aiming to reduce SHS exposure among adults and children. This article analysed trends and factors associated with SHS exposure at home among school children aged 13-15 in Viet Nam, using the Global Youth Tobacco Surveys conducted in 2007 and 2014. Descriptive and inferential statistical methods with logistic regression were applied. Overall, there was a significant reduction in the level of exposure, from 58.5% (95%CI: 57.6-59.3) in 2007 to 47.1% (95%CI: 45.4-48.8) in 2014. Of the associated factors, having one or both parents smoking was significantly associated with the highest odds of SHS exposure at home (OR=5.0; 95%CI: 4.2-6.1). Conversely, having a mother with a college or higher education level was found to be a protective factor (OR=0.5; 95%CI: 0.3-0.8).

• 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.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.1133-1139
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• 2013

Background: In India, tobacco consumption is responsible for one of the highest rates of oral cancer in the world, the annual oral cancer incidence is steadily increasing among young tobacco users. Studies have documented efforts taken by physicians, doctors and even dentists, in the form of individual or group counseling to curb tobacco use in smoke or smokeless form. However, which one is more effective, still remains an unanswered question. The aim of the study was to compare the effectiveness of individual and group counseling for cessation of the tobacco habit amongst industrial workers in Pune and to compare quit rates. Materials and methods: An interventional study design was selected for 150 industrial workers which were stratified randomly into three groups (control, individual and group counseling groups) and interventions were provided to individual and group counseling groups over a period of six months, which were then compared with the control group that received brief intervention at the start of the study. Results: There was significant difference in the quit rates of the participants in the individual counseling group (ICG) and group counseling group (GCG) when compared at 6 months with the control counseling group (CCG). In the individual counseling group was 6% while in group counseling group it was 7.5% after six months of counseling. Conclusions: No conclusion could be drawn whether individual or group counseling were better interms of quit rates. Individual and group counseling groups were definitely better than the control group when compared at 3 and 6 months, respectively.