• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.625-630
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• 2013

Background: Hardcore smoking is represented by a subset of daily smokers with high nicotine dependence, inability to quit and unwillingness to quit. Estimating the related burden could help us in identifying a high risk population prone to tobacco induced diseases and improve cessation planning for them. This study assessed the prevalence and associated factors of hardcore smoking in three South-East Asian countries and discussed its implication for smoking cessation intervention in this region. Materials and Methods: Global Adult Tobacco Survey (GATS) data of India, Bangladesh and Thailand were analyzed to quantify the hardcore smoking prevalence in the region. On the basis of review, an operational definition of hardcore smoking was adopted that includes (1) current daily smoker, (2) no quit attempt in the past 12 months of survey or last quit attempt of less than 24 hours duration, (3) no intention to quit in next 12 months or not interested in quitting, (4) time to first smoke within 30 minutes of waking up, and (5) knowledge of smoking hazards. Logistic regression analysis was carried out using hardcore smoking status as response variable and gender, type of residence, occupation, education, wealth index and age-group as possible predictors. Results: There were 31.3 million hardcore smokers in the three Asian countries. The adult prevalence of hardcore smoking in these countries ranges between 3.1% in India to 6% in Thailand. These hardcore smokers constitute 18.3-29.7% of daily smokers. The logistic regression model indicated that age, gender, occupation and wealth index are the major predictors of hardcore smoking with varied influence across countries. Conclusions: Presence of a higher number of hardcore smoking populations in Asia is a major public health challenge for tobacco control and cancer prevention. There is need of intensive cessation interventions with due consideration of contextual predictors.

• Journal of Korean Public Health Nursing
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• v.30 no.3
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• pp.495-511
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• 2016

Purpose: The present study was performed to describe the prevalence of various types of smoking statuses and to identify factors associated with different types among Korean wageworkers. Methods: The prevalence of hardcore smoking, daily smoking, and intermittent smoking was assessed in 2,126 wage workers from the Sixth Korea National Health and Nutrition Examination Survey. The associations of these three types of smoking statuses with sociodemographic characteristics, health conditions, and occupation-related characteristics were also examined in a multinomial logistic regression. Results: In men, the prevalence of hardcore smoking and daily smoking were 11.4% and 30.2%, respectively; and in women, the daily smoking prevalence was 5.6%. The education level was strongly associated with men's hardcore smoking and women's daily smoking. The household income and marital status were associated with women's daily smoking. Among occupation-related characteristics, the regularity of work and night work were associated with men's intermittent smoking. Night work was also associated with women's daily smoking. Employment condition was associated with women's intermittent smoking. Conclusion: The socioeconomic status and health conditions, compared with occupation-related factors, were found to have more influence on smoking. Therefore, antismoking programs that focus on individual characteristics should be developed for Korean wageworkers.

• Journal of Korean Academy of Nursing
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• v.49 no.1
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• pp.69-79
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• 2019

Purpose: This study aimed to identify the directionality of the causal relationship and interaction between depression and amount of smoking over time in hardcore smokers using longitudinal descriptive analysis. Methods: Secondary data from the Korean Welfare Panel Study were analyzed using autoregressive cross-lagged modeling. Participants included 342 hardcore smokers who participated in the 8th to 11th waves of the panel study. Results: Analyses revealed that change(s) in depression levels according to time had a significant positive relationship with the total amount of smoking per day (${\beta}=.29$, ${\beta}=.19$, ${\beta}=.17$, p<.001), while change(s) in total amount of smoking per day according to time had a significant positive relationship with depression (${\beta}=.43$, ${\beta}=.50$, ${\beta}=.38$, p<.001). Analysis of the cross-lagged effect between depression and total amount of smoking per day showed that depression at one time point had a significantly positive relationship with the total amount of smoking per day at the next time point (${\beta}=.14$, ${\beta}=.13$, ${\beta}=.13$, p=.021), and that the total amount of smoking per day at one time point had a significant positive relationship with depression at the next time point (${\beta}=.04$, ${\beta}=.04$, ${\beta}=.03$, p=.044). Conclusion: The findings in the present study confirmed a cross-interaction between depression and total amount of smoking per day in hardcore smokers. The present findings could be used to develop appropriate smoking-related interventions.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.5959-5963
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• 2012

Background: The term 'hardcore' has been applied to use of smoking tobacco and generally referred to as the inability or unwillingness of regular smokers to quit. The component constructs of hardcore except nicotine dependence are product neutral. With the use of 'time to first chew' as a measure of nicotine dependence, hardcore definition can be extended to characterize smokeless tobacco users. Hardcore users respond less to tobacco cessation interventions, and are prone to tobacco induced diseases including cancer. Thus identifying hardcore users would help in estimate the burden of high risk population for tobacco induced diseases. Smokeless tobacco use is predominant and accounts for more than 50% of oral cancer in India. Hence, hardcore chewing information could be used for planning of tobacco and cancer control interventions. The objective of this study was to assess the prevalence and associated factors of hardcore smokeless tobacco use in India. Materials and Methods: Global Adult Tobacco Survey (GATS)-India 2010 data were analyzed to quantify hardcore smokeless tobacco use in India with following five criteria: (1) current daily smokeless tobacco use; (2) no quit attempt in the past 12 months of survey or last quit attempt of less than 24 hours duration; (3) no intention to quit in next 12 months or not interested in quitting; (4) time to first use of smokeless tobacco product within 30 minutes of waking up; and (5) knowledge of smokeless tobacco hazards. Results: The number of hardcore smokeless tobacco users among adult Indians is estimated to be 5% (39.5 million). This group comprises 23.2% of daily smokeless tobacco users. The population prevalence varied from 1.4-9.1% across different national regions of India. Logistic regression modeling indicated age, education and employment status to be the major predictors of hardcore smokeless tobacco use in India. Conclusions: The presence of a huge number (39.5 million) of hardcore smokeless tobacco users is a challenge to tobacco control and cancer prevention in India. There is an unmet need for a universal tobacco cessation programme and intensification of anti-tobacco education in communities.