• 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.

• Korean Journal of Health Education and Promotion
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• v.28 no.2
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• pp.41-50
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• 2011

Objectives: Objectives: The objective of this study is to describe the WHO-CHOICE(World Health Organization- CHOosing Interventions that are Cost-Effective) programme, and to consider the application of WHO-CHOICE programme in Korea, especially on the health promotion policy. Methods: Literature review was conducted on the contents of WHO-CHOICE programme in the previous studies, guidebook, and software. We also contacted WHO-CHOICE team at WHO to identify the contents not clearly presented in the documents. Results: The WHO-CHOICE programme is a standardized tool for analyzing and comparing the cost effectiveness of health promotion policies. It is composed of PopMod to measure the health effect of intervention and of CostIt to measure the cost. The cost of tobacco control policy in Korea was analyzed with the cooperation of WHO-CHOICE team preliminary, and the results were different with the results of tobacco control policy on western pacific region of WHO. Conclusions: The cost effectiveness study based on WHO-CHOICE programme could help decide a priority of health promotion policy for settings with limited resources. For the improvement of health, the future work on WHO-CHOICE programme need to be considered.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.12
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• pp.5969-5973
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• 2012

Introduction: Andhra Pradesh (AP) is one of the largest tobacco producing states in India. About 29% of adults in AP currently use tobacco in some form. Almost 24% of males and 4% of females are smokers. The prevalence of tobacco use in the state is higher than the national average of 15% for male and 2% for female smokers. However, few attempts have been made to understand the current situation of tobacco control resources, activities and strategies in the context of such a high tobacco prevalence state. The present study aimed to identify the gaps in existing tobacco control program and areas where tobacco control efforts can be integrated. Methods: Data were collected using both quantitative and qualitative methods. Semi-structured interviews were undertaken with a total of 95 key officials of state health departments, program managers, and project directors in six districts to understand ongoing tobacco control efforts. To facilitate the interviews, semi-structured guides were developed. Simple descriptive statistical analysis was conducted on the quantitative data using SPSS version 17. Results: The results of the situational analysis suggest that a sufficient health workforce and infrastructure with the potential to integrate tobacco control activities is available in the surveyed districts. However, lack of integration of the tobacco control program intothe tuberculosis control program and the National Rural Health Mission was observed. Information, education and communication activities were lacking at block level health facilities. Conclusions: Our findings indicate that lack of trained health professionals, paucity of dedicated funds, lack of information, education and communication materials and low priority given to tobacco control activities are some of the factors which impede integration of tobacco control into existing health and developmental programmes in the districts of Andhra Pradesh, India.

• KOREAN JOURNAL OF CROP SCIENCE
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• v.52 no.2
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• pp.183-197
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• 2007

Field trial was conducted at the Research Farm of the Katsina State Agricultural and Rural Development Authority during the farming season of 2004 with a view to evaluate/determine the efficacy of some selected plant-derived biopesticides against the insect pests of cowpea as well as their effect on yield. The variety of the cowpea used was IT86D-719 and the plant derived biopesticides evaluated during the trial were chilli pepper, garlic, ginger, neem, sweetsop and tobacco. The experimental field was ploughed, harrowed and thereafter ridged before the commencement of the 2004 planting season. A total of twenty one (21) experimental plots were demarcated and arranged into seven treatment plots. The size of each plot was $5m{\times}4m$ while interspaces between adjacent plot and blocks were 1m and 2m, respectively. Results of the experiments showed that all the plant-derived biopesticide treatments were significantly (p>0.05) better than control treatment. The order of effectiveness of the treatments was tobacco (80-90%), sweetsop (75-85%), garlic (70-80), neem (72-78%), chilli pepper (60-70%) and ginger (30-50%). Furthermore, yield result corresponded positively with the effectiveness of the treatments. Results of the present finding suggest the use of tobacco, sweetsop and garlic as promising biopesticides in the control of cowpea insect pests.

• 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.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.2841-2846
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• 2016

Background: Tobacco use is the single most important preventable risk factor for cancer. Surveillance of tobacco-related cancers (TRC) is critical for monitoring trends and evaluating tobacco control programmes. We analysed the trends of TRC and evaluated the population-based cancer registry (PBCR) in Delhi for simplicity, comparability, validity, timeliness and representativeness. Materials and Methods: We interviewed key informants, observed registry processes and analysed the PBCR dataset for the period 1988-2009 using the 2009 TRC definition of the International Agency for Research on Cancer. We calculated the percentages of morphologically verified cancers, death certificate-only (DCO) cases, missing values of key variables and the time between cancer diagnosis and registration or publication for the year 2009. Results: The number of new cancer cases increased from 5,854 to 15,244 (160%) during 1988-2009. TRC constituted 58% of all cancers among men and 47% among women in 2009. The age-adjusted incidence rates of TRC per 100,000 population increased from 64.2 to 97.3 among men, and from 66.2 to 69.2 among women during 1988-2009. Data on all cancer cases presenting at all major government and private health facilities are actively collected by the PBCR staff using standard paper-based forms. Data abstraction and coding is conducted manually following ICD-10 classifications. Eighty per cent of cases were morphologically verified and 1% were identified by death certificate only. Less than 1% of key variables had missing values. The median time to registration and publishing was 13 and 32 months, respectively. Conclusions: The burden of TRC in Delhi is high and increasing. The Delhi PBCR is well organized and generates high-quality, representative data. However, data could be published earlier if paper-based data are replaced by electronic data abstraction.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.5
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• pp.2891-2896
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• 2013

Background: To illustrate multiple approaches and to assess participation rates adopted for a community based smoking cessation intervention programme in rural Kerala. Materials and Methods: Resident males in the age group 18-60 years who were 'current daily smokers' from 4 randomly allocated community development blocks of rural Thiruvananthapuram district, Kerala (2 intervention and 2 control groups) were selected. Smoking status was assessed through house-to-house survey using trained volunteers. Multiple approaches included awareness on tobacco hazards during baseline survey and distribution of multicolour anti-tobacco leaflets for intervention and control groups. Further, the intervention group received a tobacco cessation booklet and four sessions of counselling which included a one-time group counselling cum medical camp, followed by proactive counselling through face-to-face (FTF) interview and mobile phone. In the second and fourth session, motivational counselling was conducted. Results: Among 928 smokers identified, smokers in intervention and control groups numbered 474 (mean age: 44.6 years, SD: 9.66 years) and 454 respectively (44.5 years, SD: 10.30 years). Among the 474 subjects, 75 (16%) had attended the group counselling cum medical camp after completion of baseline survey in the intervention group, Among the remaining subjects (n=399), 88% were contacted through FTF and mobile phone (8.5%). In the second session (4-6 weeks time period), the response rate for individual counselling was 94% (78% through FTF and 16% through mobile phone). At 3 months, 70.4% were contacted by their mobile phone and further, 19.6% through FTF (total 90%) while at 6 months (fourth session), the response rate was 74% and 16.4% for FTF and mobile phone respectively, covering 90.4% of the total subjects. Overall, in the intervention group, 97.4% of subjects were being contacted at least once and individual counselling given. Conclusion: Proactive community centred intervention programmes using multiple approaches were found to be successful to increase the participation rate for intervention.

• Journal of Korean Public Health Nursing
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• v.18 no.1
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• pp.74-79
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• 2004

The purpose of this study was to evaluate the effects of smoking prevention programs offered to primary and secondary school students in Seoul, and to analyze factors related to smoking for these students. A quasi-experimental study design was employed and a total of 8,717 students for pre-test and 7,925 students for post-test were participated in the study. The smoking prevention programs included poster and slogan contests. smoking cessation workshop. distribution of smoking prevention pamphlets, reinforcement of smoking regulations, and operation of mobile smoking cessation booth. The results indicated that smoking prevalence decreased after the intervention. However. despite the reinforcement of the regulation related to sales of tobacco to adolescents. more than $50\%$ of the participants still purchased tobacco from stores, while $20.8\%$ obtained tobacco through their friends. Stress, juvenile delinquency, and pocket money were identified as significant factors associated with tobacco use for these students. In conclusion, smoking prevention programs with multiple intervention strategies were effective in decreasing the smoking prevalence among adolescents. Further study is recommended to conduct an experimental study using comparison group to control the effect of other social influences such as national smoking cessation campaigns.

• 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.15 no.15
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• pp.5983-5991
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• 2014

Introduction: Upper aero-digestive tract cancer is a multidimensional problem, international trends showing complex rises and falls in incidence and mortality across the globe, with variation across different cultural and socio-economic groups. This paper seeks some explanations and identifies some research and policy needs. Methodological Approach: The literature illustrates the multifactorial nature of carcinogenesis. At the cellular level, it is viewed as a multistep process involving multiple mutations and selection for cells with progressively increasing capacity for proliferation, survival, invasion, and metastasis. Established and emerging risk factors, in addition to changes in incidence and prevalence of cancers of the upper aero-digestive tract, were identified. Risk Factors: Exposure to tobacco and alcohol, as well as diets inadequate in fresh fruits and vegetables, remain the major risk factors, with persistent infection by particular so-called "high risk" genotypes of human papillomavirus increasingly recognised as also playing an important role in a subset of cases, particularly for the oropharynx. Chronic trauma to oral mucosa from poor restorations and prostheses, in addition to poor oral hygiene with a consequent heavy microbial load in the mouth, are also emerging as significant risk factors. Conclusions: Understanding and quantifying the impact of individual risk factors for these cancers is vital for health decision-making, planning and prevention. National policies and programmes should be designed and implemented to control exposure to environmental risks, by legislation if necessary, and to raise awareness so that people are provided with the information and support they need to adopt healthy lifestyles.