An observational study of the Korean proactive quitline service for smoking cessation and relapse prevention

Non-pharmacological interventions for tobacco cessation: A systematic review of existing practices and their effectiveness

Smoking tobacco is associated with lung cancer and other life-threatening diseases which requires serious action to curb it. Tobacco cessation interventions are available as pharmacological and non-pharmacological methods or a combination of both. The present review examines the effectiveness of the existing non-pharmacological tobacco cessation interventions and synthesizes the result for the future development of drug-free treatment in the community for tobacco cessation. The literature search was conducted in August 2020, using two electronic databases (PubMed and JSTOR), with search terms: ['tobacco cessation' OR 'smoking cessation'] AND ['intervention'] which included studies published during 2010 and 2020 (till 31st July 2020). All studies were limited to English language, human participants and excluded patients with comorbidities. A total of 2,114 publications were retrieved out of which 11 articles were reviewed. On the basis of intervention used in reviewed studies, we categorized them into seven categories: i. incentive-based intervention, ii. exercise based, iii. telephone-based proactive counselling, iv. mobile phone SMS (Short Message Service) based, v. smartphone app (application) based, vi. web-based intervention, vii. self-help material. Incentives were provided in most of the studies to maintain the retention rate and motivate the participants for completing follow-up. Non-pharmacological interventions for tobacco cessation include a combination of various elements. Our findings suggest that behavioural counselling is one of the most important elements of any non-pharmacological intervention. In addition to behaviour counselling, yoga and exercises along with self-help material, video and phone counselling may have higher efficacy. Thus, practicing non-pharmacological interventions may also increase the cessation rate and reduce the tobacco use burden.

Network Analysis of Demographics, Dietary Intake, and Comorbidity Interactions

The aim of this study was to elucidate the complex interrelationships among dietary intake, demographics, and the risk of comorbidities. We applied a Gaussian graphical model to calculate the dietary scores of the participants. The network structure of dietary intake, demographics, and comorbidities was estimated in a mixed graphical model. The centrality indices of the nodes (strength (S), closeness (C), and betweenness (B)) were measured to identify the central node. Multinomial logistic regression was used to examine the association between the factors and comorbidities. Among 7423 participants, the strongest pairwise interactions were found between sex and smoking (1.56), sex and employment (0.66), sex and marital status (0.58), marital status and income (0.65), and age and employment (0.58). Among the factors in the network, sex played a central role (S = 4.63, C = 0.014, B = 41), followed by age (S = 2.81, C = 0.013, B = 18), smoking (S = 2.72, C = 0.013, B = 0), and employment (S = 2.17, C = 0.014, B = 22). While the odds of hypertension and diabetes were significantly higher among females than males, an inverse association was observed between high cholesterol and moderate chronic kidney disease. Among these factors, dietary intake was not a strongly interacting factor in the network, whereas age was consistently associated with the comorbidities of hypertension, high cholesterol, diabetes, and chronic kidney disease.

Cigarette Smoking in South Korea: A Narrative Review

Although the prevalence of cigarette smoking has declined in Western countries over the past few decades, a comparable decline among males has not been observed in Asian countries, especially in South Korea, where approximately 40%–50% of men and 4%–8% of women have been identified as smokers, and there is a pressing need to understand the background of cigarette smoking in these populations. The present study is a narrative review of the research literature on cigarette smoking in South Korea. First, we describe the social, economic, and cultural factors that impact cigarette smoking in South Korea. The paper also reviews the available peer-reviewed literature comprising observational studies and interventional studies, including randomized controlled trials. The extant literature on smoking in Korean Americans is also reviewed. Cigarette smoking in South Korea has been relatively understudied, and this review identifies priority areas for future research, including the use of mobile interventions.

A randomized controlled trial of a videoconferencing smoking cessation intervention for Korean American women: preliminary findings

Introduction

Korean women are reluctant to pursue in-person smoking cessation treatment due to stigma attached to women smokers and prefer treatment such as telephone and online smoking cessation programs that they can access secretively at home. However, there is some evidence that face-to-face interaction is the most helpful intervention component for them to quit smoking.

Methods

This study is a pilot clinical trial that examined the acceptability and feasibility of a videoconferencing smoking cessation intervention for Korean American women and compared its preliminary efficacy with a telephone-based intervention. Women of Korean ethnicity were recruited nationwide in the United States and randomly assigned at a ratio of 1:1 to either a video arm or a telephone arm. Both arms received eight 30-minute weekly individualized counseling sessions of a deep cultural smoking cessation intervention and nicotine patches for 8 weeks. Participants were followed over 3 months from the quit day.

Results

The videoconferencing intervention was acceptable and feasible for Korean women aged <50 years, whereas it was not for older women. Self-reported abstinence was high at 67% and 48% for the video and telephone arm at 1 month post-quit, respectively. The rates declined to 33% for the video arm and 28% for the telephone arm at 3 months post-quit when salivary cotinine test was performed.

Conclusion

Findings support that both videoconferencing and telephone counseling can be effective, and personal preference is likely an important factor in treatment matching. The deep cultural smoking cessation intervention may account for the outcomes of telephone counseling being better than prior studies in the literature for Korean women.