1
|
Hashim MAB, Bin Sebri KF, Bin Mohd Hanim MF, Binti Anwar DS, Binti Mohd Radzi NA, Bin Ahmad Fuad AF, Md Sabri BAB. The Impact of Military Tobacco Control Policy: A Systematic Review. Mil Med 2024:usad507. [PMID: 38330180 DOI: 10.1093/milmed/usad507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 12/29/2023] [Indexed: 02/10/2024] Open
Abstract
INTRODUCTION Tobacco use is synonymous with the military. Despite that military personnel are trained to follow commands, opportunities exist to implement various tobacco control strategies. We conducted a systematic review to evaluate the impact of tobacco control policy employed in military settings. MATERIALS AND METHODS We searched for published English articles in Medline, Web of Science, Scopus, and Google Scholar databases using relevant subject headings without year restriction. We included randomized controlled trials, nonrandomized controlled trials, case-control, cohort, controlled before and after, and uncontrolled before and after studies evaluating the impact of tobacco control policy in the military population. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, three independent reviewers independently screened initially identified articles, reviewed the full text, and extracted the data and any disagreements resolved by consensus after data recheck. Five reviewers used a validated tool to assess the quality of the included studies. The primary outcome was the reduction of any tobacco or nicotine-contained products (TNCPs) use among the troops. The impacts of the tobacco control policy were synthesized and analyzed qualitatively. This study is registered with the International Prospective Register of Systematic Review (CRD42022314117). RESULTS Fourteen studies were included in the analysis from 5372 studies screened. Most of the studies were from the USA, and fractions were from Thailand, France, and Taiwan. These studies were methodologically heterogeneous. Most studies employed a total ban policy on TNCP use during basic military training or operational deployment as the primary strategy. Other methods utilized were the brief tobacco intervention, targeted treatment, support, and counseling provided through telephone or mailing systems, the adjunctive behavioral intervention, providing free nicotine gum, the "Pharsai clinic", active and regular smoking restriction, and interventions aimed at intrapersonal, interpersonal, and organizational levels. There is a moderate quality of evidence that the tobacco control policies effectively reduced the prevalence of TNCP use, increased the cessation rate, reduced the intake, and lowered the dependency. The adjunctive interventions provided after the total ban on TNCP use may increase its effectiveness. However, findings from this review need to be carefully considered as the definition of TNCP use status was not universal between studies and lacked a biochemical validation procedure. CONCLUSIONS There is reasonable evidence to support that the tobacco control policy employed in the military population has multiple positive impacts in reducing the prevalence of TNCP use, increasing the cessation rates, reducing the intake, and lowering dependency. Other evidence-based strategies need to be fully utilized to materialize the tobacco endgame.
Collapse
Affiliation(s)
- Muhamad Arham Bin Hashim
- Faculty of Dentistry, Universiti Teknologi MARA (UiTM) Sungai Buloh Campus, Sungai Buloh, Selangor Darul Ehsan 47000, Malaysia
- The Malaysian Armed Forces, Wilayah Persekutuan, Kuala Lumpur 50634, Malaysia
| | - Khairul Fikri Bin Sebri
- Faculty of Dentistry, Universiti Teknologi MARA (UiTM) Sungai Buloh Campus, Sungai Buloh, Selangor Darul Ehsan 47000, Malaysia
| | - Muhammad Faiz Bin Mohd Hanim
- Faculty of Dentistry, Universiti Teknologi MARA (UiTM) Sungai Buloh Campus, Sungai Buloh, Selangor Darul Ehsan 47000, Malaysia
| | - Diyana Shereen Binti Anwar
- Faculty of Dentistry, Universiti Teknologi MARA (UiTM) Sungai Buloh Campus, Sungai Buloh, Selangor Darul Ehsan 47000, Malaysia
| | - Nawwal Alwani Binti Mohd Radzi
- Faculty of Dentistry, Universiti Teknologi MARA (UiTM) Sungai Buloh Campus, Sungai Buloh, Selangor Darul Ehsan 47000, Malaysia
| | | | - Budi Aslinie Binti Md Sabri
- Faculty of Dentistry, Universiti Teknologi MARA (UiTM) Sungai Buloh Campus, Sungai Buloh, Selangor Darul Ehsan 47000, Malaysia
| |
Collapse
|
2
|
Kim S, Byun G, Jo G, Park D, Cho SI, Oh H, Kim R, Subramanian SV, Yun S, Oh K, Lee JT, Shin MJ. Gender and tobacco epidemic in South Korea: implications from age-period-cohort analysis and the DPSEEA framework. BMJ Open 2022; 12:e058903. [PMID: 35414561 PMCID: PMC9006811 DOI: 10.1136/bmjopen-2021-058903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/25/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To understand a 20-year trend of gender-specific smoking prevalence among adults in South Korea. DESIGN Age-period-cohort analysis using the intrinsic estimator method was applied to examine the separate contribution of age, period and cohort effect on smoking prevalence. The Driving Force-Pressure-State-Exposure-Effect-Action (DPSEEA) framework was used to explain the observed smoking trends by mapping potential determinants and to address policy implications. SETTING General adult population in South Korea. PARTICIPANTS 34 828 men and 43 632 women who aged 19-78 years, were not currently pregnant and were without a prior diagnosis of cardiovascular disease or cancer. OUTCOME MEASURES Gender-specific current smoking prevalence using the 1998-2017 Korea National Health and Nutrition Examination Survey. RESULTS Our results showed gender-specific age and birth cohort effects. More specifically, the smoking prevalence peaked at their mid-20s (prevalence rate ratio (PRR): 1.54, 95% CI: 1.49 to 1.59) and cohort born in 1959-1963 (PRR: 1.63, 95% CI: 1.57 to 1.70) and then decreased in men. On the other hand, in women, the smoking prevalence consistently increased until their mid-40s (PRR: 1.53, 95% CI: 1.27 to 1.84) and in recent birth cohort groups (PRR in 1994-1998 cohort: 1.55, 95% CI: 1.13 to 2.13). The period effects declined from 1998-2002 to 2003-2007, following increasing fluctuations in both genders. The smoking-DPSEEA framework showed the absence of policy actions to target female smokers and emphasised a proactive approach that tackles the upstream causes for smoking in women. CONCLUSIONS Men and women are clearly in different phases of the smoking epidemic in Korean population, and gender-tailored policies should be implemented.
Collapse
Affiliation(s)
- Sera Kim
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
| | - Garam Byun
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
| | - Garam Jo
- Division of Cardiovascular Disease Research, Department for Chronic Disease Convergence Research, Korea National Institute of Health, Cheongju, Republic of Korea
| | - Dahyun Park
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
| | - Sung-Il Cho
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Republic of Korea
| | - Hannah Oh
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
- School of Health Policy and Management, College of Health Sciences, Korea University, Seoul, Republic of Korea
| | - Rockli Kim
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
- School of Health Policy and Management, College of Health Sciences, Korea University, Seoul, Republic of Korea
| | - S V Subramanian
- Harvard Center for Population and Development Studies, Cambridge, MA 02138, USA
| | - Sungha Yun
- Division of Health and Nutrition Survey and Analysis, Bureau of Chronic Disease Prevention and Control, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Kyungwon Oh
- Division of Health and Nutrition Survey and Analysis, Bureau of Chronic Disease Prevention and Control, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Jong-Tae Lee
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
- School of Health Policy and Management, College of Health Sciences, Korea University, Seoul, Republic of Korea
| | - Min-Jeong Shin
- Interdisciplinary Program in Precision Public Health, Department of Public Health Sciences, Graduate School of Korea University, Seoul, Republic of Korea
- School of Biosystems and Biomedical Sciences, College of Health Science, Korea University, Seoul, Republic of Korea
| |
Collapse
|
3
|
Jeong JS, Choi J, Noh GY. Fear appeal effectiveness in antismoking campaigns: do anger and smoking matter? PSYCHOL HEALTH MED 2021; 27:2105-2112. [PMID: 34789030 DOI: 10.1080/13548506.2021.2006251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Although fear appeals are widely used in health campaigns, empirical studies have produced conflicting results regarding their effectiveness. To understand the impact of fear appeal in health campaigns, this study investigates the relationship between fear, anger, and smoking status in the context of an antismoking campaign. Using a survey of 829 people in South Korea, this study tests the three-way interactive model with the PROCESS macro. Results indicate that the effect of fear on attitudes toward the campaign depends on the level of anger, and show that the impact of 'anger-adjusted' additional fear appears only among nonsmokers. Implications for antismoking advertising strategies are discussed.
Collapse
Affiliation(s)
- Jae-Seon Jeong
- Debiasing and Lay Informatics Lab, Center for Applied Social Research, University of Oklahoma, Norman, OK, USA
| | - Jounghwa Choi
- Department of Advertising & Public Relations, Hallym University, Chuncheon-si, Republic of Korea
| | - Ghee-Young Noh
- Healthcare Media Research Institute, School of Media Communication, Hallym University, Chuncheon, South Korea
| |
Collapse
|
4
|
Park MB, Ranabhat CL. Effect of parental smoking on their children's urine cotinine level in Korea: A population-based study. PLoS One 2021; 16:e0248013. [PMID: 33857161 PMCID: PMC8049314 DOI: 10.1371/journal.pone.0248013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 02/17/2021] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Children may be exposed to tobacco products in multiple ways if their parents smoke. The risks of exposure to secondhand smoke (SHS) are well known. This study aimed to investigate the association between parental smoking and the children's cotinine level in relation to restricting home smoking, in Korea. METHODS Using the Korea National Health and Nutrition Health Examination Survey data from 2014 to 2017, we analyzed urine cotinine data of parents and their non-smoking children (n = 1,403), in whose homes parents prohibited smoking. We performed linear regression analysis by adjusting age, sex, house type, and household income to determine if parent smoking was related to the urine cotinine concentration of their children. In addition, analysis of covariance and Tukey's post-hoc tests were performed according to parent smoking pattern. FINDING Children's urine cotinine concentrations were positively associated with those of their parents. Children of smoking parents had a significantly higher urine cotinine concentration than that in the group where both parents are non-smokers (diff = 0.933, P < .0001); mothers-only smoker group (diff = 0.511, P = 0.042); and fathers-only smoker group (diff = 0.712, P < .0001). In the fathers-only smoker group, the urine cotinine concentration was significantly higher than that in the group where both parents were non-smoker (diff = 0.221, P < .0001), but not significantly different compared to the mothers-only smoker group (diff = - -0.201, P = 0.388). Children living in apartments were more likely to be exposed to smoking substances. CONCLUSION This study showed a correlation between parents' and children's urine cotinine concentrations, supporting the occurrence of home smoking exposure due to the parents' smoking habit in Korea. Although avoiding indoor home smoking can decrease the children's exposure to tobacco, there is a need to identify other ways of smoking exposure and ensure appropriate monitoring and enforcement of banning smoking in the home.
Collapse
Affiliation(s)
- Myung-Bae Park
- Department of Gerontology Health and Welfare, Pai Chai University, Daejeon, Republic of Korea
| | - Chhabi Lal Ranabhat
- Department of Gerontology Health and Welfare, Pai Chai University, Daejeon, Republic of Korea
- Global Center for Research and Development (GCRD), Kathmandu, Nepal
- Manmohan Memorial Institute of Health Science, Kathmandu, Nepal
| |
Collapse
|
5
|
Gunter R, Szeto E, Jeong SH, Suh S, Waters AJ. Cigarette Smoking in South Korea: A Narrative Review. Korean J Fam Med 2019; 41:3-13. [PMID: 31189304 PMCID: PMC6987030 DOI: 10.4082/kjfm.18.0015] [Citation(s) in RCA: 60] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Accepted: 09/10/2018] [Indexed: 12/17/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- Rebekah Gunter
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Edwin Szeto
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Se-Hoon Jeong
- School of Media & Communication, Korea University, Seoul, Korea
| | - Sooyeon Suh
- Department of Psychology, Sungshin Women's University, Seoul, Korea
| | - Andrew J Waters
- Department of Medical and Clinical Psychology, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| |
Collapse
|
6
|
Public support for health taxes and media regulation of harmful products in South Korea. BMC Public Health 2019; 19:665. [PMID: 31146724 PMCID: PMC6543563 DOI: 10.1186/s12889-019-7044-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 05/24/2019] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Public health policy is inevitably associated with either a strong presence or lack of public support. We investigated factors associated with both the public support of and opposition to health taxes and the media regulation regarding advertising harmful products in Korea. METHODS We interviewed 1200 respondents that were recruited using an equal-probability sampling method in accordance with the 2016 Korean census. Our investigation examined the extent of support and opposition towards health taxes and the media regulation of advertising that targets the consumption of tobacco, alcohol, and unhealthy foods according to socioeconomic characteristics, health habits, body mass index (BMI), and exposure to the advertising of harmful products. The study was conducted using a univariate and stepwise multivariate regression analysis. RESULTS The majority (71.8%) of the respondents were supportive of imposing health taxes in general. Despite a high prevalence of tobacco and alcohol consumption among the respondents, they strongly supported media regulation of tobacco (72.3%), alcohol (63.7%), and eating broadcasts (51.9%) food advertising (44.0%). Those that were non-smokers, earned a high-income, were married, or had a child were likely to support at least one kind of regulation regarding alcohol and smoking related advertising. An exposure to excessive advertising of unhealthy products was associated with increase of respondents supporting the media regulation. Those who regarded the media as being influential seemed to be more supportive of health taxes or media regulation. CONCLUSION Our results indicated strong public support among the respondents for health taxes and the media regulation regarding the advertising of unhealthy products. Based on our data, we are optimistic that countries whose population show a high rate of tobacco, alcohol or unhealthy food consumption may launch public policy in addressing these factors.
Collapse
|
7
|
Song YK, Kim JH, Choi B, Han N, Kim MG, Lee J, Lee H, Yoon J, Lee BJ, Oh JM. Strategic Priorities to Improve Effectiveness of Anti-smoking Interventions for the Korean Military: An Application of the Analytic Hierarchy Process. Mil Med 2018; 183:e223-e230. [PMID: 29961837 DOI: 10.1093/milmed/usx027] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Accepted: 10/20/2017] [Indexed: 11/14/2022] Open
Abstract
Introduction As South Korea remains technically at war with the North, higher smoking prevalence in the military might adversely affect the South Korea's military power and contribute to lifetime smoking in men with mandatory military service. This study was to identify priorities among the anti-smoking strategies to improve the existing smoking cessation programs for the Korean military. Methods The analytic hierarchy process model with a goal, decision criteria, and sub-criteria as well as candidate strategies, was developed following a literature search and expert group discussion. A survey for pairwise comparison was conducted to determine the priority of the (sub-)criteria and strategies by 14 experts. The Super-Decisions software was used to determine the priorities and to analyze their consistency ratios and sensitivities. The study was approved by the ethics committee of the Korea Ministry of Health and Welfare. Results Eight candidate strategies were developed to improve the effectiveness of military anti-smoking interventions as follows: (1) development of outcome enhancement plans for smoking cessation programs for the military, (2) development of differentiated smoking cessation programs for specific groups, (3) building of community network for continuity and accessibility of anti-smoking project, (4) building of industry-academia-government networks for anti-smoking project, (5) improvement of the perception of and strengthen the reward for smoking cessation, (6) development of a training system for army clinicians for the delivery of smoking cessation services, (7) creation of a certification system for smoking cessation programs, and (8) development of an evaluation system of project performance for smoking cessation. Through the analytic hierarchy process survey, the military specificity and its sub-criterion of practicality were selected as the top concerns of decision criteria for the anti-smoking strategies among the decision criteria of outcome improvement, military specificity, publicness, and economic efficiency. The most important strategy was to improve the perception of and strengthen the reward for smoking cessation. This strategy was most focused on the creation of an anti-smoking environment and improvement of the effectiveness of the projects. The creation of a training system for army clinicians for the delivery of smoking cessation services ranked second. Conclusion In conclusion, motivating smoking cessation and utilizing well-trained army clinicians were found to be the most important anti-smoking strategies for the Korean military. This study might provide valuable insights for policy makers to reduce tobacco use in the Korean military.
Collapse
Affiliation(s)
- Yun-Kyoung Song
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea
| | - Jae Hyun Kim
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea
| | - Boyoon Choi
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea
| | - Nayoung Han
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea
| | - Myeong Gyu Kim
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea
| | - Jeongsam Lee
- Korean Association Against Drug Abuse, 10, Dangsan-ro 48-gil, Yeongdeungpo-gu, Seoul, South Korea
| | - Handuk Lee
- Korean Association Against Drug Abuse, 10, Dangsan-ro 48-gil, Yeongdeungpo-gu, Seoul, South Korea
| | - Jieun Yoon
- Korean Association Against Drug Abuse, 10, Dangsan-ro 48-gil, Yeongdeungpo-gu, Seoul, South Korea
| | - Beom-Jin Lee
- Korean Association Against Drug Abuse, 10, Dangsan-ro 48-gil, Yeongdeungpo-gu, Seoul, South Korea.,College of Pharmacy, Ajou University, 206 Worldcup-ro, Yeongtong-gu, Suwon, South Korea
| | - Jung Mi Oh
- College of Pharmacy and Research Institute of Pharmaceutical Sciences, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea.,Korean Association Against Drug Abuse, 10, Dangsan-ro 48-gil, Yeongdeungpo-gu, Seoul, South Korea
| |
Collapse
|
8
|
Korinek K, Loebach P, Trinh HN. Military service and smoking in a cohort of northern Vietnamese older adults. Int J Public Health 2016; 62:43-51. [PMID: 27321700 DOI: 10.1007/s00038-016-0841-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Revised: 03/06/2016] [Accepted: 06/02/2016] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES Wide-ranging scholarship demonstrates war's impacts on US veterans' health. We ask whether, among Vietnamese men of a certain age, wartime experiences contributed to initiating smoking, and thus shaped one behavioral pathway linking war exposure and older adult health. METHODS We analyze the Vietnam Health and Aging Pilot Study (VHAPS), a survey of adults ages 55 and older (N = 405) conducted in one commune of northern Vietnam. We implement Cox discrete-time proportional hazards models to discern the effects of military service upon the initiation of smoking. RESULTS Military service results in a heightened risk of initiating smoking within this cohort (HR 2.13, [CI 1.36, 3.35]). Smoking initiation is also significantly gendered and age graded. Socioeconomic position and social capital variables in the models are statistically insignificant. CONCLUSIONS This study finds that, among older northern Vietnamese men whose early adulthood coincided with mass mobilization in the Vietnam War, involvement in formal military service significantly increased the risk of initiating smoking. Military-induced smoking emerges where tobacco products were not provided by the military institution, but where social availability of tobacco was widespread.
Collapse
Affiliation(s)
- Kim Korinek
- Department of Sociology, University of Utah, 380 S. 1530 E., Room 301, Salt Lake City, UT, 84112, USA.
| | - Peter Loebach
- Department of Sociology and Anthropology, Weber State University, Social Science Building, Room 114, Ogden, UT, USA
| | - Ha Ngoc Trinh
- Department of Sociology, University of Utah, 380 S. 1530 E., Room 301, Salt Lake City, UT, 84112, USA
| |
Collapse
|
9
|
Kim SS, Kim SH, Fang H, Kwon S, Shelley D, Ziedonis D. A Culturally Adapted Smoking Cessation Intervention for Korean Americans: A Mediating Effect of Perceived Family Norm Toward Quitting. J Immigr Minor Health 2015; 17:1120-9. [PMID: 24878686 PMCID: PMC4250475 DOI: 10.1007/s10903-014-0045-4] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Korean men and women have the highest current smoking rates across all Asian ethnic subgroups in the United States. This is a 2-arm randomized controlled study of a culturally adapted smoking cessation intervention. The experimental condition received eight weekly 40-min individualized counseling sessions that incorporated Korean-specific cultural elements, whereas the control condition received eight weekly 10-min individualized counseling sessions that were not culturally adapted. All participants also received nicotine patches for 8 weeks. One-hundred nine Korean immigrants (91 men and 18 women) participated in the study. The rate of biochemically verified 12-month prolonged abstinence was significantly higher for the experimental condition than the control condition (38.2 vs. 11.1 %, χ (2) = 10.7, p < 0.01). Perceived family norm significantly mediated the effect of cessation intervention on abstinence. Smoking cessation intervention for Korean Americans should be culturally adapted and involve family members to produce a long-term treatment effect.
Collapse
Affiliation(s)
- Sun S Kim
- University of Massachusetts Medical School, Department of Psychiatry, Worcester MA, USA
| | - Seong-Ho Kim
- Korean Bible University, Department of Social Welfare, Seoul, South Korea
| | - Hua Fang
- University of Massachusetts Medical School, Department of Quantitative Health Sciences, Worcester MA, USA
| | - Simona Kwon
- New York University, School of Medicine, New York, NY, USA
| | - Donna Shelley
- New York University, School of Medicine, New York, NY, USA
| | - Douglas Ziedonis
- University of Massachusetts Medical School, Department of Psychiatry, Worcester MA, USA
| |
Collapse
|
10
|
Barnett PG, Hamlett-Berry K, Sung HY, Max W. Health care expenditures attributable to smoking in military veterans. Nicotine Tob Res 2015; 17:586-91. [PMID: 25239960 PMCID: PMC5009451 DOI: 10.1093/ntr/ntu187] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Accepted: 09/03/2014] [Indexed: 11/12/2022]
Abstract
INTRODUCTION The health effects of cigarette smoking have been estimated to account for between 6%-8% of U.S. health care expenditures. We estimated Veterans Health Administration (VHA) health care costs attributable to cigarette smoking. METHODS VHA survey and administrative data provided the number of Veteran enrollees, current and former smoking prevalence, and the cost of 4 types of care for groups defined by age, gender, and region. Cost and smoking status could not be linked at the enrollee level, so we used smoking attributable fractions estimated in sample of U.S. residents where the linkage could be made. RESULTS The 7.7 million Veterans enrolled in VHA received $40.2 billion in VHA provided health services in 2010. We estimated that $2.7 billion in VHA costs were attributable to the health effects of smoking. This was 7.6% of the $35.3 billion spent on the types of care for which smoking-attributable fractions could be determined. The fraction of inpatient costs that was attributable to smoking (11.4%) was greater than the fraction of ambulatory care cost attributable to smoking (5.3%). More cost was attributable to current smokers ($1.7 billion) than to former smokers ($983 million). CONCLUSIONS The fraction of VHA costs attributable to smoking is similar to that of other health care systems. Smoking among Veterans is slowly decreasing, but prevalence remains high in Veterans with psychiatric and substance use disorders, and in younger and female Veterans. VHA has adopted a number of smoking cessation programs that have the potential for reducing future smoking-attributable costs.
Collapse
Affiliation(s)
- Paul G Barnett
- Health Economics Resource Center, U.S. Department of Veterans Affairs, Menlo Park, CA; Treatment Research Center, University of California, San Francisco, CA;
| | - Kim Hamlett-Berry
- Public Health Strategic Health Care Group, U.S. Department of Veterans Affairs, Washington, DC
| | - Hai-Yen Sung
- Institute for Health and Aging, University of California, San Francisco, CA
| | - Wendy Max
- Institute for Health and Aging, University of California, San Francisco, CA
| |
Collapse
|
11
|
Kim SS, Kim S, Seward G, Fortuna L, McKee SA. Korean American Women's Experiences with Smoking and Factors Associated with Their Quit Intentions. ISRN ADDICTION 2013; 2013:796570. [PMID: 25938119 PMCID: PMC4392973 DOI: 10.1155/2013/796570] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Accepted: 06/30/2013] [Indexed: 11/17/2022]
Abstract
This study explored Korean American women's experiences with smoking and tested the theory of planned behavior to identify factors associated with their intentions to quit smoking. It employed a mixed-methods research design, using qualitative and quantitative data. Participants were recruited via a combination of random (N = 49) and convenience (N = 45) sampling techniques. Women in this study initiated smoking at age of 23 on average, and nearly half smoked at indoor houses. They initiated smoking out of curiosity about the effect and belief that smoking would relieve their stress. Reasons for continued smoking were (a) to avoid nicotine withdrawal symptoms, (b) to cope with life stressors, including acculturative stress, and (c) to fulfill one's destiny as a lifetime smoker. Many attempted to quit due to health issues and pregnancy. Fear of disclosure and limited English proficiency were found to be major barriers to seeking help for quitting. Past-year quit attempt(s), attitudes toward quitting, and perceived family norm favoring quitting explained 25% of the variance in intentions to quit smoking (F [3,90] = 11.58, P < 0.001). Findings suggest that gender- and culture-specific intervention strategies are needed to assist Korean American women in smoking cessation.
Collapse
Affiliation(s)
- Sun S. Kim
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA 01652, USA
| | - Seongho Kim
- Department of Social Welfare, Korean Bible University, Seoul 139-791, Republic of Korea
| | - Gregory Seward
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA 01652, USA
| | - Lisa Fortuna
- Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA 01652, USA
| | - Sherry A. McKee
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT 06511, USA
| |
Collapse
|
12
|
Allem JP, Ayers JW, Unger JB, Irvin VL, Hofstetter CR, Hovell MF. Smoking trajectories among Koreans in Seoul and California: exemplifying a common error in age parameterization. Asian Pac J Cancer Prev 2013; 13:1851-6. [PMID: 22901135 DOI: 10.7314/apjcp.2012.13.5.1851] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Immigration to a nation with a stronger anti-smoking environment has been hypothesized to make smoking less common. However, little is known about how environments influence risk of smoking across the lifecourse. Research suggested a linear decline in smoking over the lifecourse but these associations, in fact, might not be linear. This study assessed the possible nonlinear associations between age and smoking and examined how these associations differed by environment through comparing Koreans in Seoul, South Korea and Korean Americans in California, United States. Data were drawn from population based telephone surveys of Korean adults in Seoul (N=500) and California (N=2,830) from 2001-2002. Locally weighted scatterplot smoothing (lowess) was used to approximate the association between age and smoking with multivariable spline logistic regressions, including adjustment for confounds used to draw population inferences. Smoking differed across the lifecourse between Korean and Korean American men. The association between age and smoking peaked around 35 years among Korean and Korean American men. From 18 to 35 the probability of smoking was 57% higher (95%CI, 40 to 71) among Korean men versus 8% (95%CI, 3 to 19) higher among Korean American men. A similar difference in age after 35, from 40 to 57 years of age, was associated with a 2% (95%CI, 0 to 10) and 20% (95%CI, 16 to 25) lower probability of smoking among Korean and Korean American men. A nonlinear pattern was also observed among Korean American women. Social role transitions provide plausible explanations for the decline in smoking after 35. Investigators should be mindful of nonlinearities in age when attempting to understand tobacco use.
Collapse
Affiliation(s)
- Jon-Patrick Allem
- University of Southern California Keck School of Medicine, Los Angeles, CA, USA.
| | | | | | | | | | | |
Collapse
|