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Kim W, Kim AR, Ock M, Jeon YJ, Lee H, Kim D, Kim M, Yoo C. Effects of a supportive workplace environment on the success rate for smoking cessation camp. Ann Occup Environ Med 2023; 35:e48. [PMID: 38148920 PMCID: PMC10751216 DOI: 10.35371/aoem.2023.35.e48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 10/18/2023] [Accepted: 10/31/2023] [Indexed: 12/28/2023] Open
Abstract
Background This study was conducted to identify the success rate for smoking cessation over time after participation in a therapeutic smoking cessation camp, and to identify how participant characteristics, including a supportive workplace environment for smoking cessation (SWESC), affect the success rate for smoking cessation. Methods In all, 296 participants at smoking cessation camps in Ulsan between 2015 and 2020 were investigated. The success rates of smoking cessation after weeks 4, 6, 12, and 24 at camp were investigated. The participants were grouped as workers with an SWESC, and workers without an SWESC, and variables (age, education, household income, marital status, drinking, exercise, body mass index, morbidity, job, number of counseling sessions, cigarettes smoked per day and smoking initiation age) were investigated. Multiple logistic regression analysis was conducted at each time point. In addition, Cox regression analysis was performed to evaluate the variables affecting the success rate for smoking cessation over time. Results The smoking cessation success rate of workers with an SWESC at week 24 (90.7%) was higher than that for workers without an SWESC (60.5%). Multiple logistic regression was performed to determine the relationship between each variable and the success rates for smoking cessation at week 6, 12, and 24. SWESC was confirmed as significant (p < 0.05) variables for increased success rate for smoking cessation at all 3 time points. After adjusting for all variables, the Cox proportional hazards survival analysis showed a hazard ratio of 6.17 for SWESC (p < 0.001,; 95% confidence interval: 3.08-12.38). Conclusions At a professional treatment smoking cessation camp, participants with an SWESC showed a significantly higher success rate for smoking cessation. Supportive workplace environment for workers' health is expected to be an important factor for smoking cessation projects as well as other health promotion projects at workplace.
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Affiliation(s)
- Woojin Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
- Ulsan Smoking Cessation Support Center, Korean Health Promotion Institute, Ulsan, Korea
| | - A Ram Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Minsu Ock
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Young-Jee Jeon
- Department of Family Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Heun Lee
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Daehwan Kim
- Department of Occupational and Environmental Medicine, Soonchunhyang University Gumi Hospital, Soonchunhyang University College of Medicine, Gumi, Korea
| | - Minjun Kim
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Cheolin Yoo
- Department of Occupational and Environmental Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
- Ulsan Smoking Cessation Support Center, Korean Health Promotion Institute, Ulsan, Korea
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Kim SK, Lee J, Lee J, Ahn J, Kim H. Health and economic impact of a smoking cessation program in Korean workplaces. Health Promot Int 2022; 37:6631501. [PMID: 35788310 DOI: 10.1093/heapro/daac063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Smoking is a leading cause of diseases and death, with significant socioeconomic consequences. The purpose of this study was to evaluate the health and economic effectiveness of a workplace smoking cessation program. A total of 89 smokers from seven workplaces in Korea were the participants of the program. For 4 months, individual counseling based on the transtheoretical model (TTM) was conducted and interpersonal and organizational components were applied to encourage entire workplaces to encourage employee smoking cessation. The primary outcome was whether participants quit smoking or not. We also evaluated the changes in attitude and perceptions related to smoking cessation before and after the program and estimated the program's economic effects. Economic effects were defined as reductions in productivity losses and medical expenses. We calculated the return on investment (ROI) values representing the averted cost through the program compared to program cost. At the end of the program, 40.4% of participants quit smoking. Improvements were observed in TTM-based attitudes and perceptions. The mean reduction in productivity losses was estimated to be $187,609.94 for 2 yr and the mean reduction in medical expenses was $3,136.49 at 20 yr among seven workplaces. When accounting for these reductions, the ROI was 15.39 (ranging from -1.00 to 44.53). These effects were robust under various scenarios. The smoking cessation program should be expanded to a wider variety of workplaces. In the future, more sophisticated economic assessment methods should be developed and applied to facilitate workplace recruitment and attract management support.
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Affiliation(s)
- Soo Kyoung Kim
- Department of Health Convergence, Ewha Womans University, Seoul, Korea
| | - Jeongeun Lee
- Health Insurance Review and Assessment Service, Wonju, Korea
| | - Jaeun Lee
- Department of Health Care Policy Research, Korea Institute for Health and Social Affairs, Sejong, Korea
| | - Jeonghoon Ahn
- Department of Health Convergence, Ewha Womans University, Seoul, Korea
| | - Hyekyeong Kim
- Department of Health Convergence, Ewha Womans University, Seoul, Korea
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Yu SH, Kim MJ, Jeon J, Park HK, Hwang HS, Park KY. Short-Term Success Rates of Smoking Cessation Support Programs and Factors Predicting Smoking Relapse: Using Data from a Smoking Cessation Clinic in a Hospital. Korean J Fam Med 2019; 40:373-379. [PMID: 31779064 PMCID: PMC6887767 DOI: 10.4082/kjfm.18.0094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 01/28/2019] [Indexed: 11/21/2022] Open
Abstract
Background Although the number of medical institutions running a smoking cessation clinic is on the rise, there remains a paucity of research on the long- and short-term success rates of smoking cessation programs, as well as on smoking relapse rates, before and after project implementation. This study assessed the general characteristics of patients visiting the smoking cessation clinic, success rate of smoking cessation in the short term, and risks of relapse. Methods Medical records from March 2015 to April 2017 were analyzed and telephone surveys were conducted with 151 smokers who visited a hospital smoking cessation clinic from March 2015 to April 2017. Results Of the 139 smokers who were eligible for follow-up, 22 (15.8%) failed to quit smoking initially. The clinic’s 6-month success rate of smoking cessation was 64.83%. Those with higher medication compliance had a lower risk of primary failure (odds ratio, 0.056; 95% confidence interval, 0.005–0.609), whereas those with higher age (hazard ratio [HR], 0.128; P=0.0252) and a greater number of visits to the clinic (HR, 0.274; P=0.0124) had a lower risk of relapsing. Conclusion The risk of primary failure to quit was higher with low medication compliance, and that of relapsing was higher with lower age and fewer number of clinic visits. Various evaluation and analysis methods can be carried out in the future based on the accumulated data for maintenance of smoking cessation and relapse prevention.
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Affiliation(s)
- Seung-Hyun Yu
- Department of Family Medicine, Hanyang University Medical Center, Seoul, Korea
| | - Myeong-Jun Kim
- Department of Family Medicine, Hanyang University Medical Center, Seoul, Korea
| | - Jin Jeon
- Department of Family Medicine, Hanyang University Medical Center, Seoul, Korea
| | - Hoon-Ki Park
- Department of Family Medicine, Hanyang University Medical Center, Seoul, Korea
| | - Hwan-Sik Hwang
- Department of Family Medicine, Hanyang University Medical Center, Seoul, Korea
| | - Kye-Yeung Park
- Department of Family Medicine, Hanyang University Medical Center, Seoul, Korea
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Yi SW, Choi JS, Yi JJ, Lee YH, Han KJ. Risk factors for hepatocellular carcinoma by age, sex, and liver disorder status: A prospective cohort study in Korea. Cancer 2018; 124:2748-2757. [PMID: 29669170 DOI: 10.1002/cncr.31406] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 03/23/2018] [Accepted: 03/30/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND To the authors' knowledge, relatively little is known regarding the interaction of risk factors for hepatocellular carcinoma (HCC) with age, sex, and liver disorder status. METHODS The authors followed 504,646 Korean patients aged 40 to 80 years who underwent routine health checkups between 2002 and 2003 until 2013 via linkage to national hospital discharge records. RESULTS HCC occurred in 2744 individuals. In the sex-adjusted and age-adjusted analysis, cirrhosis increased the incidence of HCC by 42-fold, followed by hepatitis B virus (21-fold), hepatitis C virus (HCV; 19-fold), male sex (4.3-fold), and each 5-year age increment (1.24-fold). In the multivariable adjusted analysis, diabetes increased the risk of HCC by 80%, alcohol consumption ≥80 g/day increased the risk by 75%, alcohol consumption of 40 to 79 g/day increased the risk by 37%, and being a current smoker increased the risk by 25%. The multivariable adjusted hazard ratios of male sex and HCV were 6.27 and 5.72, respectively, at age <50 years, but were 2.09 and 22.51, respectively, at age ≥70 years. Each 20 g/day of alcohol consumption increased the risk of HCC by 6% (P = .11), 8% (P = .02), 16% (P<.001), and 30% (P<.001), respectively, in individuals aged <50 years, 50 to 59 years, 60 to 69 years, and 70 to 80 years. In individuals without a liver disorder, body mass index was found to be positively associated with HCC, whereas patients with a liver disorder demonstrated an inverse association. Women had higher adjusted hazard ratios associated with age and cirrhosis compared with men. CONCLUSIONS With advancing age, the effects of alcohol use and HCV on the development of HCC become stronger, whereas the effect of male sex weakens. Lifetime moderate alcohol consumption may cause HCC in the elderly. Smoking increases the risk of HCC irrespective of viral hepatitis, and diabetes increases the risk of HCC independent of cirrhosis. Cancer 2018;124:2748-2757. © 2018 American Cancer Society.
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Affiliation(s)
- Sang-Wook Yi
- Department of Preventive Medicine and Public Health, Catholic Kwandong University College of Medicine, Gangneung, Republic of Korea.,Institute for Clinical and Translational Research, Catholic Kwandong University International St. Mary's Hospital, Incheon, Republic of Korea
| | - Ja-Sung Choi
- Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, Republic of Korea
| | - Jee-Jeon Yi
- Institute for Occupational and Environmental Health, Catholic Kwandong University, Gangneung, Republic of Korea
| | - Yong-Ho Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ki Jun Han
- Department of Internal Medicine, Catholic Kwandong University College of Medicine, International St. Mary's Hospital, Incheon, Republic of Korea
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Byeon H, Lee D, Cho S. Relationship between women's smoking and laryngeal disorders based on the urine cotinine test: results of a national population-based survey. BMJ Open 2016; 6:e012169. [PMID: 27872114 PMCID: PMC5129095 DOI: 10.1136/bmjopen-2016-012169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES There is a possibility of underestimation in the smoking rate surveyed by self-reported questionnaires. This study investigated the difference between the Korean female smoking rate as determined by self-reports and that determined by a biochemical test and elucidated the relationship between women's smoking and laryngeal disorders. DESIGN Nationwide cross-sectional survey. SETTING 2008 Korea National Health and Nutrition Examination Survey. PARTICIPANTS 1849 women who completed the health survey, urinary cotinine test and laryngoscope examinations. MAIN OUTCOME MEASURE This study defined smokers as those with urine cotinine contents of 50 ng/mL and over. Confounding factors included age, level of education, household income, occupation and problem drinking in the past year. For statistical tests, OR and 95% CI were presented by using complex samples logistic regression. RESULTS While there was no relationship between smoking as determined by a self-reported questionnaire and laryngeal disorders, smoking as determined by the urine cotinine test had a significant relationship with laryngeal disorders (p<0.05). After all the confounding factors were adjusted, those with urine cotinine concentrations of over 50 ng/mL had a 2.1 times higher risk of laryngeal disorders than those with urine cotinine concentrations of <50 ng/mL (OR=2.05, 95% CI 1.11 to 3.78) (p<0.05). CONCLUSIONS This national cross-sectional study verified that smoking is a significant risk factor for laryngeal disorders. Longitudinal studies are required to identify the causal relationship between smoking and laryngeal disorders.
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Affiliation(s)
- Haewon Byeon
- Department of Speech Language Pathology & Audiology, School of Public Health, Nambu University, Gwangju, Republic of Korea
| | - Dongwoo Lee
- Department of Physical Therapy, School of Public Health, Honam University, Gwangju, Republic of Korea
| | - Sunghyoun Cho
- Department of Physical Therapy, School of Public Health, Nambu University, Gwangju, Republic of Korea
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Hong S, Mok Y, Jeon C, Jee SH, Samet JM. Tuberculosis, smoking and risk for lung cancer incidence and mortality. Int J Cancer 2016; 139:2447-55. [PMID: 27521774 DOI: 10.1002/ijc.30384] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Revised: 06/30/2016] [Accepted: 08/04/2016] [Indexed: 12/24/2022]
Abstract
Among the exposures associated with risk for lung cancer, a history of tuberculosis (TB) is one potentially important factor, given the high prevalence of TB worldwide. A prospective cohort study was conducted to evaluate the associations of preexisting pulmonary TB with lung cancer incidence and mortality. The cohort consisted of 1,607,710 Korean adults covered by the National Health Insurance System who had a biennial national medical examination during 1997-2000. During up to 16 years of follow-up, there were 12,819 incident cases of lung cancer and 9,562 lung cancer deaths. Using Cox proportional hazards models and controlling for age, cigarette smoking and other covariates, the presence of underlying TB was significantly associated with increased risk for lung cancer incidence (HR 1.37 in men with 95% CI 1.29-1.45; HR 1.49 in women with 95% CI 1.28-1.74) and mortality (HR 1.43 in men with 95% CI 1.34-1.52; HR 1.53 in women with 95% CI 1.28-1.83). We also observed a dose-response relationship between number of cigarettes smoked daily and lung cancer risk. There was no evidence for synergism between a history of TB and smoking. The elevation in risk is relatively modest, particularly in comparison to that from smoking, and a prior history of TB is not likely to be useful risk indicator for clinical purposes. In populations with high prevalence of TB, it can be considered for incorporation into models for lung cancer risk prediction.
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Affiliation(s)
- Seri Hong
- Department of Public Health, Yonsei University Graduate School, Seoul, Republic of Korea.,Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Yejin Mok
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD.,Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Christina Jeon
- Department of Public Health, Yonsei University Graduate School, Seoul, Republic of Korea.,Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea
| | - Sun Ha Jee
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Republic of Korea.
| | - Jonathan M Samet
- Department of Preventive Medicine, Keck School of Medicine, Institute for Global Health, University of Southern California, Los Angeles, CA
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Kim H, Oh JK, Lim MK, Jeong BY, Yun EH, Park EY. The national "smoking cessation clinics" program in the republic of Korea: socioeconomic status and age matter. Asian Pac J Cancer Prev 2014; 14:6919-24. [PMID: 24377626 DOI: 10.7314/apjcp.2013.14.11.6919] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Between 1998-2009 South Korea experienced significant progress in reducing the male smoking rate from 66.3% to 46.9%. As part of a significant government effort in the area of smoking cessation intervention, the Korean government implemented the national "Smoking Cessation Clinics (SCC) " program in 2004. MATERIALS AND METHODS Data covered 804,334 adult male smokers participating in SCC program at 253 public health centers between 2006-2009. We examined participant cessation rates with the SCC program, their characteristics and program intervention components using health insurance status as a socioeconomic status (SES) indicator. Multivariate logistic regression analyses were performed correcting for intra-class correlations within public health centers. RESULTS The overall 6-month quit rate was high (46.8%). Higher odds of smoking cessation were positively associated with higher levels of behavioral counseling sessions, but not nicotine replacement therapy (NRT). Cessation rates were lower for Medicaid participants than for regular health insurance participants. Disadvantaged younger smokers were less likely to participate in the program. Older smokers were more likely to quit regardless of SES. Stress was cited as major reason for failure. CONCLUSIONS SES inequalities across different age groups exist in smoking cessation among Korean adult male smokers. There is a need for intervention programs specifically targeting sub-populations of SES by different age groups.
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Affiliation(s)
- Hyoshin Kim
- Health and Analytics, Battelle Memorial Institute, Seattle, USA E-mail :
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Kong JH, Ha Y. Effects of a Smoking Cessation Program including Telephone Counseling and Text Messaging using Stages of Change for Outpatients after a Myocardial Infarction. J Korean Acad Nurs 2013; 43:557-67. [DOI: 10.4040/jkan.2013.43.4.557] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Yeongmi Ha
- College of Nursing · Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
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Oh JK, Lim MK, Yun EH, Shin SH, Park EY, Park EC. Cost and effectiveness of the nationwide government-supported Smoking Cessation Clinics in the Republic of Korea. Tob Control 2012; 22:e73-7. [PMID: 22752272 DOI: 10.1136/tobaccocontrol-2011-050110] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE In the Republic of Korea, nationwide government-supported Smoking Cessation Clinics have been operating in 253 public health centres since 2004, but the cost and effectiveness of the service have yet to be evaluated. METHODS The cost of the service (staff salary, medication, education and promotion and overhead) was calculated from the Smoking Cessation Clinic's 2009 financial report. The number of service users, self-reported 4-week and 6-month quit rates and the proportion of nicotine replacement therapy users were collected from the service's performance monitoring data. Long-term quit rate and life-years saved by quitting were estimated and used in addition to monitoring data to evaluate the effectiveness of the service. RESULTS A total of 354 554 smokers used the Smoking Cessation Clinics in 2009. The self-reported 4-week and 6-month quit rates were 78% and 40%, respectively. Estimated 1-year and 8-year quit rates were 28.1% and 12.9%, respectively. The cost of the service in 2009 was US$21 127 thousand. Cost per service user who set a quit date was US$60. Cost per service user who maintained cessation at 4 weeks, 6 months and 1 year was US$76, US$149 and US$212, respectively. When considering 8-year quit rates, the cost per life-year saved was estimated at US$128 in the base scenario and increased to US$230 in the worst-case scenario. CONCLUSION The nationwide government-supported public health centre-based Smoking Cessation Clinics provided highly cost-effective service at a level of 0.46% of the per capita gross domestic product.
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Affiliation(s)
- Jin-Kyoung Oh
- Caner Risk Appraisal and Prevention Branch, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea
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Shiltz D, Paniagua A, Hastings JE. A Retrospective Comparison of Varenicline Monotherapy Versus the Combination of Varenicline and Bupropion or Bupropion and Nicotine Patches in a VA Tobacco Cessation Clinic. J Smok Cessat 2012. [DOI: 10.1375/jsc.6.1.65] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AbstractPurpose:To determine whether the combination of bupropion SR and varenicline offers improved smoking cessation outcomes compared to varenicline monotherapy or to combination of bupro-pion SR and nicotine patch.Methods:This retrospective chart review included 489 volunteer enrolees in a Veterans Affairs (VA) tobacco cessation clinic who received one of the three treatments upon clinic enrolment. The study endpoints were smoking cessation and clinic completion rates, changes in the number of cigarettes smoked, carbon monoxide (CO) levels, urges to smoke, self-confidence to quit and medication-attributed adverse effects.Results:The relative smoking cessation rates were 33%, 32%, and 40% for bupropion SR and nicotine patch, bupropion SR and varenicline, and varenicline groups, respectively. The 0.21 p value established that no significant cessation rate differences existed between any of the groups. Varenicline alone or in combination was as well tolerated as the combination of bupropion SR and nicotine patch.Conclusions:The combination of bupropion SR and varenicline did not demonstrate any smoking cessation advantage over varenicline monotherapy or the combination of bupropion SR and nicotine patch and therefore do not support the use of bupro-pion SR and varenicline over varenicline monotherapy.
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Jee SH, Golub JE, Jo J, Park IS, Ohrr H, Samet JM. Smoking and risk of tuberculosis incidence, mortality, and recurrence in South Korean men and women. Am J Epidemiol 2009; 170:1478-85. [PMID: 19917554 DOI: 10.1093/aje/kwp308] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The authors explored the association of cigarette smoking with tuberculosis incidence, recurrence, and mortality. A 14-year prospective cohort study (1992-2006) was carried out in 1,294,504 South Koreans. Participants were grouped by smoking history, and the authors assessed tuberculosis incidence, mortality, and recurrence risk for each group. Unadjusted and adjusted Cox proportional hazards models were used to investigate the association between smoking history and the 3 outcomes of interest, adjusting for age and alcohol use. Compared with never smokers, current smokers had increased mortality from tuberculosis among both men (adjusted hazard ratio (HR) = 1.6, 95% confidence interval (CI): 1.3, 2.0) and women (HR = 1.6, 95% CI: 1.0, 2.4). Current male smokers had greater risk of incident tuberculosis than former smokers (HR = 1.4, 95% CI: 1.3, 1.5), and risk among current smokers increased with number of cigarettes smoked daily. In females, cigarette smoking was not associated with incident tuberculosis. There was interaction between smoking and sex for incidence (P = 0.00047). The effect of smoking was generally reduced with adjustment for body mass index. Among men, the highest alcohol consumption category (> or =100 g/day) was associated with risk of incident tuberculosis (HR = 1.5, 95% CI: 1.3, 1.7). This study provides longitudinal evidence that smoking increases risk of incident tuberculosis, mortality from tuberculosis, and tuberculosis recurrence.
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Affiliation(s)
- Sun Ha Jee
- Institute for Health Promotion, Graduate School of Public Health, Yonsei University College of Medicine, Seoul, South Korea
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