Factors Associated with the 30-Day and 1-Year Smoking Abstinence of Women in Korea: The Effect of Nicotine Dependency, Self-Efficacy, and Mental Illness.

Despite the success of tobacco control efforts in reducing smoking rates during the past 50 years, data on the factors contributing to quitting success are still lacking. Smoking-related mortality among women has also not declined. Therefore, this study aimed to characterize sociodemographic features, smoking-related behaviors, mental illness, and smoking cessation in woman smokers in Korea who were registered in the Quitline program. Furthermore, factors associated with 30-day and 1-year successful smoking cessation after enrollment in the Quitline program were investigated. A total of 3360 adult woman Quitline users from 2007 to 2018 were included in the final analysis, with information on their age, education level, marital status, body mass index, frequency of alcohol consumption per month, nicotine dependency, self-efficacy for smoking cessation, presence of a smoking cessation supporter, and mental health history collected upon registration with the Quitline program in Korea. Their cessation outcome was investigated with a 1-year follow-up until the end of 2019. A multiple logistic regression analysis was conducted to identify factors associated with smoking cessation at the 30-day and 1-year follow-ups. The results of the multiple logistic regression analysis indicated that lower nicotine dependency, higher self-efficacy, and the presence of a smoking cessation supporter improved the odds of smoking cessation at the 30-day and 1-year follow-ups. In contrast, users with a mental health condition were less likely to achieve smoking cessation. Incorporating methods to increase self-efficacy in women who decide to quit smoking will contribute to facilitating more attempts to quit and achieving greater success in smoking cessation among woman smokers.

Factors associated with psychological stress and distress among Korean adults: the results from Korea National Health and Nutrition Examination Survey.

The prevalence of stress and distress has been increasing and being important public health issues; nevertheless, few studies have assessed the factors associated at the population level. This study identified factors associated and how they differentially influence stress and distress. A total of 35,105 individuals aged 19 years and older using nationally representative data from the Korea National Health and Nutrition Examination Survey (2007-2012) were included in the study. Subjects were differentiated by gender and psychological state (no symptoms, stress, distress). The associations of socio-demographics, psychosocial factors, health behaviours, and chronic illness with psychological states were analysed by gender. Socio-demographics and psychosocial factors such as lower household income, lower education level, living alone or negative outcome of marriage, and unemployment were associated with distress in both genders. Male and female educated higher and with short sleep duration, male living alone and with higher household income, and female married and with a lower household income was associated with stress. A perceived body image of slim or fat was associated with distress and stress in both genders. Behavioural factors, such as smoking, higher alcohol consumption, and abnormal calorie intake, were associated with stress and distress in both genders, with the exception of alcohol consumption in distress and abnormal calorie intake in stress of male. Socio-economic deprivation and negative psychosocial and behavioural factors were differently associated with psychological distress or stress by gender. Intervention strategies for distress and stress should be specifically tailored regarding these differences.

Comparison of smoking cessation rates of Quitline users in Korea between smokers of ultra-low nicotine yield cigarettes and other types of cigarette: a prospective study.

AIMS: It is not known whether the machine-smoked nicotine yield of usual brand of cigarette smoked is associated with the chances of success of quit attempts. This study aimed to assess this association. DESIGN: Prospective study. SETTING: Republic of Korea. PARTICIPANTS: A total of 16 808 male smokers registered for the Quitline between 7 April 2006 and 31 December 2013. Of these, 13 176 participants who were > 19 years of age and provided data on their demographic characteristics, smoking-related behaviors, nicotine dependence, tobacco brands used and self-efficacy were included in this study. MEASUREMENTS: Machine-smoked nicotine yield was based on information provided by tobacco companies on cigarette packages that smokers reported as their usual brand. Ultra-low nicotine yield was defined as ≤ 0.1 mg machine-smoked nicotine yield per cigarette, whereas higher nicotine yield was defined as > 0.1 mg machine-smoked nicotine yield. Participant personal information and self-reported continuous abstinence at 1-month, 6-month and 1-year follow-up were recorded in electronic databases. FINDINGS: Continuous abstinence rates in the ultra-low nicotine yield versus higher nicotine yield groups were, respectively, 40.7 versus 34.6% at 1 month [odds ratio (OR) = 1.22, 95% confidence interval (CI) = 1.12-1.33], 22.7 versus 18.8% at 6 months (OR = 1.20, 95% CI = 1.08-1.32) and 19.5 versus 16.6% (OR = 1.19, 95% CI = 1.10-1.29) at 1 year. The association between ultra-low nicotine yield cigarette smoking and successful quitting was stronger among the smokers with higher cigarette dependence. CONCLUSIONS: Male smokers who use the Korean Quitline are more likely to quit successfully if they smoke ultra-low nicotine yield cigarettes than if they smoke higher nicotine yield cigarettes.

Correlates of life-support treatment preferences among low-income home-based cancer management recipients.

PURPOSE: To examine the correlates of life-support treatment (LST) preferences from attitudes toward advance directives (ADs), perceived susceptibility, symptom frequency, symptom burden, and global health among low-income community-dwelling cancer management recipients, controlling for age, sex, education, and duration after cancer diagnosis. METHODS: A cross-sectional, correlational study design was used to assess LST preferences and correlates. Data were collected from low-income cancer survivors during nurses' home visits. RESULTS: Survivors who had mostly solid cancer participated (N = 107, mean age = 67.39 ±â€¯11.57 years, 32.7% males). Hospice care was the most desired (66.4%), while aggressive treatments were less preferred: cardiopulmonary resuscitation (15.9%), ventilation support (15.0%), hemodialysis (18.7%), or chemotherapy (12.1%). Higher symptom frequency was associated with a greater likelihood of preferring all aggressive treatments (odds ratios = 1.44-1.75). In addition, longer cancer duration was associated with a greater likelihood of preferring ventilation support; females had a lesser likelihood of preferring hemodialysis and chemotherapy. Higher education was associated with a lesser likelihood of preferring chemotherapy. More positive attitudes (B = 0.15, p = .001) were associated with a greater likelihood of preferring hospice care, and greater symptom burden of pain (B = -0.03, p = .047) was associated with a lesser likelihood. CONCLUSION: Results support the feasibility of incorporating ADs into cancer management among community-dwelling cancer survivors, with consideration of AD attitudes and symptom monitoring. An integration of AD discussion into the home visiting service could be a liaison for the quality and continuity of cancer survivorship care that guides and manages patients' survivorship issues.

User characteristics of national smoking cessation services in Korea: who chooses each type of tobacco cessation program?

BACKGROUND: Relatively little is known about which characteristics of smokers are related to choosing a specific type of smoking cessation service. The user characteristics of different smoking cessation services were compared to determine the service preferred by user characteristics. METHODS: The characteristics of adult smokers from Korea National Health and Nutrition Examination Survey (3762) and registered users of national smoking cessation services operated through the web (14,762), at Public Health Center-based Smoking Cessation Clinics (PHC-based SCCs) (335,532), and by telephone (Quitline) (2983) were compared. RESULTS: Females and younger aged were more in web and telephone-based cessation service users, while aged 50 years or older were more in PHC-based SCCs users. Although manufacturing and production workers were the most prevalent among smokers in the general population, office workers and others including housewives and unemployed were most prevalent among the users of Quitline and PHC-based SCCs, respectively. The number of cigarettes smoked per day was twice as high among cessation service users as in general population. Smokers with greater nicotine dependency were most prevalent in the web-based service. Overseas users were in the web-based cessation service. CONCLUSION: Identifying user-specific characteristics by the type of cessation services looks necessary to develop and offer appropriate cessation services.

Influences of Tobacco-Related Knowledge on Awareness and Behavior towards Smoking.

BACKGROUND: A considerable amount of research has shown that knowledge and appropriate awareness are essential for encouraging positive behaviors and promoting health. In Korea, the roles that behavioral changes play in the prevention of cancer have been an important issue since the introduction of the 10 codes for cancer prevention in 2006. Thus, the present study investigated the associations of tobacco-related knowledge with awareness and attitudes towards positive smoking-cessation behaviors. METHODS: The present study analyzed data from the 2010 national questionnaire survey (n = 1,006). This study evaluated sociodemographic characteristics, smoking status, self-rated health status, health-related interests, and the accuracy of 12 tobacco-related statements to determine knowledge level and to investigate its impact on awareness and behaviors related to smoking. These parameters were examined and staged using the Precaution Adoption Process Model. RESULTS: A higher level of tobacco-related knowledge was significantly associated with a positive attitude towards smoking cessation (5-8 correct answers: odds ratio [OR], 2.53; 95% confidence interval [CI], 1.57-4.08; ≥ 9 correct answers: OR, 3.90; 95% CI, 2.22-6.82; reference: ≤ 4 correct answers). Interestingly, among current smokers, only those who correctly responded to ≥ 9 of 12 tobacco-related statements were significantly associated with a positive attitude towards smoking cessation. CONCLUSION: This study found that having a higher level of tobacco-related knowledge had a significant impact on positive attitudes towards smoking cessation. This suggests that there is a need to disseminate appropriate knowledge to the general population to encourage positive attitudes and promote healthful behaviors in terms of smoking.

Awareness of and Attitudes toward Human Papillomavirus Vaccination among Adults in Korea: 9-Year Changes in Nationwide Surveys.

PURPOSE: Human papillomavirus (HPV) vaccination has been included in the National Immunization Program in Korea since 2016. We aimed to evaluate changes in the awareness of and attitudes toward HPV vaccination, among adults in Korea since the first introduction of the vaccines in 2007. MATERIALS AND METHODS: A nationwide population-based survey was conducted in 2016 for 1,200 nationally representative Korean men and women; the data obtained were compared with the data from the nationwide survey conducted in 2007. RESULTS: A significant increase in the awareness of HPV infection (35.8%) and vaccination (36.9%) was observed in 2016 from 13.3% and 8.6% in 2007, respectively. Willingness to be vaccinated against HPV decreased from 55.0% in 2007 to 25.8% in 2016, and the proportion of respondents expressing uncertainty increased from 28.3% in 2007 to 43.3% in 2016. Only 12.1% of men and 22.0% of women knew about the free national HPV vaccination program for girls, launched in June 2016. Younger women, with higher income level, awareness of the HPV vaccine, and perception of the seriousness of infections had a higher willingness to be vaccinated. A high education level, awareness of HPV infection and vaccination, and perception of the seriousness of infection were positively associated with the willingness of respondents to vaccinate their daughters. CONCLUSION: Raising the awareness of HPV infection and vaccination with appropriate knowledge is necessary for the successful implementation of the national HPV vaccination program.

Towards smoke-free cars in the Republic of Korea: Evidence from environmental and biochemical monitoring of third-hand smoke exposure in taxis.

INTRODUCTION: To evaluate the level of tobacco smoke exposure in taxis in Korea using tobacco specific environmental markers. METHODS: From June to September 2012, cross-sectional measurements of air nicotine levels and dust nicotine-derived nitrosamine ketone (NNK) concentrations were conducted in 17 taxis in Goyang, Korea. Field investigators completed an observational questionnaire on building characteristics, smoking policies and evidence of smoking. Descriptive statistics including geometric means (GMs) ± standard deviations were produced for air nicotine levels and dust NNK concentrations. RESULTS: There was no evidence of active smoking in the 17 taxis monitored, despite the fact that 10 drivers were current smokers. The overall GMs of air nicotine and dust NNK concentration were 0.42 µg/m3 and 6.78 pg/mg, respectively. These levels were 3.4-fold and 2.6-fold higher in taxis whose drivers were current smokers compared to the taxis of nonsmokers (GM of air nicotine: 0.65 µg/m3 vs 0.19 µg/m3; GM of dust NNK: 10.07 pg/mg vs 3.85 pg/mg). CONCLUSIONS: The present study shows that air nicotine and dust NNK were detected in all taxis regardless of whether the taxi driver was smoking or not, which indicates the potential for exposure to SHS or THS. It suggests that an appreciable level of SHS and TSH exposure might occur if the environment is not completely smoke-free and enforcement is lacking. ABBREVIATIONS: THS: third-hand smoke, SHS: second-hand smoke, FCTC: Framework Convention Alliance for Tobacco Control, NNK: 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone, LOD: limit of detection, GM: geometric mean, GSD: geometric standard deviation.

The prevalence trend of metabolic syndrome and its components and risk factors in Korean adults: results from the Korean National Health and Nutrition Examination Survey 2008-2013.

BACKGROUND: Abnormalities in the clinical markers of metabolic syndrome (MS) are associated with the development of cardiovascular disease, type 2 diabetes mellitus, and some cancers. MS prevalence in Korea increased between the mid-1990s and mid-2000s; however, no data on the recent trends of MS prevalence are available. Thus, we aimed to investigate the prevalence of MS, the five components of MS, and the related risk factors in Korean adults by using recent data. METHODS: Data from the Korean National Health and Nutrition Examination Survey conducted between 2008 and 2013 were used. The revised National Cholesterol Education Program criteria were used for defining MS. A multivariate logistic regression analyses was used to estimate the relationship between the related risk factors including behaviors, dietary factors, and the prevalence of MS. RESULTS: A total of 34,587 men and women were included in the analysis. Age-adjusted prevalence of MS in 2013 was 28.9% without a significant increasing or decreasing trend between 2008 and 2013. Among the five components of MS, abdominal obesity decreased in both men and women (annual percent change: -2.0 and -2.5%, respectively), the decrease being significant only in women, whereas blood pressure and blood glucose significantly increased in men (+1.9 and +2.7%, respectively). Age and obesity (odds ratio = 6.7, 95% confidence interval = 5.9-7.5 for body mass index ≥25 kg/m2 vs. body mass index <25 kg/m2) were associated with increased MS risk in both men and women. Smoking and alcohol drinking were significantly associated with increased MS risk in men, and association between MS and vitamin D deficiency was at the edge of statistical significance. Higher education and income level were significantly associated with decreased MS risk in women. During this period, smoking rate and physical activity, sodium intake, and serum vitamin D level significantly decreased. Education level, calorie intake, and intake of carbohydrate, fat, protein and calcium significantly increased. CONCLUSION: Several factors contribute to the stable MS prevalence-on the one hand, increased prevalence of high blood sugar, high blood pressure, calorie intake, and physical inactivity, and on the other hand, decreased prevalence of abdominal obesity and smoking. Lifestyle interventions to prevent and control non-communicable diseases should be implemented at the national level to reduce the burden of MS.

Public opinions on disclosure of tobacco components: Results of a nationwide cross-sectional survey in Republic of Korea.

This study aimed to explore public views on disclosure of tobacco components in an effort to develop a comprehensive regulatory system facilitating implementation of the Framework Convention on Tobacco Control (FCTC) Articles 9 and 10 in Korea.In all, 1200 representative Koreans 19 years old or older were enrolled and information on their general characteristics, smoking status, awareness of the effects of smoking on health, and views on the public disclosure of tobacco components was collected by telephone using a structured questionnaire. Factors associated with acceptance of the need for public disclosure of tobacco components were identified via multivariate analysis.Most participants considered it necessary to publicly disclose tobacco components (95.9%) and were aware of the risk to health posed by smoking (76.0%). The prevalent view was that tobacco companies should be legally required to publicly disclose details of the components of cigarettes, their levels per cigarette, and their effects on health. The most effective means of disclosure were considered to be the mass media, printed materials, and labels on cigarette packs. Females and never-smokers (odds ratio [OR]: 4.39, 95% confidence interval [95% CI]: 1.76-10.94) more readily accepted the need for public disclosure, whereas those of lower educational level and/or who were less aware of the harm to health posed by smoking (OR: 0.05, 95% CI: 0.01-0.18) were less likely to be accepting.The attitude of the general population ensures that FCTC Articles 9 and 10 will be successfully implemented in Korea. Further public consultation on the details of disclosure would be useful for the development of a comprehensive regulatory system.

Quitline Activity in the Republic of Korea.

To reduce tobacco use and related harm in Korea, telephone based cessation services (Quitlines) began full operation to provide regular behavioral counseling for smoking cessation in 2006. After registration in the cessation program, at least 21 calls per year are given to each client to help quit and encourage maintenance. Tailored programs for males, females, and adolescent smokers have been offered taking into account smokers' characteristics and smoking behavior. Mailing self-help quit packs and e-mail and SMS services are allowable as additional services.A total of 23,201 smokers were registered on the Quitline program from 2006 to 2014. In 2014, an average of 13,343 calls per month have been received by 28 coaches, the 1 year abstinence rate of clients is 26%, and clients' satisfaction rate is 81.6%. After introduction of the call system in 2007, client convenience and effective operations have been achieved with high technology support of a computer-based telephone system. Systematic education and evaluation programs for quit coaches have contributed to quality assurance of the services. Currently, research into development of new programs and evaluation of Quitline performance is being undertaken. A Comprehensive Multi-channel Cessation Center (CMCC) has been suggested and is now planned as a next step in the national program for smoking cessation.

Scientific Evidence Supporting Policy Change: A Study on Secondhand Smoke Exposure in Non-smoking Areas of PC Rooms in Korea.

PURPOSE: The objective of this study was to measure secondhand smoke (SHS) exposure in personal computer (PC) rooms with the purpose of determining the strength of scientific evidence supporting the legislative ban on smoking in PC rooms located in the Republic of Korea. MATERIALS AND METHODS: From June to September 2012, particulate matter (PM2.5) and air nicotine concentration (ANC) were measured in the smoking and non-smoking areas of PC rooms in Goyang City, Korea. In 28 randomly sampled PC rooms, field investigators completed an observational questionnaire on building characteristics, smoking policies, and evidence of smoking. The geometric means (GM) of PM2.5 and ANC in smoking and non-smoking areas were compared. RESULTS: Evidence of smoking was identified in both the smoking and non-smoking areas of all PC rooms. The GMs of PM2.5 and ANC in both areas were high and did not differ significantly (174.77 µg/m(3) and 48.95 µg/m(3) in smoking areas; 93.38 µg/m(3) and 41.30 µg/m(3) in non-smoking areas). Overall PM2.5 concentrations were 5.5-fold higher than those listed in the World Health Organization guidelines. CONCLUSION: This study supported previous reports that a partial smoking ban did not protect individuals from SHS exposure. Furthermore, the results from our study suggest how research can support policy. Countries in which smoke-free policies are not yet comprehensive may find our results useful.

Consequences of Incomplete Smoke-Free Legislation in the Republic of Korea: Results from Environmental and Biochemical Monitoring: Community Based Study.

PURPOSE: In some countries with high smoking prevalence, smoke-free legislation has only been implemented in specific public places, as opposed to a comprehensive ban on smoking in all public places. The purpose of this study was to provide valid data on second-hand smoke (SHS) exposure that reflect the consequences of incomplete smoke-free legislation, and provide a rationale for expanding this legislation. MATERIALS AND METHODS: Indoor and outdoor environmental exposure (fine particulate matter [PM2.5], air nicotine, and dust 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone [NNK]) was monitored in 35 public places where smoking is prohibited by law in Goyang, Republic of Korea. Biomarkers of SHS exposure (urinary cotinine, hair nicotine, and urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol) were measured in 37 non-smoking employees. Geometric means and standard deviations were used in comparison of each measure. RESULTS: Considerable exposure of SHS was detected at all indoor monitoring sites (PM2.5, 95.5 µg/m(3) in private educational institutions; air nicotine, 0.77 µg/m(3) in large buildings; and dust NNK, 160.3 pg/mg in large buildings); environmental measures were higher in private or closed locations, such as restrooms. Outdoor measures of SHS exposure were lowest in nurseries and highest in government buildings. Biochemical measures revealed a pattern of SHS exposure by monitoring site, and were highest in private educational institutions. CONCLUSION: The evidence of SHS exposure in legislative smoke-free places in Korea suggests that incomplete smoke free legislation and lack of enforcement of it might not protect people from exposure to smoke. Therefore, active steps should be taken toward a comprehensive ban on smoking in all public places and its enforcement.

Factors Related to Relapse After 6 Months of Smoking Cessation Among Men in the Republic of Korea: A Cross-Sectional Study.

We identified factors associated with relapse after 6 months of smoking cessation (late relapse) among males of the Republic of Korea. Of the 222,707 smokers who visited public health center-based smoking cessation clinics (SCCs) between January 1, 2009 and mid-December 2009, we included 1720 individuals who successfully completed a 6-month smoking cessation program at an SCC. These participants were selected via a random stratified sampling design and completed an SCC user satisfaction survey between December 31, 2009 and January 6, 2010. Multiple logistic regression was used to identify factors associated with late relapse, and path analysis was employed to explore relationships among these factors. The frequency of late relapse was 21.6% (n = 372). Residence in a metropolitan area, low socioeconomic status, and the use of nicotine replacement therapy (NRT) were associated with statistically significant increases in late relapse, whereas greater access to counseling and more satisfaction with the SCC were associated with reduced late relapse. The path analysis showed that a greater number of cigarettes smoked daily and a younger age at smoking initiation exerted significant indirect effects on late relapse when NRT was employed. Residence in a metropolitan area indirectly prevented late relapse as counseling frequency increased. NRT use, counseling frequency, and SCC user satisfaction were affected by both smoking behavior and socioeconomic status. Relapse prevention efforts should concentrate on increasing both counseling frequency and SCC user satisfaction. Future studies should focus on the effect of NRT on the maintenance of long-term cessation at the population level in real-world settings.

Tolerance for and potential indicators of second-hand smoke exposure among nonsmokers: a comparison of self-reported and cotinine verified second-hand smoke exposure based on nationally representative data.

OBJECTIVE: We assessed the extent to which self-reported exposure to SHS underestimates the actual exposure to SHS and what factors are associated with a tolerance for SHS exposure in the Korean setting where the smoke-free policy is incomplete. METHODS: Information on socio-demographic characteristics, alcohol drinking and smoking was collected for 7948 nonsmokers aged ≥ 19 years from the fourth Korea National Health and Nutrition Examination Survey, 2008-2009. Self-reported and cotinine verified SHS exposures were compared. Potential factors associated with cotinine verified but not self-reported SHS exposures were assessed using a logistic regression model. RESULTS: Self-reported SHS exposure significantly underestimated the actual SHS exposure as determined by cotinine verification (kappa coefficient: 0.1066). At younger age, frequent alcohol drinking in females and a longer smoking duration in males were positively associated with cotinine verified exposure but not with the self-reported SHS exposure; they were also positively associated with cotinine verified exposure irrespective of self-reported SHS exposure. CONCLUSIONS: Our findings show a tolerance for smoking in Korea. The current partial ban on smoking does not fully protect people from exposure to SHS. Smoking should be banned in all public places. In addition, efforts to de-normalize smoking in the Korean culture need to be strengthened.

Policy effects of secondhand smoke exposure in public places in the Republic of Korea: evidence from PM2.5 levels and air nicotine concentrations.

OBJECTIVE: The purpose of this study was to evaluate secondhand smoke (SHS) exposure inside selected public places to provide basic data for the development and promotion of smoke-free policies. METHODS: Between March and May 2009, an SHS exposure survey was conducted. PM2.5 levels and air nicotine concentrations were measured in hospitals (n=5), government buildings (4), restaurants (10) and entertainment venues (10) in Seoul, Republic of Korea, using a common protocol. Field researchers completed an observational questionnaire to document evidence of active smoking (the smell of cigarette smoke, presence of cigarette butts and witnessing people smoking) and administered a questionnaire regarding building characteristics and smoking policy. RESULTS: Indoor PM2.5 levels and air nicotine concentrations were relatively higher in monitoring sites where smoking is not prohibited by law. Entertainment venues had the highest values of PM2.5(µg/m3) and air nicotine concentration(µg/m3), which were 7.6 and 67.9 fold higher than those of hospitals, respectively, where the values were the lowest. When evidence of active smoking was present, the mean PM2.5 level was 104.9 µg/m3, i.e., more than 4-fold the level determined by the World Health Organization for 24-hr exposure (25 µg/m3). Mean indoor air nicotine concentration at monitoring sites with evidence of active smoking was 59-fold higher than at sites without this evidence (2.94 µg/m3 vs. 0.05 µg/m3). The results were similar at all specific monitoring sites except restaurants, where mean indoor PM2.5 levels did not differ at sites with and without active smoking evidence and indoor air nicotine concentrations were higher in sites without evidence of smoking. CONCLUSION: Nicotine was detected in most of our monitoring sites, including those where smoking is prohibited by law, such as hospitals, demonstrating that enforcement and compliance with current smoke-free policies in Korea is not adequate to protect against SHS exposure.

The national "smoking cessation clinics" program in the republic of Korea: socioeconomic status and age matter.

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.

Use of MDLC-DIGE and LC-MS/MS to identify serum biomarkers for complete remission in patients with acute myeloid leukemia.

The response criteria for complete remission (CR) in acute myeloid leukemia (AML) are currently based on morphology and blood cell counts. However, these criteria are insufficient to establish a diagnosis in cases with poor quality bone marrow (BM) samples demonstrating a loss of cellular morphology. We investigated whether the sera of patients contained biomarkers that indicate disease response status. First, we performed multidimensional liquid chromatography-differential gel electrophoresis (MDLC-DIGE) to generate protein profiles of two pooled, paired serum samples from patients who had achieved CR; one collected at diagnosis (PreCR) and the other collected after chemotherapy (CR). Then, with the biomarker candidates found, ELISA was carried out for individual PreCR and CR samples, and for other verification sets including nonremission (NR) patients and normal samples. We selected two proteins, complement factor H (CFH) and apolipoprotein H (ApoH), with dye (Cy) ratios showing greater than 2.0-fold differences between the pooled samples. ELISA showed that CFH and ApoH are useful for distinguishing between the recovered (CR and normal) and nonrecovered (PreCR, PreNR, and NR) states in AML (p <0.001). We successfully applied a protein profiling technology of MDLC-DIGE and LC-MS/MS to discover two biomarkers for CR which needs further validation for a clinical setting.

User satisfaction as a tool for assessment and improvement of Quitline in the Republic of Korea.

INTRODUCTION: There is a lack of studies on Quitline user satisfaction and its potential value to aid in understanding user demand and improve Quitline services. This study evaluated Quitline user satisfaction and its impact on smoking cessation, in order to assess the service's quality and performance in the Republic of Korea. METHODS: Between 2007 and 2009, 3,054 Quitline users were invited to participate in an investigation of user satisfaction and its impact on successful smoking cessation. Information on gender, age, education level, body mass index, nicotine dependency, the presence of a quit supporter and alcohol consumption were collected upon Quitline registration. Multiple logistic regression analysis was applied to identify the impact of user satisfaction on cessation maintenance, and an importance-performance (IP) analysis was used to identify the aspects of Quitline that need improvement. RESULTS: Satisfaction was highest among Quitline users who maintained smoking cessation for 1 year. Quitline users who were satisfied with the contents of counseling and the coaching protocol had an increased probability of successful smoking cessation. According to the IP analysis, coaching skill was the key driver of user satisfaction, while service accessibility, the contents of counseling, and the coaching protocol were factors that need to be improved with some urgency. CONCLUSION: The present study revealed low user satisfaction for the contents of counseling and the coaching protocol, which would need to be improved with some urgency to increase Quitline performance in Korea. Continued evaluation of Quitline user satisfaction could be a useful tool to understand user demand and implement improvements accordingly.

2-D DIGE and MS/MS analysis of protein serum expression in rats housed in concrete and clay cages in winter.

In a previous study, we examined the physiological responses of male Sprague-Dawley rats over a 4-week exposure to concrete and clay cages. No general toxicological changes were observed in rats exposed to either of the two cage types in summer. Under winter conditions, however, various general toxicological effects were detected in rats housed in concrete cages, although rats housed in clay cages showed no such effects. The infrared thermographic examination indicated that skin temperature in the concrete-housed rats was abnormally low, but not so in the clay-housed rats. We examined proteomic changes in the serum of rats housed in winter in concrete and clay cages using two-dimensional differential in-gel electrophoresis and mass spectrometry/mass spectrometry. Five proteins were identified and quantitatively validated; all were cold stress-induced, acute phase proteins that were either up-regulated (haptoglobin) or down-regulated (alpha-1-inhibitor III, alpha-2u globulin, complement component 3, and vitamin D-binding protein) in the concrete-housed rats. These results suggest that the 4-week exposure to a concrete cage in winter elicited a typical systemic inflammatory reaction (i.e. acute phase response) in the exposed rats.