Analysis of public perception of national obesity management policy.

PURPOSE: This study aimed to provide essential data necessary for shaping future obesity policy directions and strengthening the effectiveness of such measures. METHODS: A literature review and expert meetings were conducted to identify policy objectives that should be included in the comprehensive national obesity management plan. Based on these objectives, a questionnaire was developed, and a survey was conducted nationwide through an online panel targeting citizens aged 15-69. RESULTS: When analyzing the appropriateness of promoting national obesity policies, 38.6% of respondents answered "not appropriate," while only 8.4% answered "appropriate." We also assessed the importance of the four key areas of the national obesity management policy, with 36.9% considering "improvement of lifestyle to prevent obesity" as the most important. Additionally, we analyzed the significance of specific tasks. "Strengthening child and adolescent obesity prevention and management," "enhancing group meal nutrition and hygiene," "strengthening the operation of community-based obesity and exercise clinics," and "advancing an integrated information platform for nutrition, dietary patterns, and physical activity" emerged as pivotal tasks within their respective areas. CONCLUSION: The primary tasks identified as top priorities by the public in this study regarding national obesity policy initiatives can be incorporated into future obesity management strategies. Our approach has the potential to enhance the efficacy of these policies by aligning future obesity policy trajectories with public demands and expectations.

The creation and implementation of the newly implemented Korean Health Education Specialist certification.

Professional competencies, standards, and professional preparation of public health professionals, which includes health education and health promotion competencies, is documented in Australia, Europe, Japan, and the United States. Preparing a competent public health education workforce is a newly established priority of the South Korean Ministry of Health and Welfare. In 2010, the first ever Health Education Specialist credential was implemented in South Korea. This commentary describes the creation and implementation of the Health Education Specialist credential and initial workforce preparation outcomes of the new credential.

A three-year autoregressive cross-lagged panel analysis on nicotine dependence and average smoking.

OBJECTIVES: Previous studies have been limited to the use of cross sectional data to identify the relationships between nicotine dependence and smoking. Therefore, it is difficult to determine a causal direction between the two variables. The purposes of this study were to 1) test whether nicotine dependence or average smoking was a more influential factor in smoking cessation; and 2) propose effective ways to quit smoking as determined by the causal relations identified. METHODS: This study used a panel dataset from the central computerized management systems of community-based smoking cessation programs in Korea. Data were stored from July 16, 2005 to July 15, 2008. 711,862 smokers were registered and re-registered for the programs during the period. 860 of those who were retained in the programs for three years were finally included in the dataset. To measure nicotine dependence, this study used a revised Fagerström Test for Nicotine Dependence. To examine the relationship between nicotine dependence and average smoking, an autoregressive cross-lagged model was explored in the study. RESULTS: The results indicate that 1) nicotine dependence and average smoking were stable over time; 2) the impact of nicotine dependence on average smoking was significant and vice versa; and 3) the impact of average smoking on nicotine dependence is greater than the impact of nicotine dependence on average smoking. CONCLUSIONS: These results support the existing data obtained from previous research. Collectively, reducing the amount of smoking in order to decrease nicotine dependence is important for evidence-based policy making for smoking cessation.

The changes of blood glucose control and lipid profiles after short-term smoking cessation in healthy males.

OBJECTIVE: Our aim was to evaluate the changes in blood glucose control and lipid profiles after 2-months of smoking cessation in healthy males. METHODS: Smoking abstinence was evaluated through self-report and urine cotinine levels. 12 individuals who succeeded in quitting smoking were analyzed. Fasting values of glucose and insulin were used to estimate the ß-cell activity and insulin resistance was evaluated using the Homeostasis Model Assessment (HOMA) and Quantitative Insulin Sensitivity Check Index (QUICKI). RESULTS: The data showed that the subjects had a significant increase in weight, body mass index and fasting plasma glucose levels after smoking cessation. The HOMA-Insulin Resistance and the HOMA ß-cell function increased significantly (p=0.005, p=0.047 respectively). The QUICKI showed a significant decrease (p=0.005). In addition, the low-density lipoprotein cholesterol levels decreased significantly (p=0.028); however, changes in the high-density lipoprotein cholesterol, the triglyceride and total cholesterol levels were not significant (p=0.284, p=0.445 respectively). CONCLUSION: During the initial stage of smoking abstinence, insulin resistance increased and insulin sensitivity decreased due to elevated body weight and fat composition. Therefore, it is important to educate individuals that stop smoking about the necessity of weight control during smoking cessation programs.

Validation Study of Kim's Smoking Cessation Motivation Scale and Its Predictive Implications for Smoking Cessation.

OBJECTIVE: The purpose of this study was to develop a scale to measure motivation for smoking cessation. Motivation is known to be important for success of smoking cessation. The reliability of the scale was assessed and its predictive validity for smoking cessation was evaluated. METHODS: We recruited 333 men aged 20 to 70 that visited smoking cessation clinics at seven public health centers. The demographic characteristics were recorded and the Korean version of Stages of Readiness for Change and Eagerness for Treatment Scale for Smoking (K-SO-CRATES-S) performed. A smoking cessation motivation scale was developed with 10 questions based on the theory of motivation enhancement therapy. RESULTS: The motivation scale was composed of four subscales based on the factor analysis; each subscale had an adequate degree of internal consistency. In addition, the newly developed scale had a high degree of validity based on its significant correlation with the smoking version of SOCRATES. Moreover, the precontemplation level of motivation was found to significantly predict the success of smoking cessation. And one of the subscales of the Korean Nicotine Dependence Syndrome Scale (K-NDSS), stereotypy which also significantly predicted the success of smoking cessation, significantly correlated with the preparation 1 and 2 level of motivation. CONCLUSION: The smoking cessation motivation scale with 10 questions that was developed in this study was a highly reliable and valid scale for the prediction of success for smoking cessation for those who wanted to stop smoking.

[Validity of expired carbon monoxide and urine cotinine using dipstick method to assess smoking status].

OBJECTIVES: We investigated the validity of the dipstick method (Mossman Associates Inc. USA) and the expired CO method to distinguish between smokers and nonsmokers. We also elucidated the related factors of the two methods. METHODS: This study included 244 smokers and 50 ex-smokers, recruited from smoking cessation clinics at 4 local public health centers, who had quit for over 4 weeks. We calculated the sensitivity, specificity and Kappa coefficient of each method for validity. We obtained ROC curve, predictive value and agreement to determine the cutoff of expired air CO method. Finally, we elucidated the related factors and compared their effect powers using the standardized regression coefficient. RESULTS: The dipstick method showed a sensitivity of 92.6%, specificity of 96.0% and Kappa coefficient of 0.79. The best cutoff value to distinguish smokers was 5-6 ppm. At 5 ppm, the expired CO method showed a sensitivity of 94.3%, specificity of 82.0% and Kappa coefficient of 0.73. And at 6 ppm, sensitivity, specificity and Kappa coefficient were 88.5%, 86.0% and 0.64, respectively. Therefore, the dipstick method had higher sensitivity and specificity than the expired CO method. The dipstick and expired CO methods were significantly increased with increasing smoking amount. With longer time since the last smoking, expired CO showed a rapid decrease after 4 hours, whereas the dipstick method showed relatively stable levels for more than 4 hours. CONCLUSIONS: The dipstick and expired CO methods were both good indicators for assessing smoking status. However, the former showed higher sensitivity and specificity and stable levels over longer hours after smoking, compared to the expired CO method.