Korea Seroprevalence Study of Monitoring of SARS-COV-2 Antibody Retention and Transmission (K-SEROSMART): findings from national representative sample.

OBJECTIVES: We estimated the population prevalence of antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), including unreported infections, through a Korea Seroprevalence Study of Monitoring of SARS-CoV-2 Antibody Retention and Transmission (K-SEROSMART) in 258 communities throughout Korea. METHODS: In August 2022, a survey was conducted among 10,000 household members aged 5 years and older, in households selected through two stage probability random sampling. During face-to-face household interviews, participants self-reported their health status, COVID-19 diagnosis and vaccination history, and general characteristics. Subsequently, participants visited a community health center or medical clinic for blood sampling. Blood samples were analyzed for the presence of antibodies to spike proteins (anti-S) and antibodies to nucleocapsid proteins (anti-N) SARS-CoV-2 proteins using an electrochemiluminescence immunoassay. To estimate the population prevalence, the PROC SURVEYMEANS statistical procedure was employed, with weighting to reflect demographic data from July 2022. RESULTS: In total, 9,945 individuals from 5,041 households were surveyed across 258 communities, representing all basic local governments in Korea. The overall population-adjusted prevalence rates of anti-S and anti-N were 97.6% and 57.1%, respectively. Since the Korea Disease Control and Prevention Agency has reported a cumulative incidence of confirmed cases of 37.8% through July 31, 2022, the proportion of unreported infections among all COVID-19 infection was suggested to be 33.9%. CONCLUSIONS: The K-SEROSMART represents the first nationwide, community-based seroepidemiologic survey of COVID-19, confirming that most individuals possess antibodies to SARS-CoV-2 and that a significant number of unreported cases existed. Furthermore, this study lays the foundation for a surveillance system to continuously monitor transmission at the community level and the response to COVID-19.

Revisiting the Ramachandran plot based on statistical analysis of static and dynamic characteristics of protein structures.

Ramachandran plots, which describe protein structures by plotting the dihedral angle pairs of the backbone on a two-dimensional plane, have played an important role in structural biology over the past few decades. However, despite continued discovery of new protein structures to date, the Ramachandran plot is still constructed by only a small number of data points, and further it cannot reflect the steric information of proteins. Here, we investigated the secondary structure of proteins in terms of static and dynamic characteristics. As for static feature, the Ramachandran plot was revisited for the dataset consisting of 9,148 non-redundant high-resolution protein structures released in the protein data bank until April 1, 2022. By calculating amino acid propensities, it was found that the proportion of secondary structures with respect to residue depth is directly related to their hydrophobicity. As for dynamic feature, normal mode analysis (NMA) based on an elastic network model (ENM) was carried out for the dataset using our KOSMOS web server (http://bioengineering.skku.ac.kr/kosmos/). All ENM-based NMA results were stored in the KOSMOS database, allowing researchers to use them in various ways. In this process, it was commonly found that high B-factors appeared at the edge of the alpha helix region, which was elucidated by introducing residue depth. In addition, by investigating the change in dihedral angle, it was possible to quantitatively survey the contribution of structural change of protein on the Ramachandran plot. In conclusion, our statistical analysis of protein characteristics will provide insight into a range of protein structural studies.

The relationship between poor sleep quality measured by the Pittsburgh Sleep Quality Index and smoking status according to sex and age: an analysis of the 2018 Korean Community Health Survey.

OBJECTIVES: Multiple studies have found that cigarette smokers are more likely to experience sleep disturbances than non-smokers. This study aimed to examine various associations between smoking and sleep quality according to sex and age, which have yet to be sufficiently examined in prior studies. METHODS: Data analysis was conducted using a nationally representative sample of 224,986 Korean adults who participated in the 2018 Korea Community Health Survey. Sleep quality, as the dependent variable, was measured using the Pittsburgh Sleep Quality Index (PSQI), with PSQI scores indicating either good (≤4 points) or poor (>5 points) sleep quality. Multiple logistic regression analysis was performed considering socio-demographic factors, health behaviors, comorbidities, and psychological factors as covariates. RESULTS: The overall weighted prevalence of poor sleep quality was 39.4% (95% confidence interval, 39.1 to 39.7). In the multivariate model that excluded psychological factors, poor sleep quality positively correlated to smoking for both sexes and all age groups except for male aged ≥65 years. However, in the full model that included psychological factors, statistically significant odds ratios (approximately 1.5) for poor sleep quality according to smoking status were only observed for female under 65 years of age. CONCLUSIONS: The relationship between poor sleep quality and smoking status differed according to sex and age. In order to improve the quality of sleep, it is necessary to intervene smoking cessation along with solving psychological problems, especially female in middle age and younger.

Protein conformational transitions explored by a morphing approach based on normal mode analysis in internal coordinates.

Large-scale conformational changes are essential for proteins to function properly. Given that these transition events rarely occur, however, it is challenging to comprehend their underlying mechanisms through experimental and theoretical approaches. In this study, we propose a new computational methodology called internal coordinate normal mode-guided elastic network interpolation (ICONGENI) to predict conformational transition pathways in proteins. Its basic approach is to sample intermediate conformations by interpolating the interatomic distance between two end-point conformations with the degrees of freedom constrained by the low-frequency dynamics afforded by normal mode analysis in internal coordinates. For validation of ICONGENI, it is applied to proteins that undergo open-closed transitions, and the simulation results (i.e., simulated transition pathways) are compared with those of another technique, to demonstrate that ICONGENI can explore highly reliable pathways in terms of thermal and chemical stability. Furthermore, we generate an ensemble of transition pathways through ICONGENI and investigate the possibility of using this method to reveal the transition mechanisms even when there are unknown metastable states on rough energy landscapes.

Smoking Cessation Intention and Its Association with Advice to Quit from Significant Others and Medical Professionals.

Few studies have simultaneously considered the effects of significant others and medical professionals' advice to quit smoking on smoking cessation intention. The present study involved 3841 current adult Korean smokers, divided into four groups with an intention to quit within 1 month, within 6 months, someday, and without intention to quit. Multinomial multiple logistic regression analysis was conducted according to smoking cessation intention level, adjusted for potential confounders, including past smoking cessation attempts. Smokers who had been advised to quit smoking by both significant others and medical professionals, significant others only, and medical professionals only were 2.63 (95% confidence interval (CI): 1.62-4.29), 1.84 (95% CI: 1.17-2.89), and 1.44 (95% CI: 0.70-2.94) times more likely to intend to quit within 1 month, respectively, than those who were not advised to quit. The odds ratios of an intention to quit within 6 months were 2.91 (95% CI: 1.87-4.54), 2.49 (95% CI: 1.69-3.68), and 0.94 (95% CI: 0.44-2.05), respectively. To promote smokers' intention to quit, the role of significant others should be considered. Medical professionals' advice to quit smoking remains important, increasing the effects of significant others' advice.

Harm Perception in Response to Pictorial Warning Labels Predict Higher Non-Smoking Intention among Korean Adolescents.

Because of recent controversy surrounding the use of excessively graphic pictorial warning labels (PWL) on cigarette packs in South Korea, it is necessary to provide evidence to evaluate their effectiveness as a tobacco control policy according to the harm perception they evoke. An analysis was performed using a nationally representative survey conducted six months after the introduction of PWLs in South Korea. Among 62,276 survey participants, 43,231 students from grades 7-12 who had seen a PWL in the past 30 days comprised the research sample. Non-smoking intention was evaluated according to the harm perception evoked by PWLs, which predicted higher non-smoking intention among adolescents. Non-smoking intention was particularly higher in daily smokers with harm perception (52.0%) than those who have never smoked and have no harm perception (40.1%). In the case of those who perceived harmfulness, non-smoking intention was formed in about 45% of daily smokers who had no experience of trying to quit in the last 12 months. Therefore, it is important to select PWLs that can arouse in adolescents sufficient harm perception of smoking.

Influence of School-Based Smoking Prevention Education on Reducing Gap in Exposure to Anti-Tobacco Media Message among Korean Adolescents.

Korean adolescents at high risk for smoking are less exposed to anti-tobacco media messages. This study examines whether school-based smoking prevention education is related to media exposure and whether it can contribute to reducing the gap in exposure to anti-tobacco media messages between smoking vulnerable and non-vulnerable groups. A nationally representative dataset, the 2018 Korea youth risk behavior web-based survey, comprising 59,410 students from grades 7-12, was analyzed. Logistic regression models were designed to evaluate the association between school-based smoking prevention education and media messages exposure. Within-group differences in exposure levels based on sociodemographic characteristics were compared depending on participation or nonparticipation in school-based smoking prevention education. Experience of smoking prevention education within a year was significantly associated with exposure to anti-tobacco media messages. Among Korean adolescents who participated in smoking prevention education compared to those who did not, the media messages exposure rate was more than 20% higher, and the exposure gap within the subgroups by sociodemographic characteristics was narrower. Participation in school-based smoking prevention education was significantly related to media messages exposure. This relationship can be used to improve the overall media messages exposure rate and to reduce the differences in exposure rate based on sociodemographic traits.

Association between Intention to Quit Cigarette Smoking and Use of Heated Tobacco Products: Application of Smoking Intensity Perspective on Heated Tobacco Product Users.

Tobacco companies have designed sophisticated marketing strategies for heated tobacco products (HTPs), and many smokers are exposed to advertisements purporting that HTPs can replace combustible cigarettes. The present study evaluates the relationship between poly-use of tobacco products and intention to quit cigarette smoking in association with smoking intensity, a meaningful indication of one's interest in quitting cigarette smoking. A total of 36,397 current cigarette smokers who participated in the 2019 Korea Community Health Survey were evaluated. A multivariable logistic regression model was designed. Additionally, smoking-intensity-stratified analyses were conducted. A total of 4.7% of the participants reported planning to quit cigarette smoking within one month. Current dual users of combustible cigarettes and HTPs presented no significantly increased likelihood of intention to quit cigarette smoking regardless of cigarette-smoking intensity. By contrast, light and heavy daily smokers who accompanied e-cigarette use presented significant adjusted odds ratios (aORs) of 1.81 (95% confidence interval (CI): 1.04-3.14) and 1.97 (95% CI: 1.14-3.42), respectively. Occasional and daily smokers who reported using both HTPs and e-cigarettes presented no significance. The results of the present study suggested that a complete replacement of combustible cigarettes with HTPs was unlikely.

Cigarette or E-Cigarette Use as Strong Risk Factors for Heated Tobacco Product Use among Korean Adolescents.

Heated tobacco products (HTPs) were first introduced in Korea in June 2017. This study examined the prevalence of current HTP use among Korean adolescents and its association with conventional cigarette (CC) or electronic cigarette (EC) use. The study analyzed nationally representative data (the 2019 Korea Youth Risk Behavior Web-based Survey) from a sample of 57,303 Korean students from grades 7-12. Multinomial logistic regression models were designed to evaluate the association between EC or CC use and HTP use. A total of 2.6% of respondents were current HTP users and 95.9% of them were dual or triple users of CC or EC. The likelihood of HTP use was higher among current CC or EC users and highest among dual users. When the association between each tobacco product and current HTP use was analyzed, the dual use tendency of HTPs and other products steadily increased with the increase of CC or EC smoking frequency. Adolescents who use ECs and/or CCs are likely to use HTPs. Thus, HTPs could be a new public health concern for adolescents in terms of dual or triple use patterns of CC or EC.

Gastric and rectal cancers in workers exposed to asbestos: a case series.

BACKGROUND: The Occupational Safety and Health Research Institute (OSHRI) of the Korea had not recognized gastrointestinal cancer as work-related disease during their evaluation. However, in 2018 OSHRI recognized gastric and rectal cancers as work-related disease in asbestos-exposed workers. We present 2 such cases along supportive evidence of causation. CASE PRESENTATION: Patient A: A 57-year-old man had worked for about 40 years since 1978 as an oxygen cutter at workplaces that dismantle ships, buildings, boilers, and thermal power plants. In November 2016, endoscopy and biopsy confirmed the diagnosis of advanced gastric cancer, for which he underwent subtotal gastrectomy and chemotherapy; however, he later died of the cancer. Patient B: A 71-year-old man had worked in shipbuilding and repair workplaces for approximately 49 years, being employed in pipe laying, asbestos insulation installation, grinding, and other ship repair work. In 2003, he was diagnosed of rectal cancer by abdominal computed tomography. He accordingly underwent surgical removal of the cancer. Based on the occupational history of the 2 patients and our review of the relevant literature addressing the occupational environment, we concluded that both patients had continuous exposure to high levels of asbestos while performing their jobs for 40 and 49 years, respectively. CONCLUSION: Both patients had a history of smoking and drinking (non-occupational personal risk factors). However, the possibility of an increased risk of gastric and rectal cancers from asbestos exposure cannot be excluded. Therefore, we considered that occupational exposure to asbestos had contributed to the cancer diagnosis in these cases. Workers exposed to asbestos should be made aware of the possibility of gastric or rectal cancer, and should undergo monitoring and medical examinations. Appropriate compensation for gastric and rectal cancers that occur in workers exposed to asbestos are anticipated in future.

Heated tobacco products: Cigarette complements, not substitutes.

BACKGROUND: In Korea, the sale of the first heated tobacco product (HTP), IQOS®, commenced in June 2017. This study evaluates the rates of HTP use and examines HTP users' smoking patterns of various tobacco products. METHODS: The study analyzed the 2018 Korea Community Health Survey data of a Korean provincial division, which includes 11 cities and 14 counties. Of 21,100 participants, the proportion of current HTP users was calculated and their smoking patterns, in regard to cigarette use, were examined. A multinomial logistic regression model was used to evaluate the related factors of HTP use. RESULTS: The proportion of current HTP users (HTP use within the past 30 days) was 2.13% of the study population. Of these current HTP users, 96.25% were dual users of cigarettes. The adjusted odds ratio (AOR) for current HTP use increased proportionately with frequency and amount of cigarette consumption with statistical significance. The AOR values showed a quadratic curve, descending after the peak value for moderate daily smokers (10-19 cigarettes/day) (Ptrend<0.001, Pquadratic<0.001). Current cigarette smokers who also used HTPs were not associated with an intention to quit cigarette smoking within a month. CONCLUSIONS: Given the smoking pattern of HTP users in terms of mutual use with cigarettes, HTPs might not be an alternative to cigarettes as tobacco companies claim.

Gender differential secular trend in lifetime smoking prevalence among adolescents: an age-period-cohort analysis.

BACKGROUND: There has been a gender difference in adolescents' lifetime smoking prevalence trends over the last 10 years. This study aimed to explain the gender differential secular trend in adolescents' lifetime smoking prevalence using age-period-cohort (APC) analysis and suggests possible causes for this trend, including Korean tobacco control policies during the last 10 years. METHODS: We utilized the 2006-2017 Korea Youth Risk Behavior Web-based Survey enrolling grades 7 to 12. Using year of survey and year of entry into middle school, we classified 859,814 students who had ever smoked into 6 age groups, 12 periods, and 17 school admission cohorts. Using APC analysis with the intrinsic estimator method, the effects of age, period, and school admission cohort on lifetime smoking prevalence were analyzed according to gender. RESULTS: Overall, there was a similar tendency of all the three effects on lifetime smoking prevalence between genders: an increasing age effect with grade, negative period effect with survey period, and similar pattern of school admission cohort groups. However, compared to boys, girls experienced reduction in the increasing age effect in the 12th grade, consistent and steeper decreasing trend in the period effect from 2006 to 2016, and shorter and lower school admission cohort effect. CONCLUSIONS: Gender differential response to chronological changes in lifetime smoking prevalence was measured by the APC effect, which affected the gender differential secular trend in lifetime smoking prevalence. Therefore, considering the APC effect could help us understand the trend in smoking rates, as well as the contextual factors that affect it.

Underestimation of Self-Reported Smoking Prevalence in Korean Adolescents: Evidence from Gold Standard by Combined Method.

The objective of this study was to evaluate the validity of self-reported smoking prevalence in Korean adolescents by using an improved gold standard by a combined method. Using a stratified sampling method, we selected 13 schools from among 397 high schools that participated in the 2015 Korean Youth Health Risk Behavior Web-Based Survey (KYRBS). A second survey (repeated self-reporting questionnaire and urinary cotinine test) was conducted on 1058 students who completed the KYRBS. The gold standard of current smoker was defined as those either self-reporting as a smoker in the second survey or having a urinary cotinine concentration ≥50 ng/mL. The current smoking prevalence in the first survey (KYRBS) was 7.9% (boys 16.5% and girls 1.8%), which was lower than the results based on gold standard (11.3% total, boys 21.9% and girls 3.7%). The sensitivity and specificity of self-reported smoking status was 62.5% and 99.0%, respectively. In particular, the sensitivity of girls (43.5%) was lower than that of boys (67.0%). The self-reported smoking prevalence in Korean adolescents was underestimated, particularly among girls. Careful attention should be paid to interpreting adolescents' smoking prevalence, and supplementary surveys or periodic validity tests need to be considered in Asian countries.

Work-related olfactory disorder: a case series and review.

BACKGROUND: The olfactory bulb is anatomically exposed and thus can be directly damaged by external stimulation. This can occur as an occupational injury owing to contact with organic solvents or other causes. We present cases of eight patients who sustained occupation-related exposure to potentially toxic substances and later presented with signs and symptoms of anosmia. We examined the occupational and medical characteristics of the patients and evaluated their work-relatedness. CASE PRESENTATION: Case 1: A 50-year-old man performed high-frequency heat treatments for approximately 11 years. He experienced decreased senses for olfaction and taste during the later years culminating in the diagnosis of anosmia after 3 years (high work-relatedness). Case 2: A 54-year-old man whose work involved exposure to various organic solvents, such as spray painting and application of paint and thinners for approximately 4 years, was subsequently diagnosed with anosmia based on rhinorrhea, headache, and loss of olfaction (high work-relatedness). Case 3: A 44-year-old-man who performed spray painting for approximately 17 years developed anosmia (high work-relatedness). Case 4: A 44-year-old man was involved in ship engine cleaning once a month, for approximately 7 h per cleaning session; he was diagnosed with anosmia based on loss of olfaction (low work-relatedness). Case 5: A 41-year-old man worked in ship building block construction for approximately 13 years; anosmia diagnosis was based on loss of olfaction (low work-relatedness). Case 6: A 47-year-old woman performed product inspection and labeling at a plant manufacturing automobile parts; anosmia diagnosis was based on decreased olfaction and taste (low work-relatedness). Case 7: A 50-year-old woman performed epoxy coating in a plant manufacturing automobile parts; anosmia diagnosis was based on diminishing olfaction (low work-relatedness). Case 8: A 57-year-old woman performed cleaning of the area where mobile phone parts were manufactured; anosmia diagnosis was based on diminishing olfaction (low work-relatedness). CONCLUSION: The study results confirmed work-relatedness when the subject was young, and the duration of exposure was long without any other cause of anosmia. Regarding compensation for occupational diseases, work-relatedness can be recognized as a relative concept.

Is there differential responsiveness to a future cigarette price increase depending on adolescents' source of cigarette access?

We examined whether the responsiveness to an increase in cigarettes price differed by adolescents' cigarette acquisition source. We analyzed data on 6134 youth smokers (grades 7-12) from a cross-sectional survey in Korea with national representativeness. The respondents were classified into one of the following according to their source of cigarette acquisition: commercial-source group, social-source group, and others. Multiple logistic regressions were performed to estimate the effects of an increase in cigarette price on the intention to quit smoking on the basis of the cigarette acquisition source. Of the 6134 youth smokers, 36.0% acquired cigarettes from social sources, compared to the 49.6% who purchased cigarettes directly from commercial sources. In response to a future cigarette price increase, regardless of an individual's smoking level, there was no statistically significant difference in the odds ratio for the intention to stop smoking in association with cigarette acquisition sources. The social-source group had nonsignificant, but consistently positive, odds ratios (1.07-1.30) as compared to that of the commercial-source group. Our findings indicate that the cigarette acquisition source does not affect the responsiveness to an increase in cigarette price. Therefore, a cigarette price policy is a comprehensive strategy to reduce smoking among youth smokers, regardless of their source.

Red meat and chicken consumption and its association with high blood pressure and obesity in South Korean children and adolescents: a cross-sectional analysis of KSHES, 2011-2015.

BACKGROUND: The impact of meat consumption on high blood pressure (HBP) and obesity in children and adolescents is a subject of debate. The aim of this study was thus to evaluate the association between meat consumption and both HBP and obesity in this group. METHODS: We performed a cross-sectional analysis using nationally representative samples of children and adolescents aged 9, 12, and 15 years old (n = 136,739) who were included in the Korea School Health Examination Survey (KSHES) for the 2011-2015 period. Multiple linear and logistic regression analysis was used to determine the factors influencing systolic blood pressure (SBP), diastolic blood pressure (DBP), and body mass index (BMI, kg/m2) levels, and to test the strength of these relationships. RESULTS: Adjusted for covariates, 6.3% of those subjects who consumed >5 servings of meat (including beef, pork, and chicken) per week were obese, compared with 9.1% of the subjects who consumed <1 serving of meat/wk (obesity adjusted odds ratio [OR]: 1.44; 95% confidence interval [CI]: 1.21-1.70; P ≤0.001). Those who consumed <1 serving of meat/wk had an HBP prevalence of 8.2%, compared with 7.2% for subjects who consumed >5 servings of meat/wk (systolic HBP adjusted OR: 1.30; 95% CI: 1.05-1.62; P ≤0.01, diastolic HBP adjusted OR: 1.25; 95% CI: 1.02-1.54; P <0.05). Obese subjects were estimated to have a higher SBP (ß = 7.497, P < 0.001) and DBP (ß = 4.123, P <0.001) than subjects who had no excess weight. Compared to subjects who consumed >5 servings of meat/wk, those who consumed <3 servings of meat/wk had a higher SBP (ß = 0.574, P <0.001) and DBP (ß = 0.376, P = 0.003) after adjusting for BMI. The intake of milk, fruit, and vegetables was not associated with either SBP or DBP (P >0.05). In contrast, BMI was significantly associated with milk, fruits, and vegetables (P <0.01). CONCLUSIONS: Among children and adolescents, a higher level of meat consumption was associated with lower SBP, DBP, and BMI, and greater height, suggesting that consuming an appropriate amount of meat is important for healthy growth at a young age.

Effectiveness of workers' general health examination in Korea by health examination period and compliance: retrospective cohort study using nationwide data.

BACKGROUND: Our study evaluated the effectiveness of the Workers' General Health Examination by health examination period and compliance. METHODS: A retrospective cohort of the health examination participants in 2006 (baseline year: N = 6,527,045) was used. We identified newly occurring cardio-cerebrovascular disease over 7 years (from 2007 to 2013). After stratification by age, sex, and national health insurance type, we identified 7 years' cumulative incidence of cardio-cerebrovascular disease by health examination compliance and estimated its relative risk by health examination period and compliance. RESULTS: The compliant group presented a lower cumulative incidence of cardio-cerebrovascular disease than the non-compliant group; this result was consistent across sex, working age (40s and 50s), and workplace policyholder. Relative risk of cardio-cerebrovascular disease by health examination period (1 and 2 years) showed statistically significant results in ischemic heart disease for male participants. Of men in their 40s, office workers (over a 2-year period) presented statistically higher relative risk of ischemic heart disease than non-office workers (over a 1-year period: 1.03; 95% confidence interval, 1.02-1.03). However, there were no consistent results in ischemic cerebrovascular disease and hemorrhagic cerebrovascular disease for men or cardio-cerebrovascular disease for women. CONCLUSION: A 1-year period of Workers' General Health Examinations in non-office workers had a more significant prevention effect on ischemic heart disease than a 2-year period in office workers among working age (40s-50s) men. It is, however, necessary to consider that prevention of cardio-cerebrovascular disease can be partially explained by their occupational characteristics rather than by health examination period.

Association between Peer Cigarette Smoking and Electronic Cigarette Smoking among Adolescent Nonsmokers: A National Representative Survey.

We assessed the association between electronic cigarette (e-cigarette) use and peer cigarette smoking, a major risk factor for the initiation of cigarette smoking in adolescents. Data from the 2013 Korea Youth Risk Behavior Web-based Survey of 65,753 nonsmokers aged 13-18 years were analyzed using multiple logistic regression. A total of 3.8% of the Korean adolescents were 'ever e-cigarette' users and 1.2% were current users. Adjusted odds ratios (ORs) for current and ever e-cigarette use compared to those whose closest friends were non-smokers ranged from 2.05 (95% confidence interval [CI], 1.82-2.30) to 5.50 (95% CI, 4.77-6.34), and from 2.23 (95% CI, 1.77-2.81) to 7.82 (95% CI, 5.97-10.25) for those who had 'some' close friends to 'most/all' friends who smoked, respectively. The slopes of the adjusted ORs for e-cigarette use in 'never smokers' were more than twice as steep as those in 'former smokers', showing a significant interaction effect between the proportion of smoking closest friends and cigarette smoking status (never or former smokers) (p<0.001 for interaction). Peer cigarette smoking had a significant association with e-cigarette use in adolescent nonsmokers, and this association was greater on never smokers than former smokers.

Sex and Age Differences in Exposure to Secondhand Smoke at Home among Korean Adolescents: A Nationally Representative Survey.

The authors assessed sex and age differences in secondhand smoke (SHS) exposure among vulnerable adolescent populations. Data from the 2013 Korea Youth Risk Behavior Web-based Survey of 64,499 non-smokers aged 13-18 years were analyzed using multiple logistic regression. Girls were exposed 1.26 times (95% confidence interval, 1.21-1.32) more to home SHS than boys, and the younger adolescents were more likely to be exposed to home SHS than were the older, regardless of sex (p < 0.001). Younger girls living with or without current smokers and the younger boys living with current smokers were more likely to be exposed to SHS at home, when the data were stratified according to current household member smoking, which was one of the main risk factors for SHS exposure at home. Girls living with current smokers were more likely to be exposed to SHS at home than boys regardless age. Girls and younger adolescents, populations vulnerable to smoke exposure, were more likely to be exposed to SHS at home, even though they should be more protected. It is necessary to improve home SHS awareness, especially among these vulnerable populations.