Top

Addiction Science & Clinical Practice

Published in:

Open Access 01-12-2021 | Dyslipidemia | Research

Effects of morbidity on smoking cessation: a national smoking cessation program

Authors: Young-Gyun Seo, Min-Woo Jo, Yu-Jin Paek, Jaekyung Choi

Published in: Addiction Science & Clinical Practice | Issue 1/2021

Abstract

Background

In smokers with chronic diseases, we examined the abstinence rates over 6 months and its affecting factors in the context of the Korea National Health Insurance Service (NHIS) smoking cessation program.

Methods

To identify 6-month abstinence, we extracted a sample of 15,017 participants using the multi-stage stratified cluster sampling method from the 359,047 individuals enrolled in the 2016 NHIS smoking cessation program and 1500 smokers responded to the telephone survey. From this group, 1245 individuals (48.50 ± 12.55 years; men 89.8%) were enrolled, as they had no missing information for confounding variables. We compared chronic disease distribution between participants and current smokers in the 2016 Korea National Health and Nutrition Examination Survey. We evaluated the factors affecting continuous abstinence rate (CAR) across patients with different chronic diseases: hypertension, diabetes mellitus (DM), dyslipidemia (DL), chronic obstructive pulmonary disease, and major depressive disorder (MDD).

Results

While participation of DM patients was high, the participation of DL patients was relatively low. The CAR over 6 months was 44.74%. The adjusted odds ratio (OR) for continuous abstinence over 6 months was significantly lower in the MDD group than in the no-MDD group (OR 0.43, 95% confidence interval [CI] 0.21 to 0.85). The factors of program completion (complete versus incomplete: OR 3.11, 95% CI 2.43 to 3.98), region (non-metropolitan areas versus Seoul metropolitan area: OR 1.28, 95% CI 1.01 to 1.61), and nicotine dependence (severe versus light or moderate: OR 0.64, 95% CI 0.50 to 0.83) were significantly associated with CAR.

Conclusions

The smoking cessation program was not actively recruiting smokers with chronic diseases. The CARs in each disease group were not different from those in the non-disease groups, except that the MDD group had a lower CAR over 6 months than the no-MDD group. Recruiting smokers with chronic diseases and improving their CARs depends on the careful identification of their characteristics.

National Center for Chronic Disease Prevention and Health Promotion (US), Office on Smoking and Health. The health consequences of smoking—50 years of progress: a report of the surgeon general. Atlanta (GA): Centers for Disease Control and Prevention (US); 2014.

Forey BA, Thornton AJ, Lee PN. Systematic review with meta-analysis of the epidemiological evidence relating smoking to COPD, chronic bronchitis and emphysema. BMC Pulm Med. 2011;11:36. https://doi.org/10.1186/1471-2466-11-36.CrossRefPubMedPubMedCentral

Gandini S, Botteri E, Iodice S, Boniol M, Lowenfels AB, Maisonneuve P, et al. Tobacco smoking and cancer: a meta-analysis. Int J Cancer. 2008;122(1):155–64. https://doi.org/10.1002/ijc.23033.CrossRefPubMed

Juon HS, Shin Y, Nam JJ. Cigarette smoking among Korean adolescents: prevalence and correlates. Adolescence. 1995;30(119):631–42.PubMed

Carter BD, Abnet CC, Feskanich D, Freedman ND, Hartge P, Lewis CE, et al. Smoking and mortality–beyond established causes. N Engl J Med. 2015;372(7):631–40. https://doi.org/10.1056/NEJMsa1407211.CrossRefPubMed

World Health Organization. WHO global report: mortality attributable to tobacco. Geneva: World Health Organization. 2012. https://apps.who.int/iris/bitstream/handle/10665/44815/9789241564434_eng.pdf. Accessed 1 Jan 2021.

Jung KJ, Yun YD, Baek SJ, Jee SH, Kim IS. Smoking-attributable mortality among Korean adults, 2012. J Korea Soc Health Inform Stat. 2013;38(2):36–48 (Korean).

Han MA. The price of tobacco and its effects on smoking behaviors in Korea: The 2015 Korea Community Health Survey. Prev Med. 2019;120:71–7. https://doi.org/10.1016/j.ypmed.2019.01.010.CrossRefPubMed

Paek YJ, Choi JK, Lee ES, Jo MW. Smoking cessation services provided by the National Health Insurance Service. J Korean Med Assoc. 2018;61(3):157–62.CrossRef

10.

Seo YG, Paek YJ, Jo MW, Choi J. Predictors of long-term abstinence rate by income level in the Korean smoking cessation programme. Addiction. 2019;114(11):2056–64. https://doi.org/10.1111/add.14726.CrossRefPubMedPubMedCentral

11.

Fagard RH. Smoking amplifies cardiovascular risk in patients with hypertension and diabetes. Diabetes Care. 2009;32(Suppl 2):429–31. https://doi.org/10.2337/dc09-S354.CrossRef

12.

Kim Y. The Korea National Health and Nutrition Examination Survey (KNHANES): current status and challenges. Epidemiol Health. 2014;36:e2014002. https://doi.org/10.4178/epih/e2014002.CrossRefPubMedPubMedCentral

13.

Pasco JA, Williams LJ, Jacka FN, Ng F, Henry MJ, Nicholson GC, et al. Tobacco smoking as a risk factor for major depressive disorder: population-based study. Br J Psychiatry. 2008;193(4):322–6. https://doi.org/10.1192/bjp.bp.107.046706.CrossRefPubMed

14.

Cheslack-Postava K, Wall MM, Weinberger AH, Goodwin RD. Increasing depression and substance use among former smokers in the United States, 2002–2016. Am J Prev Med. 2019;57(4):429–37. https://doi.org/10.1016/j.amepre.2019.05.014.CrossRefPubMed

15.

Evins AE, Cather C, Laffer A. Treatment of tobacco use disorders in smokers with serious mental illness: toward clinical best practices. Harv Rev Psychiatry. 2015;23(2):90–8. https://doi.org/10.1097/HRP.0000000000000063.CrossRefPubMedPubMedCentral

16.

Fujita T, Babazono A, Harano Y, Jiang P. Risk of depressive disorders after tobacco smoking cessation: a retrospective cohort study in Fukuoka, Japan. BMJ Open. 2019;9(3):e025124. https://doi.org/10.1136/bmjopen-2018-025124.CrossRefPubMedPubMedCentral

17.

ITC Project. (November, 2012) ITC Korea National Report. Findings from the Wave 1 to 3 Surveys (2005–2010). University of Waterloo, Waterloo, Ontario, Canada; National Cancer Center and Korean Association on Smoking or Health, Republic of Korea. https://itcproject.s3.amazonaws.com/uploads/documents/ITC_Korea_National_Report_Waves_1_to_3_2005-2010_Novem.pdf. Accessed 1 Jan 2021.

18.

Eliasson B. Cigarette smoking and diabetes. Prog Cardiovasc Dis. 2003;45(5):405–13. https://doi.org/10.1053/pcad.2003.00103.CrossRefPubMed

19.

Kim SG. New start of surgical residents training: the first survey of program directors in Korea. BMC Med Educ. 2019;19(1):208. https://doi.org/10.1186/s12909-019-1646-3.CrossRefPubMedPubMedCentral

20.

Lee JY, Eun SJ, Kim HJ, Jo MW. Finding the primary care providers in the specialist-dominant primary care setting of Korea: a cluster analysis. PLoS ONE. 2016;11(8):e0161937. https://doi.org/10.1371/journal.pone.0161937.CrossRefPubMedPubMedCentral

21.

Lee ES, Seo HG, Fong GT, Yan M, Driezen P. Awareness of Korean adults smokers about national smoking cessation program in Korea: findings from the 2016 international tobacco control policy evaluation survey_Korea. J Korean Soc Res Nicotine Tob. 2018;9(Suppl S1):22–30. https://doi.org/10.25055/JKSRNT.2018.9.S1.S22(Korean).CrossRef

22.

Caponnetto P, Polosa R. Common predictors of smoking cessation in clinical practice. Respir Med. 2008;102(8):1182–92. https://doi.org/10.1016/j.rmed.2008.02.017.CrossRefPubMed

23.

Chang PY, Lo PC, Chang HC, Hsueh KC, Tsai YW. Comparative effectiveness of smoking cessation medications: a national prospective cohort from Taiwan. PLoS ONE. 2016;11(11):e0166992. https://doi.org/10.1371/journal.pone.0166992.CrossRefPubMedPubMedCentral

24.

Choi HY, Oh IJ, Lee JA, Lim J, Kim YS, Jeon TH, et al. Factors affecting adherence to antihypertensive medication. Korean J Fam Med. 2018;39(6):325–32. https://doi.org/10.4082/kjfm.17.0041.CrossRefPubMedPubMedCentral

Title: Effects of morbidity on smoking cessation: a national smoking cessation program
Authors: Young-Gyun Seo
Min-Woo Jo
Yu-Jin Paek
Jaekyung Choi
Publication date: 01-12-2021
Publisher: BioMed Central
Keywords: Dyslipidemia
Hypertension
Diabetes
Hypertension
Published in: Addiction Science & Clinical Practice / Issue 1/2021
Electronic ISSN: 1940-0640
DOI: https://doi.org/10.1186/s13722-021-00257-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Effects of morbidity on smoking cessation: a national smoking cessation program

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2021

Housing, opportunities, motivation and engagement (HOME) for homeless youth at-risk for opioid use disorder: study protocol for a randomized controlled trial

External validation of an opioid misuse machine learning classifier in hospitalized adult patients

Smoking cessation using preference-based tools: a mixed method pilot study of a novel intervention among smokers with low socioeconomic position

The validation and reliability of a Japanese version of the Problematic Online Gaming Questionnaire (POGQ-J)

Racial/ethnic equity in substance use treatment research: the way forward

Facilitating rapid access to addiction treatment: a randomized controlled trial