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"Cheol Min Lee"

Review Article

Evidence-Based Guideline for the Treatment of Smoking Cessation Provided by the National Health Insurance Service in Korea
Cheol Min Lee, Yoo-Bin Seo, Yu-Jin Paek, Eon Sook Lee, Hye Seon Kang, Soo Young Kim, Sungwon Roh, Dong Won Park, Yoo Suk An, Sang-Ho Jo, The Guideline Development Group for Developing the Korean Clinical Practice Guideline for Tobacco Cessation
Korean J Fam Med 2024;45(2):69-81.   Published online February 28, 2024
DOI: https://doi.org/10.4082/kjfm.23.0142
Although major countries, such as South Korea, have developed and disseminated national smoking cessation guidelines, these efforts have been limited to developing individual societies or specialized institution-based recommendations. Therefore, evidence-based clinical guidelines are essential for developing smoking cessation interventions and promoting effective smoking cessation treatments. This guideline targets frontline clinical practitioners involved in a smoking cessation treatment support program implemented in 2015 with the support of the National Health Insurance Service. The Guideline Development Group of 10 multidisciplinary smoking cessation experts employed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE)-ADOLOPMENT approach to review recent domestic and international research and guidelines and to determine evidence levels using the GRADE methodology. The guideline panel formulated six strong recommendations and one conditional recommendation regarding pharmacotherapy choices among general and special populations (mental disorders and chronic obstructive lung disease [COPD]). Strong recommendations favor varenicline rather than a nicotine patch or bupropion, using varenicline even if they are not ready to quit, using extended pharmacotherapy (>12 weeks) rather than standard treatment (8–12 weeks), or using pharmacotherapy for individuals with mental disorders or COPD. The conditional recommendation suggests combining varenicline with a nicotine patch instead of using varenicline alone. Aligned with the Korean Society of Medicine’s clinical guideline development process, this is South Korea’s first domestic smoking cessation treatment guideline that follows standardized guidelines. Primarily focusing on pharmacotherapy, it can serve as a foundation for comprehensive future smoking cessation clinical guidelines, encompassing broader treatment topics beyond medications.
  • 5,039 View
  • 93 Download

Original Articles

Fruits and the Risk of Type 2 Diabetes: The Korean Genome and Epidemiology Study Cohort
Hojun Yu, Cheol Min Lee, Seung-Won Oh
Korean J Fam Med 2024;45(1):44-50.   Published online November 23, 2023
DOI: https://doi.org/10.4082/kjfm.23.0201
Background
To determine the association between type 2 diabetes mellitus and the consumption of various fruits.
Methods
The Korean Genome And Epidemiology Study is an ongoing prospective longitudinal cohort study of community dwellers and participants (men and women, aged 40–69 years) recruited from the national health examinee registry of Korea. Their individual consumption habits for 12 different fruit types were recorded using food frequency questionnaires. The fruits were then divided into three groups according to their glycemic indexes and glycemic loads. Participants with extreme caloric intakes, pre-existing type 2 diabetes mellitus, chronic kidney diseases, chronic liver diseases, and ongoing cancer treatments were excluded. The incidence of type 2 diabetes in the cohort was identified through self-reporting and supplemented by glycated hemoglobin and fasting blood glucose levels.
Results
A total of 2,549 cases of type 2 diabetes were documented during 283,033.8 person-years of follow-up. After adjusting for personal, lifestyle, and dietary risk factors for diabetes, the pooled hazard ratio of type 2 diabetes for every serving per week of total whole fruit consumption was 1.02 (95% confidence interval [CI], 0.99–1.06; P=0.2). With mutual adjustment of individual fruits, the pooled hazard ratios of type 2 diabetes for every serving per week were 0.94 (95% CI, 0.88–1.00; P=0.039) for bananas, and 0.90 (95% CI, 0.84–0.96; P<0.001) for grapes.
Conclusion
Our findings suggest associations between the consumption of certain fruits and the risk of developing type 2 diabetes. A greater consumption of grapes was significantly associated with a lower risk of type 2 diabetes in our cohort, but the total amount of fruit consumption was not associated with a reduced risk.

Citations

Citations to this article as recorded by  
  • Guidelines for nutrition counseling in primary healthcare clinics
    Gyeongsil Lee, Seung-Won Oh
    Journal of the Korean Medical Association.2024; 67(4): 278.     CrossRef
  • 3,924 View
  • 107 Download
  • 1 Web of Science
  • 1 Crossref
Background
After the advent of heated tobacco products (HTPs) in 2017, domestic cigarette sales declined until 2019, but have increased in South Korea since 2020. This study aimed to analyze tobacco use and cessation behavior among HTP users compared with conventional cigarette (CC) users.
Methods
We analyzed data from the eighth Korea National Health and Nutrition Examination Survey (2019). Of 6,188 study participants, 1,181 were current tobacco product users (single, dual, and triple), including all combinations of CCs, HTPs, and electronic cigarettes (ECs). Tobacco use and cessation behaviors among single and dual users of CCs and HTPs were assessed using various categorical methods.
Results
In 2019, proportions of HTP use in men and women aged ≥19 years in South Korea were 8.8% and 1.5%, respectively, and those of single, dual, and triple users were 23.6%, 58.0%, and 18.4%, respectively. Dual users had more tobacco use than CC only and HTP only users (all P<0.001). Each daily user accounted for a lower percentage of attempt and preparation stages for cessation than intermittent users (all P<0.001, except for dual users).
Conclusion
In this study, we analyzed the differences in tobacco use and cessation behavior among CC and HTP users in various populations in South Korea. Additionally, we found that all novel tobacco product users had already experienced CCs in adulthood. Further studies that address HTP’s harmful effects in humans are necessary.

Citations

Citations to this article as recorded by  
  • Relationship between insulin resistance surrogate markers with diabetes and dyslipidemia: A Bayesian network analysis of Korean adults
    Jaeyeop Choi, Jonghyun Kim, Hyun Sook Oh, Marwan Al-Nimer
    PLOS One.2025; 20(5): e0323329.     CrossRef
  • Pharmacotherapy guidelines for smoking cessation in primary healthcare clinics
    Cheol Min Lee, Yu Jin Paek, Yoo Bin Seo, Eon Sook Lee
    Journal of the Korean Medical Association.2024; 67(4): 230.     CrossRef
  • Heated tobacco product use frequency, smoking quit attempts, and smoking reduction among Mexican adult smokers
    Lizeth Cruz-Jiménez, Inti Barrientos-Gutiérrez, Dèsirée Vidaña-Pérez, Katia Gallegos-Carrillo, Edna Arillo-Santillán, Rosibel Rodríguez-Bolaños, James W. Hardin, Minji Kim, James F. Thrasher
    Tobacco Induced Diseases.2024; 22(May): 1.     CrossRef
  • A Scoping Review of Behavioural Studies on Heated Tobacco Products
    Ian M Fearon, Sarah F Cordery, Martin Fitzpatrick, Sarah Weaver, Matthew Stevenson, Erika Grandolfo, Layla Malt, Keith Thompson, Thomas Nahde
    Cureus.2024;[Epub]     CrossRef
  • Current status of tobacco use, cessation and control policy in Korea
    Cheol Min Lee
    Journal of the Korean Medical Association.2022; 65(12): 789.     CrossRef
  • 4,290 View
  • 108 Download
  • 5 Web of Science
  • 5 Crossref
Background
Many people use both combustible cigarette (CC) and electronic cigarette (EC). We compared nicotine dependence among CC, EC, and dual users using questionnaires and urinary cotinine levels.
Methods
Data from the Korea National Health and Nutrition Examination Survey (2014–2017) databases were analyzed; 3,917 CC, EC, and dual users were administered the urinary cotinine test, and 1,045 current CC and dual users completed the Heaviness of Smoking Index (HSI) questionnaires. Weighted geometric means of urine cotinine levels were compared between exclusive CC, exclusive EC, and dual users. The distribution rate, based on time to first cigarette (TTFC), cigarettes per day (CPD), and the HSI was analyzed in two weighted groups, exclusive CC and dual users.
Results
Among those who currently use any type of cigarette, 89.4%, 1.4%, and 9.2% were exclusive CC, exclusive EC, and dual users, respectively. Weighted geometric means of urine cotinine were highest in dual users (1,356.4 ng/mL), followed by exclusive CC (1,270.3 ng/mL), and exclusive EC (867.7 ng/mL) with significant differences between all three groups (P<0.05). There were no statistically significant differences in CPD between exclusive CC and dual users (P=0.626). The proportion of TTFC ≤5 minutes was 21.5% and 29.5% in the two groups, respectively (P=0.010); however, HSI differences in the two groups was marginal (P=0.557).
Conclusion
In this study, the urinary cotinine value could distinguish the three groups, CC, EC, and dual users, but the questionnaire using HSI could not distinguish the three groups.

Citations

Citations to this article as recorded by  
  • Protocol for the development of a vaping cessation intervention for young adult veterans
    Neal Doran, Samantha Hurst, Jie Liu, Omar El-Shahawy, Mark Myers, Paul Krebs
    Contemporary Clinical Trials Communications.2024; 39: 101309.     CrossRef
  • Smoking Cessation Treatment in Primary Care
    Hye-ji An, Cheol-Min Lee, Yoo-Bin Seo, Eon-Sook Lee, Yu-Jin Paek
    Korean Journal of Family Practice.2024; 14(4): 184.     CrossRef
  • Optimum Urine Cotinine and NNAL Levels to Distinguish Smokers from Non-Smokers by the Changes in Tobacco Control Policy in Korea from 2008 to 2018
    Eun Young Park, Min Kyung Lim, Eunjung Park, Yoonjung Kim, Dohoon Lee, Kyungwon Oh
    Nicotine & Tobacco Research.2022; 24(11): 1821.     CrossRef
  • Current status of tobacco use, cessation and control policy in Korea
    Cheol Min Lee
    Journal of the Korean Medical Association.2022; 65(12): 789.     CrossRef
  • Current status of health promotion in Korea
    Soo Young Kim
    Journal of the Korean Medical Association.2022; 65(12): 776.     CrossRef
  • Recent Trends of Research and Guidelines on Pharmacotherapy for Smoking Cessation
    Choon-Young Kim
    Journal of the Korean Society for Research on Nicotine and Tobacco.2022; 13(4): 107.     CrossRef
  • Nicotine Dependence of Electronic Cigarette, Dual Combustible and Electronic Cigarette Users
    Jungun Lee
    Korean Journal of Family Medicine.2021; 42(3): 189.     CrossRef
  • Recent Updates of Pharmacotherapy for Smoking Cessation
    Ju Sam Hwang, Cheol Min Lee
    Korean Journal of Family Practice.2021; 11(6): 403.     CrossRef
  • 6,947 View
  • 134 Download
  • 5 Web of Science
  • 8 Crossref

Review Article

The Impact of Heated Tobacco Products on Smoking Cessation, Tobacco Use, and Tobacco Sales in South Korea
Cheol Min Lee
Korean J Fam Med 2020;41(5):273-281.   Published online September 18, 2020
DOI: https://doi.org/10.4082/kjfm.20.0140
Heated tobacco products (HTPs), a hybrid between conventional and electronic cigarettes, were first launched in South Korea in June 2017. Owing to advertisements stating that HTPs are odorless, tar-free, and less harmful to health, the sales of HTPs have grown quickly enough to account for about 10% of the total tobacco market in a year. HTP use by young, highly educated, and high-income groups had a significant impact on both the overall tobacco market over the past 3 years and the smoking and quitting behaviors of smokers. Based on national smoking rate statistics, tobacco sales trends, and the number of visitors to smoking cessation clinics, the following changes have been identified: (1) The decline in current smoking rates has slowed or rose in some groups. (2) The decline in total cigarette sales has slowed but rose again in the first quarter of 2020. (3) The number of visitors to smoking cessation clinics decreased just after the advent of HTPs. These results may be due to the insufficient support of tobacco regulation policies but also coincide chronologically with the appearance of HTPs in South Korea. It is necessary to investigate the usage rate of various tobacco products, including HTPs and e-cigarettes, to examine the health risks of novel tobacco products and provide accurate information to users and policymakers. Finally, tobacco companies are continuously developing new product concepts to escape the regulation of existing cigarettes; thus, comprehensive management measures for all nicotine-containing products are needed.

Citations

Citations to this article as recorded by  
  • Maintaining optimal cardiovascular health metrics and carotid intima-media thickness among Korean adolescents
    Fumie Kaneko, Hokyou Lee, Jee-Seon Shim, Hyeon Chang Kim
    Clinical Hypertension.2025;[Epub]     CrossRef
  • Assessing use of inhalable nicotine products within complex markets: the dilemma of heated tobacco products
    Connor Richard Miller, Steve S Xu, Danielle M Smith, Edward Sutanto, Maciej Lukasz Goniewicz, Anne C K Quah, Geoffrey T Fong
    Tobacco Control.2024; 33(1): 103.     CrossRef
  • The smoking population is not hardening in South Korea: a study using the Korea Community Health Survey from 2010 to 2018
    Boyoung Jung, Jung Ah Lee, Ye-Jee Kim, Hong-Jun Cho
    Tobacco Control.2024; 33(2): 171.     CrossRef
  • Heated Tobacco Product Use and Mental Health: Korean National Health and Nutrition Examination Survey (2018–2020)
    Young-Gyun Seo, Sungkyu Lee, Min Kyung Lim, Yu-Jin Paek
    International Journal of Mental Health and Addiction.2024; 22(3): 979.     CrossRef
  • Perception of heated tobacco products and support for regulations: a cross-sectional study in Hong Kong
    Yongda Socrates Wu, Yee Tak Derek Cheung, Sai Yin Ho, Henry Sau Chai Tong, Vienna Wai Yin Lai, Tai Hing Lam, Man Ping Wang
    Tobacco Control.2024; 33(e1): e132.     CrossRef
  • Heated tobacco products do not help smokers quit or prevent relapse: a longitudinal study in Japan
    Satomi Odani, Kanami Tsuno, Israel T Agaku, Takahiro Tabuchi
    Tobacco Control.2024; 33(4): 472.     CrossRef
  • A Scoping Review of Behavioural Studies on Heated Tobacco Products
    Ian M Fearon, Sarah F Cordery, Martin Fitzpatrick, Sarah Weaver, Matthew Stevenson, Erika Grandolfo, Layla Malt, Keith Thompson, Thomas Nahde
    Cureus.2024;[Epub]     CrossRef
  • Development and validation of a nomogram for predicting COPD: A nationwide population-based study in South Korea
    Seungeun Oh, Hyungkyun Mok, Kyuhee Jo
    Medicine.2024; 103(39): e39901.     CrossRef
  • Association between the dual use of electronic and conventional cigarettes and NAFLD status in Korean men
    Minjung Han, Seogsong Jeong, Jihun Song, Sun Jae Park, Cheol Min Lee, Kiheon Lee, Sang Min Park
    Tobacco Induced Diseases.2023; 21(February): 1.     CrossRef
  • JUUL preference among Korean adult tobacco users and its effect on attempts to quit tobacco: A follow- up survey four months post JUUL launch
    Ju Sam Hwang+, Kiheon Lee+, Choon-Young Kim, Heejin Kim, Sungroul Kim, Cheol Lee
    Tobacco Induced Diseases.2023; 21(March): 1.     CrossRef
  • Electronic device or regulated tobacco product? Learning from the diffusion of heated tobacco products in Spain
    J.M. Martín-Álvarez, A. Almeida, A.A. Golpe, E. Asensio
    Public Health.2023; 219: 61.     CrossRef
  • Is Using Heated Tobacco Products Helpful in Smoking Cessation?
    Young Gyu Cho
    Korean Journal of Family Medicine.2023; 44(3): 127.     CrossRef
  • Comparison of the Smoking Cessation of Heated Tobacco Product Users and Conventional Cigarette Smokers in Korea
    Doyeon Won, Wonyoung Jung, Dongwook Shin
    Korean Journal of Family Medicine.2023; 44(3): 151.     CrossRef
  • The relationship between heated cigarette smoking and blood white blood cell count: a population-based cross-sectional study
    D.-H. Koh
    Public Health.2023; 222: 154.     CrossRef
  • The Need for Policy Changes for Tobacco End Game
    Cheol Min Lee
    Journal of the Korean Society for Research on Nicotine and Tobacco.2023; 14(3): 118.     CrossRef
  • Relationship between heated tobacco product use and allergic rhinitis in Korean adults
    Young-Gyun Seo, Yu-Jin Paek, Joo-Hee Kim, Jwa-Kyung Kim, Hye-Mi Noh
    Tobacco Induced Diseases.2023; 21(November): 1.     CrossRef
  • Characterizing Heated Tobacco Product Use Among Adult Cigarette Smokers and Nicotine Vaping Product Users in the 2018 ITC Four Country Smoking & Vaping Survey
    Connor R Miller, Edward Sutanto, Danielle M Smith, Sara C Hitchman, Shannon Gravely, Hua-Hie Yong, Ron Borland, Richard J O’Connor, K Michael Cummings, Geoffrey T Fong, Andrew Hyland, Anne C K Quah, Maciej L Goniewicz
    Nicotine & Tobacco Research.2022; 24(4): 493.     CrossRef
  • Heated tobacco products for smoking cessation and reducing smoking prevalence
    Harry Tattan-Birch, Jamie Hartmann-Boyce, Loren Kock, Erikas Simonavicius, Leonie Brose, Sarah Jackson, Lion Shahab, Jamie Brown
    Cochrane Database of Systematic Reviews.2022;[Epub]     CrossRef
  • Perceived relative harm of heated tobacco products and electronic cigarettes and its association with use in smoke-free places: A cross-sectional analysis of Korean adults
    Choon-Young Kim*+, Kiheon Lee*+, Cheol Min Lee, Sungroul Kim, Hong-Jun Cho
    Tobacco Induced Diseases.2022; 20(February): 1.     CrossRef
  • Subjective Changes in Tobacco Product Use among Korean Adults during the COVID-19 Pandemic
    Jieun Hwang
    International Journal of Environmental Research and Public Health.2022; 19(6): 3272.     CrossRef
  • Methods of the 2020 (Wave 1) International Tobacco Control (ITC) Korea Survey
    Anne Quah, Sungkyu Lee, Hong Gwan Seo, Sung-il Cho, Sujin Lim, Yeol Kim, Steve Xu, Matthew Grey, Mi Yan, Christian Boudreau, Mary Thompson, Pete Driezen, Geoffrey Fong
    Tobacco Prevention & Cessation.2022; 8(March): 1.     CrossRef
  • Evaluation of Japanese university students' perception of smoking, interest in quitting, and smoking behavior: An examination and public health challenges during the COVID-19 pandemic
    Makoto Aoike, Yukihiro Mori, Kiyoshi Hotta, Yukihiro Shigeno, Yuka Aoyama, Mamoru Tanaka, Hana Kouzai, Hatsumi Kawamura, Masato Tsurudome, Morihiro Ito
    Drug Discoveries & Therapeutics.2022; 16(3): 118.     CrossRef
  • Factors Associated with Quit Intentions among Adult Smokers in South Korea: Findings from the 2020 ITC Korea Survey
    Minjung Han, Donghee Seo, Yeol Kim, Hong Gwan Seo, Sung-il Cho, Sungkyu Lee, Sujin Lim, Susan C. Kaai, Anne C. K. Quah, Mi Yan, Steve S. Xu, Geoffrey T. Fong
    International Journal of Environmental Research and Public Health.2022; 19(17): 10839.     CrossRef
  • Comparison of Tobacco Use and Cessation Behavior between Conventional Cigarette and Heated Tobacco Product Users: Based on the Analyses of the Eighth Korea National Health and Nutrition Examination Survey 2019
    Hyeree Yu, Cheol Min Lee
    Korean Journal of Family Medicine.2022; 43(5): 296.     CrossRef
  • Acute Eosinophilic Pneumonia after Combined Use of Conventional and Heat-Not-Burn Cigarettes: A Case Report
    Bo Hyoung Kang, Dong Hyun Lee, Mee Sook Roh, Soo-Jung Um, Insu Kim
    Medicina.2022; 58(11): 1527.     CrossRef
  • Current status of tobacco use, cessation and control policy in Korea
    Cheol Min Lee
    Journal of the Korean Medical Association.2022; 65(12): 789.     CrossRef
  • Prevalence and predictors of heated tobacco products use among male ever smokers: results from a Korean longitudinal study
    Jeeeun Yi, Cheol Min Lee, Seung-sik Hwang, Sung-il Cho
    BMC Public Health.2021;[Epub]     CrossRef
  • Nicotine Dependence of Electronic Cigarette, Dual Combustible and Electronic Cigarette Users
    Jungun Lee
    Korean Journal of Family Medicine.2021; 42(3): 189.     CrossRef
  • Prevalence and reasons for use of Heated Tobacco Products (HTP) in Europe: an analysis of Eurobarometer data in 28 countries
    Anthony A. Laverty, Constantine I. Vardavas, Filippos T. Filippidis
    The Lancet Regional Health - Europe.2021; 8: 100159.     CrossRef
  • Combined Associations of Changes in Noncombustible Nicotine or Tobacco Product and Combustible Cigarette Use Habits With Subsequent Short-Term Cardiovascular Disease Risk Among South Korean Men: A Nationwide Cohort Study
    Seulggie Choi, Kiheon Lee, Sang Min Park
    Circulation.2021; 144(19): 1528.     CrossRef
  • Bibliometric Analysis of Publications Related to Heated Tobacco Products Reported over the Period 2015-2020
    Min Joo Jeon, Su Mi Lee, Kiheon Lee, Eunbyul Cho, Joo Young Kim, Woo Kyung Bae, Jong Soo Han, Hyejin Lee, Se Young Jung
    Journal of the Korean Society for Research on Nicotine and Tobacco.2021; 12(2): 74.     CrossRef
  • Reasons for Using Heated Tobacco Products among South Korean Adults
    Ji Min Kim, Hong-Jun Cho
    Journal of the Korean Society for Research on Nicotine and Tobacco.2021; 12(2): 53.     CrossRef
  • Are Heated Tobacco Product Users Less Likely to Quit than Cigarette Smokers? Findings from THINK (Tobacco and Health IN Korea) Study
    Cheol Min Lee, Choon-Young Kim, Kiheon Lee, Sungroul Kim
    International Journal of Environmental Research and Public Health.2020; 17(22): 8622.     CrossRef
  • The Change of Tobacco Use Pattern among Adolescents after the Introduction of Novel Tobacco Products
    Cheol Min Lee
    Journal of the Korean Society for Research on Nicotine and Tobacco.2020; 11(2): 84.     CrossRef
  • 10,936 View
  • 151 Download
  • 31 Web of Science
  • 34 Crossref

Original Articles

The Relationship between Electronic Cigarette Use with or without Cigarette Smoking and Alcohol Use among Adolescents: Finding from the 11th Korea Youth Risk Behavior Web-based Survey
Kwang Ho Oh, Cheol Min Lee, Bumjo Oh, Seung-Won Oh, Hee-Kyung Joh, Ho Chun Choi, Seung Jae Kim, Sho Rry Lea
Korean J Fam Med 2019;40(4):241-247.   Published online January 14, 2019
DOI: https://doi.org/10.4082/kjfm.17.0094
Background
Electronic cigarette (EC) consumption (‘vaping’) is rapidly increasing, not only in adults but also in adolescents. Little is known about the association between vaping and problem behaviors such as drinking.
Methods
We used data from the 11th Korea Youth Risk Behavior Web-based Survey, which was conducted in 2015 and included 68,043 participants who were Korean middle and high school students. The survey assessed EC, cigarette, and alcohol use. Multiple regression analysis was used to examine risk of current drinking and problem drinking across the following categories of users: never user (never used either product), former user (use of EC or cigarettes in the past, but not currently), vaping only, smoking only, and dual user (current use of both products).
Results
EC only users were 1.2% in males, and 0.3% in females. Dual user of both conventional cigarettes and ECs were 5.1% in males, and 1.2% in females. Drinking frequency, drinking quantity per once, and problem drinking were higher among vapers than non-vapers and former-vapers, moreover, were higher among daily vapers than intermittent vapers. Compared to never users, EC only users were higher on risk of current drink and problem drink. The dual users were highest on risk of current drink.
Conclusion
Vaping is independently associated with alcohol use problems in Korean students, even those not currently smoking. Moreover, dual use of cigarettes and ECs is strongly associated with alcohol use problems. Therefore, vaping students should be concerned about their hidden alcohol use problems.

Citations

Citations to this article as recorded by  
  • Changes in health behaviors and obesity of Korean adolescents before and during the COVID-19 pandemic: a special report using the Korea Youth Risk Behavior Survey
    Chang-Mo Oh, Yangha Kim, Jieun Yang, Sunhye Choi, Kyungwon Oh
    Epidemiology and Health.2023; 45: e2023018.     CrossRef
  • Addiction-Related Outcomes of Nicotine and Alcohol Co-use: New Insights Following the Rise in Vaping
    Jude A Frie, Caitlin J Nolan, Jennifer E Murray, Jibran Y Khokhar
    Nicotine & Tobacco Research.2022; 24(8): 1141.     CrossRef
  • Vaping
    Chelsey DeGomez, Jennifer Feirstein
    JAAPA.2022; 35(9): 25.     CrossRef
  • Comparison of Tobacco Use and Cessation Behavior between Conventional Cigarette and Heated Tobacco Product Users: Based on the Analyses of the Eighth Korea National Health and Nutrition Examination Survey 2019
    Hyeree Yu, Cheol Min Lee
    Korean Journal of Family Medicine.2022; 43(5): 296.     CrossRef
  • Prevalence of Vaping and Behavioral Associations of Vaping Among a Community of College Students in the United States
    Ogbebor E. Omoike, Kiana R. Johnson
    Journal of Community Health.2021; 46(1): 190.     CrossRef
  • Use of Single, Dual, and Poly Tobacco Products in Korean Adolescents
    Min Kwon, Sophia J. Chung, Jinhwa Lee
    Asia Pacific Journal of Public Health.2021; 33(5): 571.     CrossRef
  • Association between preference for using alcohol beverage-named e-liquids and alcohol use among high school youth
    Asti Jackson, Ran Wu, Grace Kong, Deepa R. Camenga, Meghan Morean, Patricia Simon, Krysten W. Bold, Angela M. Haeny, Suchitra Krishnan-Sarin
    Drug and Alcohol Dependence.2020; 209: 107903.     CrossRef
  • Cross-fading: The importance of tissue injury research on dual misuse of alcohol and JUUL
    Lisa Chudomelka, Todd A. Wyatt
    Alcohol.2020; 86: 43.     CrossRef
  • Association of E-cigarettes with adolescent alcohol use and binge drinking-drunkenness: A systematic review and meta-analysis
    Ava N. Rothrock, Halle Andris, Sarah B. Swetland, Valeria Chavez, Shira Isaak, Maria Pagane, Jake Romney, Steven G. Rothrock
    The American Journal of Drug and Alcohol Abuse.2020; 46(6): 684.     CrossRef
  • Prevalence and Correlates of the Dual Use of Conventional and Electronic Cigarettes among Korean Adolescents: 2016-2018 Korean Youth Risk Behavior Survey
    Eon Sook Lee, Yu Jin Paek
    Journal of the Korean Society for Research on Nicotine and Tobacco.2020; 11(2): 64.     CrossRef
  • Electronic and Conventional Cigarette Use and Drinking Behaviors in Korean Adolescents
    Young Gyu Cho
    Korean Journal of Family Medicine.2019; 40(4): 201.     CrossRef
  • 7,034 View
  • 178 Download
  • 10 Web of Science
  • 11 Crossref
Cut-Off Values for Visceral Fat Area Identifying Korean Adults at Risk for Metabolic Syndrome
Arang Lee, Ye Ji Kim, Seung-Won Oh, Cheol Min Lee, Ho Chun Choi, Hee-Kyung Joh, Bumjo Oh, Seung-Sik Hwang, Seung Jae Kim, Oh Deog Kwon
Korean J Fam Med 2018;39(4):239-246.   Published online July 4, 2018
DOI: https://doi.org/10.4082/kjfm.17.0099
Background
Cut-off values for visceral fat area (VFA) measured by computed tomography (CT) for identifying individuals at risk of metabolic syndrome (MetS) have not been clearly established in Korean adults, particularly for large populations. We aimed to identify optimal VFA and waist circumference (WC) cut-off values and compare the ability of VFA and WC to predict the presence of ≥2 metabolic risk factors.
Methods
We included 36,783 subjects aged 19–79 years undergoing abdominal fat CT during regular health checkups between January 2007 and February 2015 in Seoul. The risk factors for MetS except WC were based on the International Diabetes Federation criteria. Receiver operating characteristic curve analyses were used to determine the appropriate VFA and WC cut-off values for MetS.
Results
VFA was a more significant predictor of metabolic risk factors than WC and body mass index (BMI). The optimal cut-off values for VFA and WC were 134.6 cm2 and 88 cm for men and 91.1 cm2 and 81 cm for women, respectively. We estimated age-specific cut-off values for VFA, WC, and BMI. VFA cut-off values increased with age, particularly among women.
Conclusion
This large population study proposed the cut-off values for VFA and WC for identifying subjects at risk of MetS among Korean adults. For more accurate diagnosis, different age-specific cut-off values for VFA and WC may be considered.

Citations

Citations to this article as recorded by  
  • Development of a sex-specific visceral fat area estimation using discrete multi-wavelength near-infrared spectroscopy measurements in Korean individuals
    Soonhyun Ban, Jihyeon Baek, Soee Choi, Sung-Ho Han
    International Journal of Obesity.2025; 49(4): 627.     CrossRef
  • Association between visceral fat area and metabolic syndrome in individuals with normal body weight: insights from a Chinese health screening dataset
    Yongbing Sun, Xinbei Lin, Zhi Zou, Yang Zhou, Ao Liu, Xin Li, Yawei Du, Xiaoqi Ji, Zhonglin Li, Xiaoling Wu, Yong Wang, Xue Lv, Tao Li, Jiancheng Zhang, Zhiping Guo, Hao Li, Yongli Li
    Lipids in Health and Disease.2025;[Epub]     CrossRef
  • Analysis of the relationship between central adiposity and biomechanical, histological, and immunohistochemical properties of the anterior wall of abdominal aortic aneurysms
    Alexandre Malta Brandão, Marcos Vinícius Melo de Oliveira, Gina Camillo Rocha Silvestre, Alexandre Queiroz Silva, Michele Alberto Marques, Suely Aparecida Pinheiro Palomino, Maria de Lourdes Higuchi, Erasmo Simão da Silva
    JVS-Vascular Science.2025; 6: 100283.     CrossRef
  • The Critical Role of Body Composition Assessment in Advancing Research and Clinical Health Risk Assessment across the Lifespan
    Jonathan P. Bennett, Soo Lim
    Journal of Obesity & Metabolic Syndrome.2025; 34(2): 120.     CrossRef
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    Sunmin Park
    Nutrients.2024; 16(4): 534.     CrossRef
  • Prediction of high visceral adipose tissue for sex‐specific community residents in Taiwan
    Yu‐Hsuan Chang, Chin‐Sung Chang, Chieh‐Yu Liu, Yin‐Fan Chang, Shiow‐Ching Shun
    Nursing & Health Sciences.2024;[Epub]     CrossRef
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    Dong Won Paik, Kyungdo Han, Se Woong Kang, Don-Il Ham, Sang Jin Kim, Tae-Young Chung, Dong Hui Lim
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The Association between Fat Mass, Lean Mass and Bone Mineral Density in Premenopausal Women in Korea: A Cross-Sectional Study
Jeehyun Kim, Hyuktae Kwon, Bo-Kyoung Heo, Hee-Kyung Joh, Cheol Min Lee, Seung-Sik Hwang, Danbee Park, Jae-Hong Park
Korean J Fam Med 2018;39(2):74-84.   Published online March 22, 2018
DOI: https://doi.org/10.4082/kjfm.2018.39.2.74
Background

We investigated the association between body composition, especially truncal or non-truncal fat mass (FM), and bone mineral density (BMD) in premenopausal women in Korea.

Methods

A cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey IV and V (2008–2011). Total lean mass (LM), total FM (TFM), truncal FM, and non-truncal FM, and BMD of the total femur, femoral neck (FN), and lumbar spine were measured using dual-energy X-ray absorptiometry. The association between body composition and BMD was analyzed using multiple linear regression. The risk of low BMD according to quartiles of TFM, truncal FM, and non-truncal FM was calculated using logistic regression. Subgroup analysis according to body mass index was also performed.

Results

In 4,343 premenopausal women, total LM was positively associated with BMD regardless of weight adjustment. TFM, truncal FM, and non-truncal FM were inversely associated with BMD after adjusting for weight. Odds ratios (ORs) for low BMD and 95% confidence intervals (CIs) of the highest quartile of TFM, truncal FM, and non-truncal FM compared with the lowest quartile were calculated. The risk of low BMD of the FN was higher in the highest quartile of TFM (OR, 4.48; 95% CI, 1.11–18.01) and truncal FM (OR, 5.48; 95% CI, 1.75–17.20). Truncal FM and not-truncal FM had an inverse association with BMD in the non-obese and obese subgroups of women.

Conclusion

Total LM has a protective effect on BMD and FM can have a detrimental effect on BMD besides its skeletal loading effect.

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    Jihan Kim, Sami Lee, Sung Soo Kim, Jong-Pyo Lee, Jong Sung Kim, Jin Gyu Jung, Seok Jun Yoon, Kyu Pil Kim, Chan-Keol Park, Yong-Hwan Kim
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Association between Physical Activity Levels and Physical Symptoms or Illness among University Students in Korea
Sang-Hyun Ahn, Yoo-Jin Um, Young-Ju Kim, Hyun-Joo Kim, Seung-Won Oh, Cheol Min Lee, Hyuktae Kwon, Hee-Kyung Joh
Korean J Fam Med 2016;37(5):279-286.   Published online September 21, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.5.279
Background

Low levels of physical activity can cause various physical symptoms or illness. However, few studies on this association have been conducted in young adults. The aim of this study was to investigate the association between physical activity levels and physical symptoms or illness in young adults.

Methods

Subjects were university students who participated in a web-based self-administered questionnaire in a university in Seoul in 2013. We obtained information on physical activities and physical symptoms or illness in the past year. Independent variables were defined as symptoms or illness which were associated with decreased academic performance. Logistic regression was performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs) of each physical symptom or illness with adjustment for covariables.

Results

A total of 2,201 participants were included in the study. The main physical symptoms or illness among participants were severe fatigue (64.2%), muscle or joint pain (46.3%), gastrointestinal problems (43.1%), headache or dizziness (38.6%), frequent colds (35.1%), and sleep problems (33.3%). Low physical activity levels were significantly associated with high ORs of physical symptoms or illness. Multivariable-adjusted ORs (95% CIs) in the lowest vs. highest tertile of physical activity were 1.45 (1.14–1.83) for severe fatigue, 1.35 (1.07–1.70) for frequent colds, and 1.29 (1.02–1.63) for headaches or dizziness. We also found that lower levels of physical activity were associated with more physical symptoms or bouts of illness.

Conclusion

Low physical activity levels were significantly associated with various physical symptoms or illness among university students. Also, individuals in the lower levels of physical activity were more likely to experience more physical symptoms or bouts of illness than those in the highest tertile of physical activity.

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  • Stress, Emotional Intelligence and the Intention to Use Cannabis in Spanish Adolescents: Influence of COVID-19 Confinement
    Cristina Liébana-Presa, María Cristina Martínez-Fernández, José Alberto Benítez-Andrades, Elena Fernández-Martínez, Pilar Marqués-Sánchez, Isaías García-Rodríguez
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  • Analysis of Motivational Climate, Emotional Intelligence, and Healthy Habits in Physical Education Teachers of the Future Using Structural Equations
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  • Gender Differences and Relationships among Lifestyle and Reproductive Health in University Students
    Ju-Hee Nho, Hee Sun Kim
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  • Physical Activity-Related Injury and Its Associated Factors among Middle School Students in Southern China
    Weicong Cai, Yang Gao, Wenda Yang, Fuyuan Cheng, Dongchun Tang, Liping Li
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  • Country and Gender-Specific Achievement of Healthy Nutrition and Physical Activity Guidelines: Latent Class Analysis of 6266 University Students in Egypt, Libya, and Palestine
    Walid El Ansari, Gabriele Berg-Beckhoff
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Discrepancy between Self-Reported and Urine-Cotinine Verified Smoking Status among Korean Male Adults: Analysis of Health Check-Up Data from a Single Private Hospital
Youngju Kim, Yoon-Jung Choi, Seung-Won Oh, Hee-Kyung Joh, Hyuktae Kwon, Yoo-Jin Um, Sang Hyun Ahn, Hyun Joo Kim, Cheol Min Lee
Korean J Fam Med 2016;37(3):171-176.   Published online May 26, 2016
DOI: https://doi.org/10.4082/kjfm.2016.37.3.171
Background

Enquiry into smoking status and recommendations for smoking cessation is an essential preventive service. However, there are few studies comparing self-reported (SR) and cotinine-verified (CV) smoking statuses, using medical check-up data. The rates of discrepancy and under-reporting are unknown.

Methods

We performed a cross-sectional study using health examination data from Healthcare System Gangnam Center, Seoul National University Hospital in 2013. We analyzed SR and CV smoking statuses and discrepancies between the two in relation to sociodemographic variables. We also attempted to ascertain the factors associated with a discrepant smoking status among current smokers.

Results

In the sample of 3,477 men, CV smoking rate was 11.1% higher than the SR rate. About 1 in 3 participants either omitted the smoking questionnaire or gave a false reply. The ratio of CV to SR smoking rates was 1.49 (95% confidence interval [CI], 1.38–1.61). After adjusting for confounding factors, older adults (≥60 years) showed an increased adjusted odds ratio (aOR) for discrepancy between SR and CV when compared to those in their twenties and thirties (aOR, 5.43; 95% CI, 2.69–10.96). Educational levels of high school graduation or lower (aOR, 2.33; 95% CI, 1.36–4.01), repeated health check-ups (aOR, 1.45; 95% CI, 1.03–2.06), and low cotinine levels of <500 ng/mL (aOR, 2.03; 95% CI, 1.33–3.09), were also associated with discordance between SR and CV smoking status.

Conclusion

Omissions and false responses impede the accurate assessment of smoking status in health check-up participants. In order to improve accuracy, it is suggested that researcher pay attention to participants with greater discrepancy between SR and CV smoking status, and formulate interventions to improve response rates.

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    World Journal of Gastroenterology.2023; 29(24): 3843.     CrossRef
  • Association between job satisfaction and current smoking and change in smoking behavior: a 16‐year longitudinal study in South Korea
    Seong‐Uk Baek, Won‐Tae Lee, Min‐Seok Kim, Myeong‐Hun Lim, Jin‐Ha Yoon, Jong‐Uk Won
    Addiction.2023; 118(11): 2118.     CrossRef
  • Evaluating the impact of varying expired carbon monoxide thresholds on smoking relapse identification: insights from the E3 trial on e-cigarette efficacy for smoking cessation
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    BMJ Open.2023; 13(10): e071099.     CrossRef
  • Current status of tobacco use, cessation and control policy in Korea
    Cheol Min Lee
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  • Secondhand tobacco smoke exposure among children under 5 years old: questionnaires versus cotinine biomarkers: a cohort study
    Nerea Mourino, Mónica Pérez-Ríos, Maria Isolina Santiago-Pérez, Bruce Lanphear, Kimberly Yolton, Joseph M Braun
    BMJ Open.2021; 11(6): e044829.     CrossRef
  • Association between Parental Cotinine-verified Smoking Status and Childhood Asthma: a Population-based Nationally Representative Analysis
    Jinho Jung, Hyun Joon Park, Minyoung Jung
    Journal of Korean Medical Science.2021;[Epub]     CrossRef
  • Validity assessment of self-reported smoking status in firefighters using the urine cotinine test
    Han Cheol Heo, Young Seok Byun, Soo Ho Sohn, Seong Min Jo, Sung Kyu Park, Joon Sakong
    Annals of Occupational and Environmental Medicine.2020;[Epub]     CrossRef
  • Are Self-Reported Surveys Accurate for Assessing the Use of Novel Tobacco Products Such as Electronic Cigarettes and Heated Tobacco Products?
    Cheolmin Lee, Hyeji Shin, Sunghee Kim, Kiheon Lee, Yongjin Cho, Yoo Seock Cheong, Sungroul Kim
    Journal of the Korean Society for Research on Nicotine and Tobacco.2019; 10(2): 106.     CrossRef
  • Impact of nicotine replacement therapy as an adjunct to anti-tuberculosis treatment and behaviour change counselling in newly diagnosed pulmonary tuberculosis patients: an open-label, randomised controlled trial
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    Scientific Reports.2018;[Epub]     CrossRef
  • Relation between secondhand smoke exposure and cardiovascular risk factors in never smokers
    Sehun Kim, Si-Hyuck Kang, Donghoon Han, Sun-Hwa Kim, Hee-Jun Kim, JIN-Joo Park, Youngjin Cho, Yeonyee E. Yoon, Kyung-Do Han, Il-Young Oh, Chang-Hwan Yoon, Jung-Won Suh, Hae-Young Lee, Young-Seok Cho, Tae-Jin Youn, Goo-Yeong Cho, In-Ho Chae, Dong-Ju Choi,
    Journal of Hypertension.2017; 35(10): 1976.     CrossRef
  • Suboptimal vitamin D status in Korean adolescents: a nationwide study on its prevalence, risk factors including cotinine-verified smoking status and association with atopic dermatitis and asthma
    Eun Jung Byun, Jinyoung Heo, Sang Hyun Cho, Jeong Deuk Lee, Hei Sung Kim
    BMJ Open.2017; 7(7): e016409.     CrossRef
  • False Replies on Smoking Rate Surveys and an In-Hospital Smoking Cessation Clinic
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    Korean Journal of Family Medicine.2016; 37(3): 135.     CrossRef
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Helicobacter pylori: A Possible Risk Factor for Bone Health
Yun Hee Chung, Jong Seop Gwak, Sung Woo Hong, Jung Hyeon Hyeon, Cheol Min Lee, Seung Won Oh, Hyuktae Kwon
Korean J Fam Med 2015;36(5):239-244.   Published online September 18, 2015
DOI: https://doi.org/10.4082/kjfm.2015.36.5.239
Background

Helicobacter pylori (H. pylori) infection may cause systemic inflammation and increase the production of tumor necrosis factor-α, interleukin-1, and interleukin-6. Unfortunately, bone mineral density also may be affected by these cytokines. This study aimed to evaluate the association between bone mineral density and H. pylori infection.

Methods

A cross-sectional study evaluated 1,126 men undergoing a comprehensive health screening in a private Korean screening center. Subjects' sera were tested for H. pylori antibodies (immunoglobulin G) using an enzyme-linked immunosorbent assay, and bone mineral densities (g/cm2) of the lumbar spine, femoral neck, and total femur were obtained using dual-energy X-ray absorptiometry. To evaluate the difference in bone mineral density according to H. pylori infection status, the adjusted mean bone mineral densities at each site were compared after adjusting for potential confounders, including age, sex, body mass index, smoking, alcohol consumption, and exercise.

Results

H. pylori infection was associated with a significant decrease in mean lumbar bone mineral density (H. pylori-positive, 1.190 g/cm2; H. pylori-negative, 1.219 g/cm2; P=0.006), which was greatest among men who were ≥50 years old (H. pylori-positive, 1.193 g/cm2; H. pylori-negative, 1.233 g/cm2; P=0.006). However, no significant association was observed in the bone mineral densities of the total femur and femoral neck.

Conclusion

In men, H. pylori infection was negatively associated with lumbar bone mineral density. This association may be useful in the early detection, prevention, and management of male osteoporosis.

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    International Journal of Molecular Sciences.2024; 25(5): 3024.     CrossRef
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    Journal of Bone and Mineral Metabolism.2023; 41(1): 74.     CrossRef
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    BMC Musculoskeletal Disorders.2020;[Epub]     CrossRef
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    BMJ Open.2019; 9(6): e027356.     CrossRef
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Breast Feeding Is Associated with Postmenopausal Bone Loss: Findings from the Korea National Health and Nutrition Examination Survey
Hyun Joo Kim, Hyuktae Kwon, Seung-Won Oh, Cheol Min Lee, Hee-Kyung Joh, Youngju Kim, Yoo-Jin Um, Sang Hyun Ahn
Korean J Fam Med 2015;36(5):216-220.   Published online September 18, 2015
DOI: https://doi.org/10.4082/kjfm.2015.36.5.216
Background

Postmenopausal osteoporosis is a common disease which can cause various morbidity and economic burden. Lactation is known to cause a decline in bone mineral density (BMD), but there are controversies on whether decreased BMD is fully recovered after lactation and whether lactation duration has an influence on postmenopausal BMD. This study was conducted to see whether breastfeeding is associated with postmenopausal bone loss using a highly representative sample of Korean population.

Methods

Retrospective cross sectional study was done using data collected from Korea National Health and Nutrition Examination Survey V. The study outcome was BMD measured with dual-energy X-ray absorptiometry and divided into 2 groups: normal or low BMD (T score<-1), and breastfeeding duration was categorized into 4 groups (never, 1st, 2nd, and 3rd tertile). Logistic regression analysis was done to examine the association between lactation duration and BMD.

Results

Among 1,694 postmenopausal women (mean age, 63.5±9.1), 85.71% were in low BMD group. Compared to never breastfeeding group, postmenopausal women with longer than 79 months of breastfeeding duration are more likely to have low BMD (adjusted risk ratio [ARR]=1.24; 95% confidence interval, 1.17 to 1.32). As the duration of breastfeeding increases, ARR and risk difference for low BMD also increases (P for trend=0.008).

Conclusion

The study results showed that total breastfeeding duration was associated with postmenopausal low BMD. All women planning on breastfeeding should be aware of its risks and should take adequate dietary calcium and vitamin D before, during, and after breastfeeding.

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    Journal of Archaeological Science.2020; 124: 105264.     CrossRef
  • Association of breastfeeding and postmenopausal osteoporosis in Chinese women: a community-based retrospective study
    Guiming Yan, Yaqi Huang, Hong Cao, Jie Wu, Nan Jiang, Xiaona Cao
    BMC Women's Health.2019;[Epub]     CrossRef
  • Could use of Selective Serotonin Reuptake Inhibitors During Lactation Cause Persistent Effects on Maternal Bone?
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  • Previous Adolescent Pregnancy and Breastfeeding Does Not Negatively Affect Bone Mineral Density at the Age of Peak Bone Mass
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    Breastfeeding Medicine.2018; 13(7): 500.     CrossRef
  • Incorporation of Flaxseed Flour as a Dietary Source for ALA Increases Bone Density and Strength in Post‐Partum Female Rats
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    Lipids.2017; 52(4): 327.     CrossRef
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  • 12 Web of Science
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Fasting Plasma Glucose Levels and Metabolic Syndrome in Normoglycemic Adults.
Jae Kyung Choi, Youl Lee Lym, Seung Won Oh, Jin Ho Park, Cheol Min Lee, Sang Ho Yoo, Yeol Kim
J Korean Acad Fam Med 2008;29(9):651-657.   Published online September 10, 2008
Background: Metabolic syndrome has been introduced to increase the incidence of cardiovascular diseases and type 2 diabetes mellitus. Our aim of this study was to investigate the association of fasting plasma glucose levels and metabolic syndrome in normoglycemic adults. Methods: We examined lifestyle factors, anthropometric and laboratory measurement of adults with no personal history of diabetes and normal fasting glucose from the Korean National Health and Nutrition Examination Survey 2001. We categorized the fasting plasma glucose levels below 100 mg/dl into the quintiles and assessed the association of metabolic syndrome with increasing glycemia in normoglycemic adults. Results: Quintiles of normal fasting plasma glucose levels showed a positive trend with metabolic risk factors including abdominal obesity, high blood pressure, and obesity in normoglycemic adults (P<0.001). Hypertriglyceridemia, low HDL-cholesterolemia, smoking, heavy drinking, and physical activity were of no significance. A multivariate model, adjusted for age, sex, smoking status, physical activity, and heavy drinking, revealed a progressively increased odds ratio of metabolic syndrome, 1.05 (95% CI, 0.76∼1.44), 1.15 (95% CI, 0.84∼1.58), 1.33 (95% CI, 0.99∼1.80), 1.55 (95% CI, 1.14∼2.10), with increasing fasting plasma glucose levels, as compared with fasting plasma glucose level of 81 mg/dl or less (P<0.001). Conclusion: Higher fasting plasma glucose levels within the normoglycemic range may constitute a risk of metabolic syndrome in normoglycemic adults. (J Korean Acad Fam Med 2008;29:651-657)
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Review

History and Evidence of 'Tobacco Harm Reduction'.
Cheol Min Lee, Hee Kyung Joh
J Korean Acad Fam Med 2007;28(8):575-588.   Published online August 10, 2007
  • 1,417 View
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Original Article
Patients' Attitudes toward Proactive Screening for Sexual Dysfunction.
Dong Wook Shin, Jong Seung Kim, Kang San Jung, Cheol Min Lee, Jae Kyung Choi, Min Su Park, Dae Hyun Yoon, Bong Yul Huh
J Korean Acad Fam Med 2006;27(8):637-644.   Published online August 10, 2006
Background
: Although proactive screening for sexual dysfunction in primary care has been emphasized as an important part of comprehensive care, doctors seldom ask their patients about their sexual function. Worry about patients' responses was reckoned as a major barrier, but few studies have dealt with how patients feel and what they want. This study was aimed to describe and analyze the attitudes of patients toward proactive screening for sexual dysfunction.

Methods : A set of self-administered questionnaire was given to every patients who visited a family medicine clinic in a university hospital for 2 weeks from March 16, 2005.

Results : A total of 185 patients were analyzed. Among them, 72.4% were willing to consult their physician when they were in trouble with their sexual function, and 84.3% said proactive screening for sexual dysfunction was necessary. Many patients did not care about 'when to be asked' and wanted to be asked in face-to-face interview rather than by a questionnaire. Sentence emphasizing that every patient is given the same question was most preferred.

Conclusion : Patients' attitude toward proactive screening for sexual dysfunction in primary care was generally positive. Patients preferred to be asked ;I ask every patient about his sexual problem. If you're OK, I ask you about your sexual problem.; regardless of timing, during the interview.
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