Background
The use of e-cigarettes is increasing globally, particularly among young adults. Although several use them to quit smoking, their effects are controversial. The Fagerstrom Test for Nicotine Dependence (FTND) was used to assess nicotine dependence in the smoking cessation process. This study examined changes in FTND scores among young adults using different types of cigarettes over a 1-year period.
Methods
Prospective cohort data were collected from cigarette users at higher education institutions in the lower northern region of Thailand to analyze changes in FTND scores over a 1-year period. E-cigarette users and combined users were compared with conventional cigarette users. A marginal structural model (MSM) with an inverse probability of weighting (IPW) was used to adjust for time-dependent and time-independent confounders.
Results
Of the 133 participants, 58 were e-cigarette users (43.6%), 33 were combined cigarette users (24.8%), and 42 were conventional cigarette users (31.6%). The results revealed that when both time-dependent and time-independent confounders were adjusted using MSM with IPW, e-cigarette users had a 0.20 decrease in the mean FTND score, and combined users had a 0.47 decrease in the mean FTND score compared to conventional cigarette users. However, the difference was not statistically significant.
Conclusion
The use of e-cigarettes or combined cigarettes did not significantly affect nicotine dependence levels in young adults over a 1-year period. Consequently, e-cigarettes should not be recommended to reduce nicotine dependence among young adult cigarette users. Further studies are required to determine whether e-cigarettes affect smoking cessation rates.

Background
Insulin resistance contributes to the development of cardiovascular disease and type 2 diabetes mellitus. Smoking leads to an increase in triglyceride levels, which, in turn, increases insulin resistance. Although the number of e-cigarette users has increased in recent years, few studies have investigated the association between ecigarette use and insulin resistance. Therefore, this study aimed to determine the association between e-cigarette use and insulin resistance using the triglyceride-glucose (TyG) index in Korean adults.
Methods
This study included 4,404 healthy adults aged ≥20 years who participated in the Korea National Health and Nutrition Examination Survey between 2019 and 2020. Participants were categorized as never-smokers or ecigarette users, and the TyG index was categorized into low- and high-TyG index groups according to the median value (9.22). A logistic regression analysis was performed to determine the association between e-cigarette smoking and insulin resistance.
Results
E-cigarette users had a higher TyG index than never smokers (e-cigarette: mean=9.35; never: mean=9.18; P<0.001). The ecigarette users had a higher risk of being in the high TyG index group than never-smokers (odds ratio [OR], 1.38; 95% confidence interval [CI], 1.03–1.84). In the subgroup analysis stratified by sex, age, and body mass index, a higher OR for a high TyG index was observed in men (OR, 1.46; 95% CI, 1.03–2.08) and individuals aged 60 years or older (OR, 3.74; 95% CI, 1.14–12.30).
Conclusion
Our findings suggest that e-cigarette use is significantly associated with insulin resistance.

Citations

• Association Between Electronic Cigarette Use and Risk of Obstructive Sleep Apnea Among Korean Adults: A Cross-Sectional Nationwide Population-Based Study
  Wonseok Jeong, Min Ji Song, Ji Hye Shin, Ji Hyun Kim
  Journal of Clinical Medicine.2025; 14(11): 3616.     CrossRef
• Unveiling the risks of noncombustible nicotine or tobacco products
  Su-Min Jeong
  Korean Journal of Family Medicine.2025; 46(5): 297.     CrossRef

Background
Noncombustible nicotine or tobacco product (NNTP) use, and cigarette smoking are associated with a high likelihood of unhealthy weight control behaviors (UWCBs) among adolescents. However, no study has addressed the differences in UWCBs among non-users, single users of combustible cigarettes (CCs) or NNTPs and dual users. This study compared the frequencies of weight control behaviors according to the status of CC and NNTP use among Korean adolescents.
Methods
This was a cross-sectional study of 25,094 adolescents who had attempted to reduce or maintain their body weight during the past 30 days, using data from the 15th Korea Youth Risk Behavior Survey, 2019. Data on the status of CC and NNTP use, weight status, and weight control behaviors were obtained using self-report questionnaires. Subjects were categorized into four groups: non-users, cigarette-only users, NNTP-only users, and dual users.
Results
Among boys and girls, current smokers and NNTP users were 8.9%±0.3% and 5.5%±0.3%, and 4.2%±0.2% and 1.7%±0.1%, respectively. Among boys, NNTP-only users were more likely to engage in extreme weight control behaviors than non-users. Among girls, users of either CCs or NNTPs were more likely to engage in extreme weight control behaviors and less extreme weight control behaviors than non-users.
Conclusion
This study shows that users of either CCs or NNTPs are more likely to engage in UWCBs, and NNTP-only users are the most likely to do so.

Citations

• Reflecting on progress and challenges: the Korean Journal of Family Medicine in 2024
  Seung-Won Oh
  Korean Journal of Family Medicine.2025; 46(2): 55.     CrossRef
• Longitudinal Associations between Adolescent Electronic Cigarette Use and Eating Behaviors
  Saira Sarwar, W. Alex Mason, Jennifer Mize Nelson, Kimberly Andrews Espy, Timothy D. Nelson
  Substance Use & Misuse.2025; 60(14): 2144.     CrossRef
• The Interconnected Nature of Smoking, Depression, and Obesity in Behavioral Medicine
  Joung Sik Son
  Korean Journal of Family Medicine.2024; 45(4): 181.     CrossRef

Background
Similar to smoking, exposure to secondhand smoke is a risk factor for developing hypertension and cardiovascular diseases; however, there is no standardized method for measuring smoke exposure. Measuring urine cotinine levels is one possible means for determining the degree of exposure to secondhand smoke. This study investigated the association between urinary cotinine levels and blood pressure in Korean adults exposed to secondhand smoke.
Methods
Data from the Korea National Health and Nutrition Examination Survey conducted between 2016 and 2018 were used. A total of 9,273 participants aged ≥19 years self-reported as current non-smokers, which was cotinine- verified. A complex sample general linear model regression analysis was performed to analyze the association between urine cotinine and blood pressure. A P-value of <0.05 was considered statistically significant.
Results
Corrected urine cotinine levels were positively associated with systolic and diastolic blood pressure in female participants (P<0.001 and P=0.040, respectively). Furthermore, a 10-fold increase in the corrected urine cotinine level of those in contact with secondhand smoke was independently associated with 2.085 mm Hg and 0.575 mm Hg increases in systolic and diastolic blood pressure, respectively. However, there was no association between systolic and diastolic blood pressure in male participants (P=0.226 and P=0.256, respectively).
Conclusion
Urinary cotinine levels were positively associated with increased blood pressure in females exposed to secondhand smoke. Therefore, urinary cotinine may be used as an indicator to quantify and monitor the effects of blood pressure elevation in females exposed to secondhand smoke.

Citations

• Association between the urine tobacco metabolite levels and physical health in Chinese primary school students with secondhand smoke exposure
  Menghan Cheng, Miao Zhang, Wen Fang, Hong Qin, Yue Pan, Shengyi Chen, Guiqi Cao, Yao Zhang, Yu Lu
  Frontiers in Public Health.2025;[Epub]     CrossRef
• Assessment of smoking exposure by urine cotinine levels in severe COVID-19 patients: a case-control study
  Medeni Arpa, Bayram Şen, Leyla Kazancıoğlu, Hülya Kılıç
  Scientific Reports.2025;[Epub]     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

• 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
• Partner’s dual use of new tobacco products and combustible cigarettes in early pregnancy was associated with hypertensive disorders of pregnancy: a cross-sectional study
  Miki Akiyama, Takehiro Michikawa, Yuki Takeda, Keiko Asakura, Haruhiko Imamura, Minami Sugimoto, Yuji Nishiwaki
  Hypertension Research.2025; 48(10): 2558.     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

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

• Evaluation of a Community-Based Quality Improvement Smoking Cessation Program Using the Ottawa Model During COVID-19
  Salma Mahmoodianfard, Ayah Rashwan, Javad Heshmati, Terefe Gelibo, Mustafa Coja, David Sabapathy, Shamara Baidoobonso, Karen Phillips, Laura MacDonald, Laura Lee Noonan, Kerri-Anne Mullen, Hassan Mir
  CJC Open.2026;[Epub]     CrossRef
• The effect of heated-cigarette smoking on voice in comparison to combustion-cigarette smoking: self-perceived evaluation
  Abdul-Latif Hamdan, Christophe Abi Zeid Daou, Yara Yammine, Christopher Jabbour, Ibana Carapiperis, Vanessa Helou, Justin Ghadieh, Jerome R Lechien
  The Journal of Laryngology & Otology.2025; 139(2): 129.     CrossRef
• 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

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

• 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

Background
The rising prevalence of alternative tobacco and nicotine products (ATNPs) use among adolescents is a global concern that has been attributed to the reemergence of preexisting alternative tobacco products and emergence of new ones in the market. This study examined ATNP use among late adolescents. The association between ATNP use and reasons for using them was explored.
Methods
This cross-sectional study conducted in 2016 involving 388 late adolescents from six government colleges in Kelantan, Malaysia, aged 18 to 19 years. They were requested to answer self-directed questionnaires with items on sociodemographic information and types of ATNP used. Other variables obtained include the environmental influence and reasons for using the products. Regression analyses between the dependent and independent variables were conducted using IBM SPSS ver. 20.0 (IBM Corp., Armonk, NY, USA).
Results
The prevalence of ATNP use among late adolescents was 14.4%. The male sex, cigarette smoking status, and peer use were significantly associated with ATNP use. Several reasons for use were not significantly associated with ATNP use: perception of ATNP being less harmful and less addictive compared with cigarettes, curiosity, less expensive than cigarettes, to aid smoking cessation, and pleasurable flavors and taste.
Conclusion
The prevalence of ATNP use among late adolescents studying in government colleges in Kelantan is significant. There is higher perception on ATNP being less harmful and addictive than the conventional cigarette among the users compared with non-users. Significant associations are seen for the male sex, peer use, and concurrent cigarette smoking.

Citations

• Factors associated with e-cigarette initiation and transition to conventional cigarette among adolescents in Malaysia, a scoping review
  Muzzammil Mohdkhairi, David Mulenga
  Discover Public Health.2025;[Epub]     CrossRef
• Prevalence and Associated Factors Related to Tobacco Consumption   Among University Students in Malaysia
  Chui Yi Chow, Md Zobaer Hasan, Anton Abdulbasah Kamil
  Health Psychology Research.2024; 12(1): 1.     CrossRef
• Factors Influencing the Use of Tobacco Among Youth in Low-Income, Lower-Middle-Income, and Upper-Middle-Income Countries: A Systematic Review
  Fahad Ali Mangrio, Penpaktr Uthis, Suwimon Rojnawee
  Journal of Research in Health Sciences.2024; 24(3): e00617.     CrossRef
• Prevalence and Associated Factors of E-Cigarette Use among Adolescents in Southeast Asia: A Systematic Review
  Miaw Yn Jane Ling, Ahmad Farid Nazmi Abdul Halim, Dzulfitree Ahmad, Norfazilah Ahmad, Nazarudin Safian, Azmawati Mohammed Nawi
  International Journal of Environmental Research and Public Health.2023; 20(5): 3883.     CrossRef
• Factors of e-cigarette use among Malaysian adolescents: A systematic review
  Vitalis Ronald Eden, Mohd Shahimi Mustapha, Saravanan Jaganathan, Hafiz Jaafar
  Journal of Health Science Research.2023; 9: 7.     CrossRef
• The Impact of Heated Tobacco Products on Smoking Cessation, Tobacco Use, and Tobacco Sales in South Korea
  Cheol Min Lee
  Korean Journal of Family Medicine.2020; 41(5): 273.     CrossRef

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

• 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

Background
To aim of this study was to examine the association between perceived possibility of purchasing cigarettes and e-cigarette experience among adolescents who currently smoke cigarettes.
Methods
Data were derived from the Korea Youth Risk Behavior Web-Based Survey; a total of 29,169 current smokers participated. The dependent variable was e-cigarette experience in the previous month. Analyses included χ² test and survey logistic regression.
Results
A perceived easy possibility of purchasing cigarettes increased the odds of e-cigarette experience (odds ratio, 1.19; 95% confidence interval, 1.07–1.33) compared to when it was perceived as impossible. An easy possibility of purchasing cigarettes increased the odds of e-cigarettes experience among males aged 12–15 or 17 years compared to when it was impossible to purchase cigarettes.
Conclusion
A perceived easy possibility of purchasing cigarettes was more likely to increase e-cigarette experience among adolescents. Laws restricting adolescents’ access to e-cigarettes must be strengthened.

Citations

• Vaping—An Emerging Threat to Youngsters of Pakistan
  Nazish Jaffar, Hafiza Tooba Siddiqui, Huda Amin, Md Ariful Haque
  Addiction Biology.2025;[Epub]     CrossRef
• Underage E-Cigarette Purchasing and Vaping Progression Among Young Adults
  Alyssa F. Harlow, Rob S. McConnell, Jessica L. Barrington-Trimis
  Journal of Adolescent Health.2023; 72(2): 260.     CrossRef
• The Impact of Heated Tobacco Products on Smoking Cessation, Tobacco Use, and Tobacco Sales in South Korea
  Cheol Min Lee
  Korean Journal of Family Medicine.2020; 41(5): 273.     CrossRef

Citations

• Time from waking to first cigarette, genetic susceptibility, and the risk of COPD: A Prospective cohort study from UK Biobank
  Liu Qiqi, Liu Haoxiang, Wu Chuansha, Sun Xiaojie, Xiong Longzhu, Kong Chunxue, Ma Jixuan, Zhou Ting
  Heart & Lung.2026; 76: 9.     CrossRef
• Alcohol and Nicotine Dependence and Time to Death in a General Adult Population: A Mortality Cohort Study
  Ulrich John, Hans-Jürgen Rumpf, Monika Hanke, Christian Meyer
  European Addiction Research.2023; 29(6): 394.     CrossRef
• Association of demographic variables and smoking habits with the severity of lung function in adult smokers
  Arash Toghyani, Somayeh Sadeghi
  Journal of Research in Medical Sciences.2022; 27(1): 18.     CrossRef
• Association between Time to First Cigarette and Health-Related Quality of Life of Middle-Aged Male Current Smokers: A Nationwide Representative Study in Korea
  Sung Eun Jo, Hye Rim Hwang, Yun Jin Kim, Sang Yeoup Lee, Jeong Gyu Lee, Yu Hyeon Yi, Young Hye Cho, Young Jin Tak, Seung Hun Lee, Eun Ju Park, Youngin Lee
  Korean Journal of Family Medicine.2021; 42(3): 225.     CrossRef
• Time to First Cigarette and Self-Reported Health Among US Adult Smokers
  Baksun Sung
  Tobacco Use Insights.2019;[Epub]     CrossRef
• Effects of smoking on the lower respiratory tract microbiome in mice
  Rui Zhang, Ling Chen, Lei Cao, Kang-jie Li, Yao Huang, Xiao-qian Luan, Ge Li
  RESPIRATORY RESEARCH.2018;[Epub]     CrossRef

Background
As one of harm reduction strategies, tobacco manufacturers have begun to introduce lower-yield cigarettes. Lower-yield cigarettes, so called light cigarettes, have been perceived as less hazardous by some smokers. However, there have been very few studies concerning smoking lower yield products the lead to lower nicotine absorption. We evaluated the association between brand nicotine yield of cigarettes and actual nicotine intake by measuring urinary cotinine. Methods: Four hundred sixty four male smokers aged 18 or over who participated in health check-ups in a hospital from May to October 2007 fi lled out a self-administered smoking questionnaire. Urinary cotinine concentration was measured at the time of participation. The subjects were divided into three groups (ultralight [nicotine: 0.05 mg], light [0.1 mg], and regular [> 0.1 mg] group) according to the level of brand nicotine yield of cigarettes which they smoked. Results: The median urinary cotinine concentrations of ultralight (N = 62), light (N = 216), and regular (N = 186) groups were 735.5 ng/mL (interquartile range, 320 to 1,300 ng/mL), 956.0 ng/mL (429 to 1,491 ng/mL), and 1,067.5 ng/mL (615 to 1,613 ng/mL), respectively. There was a signifi cant difference in urinary cotinine between the regular and the other groups (P = 0.015). However, multiple logistic regression analysis to evaluate the risk of being in the highest quartile of urinary cotinine concentration (≥ 1,532 ng/mL) after adjusting for possible confounding variables showed that the odds ratios were 0.84 (95% CI, 0.52 to 1.37) in the light nicotine group and 0.82 (95% CI, 0.38 to1.72) in the ultralight nicotine group compared to the regular nicotine group. Conclusion: There was no significant difference in the risk of elevated urinary cotinine concentrations in male adult smokers according to brand nicotine yield of cigarettes groups.

Background
Recently, a variety of cigarettes which contain a low content of nicotine are on the market and the nicotine tends to be reduced continuously. However, studies have not yet fully demonstrated that low-nicotine cigarettes are subservient to quitting smoking. This study was designed to investigate the effects of the nicotine content on smoking attitudes and on the factors associated with successful smoking cessation. Methods: One hundred twenty-fi ve adult smokers, who had undergone a health examination in a general hospital, had their carbon monoxide measured after responding to the questionnaire. The items of questionnaire consisted of the duration of smoking, the age of starting to smoke, the number of attempts to stop smoking, recognition of nicotine dependence, and nicotine dependence score. Results: The subjects consisted of two groups. One group was low nicotine group and the nicotine content was lower than 0.35 mg per cigarette. The other group was high nicotine group and the nicotine content was over 0.35 mg per cigarette. he age was younger and duration of smoking was shorter in low nicotine group. Monthly income, last schooling and number of attempts to stop smoking were higher in low nicotine group. There was no statistical signifi cant differences between the two groups in the frequency of alcohol drinking, the age of starting to smoke, marital status, nicotine dependence, carbon monoxide concentration and recognition of nicotine dependence. Conclusion: As there was no differences in smoking habits which has infl uence on achieving quit smoking of low nicotine group, we made our conclusion that low nicotine cigarette might be unhelpful in quit smoking.

Background
The Fagerstrom Test for Nicotine Dependence (FTND) is a widely used six-item questionnaire. Its completion require a few minutes, but such time may be too much for busy clinicians and large epidemiologic surveys. The goals of this study was to compare the sensitivity and the specificity of Heavy Smoking Index (HSI) of high nicotine dependence. Methods: The FTND was administered to 943 current smokers from a smoking-cessation clinic in Gwangjin-gu, Seoul. The HSI which combines two items of the FTND (the number of cigarettes per day and the time of the first cigarette of the day) was compared to the FTND. We measured cigarette per day, duration of smoking, and age of smoking initiation. Results: A cutoff score equal or greater than 4 on the HSI detected a similar rate of nicotine dependence as a cutoff score equal or greater than 6 on the FTND. The HSI showed a sensitivity of 88.0% and a specificity of 86.5%. The concordance between the two instruments was high (kappa= 0.74). Conclusion: The HSI was proven to be very useful. If HSI had a proper validity, the HSI can be a good standard of high nicotine dependence for busy clinician and epidemiologists. (J Korean Acad Fam Med 2008;29:405-411)

Background
This study investigated the relationship between stress and nicotine dependence, dividing stress into external stress and internal response. Methods: The subjects were 263 male adults who had visited the General Health Promotion Center at Chungnam National University Hospital in Korea between April and June 2005. Nicotine dependence, external stress and internal response were measured by the Fagerstrom test for nicotine dependence, life change unit of the social readjustment rating scale and the brief encounter psychosocial instrument. Results: The mean (±SD) score of external stress in smokers (n=107) was 150.79 (±109.02), which was significantly (P<0.001) higher than 92.96 (±126.27) in non- smokers, and the mean (±SD) score of internal response in smokers was 10.30 (±3.16), which was also significantly (P<0.001) higher than 8.71 (±3.33) in non- smokers. The smokers' nicotine dependence showed positive correlation with the score of external stress (r=0.436, P<0.001) and the score of internal response (r=0.579, P<0.001). The stepwise multiple regression analysis showed that nicotine dependence was related to the score of internal response, the score of external stress, the duration of education, the age of first smoking (overall R²=0.433, P=0.040), and most closely to the score of internal response (partial R²=0.335, P<0.001). Conclusion: In order to develop an effective strategy for quitting smoking, the internal response to stress needs to be considered as one of evaluation items. (J Korean Acad Fam Med 2007;28:604-609)

Background
Cotinine, a nicotine metabolite detected in urine, has been recommended as the best quantitative marker of smoking and environmental tobacco smoke (ETS) exposure. The aim of this study was to analyze the relationship between indoor ETS and urinary cotinine level of the passive smokers. Methods: We selected 42 nonsmokers who lived in Seoul and were not exposed to passive smoking at least 5 days before test. Urinary cotinine levels were measured by Smokescreen Colorimeter (Surescreen Diagnostics LTD, U.K.). We measured urinary cotinine levels twice (before and after smoking exposure). Results: The mean urinary cotinine level was 0.33μg/mL before smoking exposure, and 0.46μg/mL after smoking exposure. There was statistically significant difference (P-value=0.003). There was no significant difference between exposure time and increase of urinary cotinine level(P=0.138, r=⁣0.233). There was also no significant difference between measuring time taking after exposure and increase of urinary cotinine level (P=0.671, r=0.067). Conclusion: One experience of indoor exposure to ETS caused significant elevation of urinary cotinine level. (J Korean Acad Fam Med 2007;28:379-382)

Smoking and tobacco addiction are serious public health problems worldwide. New research reveals that addiction to tobacco can begin very early, with very low levels of smoking. Family physicians are in a unique position to prevent smoking initiation by youths and to diagnose and treat tobacco addiction in young smokers. In this paper we discuss the factors that prompt youths to try smoking, how quickly addiction to tobacco begins after the onset of smoking, how a family physician can determine whether a young patient is addicted, and what the physician can do to prevent adolescent patients from beginning to smoke or to assist them to quit if they already smoke.

Background
: Among the various brands of herbal cigarettes currently available in Korea, Kumyeoncho is the most popular. However, there is no clinical evidence that these herbal cigarettes are effective in helping smokers quit smoking. This study was performed to determine the long term effectiveness of Kumyeoncho herbal cigarettes.

Methods : Two hundred smokers, all employees of the same company in Cheonan city, voluntarily participated in this study. They were divided into two random groups: 100 smokers used Kumyencho (herbal cigarettes), and the other 100 smokers used nicotine patches. Between July 2002 and February 2003, the smoking status of all participants was evaluated at one month, three months, and six months, after they stopped using regular cigarettes.

Results : The success rates at 1 month were 54.5% for the Kumyeoncho group and 50.7% for the nicotine patch group (P=0.643). The success rates at 3 month were 41.4% and 39.4%, respectively (P=0.875). And the success rates at 6 month were 38.8% and 35.2%, respectively (P=0.747). Statistical analysis showed that the success rate for the Kumyeoncho group was not less than that for the nicotine patch group in all periods. Thirty-seven cases of adverse effects were reported in the Kumyeoncho group: 25 (25.5%) of nausea, 6 (6.1%) of coughing, 5 (5.1%) of dizziness, and 1 (1.0%) of palpitation; thirty-nine cases of adverse effects were reported for nicotine patch users: 18 (25.4%) of itching, 15 (21.1%) of skin irritation and erythema, 2 (2.8%) of dizziness and headache each, and 1 (1.4%) of nausea and palpitation each.

Conclusion : With respect to the short and long term effects of herbal cigarettes, Kumyeoncho is considered similarly effective to nicotine patches.

Background
: In comparison to the decreasing smoking rate of adults, the smoking rate in adolescents and women is still increasing worldwide including Korea. Previous studies on the smoking rate of adolescents were done by questionnaires allowing bias in their response because of smoking ban among adolescents in Korea. In order to know the actual smoking rate of Korean adolescents, we performed an objective study using urine nicotine detection.

Methods : From April to July 2002, 306 boy's high school students and 325 girl's high school students in Seoul were included for this study. We obtained self-reported questionnaire from them and assessed urine nicotine level by NicCheck I Test Strip to check their actual smoking status.

Results : The current smoking rate of male students by self-reported questionnaire was 14.9%, 20.4%, 22.5%, respectively and that by detection of urine nicotine was 26.6%, 38.0%, 29.6%, respectively, in the 1st, 2nd and 3rd grade. The current smoking rate of female students by self-reported questionnaire was 22.6%, 23.9%, respectively and that by detection of urine nicotine was 46.6%, 35.4%, respectively in the 2nd and 3rd grade. The Kappa index of the questionnaire results was 0.27, 0.46, 0.75, respectively in the 1st, 2nd and 3rd grade male students and 0.33, 0.44, respectively in the 2nd and 3rd grade female students respectively.

Conclusion : The smoking rate of students by detection of urine nicotine was higher than that of the self-reported questionnaire results. The validity of the questionnaire results was more accurate in males than females, and higher grade than lower grade. The self-reported questionnaire was an insufficient tool for evaluation of adolescents' smoking status, especially in female students and lower grade students.

Background
: Although the Fagerstrom Tolerance Questionnaire (FTQ) and the Fagerstrom Test for Nicotine Dependence (FTND), which are the tools to measure Nicotine Dependence, have a high internal reliability and a high test-retest reliability, they have not been tested domestically. A Korean-Version Questionnaire for Nicotine Dependence was assessed to find out the internal reliability, test-retest reliability and validity.

Methods : The research subjects were adult smokers of ages between 19 and 77 among hospital visitors, hospital staffs, inpatients and outpatients. The smokers had their carbon monoxide measured after responding to the questionnaire. The questionnaire consisted of Nicotine Dependence (FTQ & FTND), the history of smoking, the variables related to Nicotine Dependence, and factors that influence carbon monoxide(CO) measurement. Micro II smokerlyzer (Bedfont Instruments Ltd, England) was used to analyze CO concentration in expired air. The method used for measuring CO concentration was to deeply inhale and hold one's breath for 15 seconds and measure CO concentration while exhaling.

Results : The total number of subjects was 205 (199 males, 6 females) consisting of 124 hospital visitors, 67 hospital staff, 8 inpatients, and 6 inpatients. The average FTQ was 4.68 and the average FTND was 3.95. Cronbach's alpha, which indicates the internal reliability, was 0.6679 for FTQ and 0.6913 for FTND. The correlation coefficient which indicates test-retest reliability was 0.783 for FTQ and 0.880 for FTND. The correlation coefficient which indicates the relationship between the level of Nicotine Dependence and expired air CO concentration was 0.484 for FTQ and 0.563 for FTND. The correlation coefficient of the smoking period was 0.247 for FTQ and 0.252 for FTND.

Conclusion : This Korean-Version Questionnaires for Nicotine Dependence (FTQ & FTND) were both satisfactory from the aspects of reliability and validity. It was concluded that the Korean-Version of FTND was a reliable method to reflect the level of nicotine dependence of smokers from the fact that the reliability and validity of FTND was higher than that of FTQ.

Background
: In spite of harmfulness of smoking, the smoking rate of adult male is high in Korea and that of adolescent and women has risen recently. Most smokers try to stop smoking for themselves without doctor's help or medication, but the success rate is extremely low. Although the number of smoking-cessation clinic has risen year by year, there are few researches about smoking cessation. In this study, we tried to find the factors associated with successful smoking cessation and the effective smoking cessation modalities.

Methods : 114 smokers, who has visited the smoking-cessation clinic of Seoul Paik Hospital from Oct. 1998 to June 2000, were included. After doing a survey with basic questionnaire and smoking cessation counselling, we followed up them. We also checked their smoking behavior 6 months later.

Results : The success rate was 32.5%. the demographic characteristics of success group and failure group showed no significant difference. But the factors such as age, BMI, expiratory CO level at initial visit to hospital, nicotine dependence scale, the duration using nicotine patch and the number of visit to smoking-cessation clinic showed significant difference between the two groups.

Conclusion : The results of logistic regression showed that BMI and nicotine dependence scale were significantly different.

Background
: Smoking is the single most important factor of the prevention of diseases and the promotion of health. The objectives of this study are to compare the health-related quality of life and other factors between the adult male smokers and nonsmokers.

Methods : Study subjects were selected from the parents of students of three schools; one elementary school, one middle school, and one high school in Suwon city , Kyungki- Do. Among 2.308 respondents to the questionnaire, 1.127 were analyzed.
The questionnaire consisted of questions of general socioeconomic status, health-related quality of life questionnaire, Fagerstrom nicotine tolerance questionnaire, and the Why test.

Results : There were no significant socioeconomic differences between the smokers and nonsmokers except religion(p=0.000). The smoking rage of the subjects was 66.2%, the average amount smokers ranked lower scores in all scales of the health-related quality of life than nonsmoker. The health-related quality of life of the group of high nicotine dependence was low in comparison with the group of low nicotine dependence. The most common reason of smoking was to relieve tension.

Conclusion : Smokers ranked lower scores in all scales of the health-related quality of life than nonsmoker.

Background
: The increase of smoking prevalence in adolescents is serious problem because of physical and psychological influences furthermore, fixation of smoking habit. This study is aimed at providing applicable basic information to setting up the education programs and strategies to prevent smoking among high school students by analysis smoking behavior an its related factors.

Methods : 835 students from one senior high school in Taegu completed a self administerd questionnaire during school hours in May, 1996. 813 questionnaires with adequate responses were analyzed using SPSS/PC program. All students were asked class years, school satisfaction, school performance score, number of their three best friends who smoke, smoking status of their fathers, religion, allowance, alcoholic drinks, addicting drug use, Zung's self-rating depression scale(SDS) and Zung's self-rating anxiety scale(SAS). Smokers were asked amount of smoking, motives for smoking, when they started smoking, Fagerstrom score.

Results : Of the 813 students in the sample 135(16.6%) were current smokers. About the amount of smoking, 59.3% smoked less than 5 cigarettes/day. About the motives of smoking, 34.8% started smoking through the solicitation by friends or for making friends. About when they started smoking, 52.6% started smoking before entrance into senior high school. The related factor with smoking included class years, school satisfaction, school performance score, number of three best friends who smoke, allowance, alcoholic drinking, addicting drug use, SDS. Predictors of smoking were number of three best friends who smoke, number of alcoholic drinking, and allowance. The related factors of nicotine dependency were amount of smoking, allowance, when they started smoking. Predictor of nicotine dependency were amount of smoking, number of three best friends who smoke.

Conclusion : The related factors with smoking included class years, school satisfaction, school performance score, number of three best friends who smoke, allowance, alcoholic drinking, addicting drug use, and SDS. Predictors of smoking were number of three best friends who smoke, number of alcoholic drinking, and allowance.