Factors influencing cigarette smoking and quantified implications for anti-smoking policy: evidence from South Korea

ObjectivesThe aim of this study was to determine the factors that are associated with adult males’ smoking in South Korea and simulate the effects of a potential anti-smoking policy.MethodsWe conducted a national, cross-sectional, telephone survey among males aged 20 years and older in 2006 and analyzed a dataset of 2,847 subjects by using the full information maximum likelihood sample selection model.ResultsThe likelihood of smoking was highest among the wealthy, employed, Christian, or people who exercise regularly. The low rate of smoking participation was associated with either low pure alcohol intake or increased awareness of lung cancer from smoking. We found that policies to reduce cigarette consumption should focus on lowering smoking participation rather than the amount of cigarettes smoked. Compared to the current state, a policy package consisting of mutually reinforcing measures could reduce the probability of smoking and the average number of cigarettes consumed among all adult males by 34 and 51%, respectively.ConclusionsUnderstanding the country-specific factors affecting smoking behavior and selecting an appropriate anti-smoking measure could greatly reduce smoking participation and cigarette consumption.

[1]  Teh-Wei Hu,et al.  The effect of a major cigarette price change on smoking behavior in california: a zero-inflated negative binomial model. , 2004, Health economics.

[2]  Jahyun Kim Haboush,et al.  Women and Confucian cultures in premodern China, Korea, and Japan , 2003 .

[3]  Sung-il Cho,et al.  Understanding Women, Health, and Social Change: The Case of South Korea , 2006, International journal of health services : planning, administration, evaluation.

[4]  S. Jee,et al.  Economic burden of smoking in Korea. , 2003, Tobacco control.

[5]  S. Reijneveld,et al.  The impact of individual and area characteristics on urban socioeconomic differences in health and smoking. , 1998, International journal of epidemiology.

[6]  S. Jabbour,et al.  Religion-based tobacco control interventions: how should WHO proceed? , 2004, Bulletin of the World Health Organization.

[7]  Martina Deuchler,et al.  The Confucian Transformation of Korea: A Study of Society and Ideology. , 1994 .

[8]  L. Pederson,et al.  Prevalence of current cigarette smoking among adults and changes in prevalence of current and some day smoking--United States, 1996-2001. , 2003, MMWR. Morbidity and mortality weekly report.

[9]  David Satcher,et al.  Women and smoking: a report of the Surgeon General. , 2002, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[10]  K. Hunt,et al.  Irish descent, religion, and alcohol and tobacco use. , 1996, Addiction.

[11]  M. Denniston,et al.  Risk perception and cigar smoking behavior. , 2001, American journal of health behavior.

[12]  E. Gilpin,et al.  Adult smokers who do not smoke daily. , 1997, Addiction.

[13]  T. Hu,et al.  The demand for cigarettes in California and behavioural risk factors. , 1995, Health economics.

[14]  C. Derby,et al.  Characteristics of smokers who attempt to quit and of those who recently succeeded. , 1994, American journal of preventive medicine.

[15]  Sunmi Lee,et al.  [The effect of cigarette price on smoking behavior in Korea]. , 2007, Journal of preventive medicine and public health = Yebang Uihakhoe chi.

[16]  M. Lee,et al.  Cigarette Smoking and Risk of Lung Cancer in Korean Men: The Seoul Male Cancer Cohort Study , 2007, Journal of Korean medical science.

[17]  Y. Khang,et al.  [Occupational differentials in cigarette smoking in South Korea: findings from the 2003 Social Statistics Survey]. , 2006, Journal of preventive medicine and public health = Yebang Uihakhoe chi.

[18]  Y. Khang,et al.  Marital status and smoking in Korea: the influence of gender and age. , 2008, Social science & medicine.

[19]  J. Samet,et al.  Medical expenditure of national health insurance attributable to smoking among the Korean population. , 2007, Journal of preventive medicine and public health = Yebang Uihakhoe chi.

[20]  R. West,et al.  Does exercise aid smoking cessation? A systematic review. , 2000, Addiction.

[21]  Kazumitsu Nawata,et al.  Estimation of sample selection bias models , 1996 .

[22]  E. McAuley,et al.  Exercise and Self-Esteem in Middle-Aged Adults: Multidimensional Relationships and Physical Fitness and Self-Efficacy Influences , 1997, Journal of Behavioral Medicine.

[23]  D. Thomas,et al.  Effects of physical activity on risk factors for coronary heart disease in previously sedentary women: a five-year longitudinal study. , 1988, Australian and New Zealand journal of medicine.

[24]  David M. Burns,et al.  Occasional smoking among adults: evidence from the California Tobacco Survey , 1992 .

[25]  J. Pierce,et al.  A population study of low-rate smokers: quitting history and instability over time. , 2003, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[26]  F. Gibbons,et al.  Perceptions of smoking risk as a function of smoking status , 1992, Journal of Behavioral Medicine.

[27]  J. Heckman.  The Common Structure of Statistical Models of Truncation, Sample Selection and Limited Dependent Variables and a Simple Estimator for Such Models , 1976 .

[28]  I. Choi,et al.  Smoking, alcohol and gastric cancer risk in Korean men: the National Health Insurance Corporation Study , 2007, British Journal of Cancer.

[29]  K. Jung-Choi,et al.  The impact of governmental antismoking policy on socioeconomic disparities in cigarette smoking in South Korea. , 2009, Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco.

[30]  D. Gregorio,et al.  The effects of occupation-based social position on mortality in a large American cohort. , 1997, American journal of public health.

[31]  Tim Stockwell,et al.  INTERNATIONAL GUIDE FOR MONITORING ALCOHOL CONSUMPTION AND RELATED HARM , 2000 .

[32]  K. Cummings,et al.  Reduction in amount smoked predicts future cessation. , 2005, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[33]  Y. Khang,et al.  Socioeconomic inequality in cigarette smoking: trends by gender, age, and socioeconomic position in South Korea, 1989-2003. , 2006, Preventive medicine.

[34]  Melanie C. Green,et al.  Telephone versus Face-to-Face Interviewing of National Probability Samples with Long Questionnaires: Comparisons of Respondent Satisficing and Social Desirability Response Bias , 2003 .

[35]  Y. Fukuda,et al.  Socioeconomic pattern of smoking in Japan: income inequality and gender and age differences. , 2005, Annals of epidemiology.

[36]  K. Emmons,et al.  Cognitive-behavioral mediators of changing multiple behaviors: smoking and a sedentary lifestyle. , 1996, Preventive medicine.

[37]  K M Cummings,et al.  Tax, price and cigarette smoking: evidence from the tobacco documents and implications for tobacco company marketing strategies , 2002, Tobacco control.

[38]  K. Nawata.  Estimation of sample selection bias models by the maximum likelihood estimator and Heckman's two-step estimator , 1994 .

[39]  Peter Salovey,et al.  Perceived risks and benefits of smoking cessation: gender-specific predictors of motivation and treatment outcome. , 2005, Addictive behaviors.

[40]  Kazumitsu Nawata,et al.  A note on the estimation of models with sample-selection biases , 1993 .

[41]  S. J. Palmer.  Korea and Christianity : the problem of identification with tradition , 1967 .