Consumed substances, including food, drink, and tobacco, produced in the environment are exposure sources of Cd. The object of the present study was to estimate Cd exposure and absorption amount from smoking cigarettes, one exposure source of Cd, using recent findings from Japan. The market share of cigarettes produced in foreign countries has increased in Japan, the proportion of tobacco leaves harvested in foreign countries has increased in cigarettes produced in Japan, and the percentage of smokers in Japan has changed. Therefore, obtaining the absorption value of Cd from smoking cigarettes using recent findings from Japan is significant. We collected information on (1) the concentrations of Cd in tobacco leaves by country of harvest and in cigarettes by country of production, (2) the concentrations of Cd in cigarette smoke, (3) the proportion of tobacco leaves harvested in foreign countries used in cigarettes made and sold in Japan, (4) the absorption rate of Cd in the airways for cigarette smoke, (5) the smoking rate by gender, age, and year in Japan, (6) the number of cigarettes sold in Japan by year and country of production, (7) the number of cigarettes smoked by smokers per day according to gender and age in Japan, and (8) the population size in 1998 by gender and age in Japan. The mean amount of Cd absorbed via the airways by smoking for smokers in Japan was calculated to be 0.89-1.78 μg/day from the above information. The values are not small in comparison with the amount of Cd absorbed from the digestive organs. The concentration of Cd in tobacco leaves harvested in Japan and cigarettes produced in Japan is generally higher than that of leaves harvested and cigarettes produced in foreign countries. The increase in the market share of cigarettes produced in foreign countries and sold in Japan and the increase in the proportion of tobacco leaves harvested in foreign countries used in cigarettes made and sold in Japan have decreased the amount of Cd absorbed by smoking for smokers in Japan.
Japan ; CIGARETTES (CONTAINING TOBACCO) ; Cadmium ; Smoking ; Tobacco

Introduction: Smoking amongst medical students is rather common practice. According to a WHO report in 1989, the rate of smoking among the students of Hanoi Medical University was 38.3%. However, there has not been any investigation aimed at reevaluating the smoking situation among students of this university.\r\n', u'Objectives: To understand the smoking situation and factors that influences the students of Hanoi Medical University. \r\n', u'Subjects and methods: A questionnaire on tobacco use among youths, which was documented by the Institute of Global Tobacco Control, is used to collect the data. \r\n', u'Results: The smoking rate is 23.6%, (43.4% in men versus 1.3% in women). Average age of first use is about 19 years of age. Smoking trend increases across the age groups and academic years, while the intention of quitting cigarette decreases across age cohorts. 4 factors affecting smoking are belief, attitude to cigarette control, exposure to family and friends that smoke. The relationship between knowledge and smoking is not statistically significant. \r\n', u"Conclusion: Smoking among medical students in Hanoi Medical University is relatively prevalent. Early impaction is necessary to promote quitting cigarettes. Impact on knowledge is not enough; it also needs to focus on the surrounding environment of students through their family members and friends. Like direct interventions on the students' family and friends as both receivers and providers of intervention. Consolidating beliefs and attitudes to tobacco control also plays a critical part. \r\n", u'
Students ; medical students ; Hanoi Medical University ; Cigarette ; smoking cigarettes

BACKGROUND: Online health information can influence consumers to make informed decisions. There are conflicting messages online about health concerns on the use of e-cigarettes. We aimed to investigate differences in those messages through Naver and Google's English versions, which are the most representative portal sites in Korea and in the world. METHODS: We reviewed the top 100 web pages related to health effects of e-cigarettes on Naver and Google in May 2018. Two medical doctors sorted the web pages into three groups as positive, negative, and mixed messages for e-cigarettes, as well as two groups based on the relative safety of conventional smoking versus e-cigarettes. RESULTS: There were 10 and 27 positive, 65 and 45 negative, and 25 and 28 mixed messages on Naver and Google, respectively. There were 15 messages on Naver and 53 on Google that considered e-cigarettes safer than conventional cigarettes. The most frequent topics were toxicity (71%) and diseases (22%) on Naver. Google provides topics of health concerns for young people, including gateway effect (47%), diseases (35%), and toxicity (25%). Particularly, harm reduction which was not present on Naver, came up on Google as 24%. CONCLUSIONS: We found that Naver provides more negative messages on e-cigarettes than does Google, which means that Koreans are exposed more to negative information on e-cigarettes than are foreign people who use Google. In future, more open discussions about harm reduction should be conducted to resolve the imbalance in information regarding health effects of e-cigarettes in Korea.
Electronic Cigarettes ; Harm Reduction ; Internet ; Korea ; Smoke ; Smoking ; Smoking Cessation ; Tobacco Products

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.
Adolescent* ; Electronic Cigarettes* ; Humans ; Jurisprudence ; Korea ; Logistic Models ; Male ; Risk-Taking ; Smoke ; Smoking ; Tobacco Products*

PURPOSE: The purpose of the study was to examine the relationship between smoking attitude and coping skills toward secondhand e-cigarette smoking among nonsmoking college students. METHODS: This study was conducted with 148 students from a University in Seoul, Korea. Participants completed questionnaires and the data were analyzed using a T-test, ANOVA, and Pearson’s correlation coefficients. RESULTS: The mean score of smoking attitude is 51.35±4.73. The mean score of coping skills is 13.89±2.53 in verbal skills, 10.16±2.37 in behavioral skills, and 8.32±2.30 in assertive skills. Coping skills toward secondhand smoking are noted as being different by current cohabitation smoker. A significant relationship between smoking attitude and behavioral coping skills(r=.23, p=.004) was found, which means that a better smoking attitude was correlated with more active behavioral coping skills. CONCLUSION: The results showed that nonsmoking college students with better smoking attitude react to the E-cigarette smoking with more active behaviors. Therefore, interventions are needed to be developed to encourage better smoking attitude and coping skills toward secondhand E-cigarette smoking.
Adaptation, Psychological ; Electronic Cigarettes ; Humans ; Korea ; Seoul ; Smoke ; Smoking ; Tobacco Smoke Pollution

PURPOSE: We aimed to identify associations between the frequency of electronic cigarette (e-cigarette) use and smoking-related characteristics among adolescent smokers.METHODS: We used data from the 14th Korea Youth Risk Behavior Survey. The participants were 3,722 smokers who had smoked cigarettes on at least one day during the past 30 days. The frequency of e-cigarette use was defined as the number of days that participants used e-cigarettes during the past 30 days, and was divided into four categories: 0, 1~2, 3~9, and ≥10 days. We used the χ² test and multinomial logistic regression to examine the associations between the frequency of e-cigarette use and smoking-related characteristics.RESULTS: Those who attempted to quit smoking, had used a heated tobacco product (HTP) at least once, or initiated e-cigarette use before middle school were more likely to use e-cigarettes for 3~9 days in the past 30 days. More frequent e-cigarette use (≥10 days) was associated with a higher frequency and greater amount of cigarette use, lifetime HTP use, and earlier initiation of e-cigarette use.CONCLUSION: Smoking-related characteristics differed by the frequency of e-cigarette use. Therefore, intervention programs targeting adolescent smokers should consider differences in smoking-related characteristics based on the frequency of e-cigarette use.
Adolescent ; Electronic Cigarettes ; Hot Temperature ; Humans ; Korea ; Logistic Models ; Risk-Taking ; Smoke ; Smoking ; Tobacco Products

smoking status including use of electronic cigarettes (E-cigars).METHODS: We used data from the Korea National Health and Nutritional Survey 2013 and 2016. A total of 4,744 participants (2,162 men and 2,582 women) were included and were categorized into five groups (Non-smokers, E-cigar non-users in past-smokers, E-cigar users in past-smokers, E-cigar non-users in cigarette-smokers and E-cigar users in cigarette-smokers). Cadmium blood concentration was categorized into tertiles. All sampling and weight variables were stratified, and analysis to account for the complex sampling design was conducted.RESULTS: In both genders, the geometric cadmium concentration was significantly different according to smoking status (both genders, analysis of variance P value < 0.001). In men, E-cigar users were significantly higher than the non-smokers (P value = past-smokers, 0.017; cigarette-smokers, < 0.001) when fully adjusted. Compared with non-smokers, fully-adjusted odds ratios (95% confidence intervals) for the highest cadmium tertiles of E-cigar non-users in cigarette-smokers and E-cigar users in cigarette-smokers were 6.56 (3.55–12.11) and 5.68 (1.96–16.50) in men and 2.74 (1.42–5.29) and 1.29 (0.10–17.44) in women.CONCLUSION: Conventional cigarette smoking in men and women and E-cigar use in men are associated with higher risk of elevated blood cadmium level. Preventive management of cadmium exposure monitoring in conventional cigarette-smokers and E-cigar users may be needed.]]>
Cadmium ; Electronic Cigarettes ; Female ; Humans ; Korea ; Male ; Nutrition Surveys ; Odds Ratio ; Smoke ; Smoking ; Tobacco ; Tobacco Products

BACKGROUND: Although the electronic cigarette (e-cigarette) market is growing rapidly, few studies have been conducted on e-cigarettes in South Korea. This study aims to analyze the general characteristics of Korean adult smokers with e-cigarette use.METHODS: This study used data from the 6th National Health and Nutrition Survey (NHANS). Multivariate logistic regression analysis was conducted to examine subjects' general characteristics and a questionnaire related to smoking cessation, stress perception, and depression. A frequency analysis of reasons for using e-cigarettes was conducted of 318 subjects of the 2015 NHANS who were smokers and used e-cigarettes.RESULTS: The study found that smokers with experience using e-cigarettes were younger and had a higher income level (odds ratio [OR], 1.45; 95% confidence interval [CI], 1.03–2.05) than smokers without e-cigarette experience. Professional, management, and office worker groups were associated with e-cigarette use (OR, 1.40; 95% CI, 1.10–1.77). Willingness to quit smoking was also higher in subjects with experience using e-cigarettes (OR, 1.35; 95% CI, 1.09–1.68). The most common reason for smoking cessation in both groups was concern about their own and their family's health. About 50% of smokers with experience using e-cigarettes thought e-cigarettes would be more helpful for smoking cessation than regular cigarettes.CONCLUSION: Although the safety and rationale of using e-cigarettes as a smoking cessation aid are unproven, many smokers consider them a method of smoking cessation. It is necessary to provide correct information on e-cigarettes.
Adult ; Depression ; Electronic Cigarettes ; Humans ; Korea ; Logistic Models ; Methods ; Nutrition Surveys ; Smoke ; Smoking ; Smoking Cessation ; Tobacco Products

One person dies every six seconds from a smoking-related disease and this problem is likely to worsen. While many people try to quit smoking on their own or with using medicinal products, many of them fail. There is an ongoing debate within the public health community about e-cigarettes on whether they have a potential role in smoking cessation, whether their use can reduce harm for individual users, whether the widespread use of these devices has the potential to reduce or increase population-level harm, and how best to regulate e-cigarette use to minimize both individual and population-level harm. Although the long-term effects of e-cigarette use among smokers and non-smokers are not known, nicotine aerosol produced from a solution, rather than from burning tobacco, releases fewer harmful substances than cigarette smoke does. Some experts advocate wider availability and softer regulations regarding e-cigarette use and perceive them as having the potential to help smokers quit or switch to a harm-reducing means of consuming nicotine. Based on scientific evidence on e-cigarettes, this article explores its pros and cons to public health in order to guide practice, policy, and regulation through reviews of debate articles. ‘Quit or die’ is no longer the only option for those who cannot quit. Safer nicotine products offer another way. There is substantial international and independent evidence that these products are safer than cigarettes.
Burns ; Electronic Cigarettes ; Harm Reduction ; Humans ; Nicotine ; Public Health ; Smoke ; Smoking ; Smoking Cessation ; Social Control, Formal ; Tobacco ; Tobacco Products

OBJECTIVES: To characterize the usage patterns of new types of tobacco products (NTTPs) to develop effective strategies for the regulation of NTTPs in Korea. METHODS: We conducted focus group interviews to identify the NTTP usage patterns of research subjects. The NTTPs were limited to electronic cigarettes (e-cigarettes), waterpipe tobacco, and rolling tobacco. We categorized 30 research subjects into 4 groups. The e-cigarette group was divided into adult and adolescent groups. Each group contained 7-8 subjects. An interview lasting approximately 2 hours was conducted with each group. RESULTS: Ninety percent of NTTP users used an NTTP in combination with conventional cigarettes. Subjects mostly bought NTTPs online, unlike how they bought cigarettes. Additionally, a great deal of information, such as how to use NTTPs and descriptions of NTTP products, was exchanged through online or offline societies. The primary reason why the subjects used NTTPs was that NTTPs offer a greater range of flavors and aromas than cigarettes. Moreover, NTTPs were felt to be less repulsive than cigarettes. NTTPs were not used as a cigarette substitute; rather, they were mostly used in places and situations where traditional cigarette smoking was not allowed. CONCLUSIONS: Based on the results of this study, the government should conduct studies on the effects of the combined use of NTTPs and cigarettes on the human body, obtain and provide accurate data regarding NTTP use, and develop and implement polices to ban NTTP advertising, which may arouse adolescents' curiosity, and the addition of flavoring substances to tobacco products.
Adolescent ; Adult ; Electronic Cigarettes ; Exploratory Behavior ; Focus Groups* ; Human Body ; Humans ; Korea ; Research Subjects ; Smoking ; Tobacco Products* ; Tobacco*