2.Sex-specific associations between tobacco smoking and risk of cardiovascular diseases in Chinese adults.
Qian SHEN ; Nan Bo ZHU ; Can Qing YU ; Yu GUO ; Zheng BIAN ; Yun Long TAN ; Pei PEI ; Jun Shi CHEN ; Zheng Ming CHEN ; Jun LYU ; Li Ming LI
Chinese Journal of Epidemiology 2018;39(1):8-15
Objective: To examine the sex-specific associations between tobacco smoking and risk of cardiovascular diseases in Chinese adults. Methods: The present analysis included 487 373 participants from the China Kadoorie Biobank after excluding those with cancer, heart diseases, stroke at baseline survey. The baseline survey was conducted from June 2004 to July 2008. The number of follow-up years was calculated from the time that the participants completed baseline survey to the time of any event: CVD incidence, death, loss of follow-up, or December 31, 2015, whichever occurred first. We used Cox proportional hazards regression models to estimate the HRs and 95%CI of incident cardiovascular diseases with tobacco smoking. Results: During a median follow-up of 8.9 years(a total of 4.1 million person years), we documented 33 947 cases of ischemic heart diseases, 6 048 cases of major coronary diseases, 7 794 cases of intracerebral hemorrhage, and 31 722 cases of cerebral infarction. The prevalence of smoking was much higher in men (67.9%) than in women (2.7%). Smoking increased risk of all subtypes of cardiovascular diseases. Compared with nonsmokers, the multivariable-adjusted HRs (95% CI) for current smokers were 1.54 (1.43-1.66) for major coronary event, 1.28 (1.24-1.32) for ischemic heart disease, 1.18 (1.14-1.22) for cerebral infarction, and 1.07 (1.00-1.15) for intracerebral hemorrhage, respectively. Female smokers tended to have greater risk of developing major coronary event associated with amount of tobacco smoked daily (interaction P=0.006) and age when smoking started (interaction P=0.011). There was no sex difference in these two effects for ischemic heart diseases, intracerebral hemorrhage and cerebral infarction (all interaction P>0.05). Conclusions: This prospective study confirmed increased risk of all subtypes of cardiovascular diseases in current smokers. Smoking was more harmful to women than to men for major coronary event.
Adult
;
Asian People/statistics & numerical data*
;
Cardiovascular Diseases/epidemiology*
;
China/epidemiology*
;
Female
;
Humans
;
Incidence
;
Male
;
Neoplasms/epidemiology*
;
Prevalence
;
Prospective Studies
;
Risk Factors
;
Smoking/ethnology*
;
Smoking Cessation
;
Stroke/epidemiology*
;
Tobacco Smoking/adverse effects*
3.Discriminative Factor Analysis of Juvenile Delinquency in South Korea.
Journal of Korean Academy of Nursing 2006;36(8):1315-1323
PURPOSE: The present study was intended to compare difference in research variables between delinquent adolescents and student adolescents, and to analyze discriminative factors of delinquent behaviors among Korean adolescents. METHODS: The research design of this study was a questionnaire survey. Questionnaires were administered to 2,167 adolescents (1,196 students and 971 delinquents), sampled from 8 middle and high school and 6 juvenile corrective institutions, using the proportional stratified random sampling method. Statistical methods employed were Chi-square, t-test, and logistic regression analysis. RESULTS: The discriminative factors of delinquent behaviors were smoking, alcohol use, other drug use, being sexually abused, viewing time of media violence and pornography. Among these discriminative factors, the factor most strongly associated with delinquency was smoking (odds ratio: 32.32). That is, smoking adolescent has a 32-fold higher possibility of becoming a delinquent adolescent than a non-smoking adolescent. CONCLUSIONS: Our findings, that smoking was the strongest discriminative factor of delinquent behavior, suggest that educational strategies to prevent adolescent smoking may reduce the rate of juvenile delinquency. Antismoking educational efforts are therefore urgently needed in South Korea.
Adolescent
;
Adolescent Behavior/*ethnology
;
Adolescent Psychology
;
Chi-Square Distribution
;
Child Abuse, Sexual/ethnology
;
Cross-Sectional Studies
;
Discriminant Analysis
;
Erotica/psychology
;
Factor Analysis, Statistical
;
Family/ethnology
;
Female
;
Health Education
;
Humans
;
Juvenile Delinquency/*ethnology/prevention & control/statistics & numerical data
;
Korea/epidemiology
;
Logistic Models
;
Male
;
Mass Media
;
Questionnaires
;
Risk Assessment
;
Risk Factors
;
Smoking/adverse effects/ethnology
;
Students/psychology/statistics & numerical data
;
Substance-Related Disorders/complications/ethnology
;
Violence/ethnology
4.Epidemiologic differences in esophageal cancer between Asian and Western populations.
Han-Ze ZHANG ; Guang-Fu JIN ; Hong-Bing SHEN
Chinese Journal of Cancer 2012;31(6):281-286
Esophageal cancer is a common cancer worldwide and has a poor prognosis. The incidence of esophageal squamous cell cancer has been decreasing, whereas the incidence of esophageal adenocarcinoma has been increasing rapidly, particularly in Western men. Squamous cell cancer continues to be the major type of esophageal cancer in Asia, and the main risk factors include tobacco smoking, alcohol consumption, hot beverage drinking, and poor nutrition. In contrast, esophageal adenocarcinoma predominately affects the whites, and the risk factors include smoking, obesity, and gastroesophageal reflux disease. In addition, Asians and Caucasians may have different susceptibilities to esophageal cancer due to different heritage backgrounds. However, comparison studies between these two populations are limited and need to be addressed in the near future. Ethnic differences should be taken into account in preventive and clinical practices.
Adenocarcinoma
;
ethnology
;
etiology
;
genetics
;
Alcohol Drinking
;
adverse effects
;
Asia
;
epidemiology
;
Asian Continental Ancestry Group
;
genetics
;
Carcinoma, Squamous Cell
;
ethnology
;
etiology
;
genetics
;
Esophageal Neoplasms
;
ethnology
;
etiology
;
genetics
;
European Continental Ancestry Group
;
genetics
;
Gastroesophageal Reflux
;
complications
;
Genetic Predisposition to Disease
;
Humans
;
Incidence
;
Obesity
;
complications
;
Polymorphism, Single Nucleotide
;
Risk Factors
;
Smoking
;
adverse effects
;
United States
;
epidemiology
5.Awareness of chronic obstructive pulmonary disease in current smokers: a nationwide survey.
So Yeong MUN ; Yong Il HWANG ; Joo Hee KIM ; Sunghoon PARK ; Seung Hun JANG ; Jae Yong SEO ; Ja Kyung KIM ; Yong Bum PARK ; Jae Jung SHIM ; Ki Suck JUNG
The Korean Journal of Internal Medicine 2015;30(2):191-197
BACKGROUND/AIMS: Cigarette smoking is the most common risk factor for chronic obstructive pulmonary disease (COPD). However, few studies of the attitudes toward COPD of smokers, the group at risk of developing this condition, have been conducted. The purpose of this study was to explore the awareness of and attitudes toward COPD of current smokers. METHODS: The sample consisted of 502 individuals aged 45 and older from throughout Korea who smoked at least 10 packs of cigarettes per year. Telephone interviews using a structured questionnaire were conducted with respondents. RESULTS: First, we evaluated the health status of subjects, finding that 45.4% considered themselves to be in good health. We also asked about COPD-related symptoms, and 60.6% of subjects reported such symptoms. However, only 1.2% of subjects had been diagnosed with or treated for COPD, only 0.4% spontaneously mentioned COPD as a respiratory disease, and only 26.5% recognized COPD as a respiratory disease after seeing a list of such diseases. Television ranked as the top source of information about COPD. The willingness of 45.0% of subjects to stop smoking increased after being informed about COPD. CONCLUSIONS: Despite having COPD-related symptoms, most smokers did not know that COPD is a respiratory disease. The attitudes of smokers toward COPD and smoking cessation varied according to socioeconomic status. In summary, a continuous effort to increase the awareness of COPD among smokers is needed. Additionally, strategies tailored according to different socioeconomic groups will also be necessary.
Aged
;
Asian Continental Ancestry Group/*psychology
;
*Awareness
;
Consumer Health Information
;
Cross-Sectional Studies
;
Female
;
Health Knowledge, Attitudes, Practice/*ethnology
;
Health Promotion
;
Health Status
;
Health Surveys
;
Humans
;
Male
;
Mass Media
;
Middle Aged
;
Patient Compliance/ethnology
;
Pulmonary Disease, Chronic Obstructive/diagnosis/*ethnology/psychology/therapy
;
Republic of Korea/epidemiology
;
Risk Factors
;
Risk Reduction Behavior
;
Smoking/*adverse effects/*ethnology/prevention & control/psychology
;
Smoking Cessation/ethnology
;
Socioeconomic Factors
;
Surveys and Questionnaires
;
Time Factors
6.Frequency and Related Factors of Masked Hypertension at a Worksite in Korea.
Sang Kyu KIM ; Jun Ho BAE ; Dung Young NAH ; Dong Wook LEE ; Tae Yoon HWANG ; Kyeong Soo LEE
Journal of Preventive Medicine and Public Health 2011;44(3):131-139
OBJECTIVES: Masked hypertension is associated with metabolic risks and increased risk of cardiovascular disease. The purpose of this study was to identify the frequency of and risk factors of masked hypertension in Korean workers. METHODS: The study was conducted among 121 employees at a hotel in Gyeongju, Korea, from December 2008 to February 2009. We measured blood pressure (BP) both in the clinic and using 24-hour ambulatory BP monitors for all subjects. Hypertension was defined independently by both methods, and subjects were classified into four groups: true normotension, masked hypertension, white coat hypertension, and sustained hypertension. RESULTS: The frequency of masked hypertension in our study group was 25.6%. Compared with true normotension, the factors related to masked hypertension were male gender (odds ratio [OR], 10.7; 95% confidence interval [CI], 1.41 to 81.09), aging one year (OR, 0.88; 95% CI, 0.78 to 0.99), clinic BP 120-129/80-84 mmHg (OR, 8.42; 95% CI, 1.51 to 46.82), clinic BP 130-139 / 85-89 mmHg (OR, 12.14; 95% CI, 1.80 to 81.85), smoking (OR, 5.51; 95% CI, 1.15 to 26.54), and increase of total cholesterol 1 mg / dL (OR, 1.05; 95% CI, 1.02 to 1.08). In males only, these factors were clinic BP 120-129 / 80-84 mmHg (OR, 15.07; 95% CI, 1.55 to 146.19), clinic BP 130-139 / 85-89 mmHg (OR, 17.16; 95% CI, 1.56 to 189.45), smoking (OR, 11.61; 95% CI, 1.52 to 88.62), and increase of total cholesterol 1 mg/dL (OR, 1.05; 95% CI, 1.01 to 1.09). CONCLUSIONS: The frequency of masked hypertension was high in our study sample. Detection and management of masked hypertension, a known strong predictor of cardiovascular risk, could improve prognosis for at-risk populations.
Adult
;
Age Factors
;
Blood Pressure
;
Female
;
Health Behavior
;
Humans
;
Hypertension/*ethnology
;
Lipids/blood
;
Male
;
Middle Aged
;
Occupational Diseases/ethnology
;
Occupational Health/statistics & numerical data
;
Prevalence
;
Republic of Korea/epidemiology
;
Risk Factors
;
Sex Factors
;
Smoking/adverse effects/ethnology
;
Socioeconomic Factors
;
Stress, Psychological/complications/ethnology
;
Workplace/psychology/statistics & numerical data
7.East meets West: ethnic differences in epidemiology and clinical behaviors of lung cancer between East Asians and Caucasians.
Chinese Journal of Cancer 2011;30(5):287-292
Lung cancer is the leading cause of cancer death worldwide, with large variation of the incidence and mortality across regions. Although the mortality of lung cancer has been decreasing, or steady in the US, it has been increasing in Asia for the past two decades. Smoking is the leading cause of lung cancer, and other risk factors such as indoor coal burning, cooking fumes, and infections may play important roles in the development of lung cancer among Asian never smoking women. The median age of diagnosis in Asian patients with lung cancer is generally younger than Caucasian patients, particularly among never-smokers. Asians and Caucasians may have different genetic susceptibilities to lung cancer, as evidenced from candidate polymorphisms and genome-wide association studies. Recent epidemiologic studies and clinical trials have shown consistently that Asian ethnicity is a favorable prognostic factor for overall survival in non-small cell lung cancer (NSCLC), independent of smoking status. Compared with Caucasian patients with NSCLC, East Asian patients have a much higher prevalence of epidermal growth factor receptor (EGFR) mutation (approximately 30% vs. 7%, predominantly among patients with adenocarcinoma and never-smokers), a lower prevalence of K-Ras mutation (less than 10% vs. 18%, predominantly among patients with adenocarcinoma and smokers), and higher proportion of patients who are responsive to EGFR tyrosine kinase inhibitors. The ethnic differences in epidemiology and clinical behaviors should be taken into account when conducting global clinical trials that include different ethnic populations.
Adenocarcinoma
;
ethnology
;
genetics
;
metabolism
;
Asian Continental Ancestry Group
;
genetics
;
Carcinoma, Non-Small-Cell Lung
;
ethnology
;
genetics
;
metabolism
;
European Continental Ancestry Group
;
genetics
;
Far East
;
epidemiology
;
Female
;
Genetic Predisposition to Disease
;
Humans
;
Lung Neoplasms
;
ethnology
;
genetics
;
metabolism
;
Mutation
;
Oncogene Proteins, Fusion
;
metabolism
;
Receptor, Epidermal Growth Factor
;
genetics
;
metabolism
;
Risk Factors
;
Smoking
;
adverse effects
;
United States
;
epidemiology
;
ras Proteins
;
genetics
;
metabolism
8.Risk factors for intracranial aneurysm in a Chinese ethnic population.
Yu-xiang GU ; Xian-cheng CHEN ; Dong-lei SONG ; Bing LENG ; Fan ZHAO
Chinese Medical Journal 2006;119(16):1359-1364
BACKGROUNDIntracranial aneurysm (IAN) is a protruding bubble or a sac on a brain artery that balloons out over time, which may lead to spontaneous subarachnoid hemorrhage (SAH), ultimately disability and mortality. Current research indicates that the disease is due to multiple causes, including environmental factors and various congenital abnormalities of blood vessels. Apart from congenital predisposition, various high-risk factors such as sex, age, hypertension, and atherosclerosis are involved in the formation of intracranial aneurysms. The aim of this study was to investigate the risk factors associated with the formation of sporadic intracranial aneurysms in Chinese Han ethnic patients.
METHODSA total of 251 patients with intracranial aneurysm and 338 patients with other cerebral diseases (control group) were enrolled in this study. Single factor and logistic regression model were used to analyze the association of intracranial aneurysms with age; sex; cigarette smoking; alcohol or cocaine consumption; history of hypertension, coronary artery disease, diabetes mellitus and inherited connective tissue disease; and the levels of fasting blood glucose and blood fat. The data expressed as mean +/- standard deviation were processed with the statistical software SPSS13. Quantitative and qualitative data were analyzed by the independent-sample t test, and the chi-square test respectively. Logistic regression method was used to analyze the multiple factors.
RESULTSIn the 251 patients, 163 (64.94%) were at age of 40 to 60 years. Sex (OR, 1.41; 95% CI, 1.01 - 1.96), cigarette smoking (OR, 1.81; 95% CI, 1.06 - 3.10), hypertension (OR, 2.32; 95% CI, 1.30 - 4.16) and fasting blood glucose were significantly associated with intracranial aneurysm (P < 0.05). Intracranial aneurysm was correlated with alcohol consumption, coronary artery disease, and the level of blood lipids (P > 0.05). Using logistic regression analysis, we identified female sex and advanced age as significant risk factors for sporadic intracranial aneurysms.
CONCLUSIONSSporadic intracranial aneurysms mostly occur in people aged 40 to 60 years. Feminine, cigarette smoking, and hypertension are independent risk factors for the disease, and the gender is the most significant factor. Advanced age can increase the effect of these risk factors.
Adolescent ; Adult ; Age Factors ; Aged ; Aged, 80 and over ; Atherosclerosis ; complications ; China ; ethnology ; Female ; Humans ; Hypertension ; complications ; Intracranial Aneurysm ; etiology ; Logistic Models ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Sex Factors ; Smoking ; adverse effects
9.Combined effects of both cardiovascular disease family history and smoking on the incidence of ischemic stroke.
Qin LU ; Jianhui ZHANG ; Yongyue LIU ; Hongmin LU ; Yunfan TIAN ; Batu BUREN ; Yipeng ZHOU ; Yonghong ZHANG
Chinese Journal of Epidemiology 2016;37(4):475-479
OBJECTIVETo investigate the cumulative effect regarding the family history of cardiovascular disease and smoking on ischemic stroke events in population with Mongolian ethnicity.
METHODSBased on data gathered from the baseline investigation, a 10-year prospective cohort follow-up project was conducted among 2 589 participants with Mongolian ethnicity. Ischemic stroke events were defined as the outcomes of the study. All the 2 589 participants were categorized into four subgroups: without family history of cardiovascular disease/nonsmokers, without family history of cardiovascular disease/smokers, with family history of cardiovascular disease/nonsmokers and with family history of cardiovascular disease/smokers, according to family history of cardiovascular disease and smoking status. Cumlative incidence rates of events among the four subgroups was described with Kaplan-Meier curves. Cox proportional hazards model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (95%CI) of ischemic stroke events among the four subgroups.
RESULTSData from the Kaplan-Meier curves showed that the cumulative incidence rates of ischemic stroke were 1.17% (15/1 278), 3.83% (37/967), 5.70% (9/158) and 8.33% (15/180) for the groups of no family history of cardiovascular disease/nonsmokers, no family history of cardiovascular disease/smokers, with family history of cardiovascular disease/nonsmokers and with family history of cardiovascular disease/smokers, respectively. By cox proportional hazards model, after adjusting for age, male, drinking status, systolic and diastolic blood pressure, body mass index, fasting glucose, total cholesterol, triglycerides, LDL cholesterol factors, the HRs (95% CI) of ischemic stroke were 2.26 (1.19-4.28) and 2.45 (1.13-5.33) in the no family history of cardiovascular disease/smokers group, with family history of cardiovascular disease/smokers group when compared to the no family history of cardiovascular disease/nonsmokers group, respectively. The risk of ischemic stroke appeared the highest in the group with family history of cardiovascular disease/smokers (all P<0.05).
CONCLUSIONSmoking may increase the risk of ischemic stroke events among the population with family history of cardiovascular disease.
Alcohol Drinking ; Asian Continental Ancestry Group ; ethnology ; genetics ; Blood Glucose ; Blood Pressure ; Body Mass Index ; Cardiovascular Diseases ; ethnology ; genetics ; Cholesterol ; Cholesterol, LDL ; Genetic Predisposition to Disease ; Humans ; Incidence ; Male ; Mongolia ; epidemiology ; Population Surveillance ; Proportional Hazards Models ; Prospective Studies ; Risk Factors ; Smoking ; adverse effects ; epidemiology ; Stroke ; epidemiology ; genetics