Physicians should take advantage of each contact with smokers to encourage and support smoking cessation. Once a patient is identified as a smoker, tools are available to assess readiness for change. Using motivational interviewing techniques, the physician can help the patient move from the precontemplation stage through the contemplation stage to the preparation stage, where plans are made for the initiation of quitting smoking. Continued motivational techniques and support are needed in the action stage, when the patient stops smoking. Major treatment guidelines emphasize that three treatment elements in particular are effective for smoking cessation intervention : nicotine replacement therapy, social support for cessation, and skills training/problem solving. Guidelines emphasize the dose-response relationship between the intensity and duration of treatment and its effectiveness. In general, the more intense the treatment, the more effective it is in producing long-term abstinence from tobacco. Group or individual behavioral counselling can facilitate smoking cessation and improve the cessation rates. A plan should be in place for recycling the patient through the appropriate stages if relapse should occur.
Evidence-Based Medicine ; Humans ; Motivational Interviewing ; Nicotine ; Recurrence ; Recycling ; Smoke* ; Smoking Cessation* ; Smoking* ; Tobacco

No abstract available.
Bioethics* ; Curriculum* ; Humans

No abstract available.
Korea* ; Strikes, Employee*

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.
Chungcheongnam-do ; Cough ; Dizziness ; Erythema ; Headache ; Korea ; Nausea ; Nicotine* ; Pruritus ; Skin ; Smoke* ; Smoking Cessation* ; Smoking* ; Tobacco Products* ; Tobacco Use Cessation Products*

BACKGROUND: Cigarette smoking is a major risk factor for cancer and vascular disease but, a correctable habit. Despite widespread recognition of the hazardous health effects of smoking, Korean men and adolescents' smoking rates are not decreasing and is, emerging as a public health problem. Health care managers in schools and factories are expected to play a critical role in smoking cessation. Health education is one important area that will benefit from using a personal computer (PC). To promote smoking cessation, specified and risk-based approaches are considered to encourage the motivation of smokers. METHODS: This smoking cessation software (CD-Rom) was developed for health care managers in schools and factories using Microsoft Visual Basic and Access. RESULTS: This program divided into two major categories. Part one is a library of various kinds of information about smoking such as articles, lecture notes, pictures, slides, mp3 and motion files. The other part was an autonomous smoking cessation prescription program. This program analyzed smokers' smoking pattern (using WHY test), nicotine addiction level (using Fagerstrom score), stress level (using BEPSI test), and smokers' confidence level. After input of smoker's history by oneself, the program showed smoking cessation prescription automatically in monitor or printer. CONCLUSION: Health care managers in schools and factories can be experts of smoking cessation easily with this program in their work places.
CD-ROM ; Delivery of Health Care* ; Health Education ; Humans ; Male ; Microcomputers* ; Motivation ; Nicotine ; Prescriptions ; Public Health ; Risk Factors ; Smoke* ; Smoking Cessation* ; Smoking* ; Vascular Diseases ; Workplace

BACKGROUND: No-show is a major obstacle for proper management in outpatient clinic. This study was performed to evaluate the effectiveness of a reminding telephone call on the compliance after no-show patients in family practice. METHODS: A nurse in family practice called to 590 non-compliant patients who did not visit on the appointment day for 80 days. A single telephone call attempt was directed primarily to the patient or family members for them to make another appointment. The outcome measure was an increased attendance rate within 3 months after telephone calling. RESULTS: The completed telephone contacted group (N=242) and failed group (N=348) were well balanced for all study variables except age. The attendance rate of 60.7 % in the completed group, regardless of who was contacted by telephone, was 40.7 % greater than 23.0 % attendance rate in the failed group. In the univariate analysis, attendance for patients who lived near the clinic (within 1 hour ) was better (45.3%) than that for any group (P = .02). In the logistic regression analysis, only the telephone call reminder was an independent predictor of attendance (Adjusted OR=5.03, P<0.001). CONCLUSION: Telephone reminder is a very effective method of increasing attendance in a hospital-based family clinic. The reminder is a consistently effective intervention whether the message is delivered to the patient or the family member.
Ambulatory Care Facilities* ; Compliance ; Family Practice ; Humans ; Logistic Models ; Outcome Assessment (Health Care) ; Outpatients* ; Telephone*

The Korean medical establishment has traditionally shown little concern for formal training in medical ethics; only recently have courses in medical ethics been included in the curricula of Korea's medical schools. The importance and effectiveness of such courses is still a matter of some debate. This study attempted to measure the effects of a course in medical ethics on senior medical students. For this study, a discussion based course was designed, which made considerable use of video-taped ethical situations. Students were requested to answer a series of ethics related questions both before and after taking the course. Prior to taking the course, students indicated that treatment refusal, abortion, sex pre-selection, and euthanasia are the most important ethical issues in contemporary medical practice in Korea. However, after taking the course, students modified this list slightly by replacing the issue of euthanasia with that of equal access to health care resources. No significant changes were observed in students' value systems. The students' response to the course was favorable.
Curriculum ; Ethical Theory ; Ethics ; Ethics, Medical* ; Euthanasia ; Health Services Accessibility ; Humans ; Korea ; Schools, Medical ; Students, Medical* ; Treatment Refusal

In the past twenty years, medical ethics has emerged as a priority within medical schools in Korea. This article contains important messages about the general overviews and current status, such as the educator, teaching method, and goals of medical ethics education in medical schools. The author suggests ideas of improvement and qualification of the medical ethics education in Korea. There are two points of view regarding the purpose of teaching medical ethics: (1) that it is a means of creating virtuous physicians; and (2) that it is a means of providing physicians with a skill set for analyzing and resolving ethical dilemmas. The field would benefit from further theoretical work aimed at better delineating the core content, core processes, and core skills relevant to the ethical practice of medicine. They are in agreement that a multidiciplinary team of ethicist-philosophers and physicians should teach medical ethics, and ethics education should be integrated longitudinally throughout the 4 years of medical school. Within a few decades the number of Korean medical schools requiring medical ethics has increased in volume. Further progress in ethics education may depend on medical schools' willingness to devote more curricular time and funding to medical ethics for faculty development and resources.
Education, Medical ; Ethics, Medical ; Financial Management ; Korea ; Quality Improvement ; Republic of Korea ; Schools, Medical ; Teaching

BACKGROUND: According to recent studies of smoking rates among adolescents, the age at which young people begin to smoke is decreasing. The present study reports the results of a survey, conducted by the Korean National Tuberculosis Association (KNTA) in 2002, of the smoking status of Korean middle school students. METHODS: From April to November 2002, the KNTA surveyed the present smoking status of middle school students (total 14,296: boys-8,697, girls-5,599) according to sex and grade in 125 schools in 12 provinces during a smoking cessation education program. RESULTS: The survey showed that 18.4% of the males (7th grade-15.8%, 8th grade-17.6%, 9th grade-21.8%) and 8.3% of the females (7th grade-6.2%, 8th grade-9.3%, 9th grade-9.5%) had smoking experience. Approximately 2.5% of the males (7th grade-1.2%, 8th grade-1.8%, 9th grade-4.6%) and 1.0% of the females (7th grade- 0.3%, 8th grade-1.2%, 9th grade-1.5%) smoked regularly. The boys' smoking rate was higher than that of the girls in all grades. Smoking rates varied among the provinces, with Chungbuk having the highest rate (2.8%) and Jeonbuk having the lowest (0.9%). The time when most smokers began to smoke was in 6th grade of elementary school for the boys (15.9%) and 7th grade of middle school for the girls (28.6%). Approximately 69.4% of smokers answered that "curiosity" was the most important motivational factor. Statistical analysis indicated that smoking rates were positively correlated with alcohol use and height of students, but were negatively correlated with parents' level of education. At the end of the smoking cessation education program, the number of smokers had reduced for the boys (from 2.6% to 2.2%), but had increased for the girls (from 1.8% to 2.0%). The pre- program survey on the trans-theoretical stage of smoking cessation revealed that 34.2% fell into a pre- contemplation stage, 34.2% into a contemplation stage, and 31.6% into a preparation stage. The post-education survey showed remarkable changes: 24.0% were in the pre-contemplations stage, 40.0% in the contemplation stage, and 36.0% were in the preparation stage. CONCLUSION: This study reports the results of a survey, conducted by the KNTA in 2002, concerning the national smoking status of middle school students, relating factors, and levels of motivation for quitting smoking. The smoking cessation education program run by the KNTA had an impact on the motivational stage of smoking cessation.
Adolescent ; Chungcheongbuk-do ; Education ; Female ; Humans ; Jeollabuk-do ; Male ; Motivation ; Smoke* ; Smoking Cessation ; Smoking* ; Tuberculosis

BACKGROUND: In spite of worldwide recognition of the hazardous effects of smoking, the adolescent smoking rate in Korea continues to increase. This study was performed to determine the smoking statistics for the Chonan area, and to evaluate the effectiveness of mass smoking cessation education based on Prochaska's trans-theoretical model in adolescents. METHODS: To obtain the smoking statistics, an on-site questionnaire survey was performed on 7,373 students from 5 middle and 6 high schools in the Chonan area from May to July, 2001. A logistic regression analysis was done on the variables in order to determine the factors related to smoking. Immediately after completing smoking cessation education, the second questionnaire, which included questions on the effectiveness and satisfaction of the education, was conducted in one high school. RESULTS: The smoking rates were 18.0% in males, 8.8% in females; 4.3% in middle school students, and 21.1% in high school students. The smoking rate in vocational high schools (30.7%) was higher than in general high schools (11.9%)(P<0.001). Multiple logistic regression analyses indicated that the smoking rate increased in males (OR= 2.28), father's smoking status (OR=1.55), mother's smoking status (OR=2.98), and sibling's smoking status (OR=3.57). Approximately 47% of smokers answered that "curiosity" was their most important motivational factor; 29.1% of smokers started smoking in second grade of middle school. The pre-education survey on the trans-theoretical stage of smoking cessation revealed that 38.1% fell into pre-contemplation stage, 36.8% into contemplation stage, and 25.1% into preparation stage. The post-education survey showed remarkable change to 20.8% of pre-contemplations stage, 47.6% of contemplation stage, and 31.6% of preparation stage. CONCLUSION: The mass smoking cessation education run by doctors did have an impact on the motivational stage of smoking cessation. Therefore, to improve adolescents' health, an active non-smoking campaign and education should be continued in various ways.
Adolescent ; Chungcheongnam-do* ; Education* ; Female ; Humans ; Korea ; Logistic Models ; Male ; Smoke* ; Smoking Cessation* ; Smoking* ; Surveys and Questionnaires