Gender differences of nicotine dependence in South Korea

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Kim, S. K.; Lee, Y. R.; Joe, M. J.; Jeon, H. J.; Lee, J. H.; Chang, S. M.

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Purpose: The goal of this study was to investigate gender differences
of nicotine dependence in South Korea regarding prevalence,
sociodemographic factors, smoking behaviors, associated
psychiatric disorders.
Method: Data was collected from the 2006 Epidemiological
Survey of Psychiatric Illnesses in Korea. The Ministry of Health
and Welfare conducted the survey jointly with the Seoul National
University College of Medicine from June 20, 2006 to August 20,
2007. The subjects enrolled in this study were selected using a
stratified, multistage, cluster sampling design, which was based on
the 2005 census. 12 catchments areas were chosen in proportion
to the population of each area from 6 provinces of Korea. Finally,
6,510 subjects from 12,849 households completed face-to-face
interview. The response rate was 81.7%. The Korean version
of the Composite International Diagnostic Interview (K-CIDI),
which was validated by Cho et al. was used in this study.
Weighted values were calculated for respondents and used to
adjust data, in order to approximate the national population in
terms of age and gender in each catchment area, as defined by
Korean National Statistical Office's 2005 census.
Sociodemographic factors and smoking behaviors between men
and women were compared using chi-square test or t-test. Logistic
regression was used to compute the odds ratios (OR) between
nicotine dependence and alcohol use disorders (alcohol dependence
or abuse), affective disorders, anxiety disorders.
Results: The lifetime prevalence of DSM-IV nicotine dependence
was 7.7% (men: 14.0%, women: 1.4%), which was a little
low compared to 2001 nationwide epidemiological survey (total:
9.4%, men: 17.1%, women 1.5%). Sociodemographic variables
were compared with regard to gender, age, education, occupation,
residence, income. There were significant statistical differences
between men and women in occupation (% full-time job; 67.7% vs
37.8%, X2 = 16.1, d.f. = 1, p < 0.05), and marital state (% married;
59.7% vs 42.2%, X2 = 5.1, d.f. = 1, p < 0.01).
In smoking behaviors, average age onset of smoking for men
and women were 20.2±4.7 years old and 21.9±7.5 years old, and
it took 9.3±9.9 years for men and 5.8±10.6 years for women
to reach nicotine dependence. In the case of women, although
average onset age of smoking was significantly later than men
but it took significantly shorter than men to reach nicotine dependence.
Besides these factors, men showed a significantly higher
number of cigarettes smoked per day during the period of highest
consumption and higher chain-smoking rate for several days
than women among the DSM-IV diagnostic criteria of nicotine
The prevalence rates ofother DSM-IV disorders among nicotine
dependence as well as OR were calculated. Women had higher
prevalence than men for alcohol abuse (5.7% vs 11.0%), alcohol
dependence (14.9% vs 18.5%), major depressive disorder (6.1% vs 20.1 %), anxiety disorder (8.0% vs 16.6%), specific phobia (4.5%
vs 11.8%). OR of women with alcohol abuse (14.9, 95%CI =
4.2-52.6), alcohol dependence (13.4, 95%CI = 4.7-38.0) were
relatively greater than OR of men (alcohol abuse: 1.8, 95% CI =
1.1-3.1, alcohol dependence: 13.4, 95%CI = 4.7-38.0).
Conclusion: The results of the present study suggest that there
are obvious gender differences in nicotine dependence in terms of
sociodemographic factors, smoking behaviors, associated mental
disorders. If this is true, further studies to distinguish these two
groups and development of effective anti-smoking programs and
proper therapeutic approaches for women are necessary.
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College of Medicine/School of Medicine (의과대학/대학원)Psychiatry (정신과학전공)Journal Papers (저널논문_정신과학전공)
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