Gender differences of nicotine dependence in South Korea

Abstract

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 dependence. 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.