한국 남성에서 흡연 시작과 금연에 관여하는 사회경제적 요인
Socioeconomic Factors Associated with Initiating and Quitting Cigarette Smoking Among Korean Men
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연구배경: 한국 남성에서 다양한 사회경제적 위치 지표에 따 른 흡연 시작률과 금연비를 분석하고, 여러 사회경제적 위치 지표 중에서 흡연 시작 위험과 금연 성공에 대한 불평등과 관 련성이 보다 높은 지표를 파악하고자 한다. 방법: 2005년 국민건강영양조사 자료에서 25-64세 남자 2,798 명을 분석하였다. 로지스틱 회귀모델을 이용하여 사회경제적 위치 지표별 흡연 시작 위험과 금연 성공에 대한 교차비(OR) 와 95% 신뢰구간(CI)을 계산하였다. 연령 보정 교차비와 교육 수준과 직업, 소득수준, 결혼상태, 음주량을 모두 보정한 다변 량 보정 교차비를 제시하였다. 결과: 대상자의 평균 나이는 41.6세였으며, 85.0%가 흡연을 경 험한 적이 있으며 이 중 32.3%가 금연을 하였고 현재 흡연율 은 55.5%였다. 다른 사회경제적 요인을 모두 보정하였을 때 12년 초과 학력군에 비해 10-12년 학력군의 흡연 시작이 유 의하게 많았으며(OR=1.51; 95% CI=1.09-2.09), 비육체노동 군에 비해 육체노동군의 흡연 시작이 많았다(OR=1.55; 95% CI=1.12-2.14). 상위삼분위소득군에 비해 중간, 하위삼분위소 득군의 금연이 통계적으로 유의하게 적었으며(각각 OR=0.72; 95 CI=0.55-0.92, OR=0.60; 95% CI=0.46-0.79) 비육체노동군 에 비해 육체노동군의 금연이 적었다(OR=0.66; 95% CI=0.50- 0.86). 결론: 한국 남성에서 흡연 시작 위험과 금연 성공 모두에서 사 회경제적 위치에 따른 불평등이 존재하였다. 흡연 시작 위험 에 대한 강력한 관련인자는 교육 수준과 직업인 반면, 금연 성 공의 강력한 관련인자는 소득수준과 직업으로 나타나 흡연 각 단계의 관련인자가 다름을 보여 주었다. 이에 따라 흡연에 서의 사회경제적 불평등을 줄이기 위해서는 흡연 단계에 따 른 사회경제적 위치를 고려한 흡연예방 및 금연정책이 필요 하다.
Abstract
Background: The prevalence of current cigarette smoking is the net result of different processes over the entire life course, namely initiation, continuation and cessation of smoking. This study examined the association of socioeconomic indicators with initiating and quitting smoking among South Korean men. Methods: We analyzed a total of 2,798 men aged 25-64 who participated in the Korean National Health and Nutrition Examination Survey in 2005. Odds ratios (ORs) with 95% confi dence intervals (CIs) for smoking initiation and cessation according to socioeconomic position indicators were calculated with logistic regression. Socioeconomic position was measured by education, occupation, income and marital status. Results: Greater rates of ever initiation of smoking were observed among lower educated men (OR = 1.51; 95% CI = 1.09- 2.09) after controlling for other socioeconomic factors. Independent associations were found among men who performed manual labor (OR = 1.55; 95% CI = 1.12-2.14). After simultaneous adjustment for socioeconomic factors, lower likelihood of quitting smoking was detected among men who were in the middle third and the lower third income group (OR = 0.72; 95% CI = 0.55-0.92, OR = 0.60; 95% CI = 0.46-0.79, respectively), who performed manual labor (OR = 0.66; 95% CI = 0.50- 0.86) or who were not married (OR for never-married = 0.65; 95% CI = 0.42-0.99 and OR for divorced or widowed = 0.56; 95% CI = 0.36-0.87, respectively). Conclusion: For Korean men, educational attainment was a strong predictor of ever initiating smoking, however, smoking cessation was independently related to income and marital status. To be effective, tobacco control interventions should consider these different social determinants in initiating and quitting smoking.
참고문헌 (30)
- "The surgeon general's 1989 report on reducing the health consequences of smoking: 25 years of progress", MMWR Morb Mortal Wkly Rep, 38(2), pp.1~32 (1989)
- The third Korea Natio nal Health and Nutrition Examination Survey, 2005, "Korean Ministry of Health and Welfare", Korean Ministry of Health and Welfare, ~ (2005)
- Galobardes B, "Trends in risk factors for the major "lifestyle-related diseases" in Geneva, Switzerland, 1993-2000", Ann Epidemiol, 13, pp.537~540 (2003)
- Pierce JP, "International comparisons of trends in cigarette smoking prevalence", Am J Public Health, 79, pp.152~157 (1989)
- Bartley M, "Social distribution of cardiovascular disease risk factors: change among men in England 1984-1993", J Epidemiol Community Health, 54, pp.806~814 (2000)
- Borrell C, "Trends in social class inequalities in health status, health-related behaviors, and health services utilization in a Southern European urban area (1983-1994)", Prev Med, 31, pp.691~701 (2000)
- Cho HJ, "Trends in socioeconomic diff erentials in cigarett e smoking behaviour between 1990 and 1998: a large prospective study in Korean men", Public Health, 118, pp.553~558 (2004)
- 김혜련, "우리나라에서 흡연율의 사회계층별 불평등과 변화추이", 보건사회연구, 27(2), pp.25~43 (2007), 한국보건사회연구원
- Khang YH, "Socioeconomic inequality in cigarette smoking: trends by gender, age, and socioeconomic position in South Korea, 1989-2003", Prev Med, 42, pp.415~422 (2006)
- Khang YH, "Explaining agespecific inequalities in mortality from all causes, cardiovascular disease and ischaemic heart disease among South Korean male public servants: relative and absolute perspectives", Heart, 94, pp.75~82 (2008)
- Kim HR, "Socioeconomic, behavioral, nutritional, and biological deter-minants of morbidity, mortality, and medical utilization in South Korea" (2006), Korea Institute for Health and Social Affairs
- Townsend J, "Cigarett e smoking by socioeconomic group, sex, and age: effects of price, income, and health publicity", BMJ, 309, pp.923~927 (1994)
- Gilman SE, "Socioeconomic status over the life course and stages of cigarett e use: initiation, regular use, and cessation", J Epidemiol Community Health, 57, pp.802~808 (2003)
- Fernandez E, "Smoking initiation and cessation by gender and educational level in Catalonia, Spain", Prev Med, 32, pp.218~223 (2001)
- Leinsalu M, "Social determinants of ever initiating smoking diff er from those of quitt ing: a cross-sectional study in Estonia", Eur J Public Health, 17, pp.572~578 (2007)
- Schiaffi no A, "Gender and educational differences in smoking initiation rates in Spain from 1948 to 1992", Eur J Public Health, 13, pp.56~60 (2003)
- Federico B, "Educational inequalities in initiation, cessation, and prevalence of smoking among 3 Italian birth cohorts", Am J Public Health, 97, pp.838~845 (2007)
- Backlund E, "A comparison of the relationships of education and income with mortality: the National Longitudinal Mortality Study", Soc Sci Med, 49, pp.1373~1384 (1999)
- Galobardes B, "Indicators of socioeconomic position (part 1)", J Epidemiol Community Health, 60, pp.7~12 (2006)
- Khang YH, "Relationship of education, occupation, and income with mortality in a representative longitudinal study of South Korea", Eur J Epidemiol, 20, pp.217~220 (2005)
- World Health Organization, "Guidelines for controlling and monitoring the tobacco epidemic" (1998), World Health Organization
- Andreeva TI, "Correlates of smoking initiation among young adults in Ukraine: a crosssectional study", BMC Public Health, 7, pp.106~ (2007)
- 조홍준, "우리 나라 표준직업분류에 따른 흡연율 차이: 2003년도 사회통계조사 자료의 분석", 예방의학회지, 39(4), pp.359~364 (2006), 대한예방의학회
- Jarvis MJ, "Why people smoke", BMJ, 328, pp.277~279 (2004)
- Fernandez E, "Wideningsocial inequalities in smoking cessation in Spain, 1987-1997", JEpidemiol Community Health, 55, pp.729~730 (2001)
- Phang H, "Change and inheritance: the structure and process of social status achievement in Korea", Korean J Sociol, 35, pp.1~30 (2001)
- 장세진, "우리나라 직장인 스트레스의 역학적 특성", 예방의학회지, 38(1), pp.25~37 (2005), 대한예방의학회
- Droomers M, "Educational diff erences in the intention to stop smoking: explanations based on the theory of planned behaviour", Eur J Public Health, 14, pp.194~198 (2004)
- Droomers M, "Why do lower educated people continue smoking? Explanations from the longitudinal GLOBE study", Health Psychol, 21, pp.263~272 (2002)
- Jarvis MJ, "Social patterning of individual health behaviors: the case of cigarette smoking, in Social Determinants of Health", pp.240~256 (1999), Oxford Univ. Press