Factors Related to Smoking Relapse among Military Personnel in Korea: Data from Smoking Cessation Clinics, 2015–2017
- Eunjoo Kwon, Eun-Hee Nah
- Received July 07, 2018 Accepted August 31, 2018
- ABSTRACT
-
- Background
- Relapse is the common situation of smoking cessation attempts. There are few studies that analyzed the related factors of smoking relapse among military personnel. Thus, This study was performed to investigate factors related to smoking relapse among military personnel who participated smoking cessation clinics in Korea.
- Methods
- The study subjects were 19,874 military personnel who enrolled smoking cessation clinic from January in 2015 to December in 2017. Smoking cessation applied to criteria exhaled carbon monoxide and urine cotinine levels. Binominal logistic regression analysis was performed to confirm related factors of smoking relapse among military personnel who succeed to quit smoking.
- Results
- The smoking relapse rate of study subjects who succeeded in quitting smoking for 1-month was 15.3% after 3-months and 60.8% after 6-months follow-up. The factors associated with relapse smoking included implementing year, past year quit attempts, number or cigarettes smoked per day, regular exercise, blood pressure. Levels of nicotine dependence affected smoking relapse at 3-months follow-up.
- Conclusions
- Tailored approaches are necessary to reduce the rates of smoking relapse for military personnel who succeeded to quit smoking shortly but relapse back to smoking.
Table 1.
Characteristics of the study population
| Total | Smoking status at 1 month | Pb | ||
|---|---|---|---|---|
| Smoking cessation | Smoking | |||
| Sex | ||||
| Malea | 19,874 (100.0) | 16,661 (100.0) | 3,213 (100.0) | |
| Age, y | <0.001 | |||
| <20 | 309 (1.5) | 258 (1.5) | 51 (1.6) | |
| 20–24 | 16,665 (83.9) | 14,217 (85.3) | 2,448 (76.2) | |
| 25–29 | 1,154 (5.8) | 926 (5.6) | 228 (7.1) | |
| ≥30 | 1,746 (8.8) | 1,260 (7.6) | 486 (15.1) | |
| Type of military forces | <0.001 | |||
| Army | 14,125 (71.1) | 12,110 (72.7) | 2,015 (62.7) | |
| Navy/marine corps | 1,949 (9.8) | 1,577 (9.5) | 372 (11.6) | |
| Air forces | 3,323 (16.7) | 2,550 (15.3) | 773 (24.1) | |
| Auxiliary police, others | 477 (2.4) | 424 (2.5) | 53 (1.6) | |
| Military level | <0.001 | |||
| Private | 1,339 (6.7) | 1,142 (6.9) | 197 (6.1) | |
| Lance-coporal to coporal | 13,540 (68.1) | 11,712 (70.3) | 1,828 (56.9) | |
| Sergeant | 1,820 (9.2) | 1,422 (8.5) | 398 (12.4) | |
| Military officer | 3,175 (16.0) | 2,385 (14.3) | 790 (24.6) | |
| Year | <0.001 | |||
| 2015 | 7,903 (39.8) | 6,221 (37.3) | 1,682 (52.3) | |
| 2016 | 5,666 (28.5) | 4,652 (27.9) | 1,014 (31.6) | |
| 2017 | 6,305 (31.7) | 5,788 (34.8) | 517 (16.1) | <0.001 |
| Past year quit attempts | ||||
| Yes | 11,225 (56.5) | 13,452 (80.7) | 2,495 (77.7) | |
| No | 8,649 (43.5) | 3,209 (19.3) | 718 (22.3) | |
| Age of initial smoking, y | 17.5±3.0 | 17.5±3.0 | 17.6±3.0 | 0.663 |
| Number of cigarettes smoked per day | 11.9±6.0 | 11.6±5.9 | 13.0±6.0 | <0.001 |
| Smoking duration, y | 5.5±5.6 | 5.3±5.4 | 6.6±6.8 | <0.001 |
| Nicotine dependence, FTND | 3.1±2.2 | 3.0±2.1 | 3.4±2.1 | <0.001 |
| Body mass index, kg/m2 | 22.7±2.7 | 22.7±2.7 | 22.9±2.9 | <0.001 |
| Systolic blood pressure, mmHg | 122.7±11.5 | 122.6±11.3 | 123.4±12.7 | 0.001 |
| Diastolic blood pressure, mmHg | 77.7±9.2 | 77.6±9.0 | 78.2±10.0 | <0.001 |
| Regular exercise | <0.001 | |||
| Yes | 15,947 (80.2) | 13,452 (80.7) | 2,495 (77.7) | |
| No | 3,927 (19.8) | 3,209 (19.3) | 718 (22.3) | |
| High blood pressure | <0.001 | |||
| Normal | 4,920 (24.8) | 4,142 (24.9) | 778 (24.2) | |
| Borderline | 12,547 (63.1) | 10,576 (63.5) | 1,971 (61.4) | |
| Abnormal | 2,407 (12.1) | 1,943 (11.6) | 464 (14.4) | |
Table 2.
Smoking relapse at 3, 6 months who quitted smoking at 1 month in 2015–2017
| Smoking status at 3 months | Smoking status at 6 months | |||||
|---|---|---|---|---|---|---|
| Smoking relapse | Smoking cessation | Pa | Smoking relapse | Smoking cessation | Pa | |
| Total | 2,556 (15.3) | 14,105 (84.7) | 10,128 (60.8) | 6,533 (39.2) | ||
| Year | <0.001 | <0.001 | ||||
| 2015 | 1,114 (17.9) | 5,107 (82.1) | 4,327 (69.6) | 1,894 (30.4) | ||
| 2016 | 646 (13.9) | 4,006 (86.1) | 2,687 (57.8) | 1,965 (42.2) | ||
| 2017 | 796 (13.8) | 4,992 (86.2) | 3,114 (53.8) | 2,674 (46.2) | ||
| Age, y | <0.001 | <0.001 | ||||
| <20 | 53 (20.5) | 205 (79.5) | 202 (78.3) | 56 (21.7) | ||
| 20–24 | 2,096 (14.7) | 12,121 (85.3) | 8,549 (60.1) | 5,668 (39.9) | ||
| 25–29 | 165 (17.8) | 761 (82.2) | 584 (63.1) | 342 (36.9) | ||
| ≥30 | 242 (19.2) | 1,018 (80.8) | 793 (62.9) | 467 (37.1) | ||
| Type of military forces | <0.001 | 0.146 | ||||
| Army | 1,797 (14.8) | 10,313 (85.2) | 7,426 (61.3) | 4,684 (38.7) | ||
| Navy/marine corps | 263 (16.7) | 1,314 (83.3) | 941 (59.7) | 636 (40.3) | ||
| Air forces | 463 (18.2) | 2,087 (81.8) | 1,511 (59.3) | 1,039 (40.7) | ||
| Auxillary police, others | 33 (7.8) | 391 (92.2) | 250 (59.0) | 174 (41.0) | ||
| Military level | <0.001 | 0.003 | ||||
| Private | 174 (15.2) | 968 (84.8) | 711 (62.3) | 431 (37.7) | ||
| Lance coporal-coporal | 1,671 (14.3) | 10,041 (85.7) | 7,013 (59.9) | 4,699 (40.1) | ||
| Sergeant | 251 (17.7) | 1,171 (82.3) | 902 (63.4) | 520 (36.6) | ||
| Military officer | 460 (19.3) | 1,925 (80.7) | 1,502 (63.0) | 883 (37.0) | ||
| Nicotine dependence | <0.001 | 0.014 | ||||
| Low | 1,445 (14.4) | 8,591 (85.6) | 6,014 (59.9) | 4,022 (40.1) | ||
| Moderate | 930 (16.7) | 4,652 (83.3) | 3,478 (62.3) | 2,104 (37.7) | ||
| Severe | 181 (17.4) | 862 (82.6) | 636 (61.0) | 407 (39.0) | ||
| Past year quit attempts | <0.001 | <0.001 | ||||
| Yes | 1,379 (14.4) | 8,224 (85.6) | 5,650 (58.8) | 3,953 (41.2) | ||
| No | 1,177 (16.7) | 5,881 (83.3) | 4,478 (63.4) | 2,580 (36.6) | ||
| Regular exercise | <0.001 | <0.001 | ||||
| Yes | 1,954 (14.5) | 11,498 (85.5) | 8,016 (59.6) | 5,436 (40.4) | ||
| No | 602 (18.8) | 2,607 (81.2) | 2,112 (65.8) | 1,097 (34.2) | ||
| Number of cigarettes smoked per day | 0.001 | <0.001 | ||||
| ≤5 | 283 (12.8) | 1,930 (87.2) | 1,272 (57.5) | 941 (42.5) | ||
| 6–10 | 1,159 (15.3) | 6,425 (84.7) | 4,570 (60.3) | 3,014 (39.7) | ||
| 11–20 | 1,049 (16.1) | 5,464 (83.9) | 4,057 (62.3) | 2,456 (37.7) | ||
| ≥20 | 65 (18.5) | 286 (81.5) | 229 (65.2) | 122 (34.8) | ||
| Age of initial smoking, y | 0.590 | 0.955 | ||||
| <15 | 329 (15.5) | 1,797 (84.5) | 1,286 (60.5) | 840 (39.5) | ||
| 15–19 | 1,516 (15.1) | 8,511 (84.9) | 6,099 (60.8) | 3,928 (39.2) | ||
| ≥20 | 711 (15.8) | 3,797 (84.2) | 2,743 (60.8) | 1,765 (39.2) | ||
| Smoking duration, y | 0.001 | 0.030 | ||||
| <5 | 1,294 (15.1) | 7,267 (84.9) | 5,250 (61.3) | 3,311 (38.7) | ||
| 5–9 | 949 (14.8) | 5,463 (85.2) | 3,822 (59.6) | 2,590 (40.4) | ||
| ≥10 | 313 (18.5) | 1,375 (81.5) | 1,056 (62.6) | 632 (37.4) | ||
| Obesity | 0.539 | 0.602 | ||||
| Underweight | 54 (14.0) | 333 (86.0) | 237 (61.2) | 150 (38.8) | ||
| Normal | 1,303 (15.4) | 7,149 (84.6) | 5,156 (61.0) | 3,296 (39.0) | ||
| Overweight | 632 (14.9) | 3,620 (85.1) | 2,548 (59.9) | 1,704 (40.1) | ||
| Obesity | 567 (15.9) | 3,003 (84.1) | 2,187 (61.3) | 1,383 (38.7) | ||
| High blood pressure | <0.001 | <0.001 | ||||
| Normal | 554 (13.4) | 3,588 (86.6) | 2,428 (58.6) | 1,714 (41.4) | ||
| Borderline | 1,693 (16.0) | 8,883 (84.0) | 6,575 (62.2) | 4,001 (37.8) | ||
| Abnormal | 309 (15.9) | 1,634 (84.1) | 1,125 (57.9) | 818 (42.1) | ||
Table 3.
Adjusted ORs of smoking relapse at 3, 6 months who quitted smoking 1 month after smoking cessation interventiona
| Smoking relapse at 3 monthsb | Smoking relapse at 6 monthsb | |||||
|---|---|---|---|---|---|---|
| OR | CI | P | OR | CI | P | |
| Age, y | ||||||
| <20 | 1.426 | (0.920–2.211) | 0.113 | 2.266 | (1.536–3.343) | <0.001 |
| 20–24 | 0.991 | (0.726–1.354) | 0.957 | 0.963 | (0.753–1.231) | 0.762 |
| 25–29 | 1.049 | (0.799–1.377) | 0.729 | 1.074 | (0.864–1.335) | 0.519 |
| ≥30 | 1 (reference) | 1 | ||||
| Year | ||||||
| 2017 | 0.738 | (0.666–0.818) | <0.001 | 0.518 | (0.479–0.559) | <0.001 |
| 2016 | 0.746 | (0.670–0.831) | <0.001 | 0.612 | (0.564–0.664) | <0.001 |
| 2015 | 1 | 1 | ||||
| Nicotine dependence | ||||||
| Severe | 1.150 | (0.950–1.392) | 0.151 | 0.905 | (0.782–1.049) | 0.185 |
| Moderate | 1.163 | (1.050–1.287) | 0.004 | 1.030 | (0.954–1.112) | 0.453 |
| Low | 1 | 1 | ||||
| Past year quit attempts | ||||||
| No | 1.143 | (1.048–1.246) | 0.003 | 1.133 | (1.062–1.210) | <0.001 |
| Yes | 1 | 1 | ||||
| Number of cigarettes smoked per day | ||||||
| ≥20 | 1.281 | (0.926–1.772) | 0.134 | 1.319 | (1.020–1.705) | 0.034 |
| 11–20 | 1.212 | (1.036–1.418) | 0.016 | 1.160 | (1.039–1.297) | 0.009 |
| 6–10 | 1.224 | (1.061–1.412) | 0.005 | 1.075 | (0.974–1.187) | 0.151 |
| ≤5 | 1 | 1 | ||||
| Smoking duration, y | ||||||
| ≥10 | 0.979 | (0.763–1.257) | 0.871 | 1.016 | (0.839–1.231) | 0.868 |
| 5–9 | 0.939 | (0.852-.1035) | 0.207 | 0.942 | (0.877–1.012) | 0.104 |
| <5 | 1 | 1 | ||||
| Regular exercise | ||||||
| No | 1.343 | (1.212–1.488) | <0.001 | 1.288 | (1.186–1.399) | <0.001 |
| Yes | 1 | 1 | ||||
| Blood pressure | ||||||
| Abnormal | 1.216 | (1.043–1.418) | 0.012 | 1.008 | (0.901–1.127) | 0.893 |
| Borderline | 1.178 | (1.061–1.308) | 0.002 | 1.099 | (1.020–1.184) | 0.013 |
| Normal | 1 | 1 | ||||
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