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        Medical Expenditure of National Health Insurance Attributable to Smoking among the Korean Population

        Lee, Sang-Yi,Jee, Sun-Ha,Yun, Ji-Eun,Kim, Su-Young,Lee, Ja-Kyung,Samet, Jonathan M.,Kim, Il-Soon The Korean Society for Preventive Medicine 2007 예방의학회지 Vol.40 No.3

        Objectives : The purpose of this study was to determine the population-attributable risk (PAR) and estimate the total medical expenditure of the Korean National Health Insurance (KNHI) due to smoking. Methods : We used data from the Korean Cancer Prevention Study of 1,178,138 Koreans aged 30 to 95. These data were available from 1992 to 2003 and covered a long-term follow-up period among the Korean population. Results : The total medical expenditure of KNHI related to smoking increased by 27% from $324.9 million in 1999 to $413.7 million in 2003. By specific diseases, smoking-attributable KNHI medical expenditure was the highest for lung cancer ($74.2 million), followed by stroke ($65.3 million), COPD ($50.1 million), CHO ($49 million) and stomach cancer ($30 million). A total of 1.3 million KNHI patients were suffering from smoking-related diseases in 2003. We predicted rises in total KNHI medical expenditure related to smoking to $675.1 million (63% increase compared with that of 2003) and in the total number of KNHI patients suffering from smoking-related diseases to about 2.6million (an approximate 100% increase compared with those in 2003) in 2015. Conclusions : We found a substantial economic burden related to the high smoking prevalence in South Korea.

      • Fasting Glucose Level and the Risk of Incident Atherosclerotic Cardiovascular Diseases

        Park, Chanshin,Guallar, Eliseo,Linton, John A.,Lee, Duk-Chul,Jang, Yangsoo,Son, Dong Koog,Han, Eun-Jeong,Baek, Soo Jin,Yun, Young Duk,Jee, Sun Ha,Samet, Jonathan M. American Diabetes Association 2013 Diabetes care Vol.36 No.7

        <P><B>OBJECTIVE</B></P><P>Although diabetes increases the risk of cardiovascular disease (CVD) and mortality, the dose-response relationship between fasting glucose levels below those diagnostic of diabetes with cardiovascular events has not been well characterized.</P><P><B>RESEARCH DESIGN AND METHODS</B></P><P>A prospective cohort study of more than one million Koreans was conducted with a mean follow-up of 16 years. A total of 1,197,384 Korean adults with no specific medical conditions diagnosed were classified by baseline fasting serum glucose level. Associations of fasting glucose level with CVD incidence and mortality, stroke incidence and mortality, and all-cause mortality were analyzed using multivariate proportional hazards regression.</P><P><B>RESULTS</B></P><P>The relationships between fasting glucose levels and CVD risks generally followed J-shape curves, with lowest risk in the glucose range of 85–99 mg/dL. As fasting glucose levels increased to >100 mg/dL, risks for CVD, ischemic heart disease, myocardial infarction, and thrombotic stroke progressively increased, but risk for hemorrhagic stroke did not. Fasting glucose levels <70 mg/dL were associated with increased risk of all stroke (hazard ratio 1.06, 95% CI 1.01–1.11) in men and (hazard ratio 1.11, 1.05–1.17) in women.</P><P><B>CONCLUSIONS</B></P><P>Both low glucose level and impaired fasting glucose should be considered as predictors of risk for stroke and coronary heart disease. The fasting glucose level associated with the lowest cardiovascular risk may be in a narrow range.</P>

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        한국인 흡연과 사망위험에 대한 11년 추적연구

        지선하(Sun-Ha Jee),조인호(In-Ho Jo),윤지은(Ji-Eun Yun),박정용(Jung-Yong Park),설재웅(Jae-Woong Sull),오희철(Hee-Choul Ohrr),이상이(Sang-Vi Lee),윤유식(Yoo-Sik Yoon),Jonathan M Samet, 김일순(II-Soon Kim) 한국역학회 2005 Epidemiology and Health Vol.27 No.1

        Objective : In Korea, male smoking prevalence is among the world's highest and mortality rates from smoking-caused cancers, particularly lung cancer, are escalating. This cohort study examined the effects of cigarette smoking on the risk of mortality from all causes, cancers and cardiovascular diseases(CVD), and characterized the relationship of the risk with the amount and duration of cigarette smoking. Method : A eleven-year prospective cohort study was carried out of on 1,207,592 Koreans, 30 to 95 years of age. The study population includes participants in a national insurance program, who completed a questionnaire on smoking and other risk factors. The main outcome measures were death from all causes, cancer and CVD, obtained through record linkage. At baseline, 482,997 men(60.0%) and 19,755(5.3%) women were current cigarette smokers. Results : In multivariate Cox proportional hazards models, controlling for age, alcohol drinking, exercise, and obesity, current smoking among men increased the risks of mortality from all cause death (relative risk[RR], 1.56; 95% confidence interval[CI], 1.52~1.59), all cancer (1.75, 1.68~1.82), and CVD(1.46, 1.38~1.55). Similar results were found for mortality among women. Smoking also increased the risks of mortality for cancer of the lung(4.60, 4.09~5.33) and other cancers, including larynx, bile duct, esophagus, liver, stomach, pancreas, bladder, and also leukemia. Current smoking among women increased the risk of lung cancer mortality(RR=2.83, 95% CI 2.38~3.36). Conclusion : In Korea, smoking is an independent risk factor for death from all causes, CVD and a number of major cancers. The findings affirm the need for aggressive tobacco control in Korea in order to minimize the epidemic of smoking-caused disease.

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