A Cohort Study of Active and Passive Smoking in Korea

韩国主动吸烟和被动吸烟的队列研究

• 批准号: 6448550
• 负责人: JONATHAN M SAMET
• 金额: $ 7.42万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-04-19 至 2004-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6448550
• 关键词: Asia; adolescence (12-20); adult human (21+); cancer risk; data collection; disease /disorder proneness /risk; epidemiology; health insurance; hospital utilization; human data; human mortality; information systems; passive smoking; questionnaires; smoking

Although 50 years of research findings have causally linked active and passive smoking to cancer and other diseases, further epidemiologic research on the risks of tobacco smoking is still needed. One specific need is for studies in countries other than the developed, western countries where the majority studies have been conducted to date. Most of the world's smokers live outside of the western countries, primarily in Asia where a majority of males are smokers in many countries. Background disease rats and distributions of lifestyle risk factors are notably distinct in these populations, particularly in comparison with populations of previously studied western males. The majority of women, largely non-smokers, and children in Asian countries are exposed to environmental tobacco smoke (ETS). This small grant application requests support to establish a cohort study of active and passive smoking and risk for cancer and other diseases among persons receiving health insurance coverage through the Korean Medical Insurance Corporation (KMIC). The KMIC provides coverage to civil service workers, teachers, and their dependents in the Republic of Korea (South Korea). The total population insured by the KMIC is substantial, accounting for 11% of the country's 43 million residents in 1990. The insured then included approximately 1.2 million workers and an additional 3.4 dependents. A cohort study will be developed using the database of the KMIC. Risk factor information is collected in biennial medical examinations, which are required for the insured workers and are voluntarily completed by dependents. The data collected in the biennial examinations covering smoking and other lifestyle risk for disease and findings from routine laboratory work are also available. Outcomes are tracked through the hospital record system and also by mortality matches. Family members of the insured can be identified through record linkage using the unique identification number of the insured. In an effort to advance understanding of smoking and cancer and other diseases in Asian countries, as well as among Asian Americans, investigators at the Yonsei University and the Johns Hopkins University School of Hygiene and Public Health plan to collaborate in developing and then using this epidemiologic resource to carry out a major program of research on the risks of active and passive smoking in Korea. The Yonsei University has access to the KMIC cohort and already has shown its potential in several reports on cancer and cardiovascular disease. The Johns Hopkins group adds expertise in cohort studies and smoking. This application requests support to establish a comprehensive database in support of the cohort study and to carry out analyses on active and passive smoker and cancer. During the two years of support requested in this small grant application, data will be abstracted from medical records on key exposure variables from exams carried out in 1992 and 1993, providing lifestyle and laboratory data for cohort expected to number approximately 1.6 million adults. Mortality will be tracked from 1992-2003 and inpatient encounters, coded by diagnosis, will be identified for 1998-2003. To demonstrate the potential of the study, an investigation will be carried out on active and passive smoking and lung cancer risk. We intend to set data collection in place to maintain and extend this cohort. The large size of this cohort and the unusually strong possibility for data linkage makes the KMIC population a unique and cost effective study opportunity. This cohort study would have the potential to generate powerful evidence to describe the risk of smoking in a population with distinct background disease rates and distribution of lifestyle risk factors relative to western populations previously studied.

尽管有50年的研究结果与癌症和其他疾病有因果关系和被动吸烟与癌症和其他疾病的联系，但仍需要进一步的流行病学研究对吸烟的风险。一个特定的需求是在迄今为止已经进行多数研究的西方国家以外的其他国家进行研究。世界上大多数吸烟者都生活在西方国家以外，主要是在许多国家中大多数男性都是吸烟者的亚洲。背景疾病大鼠和生活方式危险因素的分布在这些人群中明显不同，尤其是与先前研究的西方男性相比。大多数妇女，大部分非吸烟者和亚洲国家的儿童都暴露于环境烟草烟雾（ETS）。这项小型赠款申请要求支持通过韩国医疗保险公司（KMIC）在接受健康保险范围的人员中建立积极和被动吸烟和其他疾病的风险和其他疾病的队列研究。 KMIC为韩国共和国（韩国）（韩国）的公务员，教师及其家属提供报道。 KMIC保险的总人口是可观的，占1990年该国4300万居民的11％。当时，被保险人包括约120万工人和另外3.4家依赖人。将使用KMIC的数据库开发一项队列研究。风险因素信息收集在两年一的医学检查中，这些医学检查是被保险人所需的，并由家属自愿完成。在两年期检查中收集的数据涵盖了吸烟和其他生活方式风险以及常规实验室工作的发现。通过医院记录系统和死亡率匹配跟踪结果。可以使用被保险人的唯一标识号通过记录联系来确定被保险人的家庭成员。为了提高亚洲国家以及亚裔美国人的吸烟和癌症以及其他疾病的了解，Yonsei大学的研究人员和约翰·霍普金斯大学卫生学院和公共卫生计划和公共卫生计划在开发中合作，然后利用这种流行病学资源来实施有关韩国活跃和被动吸烟风险的主要研究计划。 Yonsei大学可以进入KMIC队列，并且已经在几种有关癌症和心血管疾病的报告中表现出了潜力。约翰·霍普金斯（Johns Hopkins）集团在队列研究和吸烟方面增加了专业知识。该应用程序要求支持建立一个全面的数据库，以支持队列研究，并对主动和被动吸烟者和癌症进行分析。在此小型赠款申请中要求的两年支持中，将从1992年和1993年进行的考试的关键暴露变量的医疗记录中抽象出数据，从而提供了预期约160万成年人的同伙生活方式和实验室数据。将在1992 - 2003年从1998 - 2003年确定死亡率，并通过诊断进行编码。为了证明研究的潜力，将对积极和被动吸烟和肺癌风险进行研究。我们打算将数据收集设置在适当的位置，以维护和扩展此队列。该队列的庞大尺寸以及与数据链接的异常强大的可能性使KMIC人群成为独特而成本效益的学习机会。这项队列研究将有可能产生有力的证据，以描述与先前研究的西方人群相比，具有不同背景疾病率和生活方式风险因素分布的人群中吸烟的风险。