Epidemiol Health.  2017;39:e2017026. 10.4178/epih.e2017026.

The association between smoking or passive smoking and cardiovascular diseases using a Bayesian hierarchical model: based on the 2008-2013 Korea Community Health Survey

Affiliations
  • 1Graduate School of Public Health, Seoul National University, Seoul, Korea. hokim@snu.ac.kr

Abstract


OBJECTIVES
Smoking and passive smoking have been extensively reported as risk factors of cardiovascular morbidity and mortality. Despite the biological mechanisms underlying the impact of hazardous chemical substances contained in tobacco in cardiovascular diseases (CVD), studies investigating the association between smoking and passive smoking with morbidity are at an inchoate stage in Korea. Therefore, this study aimed to estimate the risks of smoking and passive smoking on cardiovascular morbidity at the national and regional levels.
METHODS
This study calculated sex-standardized and age-standardized prevalence of CVD and smoking indices in 253 community health centers (si/gun/gu) in Korea using the 2008-2013 Korea Community Health Survey data. Furthermore, a Bayesian hierarchical model was used to estimate the association of smoking and passive smoking with the prevalence of CVD from the national and regional community health centers.
RESULTS
At the national level, smoking was significantly associated with stroke (relative risk [RR], 1.060) and hypertension (RR, 1.016) prevalence, whilst passive smoking at home and work were also significantly associated with prevalence of stroke (RR, 1.037/1.013), angina (RR, 1.016/1.006), and hypertension (RR, 1.010/1.004). Furthermore, the effects of smoking and passive smoking were greater in urban-industrial areas than in rural areas.
CONCLUSIONS
The findings of this study would provide grounds for national policies that limit smoking and passive smoking, as well as regionally serve as the basis for region-specific healthcare policies in populations with high CVD vulnerability.

Keyword

Smoking; Passive smoking; Cardiovascular diseases; Korea Community Health Survey; Korea

MeSH Terms

Cardiovascular Diseases*
Community Health Centers
Delivery of Health Care
Health Surveys*
Hypertension
Korea*
Mortality
Prevalence
Risk Factors
Smoke*
Smoking*
Stroke
Tobacco
Tobacco Smoke Pollution*
Smoke
Tobacco Smoke Pollution
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