Epidemiology and Health

COVID-19: Special Article

Smoking, drinking, and physical activity among Korean adults before and during the COVID-19 pandemic: a special report of the 2020 Korea National Health and Nutrition Examination Survey: Sunhye Choi, Jinwook Bahk, Suyeon Park, Kyungwon Oh, Kyunghee Jung-Choi; Epidemiol Health. 2022;44:e2022043. Published online April 25, 2022; DOI: https://doi.org/10.4178/epih.e2022043

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Abstract

OBJECTIVES
This study aimed to describe trends in health behaviours between 2011 and 2020 and compare the changes in these behaviours between the 2020 COVID-19 pandemic and previous periods according to socio-demographic variables.

METHODS

This study used data from the 2011 to 2020 Korea National Health and Nutrition Examination Survey. Current cigarette smoking, high-risk drinking, and inadequate physical activity levels were used as health behaviour indicators. The age-standardized prevalence, differences in prevalence between the periods, and the annual percentage change (APC) were calculated.

RESULTS

Current cigarette smoking showed a decreasing trend (APC, -2.6), high-risk drinking remained unchanged, and inadequate physical activity levels increased (APC, 3.5) during 2011-2020. There were significant differences in high-risk drinking (3.1%p; 95% confidence interval [CI], 0.3 to 5.9) and inadequate physical activity levels (4.3%p; 95% CI, 0.4 to 8.1) between 2019 and 2020 in men. Among men, increased high-risk drinking was found in those aged 40-49 years, non-single households, urban residents, and the middle and highest income groups between 2019 and 2020. The low educational group and manual workers among men aged 30-59 years also showed an increased proportion of high-risk drinking. Inadequate physical activity levels also increased among men between 2019 and 2020 in those aged 30-39 years, non-single households, urban residents, and the upper-middle-income group.

CONCLUSIONS

In the first year of the COVID-19 pandemic, Korean men’s high-risk drinking and inadequate physical activity levels increased. In addition to social efforts to reduce the spread of infectious diseases, active measures to positively change health behaviour are needed.

Summary

Korean summary
코로나 대유행 첫 해인 2020년, 한국 남성에서 고위험음주와 부적절한 신체 활동 수준이 증가하였다. 감염성 질환 대유행 시기, 확산을 차단하기 위한 사회적 노력과 더불어 건강행태에 부정적인 여파가 미치지 않도록 적극적인 대책이 필요함을 시사한다.

Key Message
In the first year of the COVID-19 pandemic, Korean men’s high-risk drinking and inadequate physical activity levels increased. Despite Korea's positive performance in various indicators during the COVID-19 pandemic, the socioeconomic and cultural effects of COVID-19 have affected people's health behaviour. In addition to social efforts to reduce the spread of infectious diseases, active measures to positively change health behaviour are needed.

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Current status of health promotion in Korea
Soo Young Kim
Journal of the Korean Medical Association.2022; 65(12): 776. CrossRef

Original Articles

Deprived areas and community water fluoridation in Brazil: a multilevel approach for refocusing public policy: Franklin Barbosa da Silva, José Leopoldo Ferreira Antunes, Paulo Frazão; Epidemiol Health. 2021;43:e2021031. Published online May 1, 2021; DOI: https://doi.org/10.4178/epih.e2021031

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Abstract PDF: Abstract
OBJECTIVES
The aim of this study was to determine whether geographic location, socioeconomic status, infant mortality, and mortality from diarrheal disease in health regions are associated with the provision of community water fluoridation (CWF) in Brazilian municipalities.
METHODS
A multilevel ecological study was conducted based on data from the National Survey of Basic Sanitation and Human Development Atlas. A multilevel analysis was carried out considering Brazilian municipalities as the first level and health regions as the second level, comprising sanitation, demographic, socioeconomic, and health characteristics.
RESULTS
The observation units comprised 5,565 municipalities clustered in 438 health regions in Brazil. The lack of CWF provision was positively associated with the following municipal characteristics: a below-median proportion of inhabitants covered by the sewage network, medium to very low human development index, below-median per capita gross domestic product, and an above-median percentage of expenditures on sanitation. In relation to the health regions, the likelihood of a lack of CWF provision was greater in the municipalities belonging to the health regions located in the Northern and Northeastern areas of Brazil and in those where child mortality due to acute diarrheal disease and the proportion of people with low income were higher when adjusted by municipal indicators.
CONCLUSIONS
Information on the characteristics associated with CWF provision constitutes important input for refocusing public policy to reduce inequalities among Brazilian municipalities and health regions. These findings may help policy-makers to understand the challenges facing CWF expansion in low-, middle-, and high-income countries.; Summary

Korean summary

Key Message
Just as the challenges for CWF's expansion in Brazil's most vulnerable areas require firm leadership for refocusing public policy, expansion in low- and middle-income countries demands a continued global collaborative effort.

Trends in health behaviors over 20 years: findings from the 1998-2018 Korea National Health and Nutrition Examination Survey: Soyeon Kim, Sunhye Choi, Jihee Kim, Suyeon Park, Young-Taek Kim, Ok Park, Kyungwon Oh; Epidemiol Health. 2021;43:e2021026. Published online April 19, 2021; DOI: https://doi.org/10.4178/epih.e2021026

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Abstract

OBJECTIVES
This study aimed to examine the trends in health behaviors in Korean population using data from the Korea National Health and Nutrition Examination Survey (KNHANES).

METHODS

The subjects were 96,408 adults aged 19 years or older who participated in the first (1998) through seventh (2016-2018) KNHANES health interview. The prevalence of health behaviors (cigarette smoking, alcohol drinking, and physical activity) and annual percent change (APC) were estimated using SAS and the Joinpoint program.

RESULTS

The prevalence of current cigarette smoking in men decreased by 2.8%p (APC= -2.8, p< 0.001) annually over the 20-year period, and the prevalence of exposure to secondhand smoke at home substantially decreased compared to 2005 (APC= -8.8, p< 0.001). Compared to 2005, the prevalence of current alcohol drinking in women, but not men, increased (APC= 2.0, p< 0.001), and the prevalence of binge drinking decreased in men (APC= -0.7, p< 0.001) and increased in women (APC= 2.4, p< 0.001). The prevalence of aerobic physical activity decreased from 2014 in both gendersd (p< 0.001). The prevalence of healthy behaviors practice (non-smoking, alcohol abstinence, and aerobic physical activity) was down-trending (APC= -5.3, p< 0.001), especially among women (APC= -6.4, p< 0.001).

CONCLUSIONS

Over the past 20 years, smoking behaviors improved. However, drinking behavior was unchanged and physical activity indicators markedly decreased. More active programs are necessary for improving health behaviors, which are major risk factors linked to chronic diseases.

Summary

Korean summary
국민건강영양조사(1998-2018) 자료를 활용하여 지난 20년간 성인의 건강행태를 분석한 결과 흡연율과 간접흡연 노출률은 지속적으로 감소하였고, 신체활동 실천율 또한 감소하였다. 월간음주율과 폭음률의 경우 남자는 큰 변화가 없었던 반면 여자는 모두 증가하였다.

Key Message
This study aimed to examine the trends in health behaviors in Korean population using data from the 1998-2018 Korea National Health and Nutrition Examination Survey (KNHANES). Over the past 20 years, the prevalence of cigarette smoking and exposure to secondhand smoke in Korean adults consistently decreased, as well as the prevalence of physical activity. There was no considerable change in men, whereas in women, the prevalence of alcohol drinking and binge drinking both increased.

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Adherence to Cancer Prevention Guidelines and Cancer Incidence and Mortality: A Population-Based Cohort Study
Jin-Kyoung Oh, Minji Han, Byungmi Kim, Eun Young Park
Cancer Research and Treatment.2023; 55(1): 15. CrossRef
Ocular motility disorders following coronavirus disease-19 vaccination
Kyung-Ah Park, Hyeshin Jeon, Dong Gyu Choi, Jae Ho Jung, Hyun-Jin Shin, Byung Joo Lee, Yeji Moon, Se-Youp Lee, Dong Cheol Lee, Soon Young Cho, Seong-Joon Kim, Sei Yeul Oh, Sunghyuk Moon, Shin Yeop Oh, Daye Diana Choi, Mi Young Choi, Won Jae Kim, Ungsoo Sa
Graefe's Archive for Clinical and Experimental Ophthalmology.2023; 261(4): 1127. CrossRef
Alcoholic liver disease in relation to cancer incidence and mortality: Findings from a large, matched cohort study in South Korea
Thi Phuong Thao Tran, Minji Han, Ngoc Minh Luu, Jin‐Kyoung Oh
Cancer Medicine.2023; 12(7): 8754. CrossRef
Associations of dual use of tobacco cigarettes and e‐cigarettes, sleep duration, physical activity and depressive symptoms among middle‐aged and older Korean adults
Mi‐Ae You, JiYeon Choi, Youn‐Jung Son
Nursing Open.2023; 10(6): 4071. CrossRef
Prevalence, Trend, and Risk Factors for Early Chronic Obstructive Pulmonary Disease: An Analysis of the Nationwide Population-Based Survey from 2010 to 2019 in South Korea
Taeyun Kim, Hyunji Choi, Ju-il Seo, Seung-Jin Kim, Ji-Eun Choi, Minsu Yun, Jihun Kang
COPD: Journal of Chronic Obstructive Pulmonary Disease.2023; 20(1): 153. CrossRef
Association of Muscle Strength with Non-Alcoholic Fatty Liver Disease in Korean Adults
Sung-Bum Lee, Yu-Jin Kwon, Dong-Hyuk Jung, Jong-Koo Kim
International Journal of Environmental Research and Public Health.2022; 19(3): 1675. CrossRef
Association of Handgrip Strength with Diabetes Mellitus in Korean Adults According to Sex
Sung-Bum Lee, Ji-Eun Moon, Jong-Koo Kim
Diagnostics.2022; 12(8): 1874. CrossRef
Smoking trajectory and cancer risk: A population-based cohort study
Minh Luu, Minji Han, Tra Bui, Phuong Thao Tran, Min-Kyung Lim, Jin Oh
Tobacco Induced Diseases.2022; 20(August): 1. CrossRef
Awareness of and practice toward cancer prevention recommendations: results of the Korean National Cancer Prevention Awareness and Practice Survey in 2021
Jin Kyoung Oh, Eunjung Park, Byungmi Kim, Yoon-Jung Choi, E Hwa Yun, Min Kyung Lim, Jeong-Soo Im, Eun Young Park
Epidemiology and Health.2022; : e2022068. CrossRef

Alcohol-related emergency department visits and income inequality in New York City, USA: an ecological study: Kathleen H. Reilly, Katherine Bartley, Denise Paone, Ellenie Tuazon; Epidemiol Health. 2019;41:e2019041. Published online October 8, 2019; DOI: https://doi.org/10.4178/epih.e2019041

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Abstract

OBJECTIVES
Previous research has found that greater income inequality is related to problematic alcohol use across a variety of geographical areas in the USA and New York City (NYC). Those studies used self-reported data to assess alcohol use. This study examined the relationship between within-neighborhood income inequality and alcohol-related emergency department (ED) visits.

METHODS

The study outcome was the alcohol-related ED visit rate per 10,000 persons between 2010 and 2014, using data obtained from the New York Statewide Planning and Research Cooperative System. The main predictor of interest was income inequality, measured using the Gini coefficient from the American Community Survey (2010-2014) at the public use microdata area (PUMA) level (n=55) in NYC. Variables associated with alcohol-related ED visits in bivariate analyses were considered for inclusion in a multivariable model.

RESULTS

There were 420,568 alcohol-related ED visits associated with a valid NYC address between 2010 and 2014. The overall annualized NYC alcohol-related ED visit rate was 100.7 visits per 10,000 persons. The median alcohol ED visit rate for NYC PUMAs was 88.0 visits per 10,000 persons (interquartile range [IQR], 64.5 to 133.5), and the median Gini coefficient was 0.48 (IQR, 0.45 to 0.51). In the multivariable model, a higher neighborhood Gini coefficient, a lower median age, and a lower percentage of male residents were independently associated with the alcohol-related ED visit rate.

CONCLUSIONS

This study found that higher neighborhood income inequality was associated with higher neighborhood alcohol-related ED visit rates. The precise mechanism of this relationship is not understood, and further investigation is warranted to determine temporality and to assess whether the results are generalizable to other locales.

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Jennifer Candipan, Alicia R. Riley, Janeria A. Easley
Housing Policy Debate.2023; 33(1): 129. CrossRef
Distribution of the compression and expansion of morbidity in 194 countries and territories, 1990–2016: The role of income inequality
He Chen, Jing Ning, Hongwei Hu, Haotian He
Sociology of Health & Illness.2023;[Epub] CrossRef
Variation in intervention stigma among medications for opioid use disorder
Erin F. Madden, Kristin K. Barker, Joshua Guerra, Corey Villanueva, Sandra H. Sulzer
SSM - Qualitative Research in Health.2022; 2: 100161. CrossRef
Bayesian Spatio-Temporal Modeling for the Inpatient Hospital Costs of Alcohol-Related Disorders
Zhen Yu, Keming Yu, Wolfgang K. Härdle, Xueliang Zhang, Kai Wang, Maozai Tian
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Social vulnerabilities for substance use: Stressors, socially toxic environments, and discrimination and racism
Hortensia Amaro, Mariana Sanchez, Tara Bautista, Robynn Cox
Neuropharmacology.2021; 188: 108518. CrossRef

Relationship between binge drinking experience and suicide attempts in Korean adolescents: based on the 2013 Korean Youth Risk Behavior Web-based Survey: Kyeong Hyang Byeon, Sun Ha Jee, Jae Woong Sull, Bo Young Choi, Heejin Kimm; Epidemiol Health. 2018;40:e2018046. Published online September 26, 2018; DOI: https://doi.org/10.4178/epih.e2018046

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Abstract

OBJECTIVES
Suicide and drinking problems in adolescents are increasing every year, and it is known that suicide is related to drinking. This study aims to identify the relationship between binge drinking experience (BDE) and suicide attempts in Korean adolescents.

METHODS

The Ninth Korean Youth Risk Behavior Web-based Survey (KYRBS), conducted in 2013, was used for analysis. Multiple logistic regression analysis was used to identify the relationship between BDE and suicide attempts, and the relationship between BDE and suicide attempts in middle and high school students was stratified by age.

RESULTS

BDE and suicide attempts were highly related. The odds ratio (OR) of attempted suicide in BDE was 1.63 times (95% confidence interval [CI], 1.28 to 2.09) higher then non-drinking in males. And the OR of attempted suicide in females was 1.21 times (95% CI, 1.07 to 1.37) higher then non-drinking in non-BDE, 1.79 times (95% CI, 1.47 to 2.19) higher in BDE. BDE was associated with suicide attempts in males aged 12 or 13 years (OR, 3.97; 95% CI, 1.57 to 10.03) and in females aged 15 years (OR, 2.66; 95% CI, 1.79 to 3.96).

CONCLUSIONS

BDE is an important factor related to suicide attempts in adolescents. In order to reduce suicide attempts, it is necessary to educate the youth about the regulation of BDE and drinking prevention.

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Thaise Queiroz de Melo, Delmilena Maria Ferreira de Aquino, Alisse Maria Chaves de Lima Peixoto, Jonathan Lopes de Lisboa, Raquel Conceição Ferreira, Patricia Maria Pereira de Araújo Zarzar, Viviane Colares, Fabiana de Godoy Bene Bezerra Laureano, Carolin
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Abel Emigdio-Vargas, Arcadio Morales-Pérez, Elizabeth Nava-Aguilera, Alfonso Dávalos-Martínez, Nubia Blanco-García, Elia Barrera-Rodriguez, Liliana Morales-Nava, Neil Andersson
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Aniceto Echalico Braza, Jinsoo Jason Kim, Sun Hee Kim
Journal of Lifestyle Medicine.2022; 12(3): 153. CrossRef
Impulsivity and Impulsivity-Related Endophenotypes in Suicidal Patients with Substance Use Disorders: an Exploratory Study
Alessandra Costanza, Stéphane Rothen, Sophia Achab, Gabriel Thorens, Marc Baertschi, Kerstin Weber, Alessandra Canuto, Hélène Richard-Lepouriel, Nader Perroud, Daniele Zullino
International Journal of Mental Health and Addiction.2021; 19(5): 1729. CrossRef
Association between sleep insufficient type and suicidal ideation among Korean middle and high school student
Soojeong Kim, Jin A Han, Eun-Ji Kim, Soon Young Lee
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Association Between Suicide and Drinking Habits in Adolescents
Ji Won Lee, Bong-Jo Kim, Cheol-Soon Lee, Boseok Cha, So-Jin Lee, Dongyun Lee, Jiyeong Seo, Young-Ji Lee, Youn-Jung Lee, Eunji Lim, Jae-Won Choi
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Victimization as a mediator in the relationship between sexual orientation and adolescent alcohol use
Ji-Su Kim, Yeji Seo
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Suicide Attempts and Contributing Factors among South and North Korean-Family Youth Using the Korean Youth Risk Behavior Web-based Survey
Soo Jung Rim, Min Geu Lee, Subin Park
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Associations between Gender, Alcohol Use and Negative Consequences among Korean College Students: A National Study
Patrick Allen Rose, Hugh Erik Schuckman, Sarah Soyeon Oh, Eun-Cheol Park
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Prediction models for high risk of suicide in Korean adolescents using machine learning techniques
Jun Su Jung, Sung Jin Park, Eun Young Kim, Kyoung-Sae Na, Young Jae Kim, Kwang Gi Kim, Vincenzo De Luca
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Association between Metabolic Syndrome and Alcohol drinking and Smoking histories in a rural area of Korea.: Hee Sung Ha, Hyeon Woo Yim, Yong Moon Park, Jin Hee Lee, Seung Hwan Lee, Hyuk Sang Kwon, Kun Ho Yoon, Ho Young Son, Moo Il Kang, Won Chul Lee; Korean J Epidemiol. 2008;30(2):281-293. Published online December 31, 2008; DOI: https://doi.org/10.4178/kje.2008.30.2.281

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Abstract PDF: Abstract
PURPOSE
Prevalence of metabolic syndrome is increasing markedly in rural area of Korea. Alcohol drinking and smoking are the main risk factors which shows the highest prevalence rate among the risk factors of metabolic syndrome. The aim of this study was to investigate the association between metabolic syndrome and alcohol drinking and smoking histories in a rural area of Korea.
METHODS
Data was obtained from 1,332(507 men, 825 women) individuals aged over 40 years who lived in rural area of Chungju city in 2007. Metabolic syndrome was defined by NCEP ATP III criteria and waist circumference was defined by WHO-APR(Asia Pacific Region). Data analysis was carried out using SAS version 8.02.
RESULTS
In men, adjusted odds ratio for metabolic syndrome was 2.78(1.09-7.05) for current alcohol drinker, 2.75(1.38-5.51) for past alcohol drinker, 3.25(1.58-6.67) for under 21 years old at start of alcohol drinking, 2.62(1.12-6.11) for light alcohol drinker, 6.01(2.65-13.64) for heavy alcohol drinker. In women, all the alcohol related risk factors were not statistically significant with metabolic syndrome. For all the smoking related risk factors were not statistically significant with metabolic syndrome in men and women. Adjusted odds ratio of alcohol drinking habits for each components of diagnostic criteria of metabolic syndrome was significant for high blood pressure, high fasting glucose and hypertriglyceridemia in men and abdominal obesity in women. Adjusted odds ratio of cigarette smoking habits for each components of diagnostic criteria of metabolic syndrome was significant for abdominal obesity in women.
CONCLUSION
Controlling alcohol drinking habits in men should be reinforced in order to prevent the metabolic syndrome in a rural area of Korea.; Summary

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Epidemiologic Study for the Association between Phenol Contaminated Drinking Water and Poor Pregnancy Outcomes in Taegu City.: Jung Han Park, Ju Young Lee; Korean J Epidemiol. 2000;22(1):20-31.

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From 14 to 17 March 1991 the Nakdong River which is a major source of drinking water for Taegu was contaminated with phenol that was spilled out of a factory in Gumi industrial park. Many people who drank the contaminated water complained of various symptoms and were apprehensive of possible adverse effect to the fetus. This study was conducted to examine the effect of drinking water contaminated with phenol on pregnancy outcome in Taegu. All of livebirths and stillbriths delivered in the 5 General Hospitals in Taegu during 1 year from 1 April 1991 were included for this study. For this duration, total number of babies delivered in the 5 General Hospitals was 21,196. Among them, 77.7%(16,468) were delivered from women living in Taegu and it accounted for 47.5% of 34,688 livbirths registered in Taegu during the same period. The babies born to the women living in Taegu were divided into phenol-exposed and unexposed groups. Exposed group was the residents of the area where contaminated water was supplied and they accounted for 81.4% of the women included for this study. Unexposed group was the residents of the area where drinking water was not contaminated with phenol and they accounted for 18.6% of the study subjects. Data were abstracted from the hospital records. All the rates were adjusted for the maternal age and parity by direct method. The abortion rates for the exposed group was 1.7 per 1,000 abortions and livebirths and 1.6 for the unexposed group. The stillbirth rate for the exposed group was 10.5 per 1,000 livebirths and stillbirths 20 weeks of gestation and 9.5 for unexposed group. The early neonatal death rate(within the 1st week after birth) for the exposed group was 7.8 per 1,000 livebirths and 5.4 for the unexposed group. The perinatal death rate for the exposed group was higher as 14.1 per 1,000 livebirths and stillbirths 28 weeks of gestation than 10.8 for the unexposed group. The proportions of intrauterine growth retardation(IUGR) were 2.7% for the exposed group and 3.3% for the unexposed group. Congenital anomaly incidence rates per 1,000 livebirths was 7.4 for the exposed group and 8.4 for the unexposed group. The low birthweight incidence rate for the exposed group was 6.6% and 6.5% for the unexposed group. These differences between two groups were not statistically significant. The premature birth rate(< 37 completed gestational week) was 6.0% for the exposed group and 4.8% for the unexposed group and the difference was statistically significant(p<0.05). Monthly variation of these indices did not show any clue that suggested concurrent change with the phenol contamination of the drinking water. There were no sufficient evidence that could support the hypothesis of adverse effects of phenol contaminated water on pregnancy outcome, such as abortion, stillbirth, premature birth, IUGR, congenital anomalies and early neonatal death.; Summary

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The Cross-sectional Study on the Relationship of Health Behavior and Immune Function.: Soon Young Lee, Yeon Sook Yun, Ki Whan Kim, Seon Woo Kim, Ju Won Park; Korean J Epidemiol. 1998;20(2):212-218.

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To investigate the association of individual health behaviors with imune response against tumor or viral infection, peripheral blood lymphocytes of 185 healthy males in aged from 35 to 44 years for natural killer(NK) cell activity, frequencies of lymphocytes subsets and proliferation response of T and B cell. NK cell activity was determined by Cr release activity assay and lymphocytes subsets were counted using surface antigens(CD4, CD8, CD56) by flow cytometry. The responsiveness of T and B were measured as proliferation stimulated by mitogens. Subjects were classified into four distinct lifestyle patterns, health promotive lifestyle, passive lifestyle, fitness lifestyle and hedonic lifestyle from information on their health behaviors(cigarette smoking, alcohol consumption, and physical activity). Health promotive lifestyle had the highest NK cell activity(Lu30/10(6)CD56) which was significantly higher than hedonic lifestyle)p<0.05). The responsiveness of T cell was significantly lower in passive lifestyle and hedonic lifestyles compared to health promotive lifestyle and fitness lifestyles(p<0.05). However, there was no significant difference in the responsiveness of B cell, CD4, and CD8 among four lifestyles. This cross-sectional study showed the NK cell activity in individuals with desirable health behaviors was lower. The variation of immunity among individuals was not considered in this study, hence the intervention study reflection individual variations is recommended.; Summary

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Cigarette Smoking, Alcohol Consumption, and Breast Cancer in Korea.: Dae Hee Kang, Keun Young Yoo, Sue Kyung Park, Hye Won Koo, Jun Suk Suh, Young Chul Kim, Dong Young Noh, Kuk Jin Choe; Korean J Epidemiol. 1998;20(1):60-69.

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A hospital-based case-control study was conducted to assess the relationship between cigarette smoking, alcohol consumption, and the risk of bgreast cancer in Korea. Histologically confirmed incident cases of breast cancer(n=146) were selected from the inpatients at the Department of Surgery, Seoul National University Hospital and Borame Hospital during 1994 to 1997. Women ithout self-reported past history of any malignandies were regarded as controls and selected at the same hospitals during the same period(n-153). Information on life-styles including cigarette smoking, alcohol drinking, and reproductive history were obtained by direct interview using standardixed questionnaire. Each case was matched with one control by 5-year age category(n=146). Adjusted odds ratios and 90% confidence intervals were estimated by unconditional linear logistic regression model. For smokers, age at first smoking was significantly associated with the breat cancer risk(adjusted OR=14.1, 90% CI=1.24-364.2). Particularly noteworthy was an increasing tendency of the breast cancer risk with the duration of alcohol consumtion in years aong alcohol drinkers(ptrend<0.1). These findings suggest that cigarette smoking at an earlier age and alcohol intake might contribute to the risk factor of breast cancer in Korean women. Further investigation on the association between genetic polymorphism of xenobiotic metabolism enxymes of environmental carcinogens and breast cancer should be needed.; Summary

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