Trajectory of Smoking and Incidence of Atherosclerotic Cardiovascular Disease among Korean Young Adult Men

Abstract

Introduction: Smoking among young adults is associated with atherosclerotic cardiovascular disease (ASCVD) in middle age. Our aim was to analyze the trajectory of smoking in young adults and analyze the effects of the trajectory group on incident ASCVD. Methods: This study was conducted among 60,709 young adult men aged 20–29 years who received health screening every two years from 1992–2004. Trajectory analysis was performed through smoking survey data measured 7 times during this period. ASCVD, including ischemic heart disease (IHD) and stroke events were confirmed from 2005–2015. The association between the trajectory group and ASCVD risk was analyzed using Cox proportional hazard models, controlling for covariates and mediators. Results: Trajectory analysis showed that smoking categorized into five groups as follows: Group 1 (28.3%), low steady; Group 2 (14.7%), lowering; Group 3 (17.3%), high steady; Group 4 (15.6%), rise and fall; and Group 5 (24.2%), very high steady. The model performance of the trajectory model (Akaike information criterion; AIC = 51,670.78) with mediators was better than the model (AIC = 51,847.85) without mediators. Group 5 showed a 49% higher risk of ASCVD than Group 1. The risk of IHD was 1.63-times higher for Group 5 and 1.31-times higher for Group 4, compared to Group 1. Compared to Group 1, Group 5 had a 1.36- and 1.58-times higher risk for total stroke and ischemic stroke, respectively. Conclusions: In young adult men, the multiple measured trajectory model with mediators was far more informative than one-time smoking for explaining the association with cardiovascular disease.

Smoking trajectory and cancer risk: A population-based cohort study

“…In addition, the difference originated from the participants. The sample in our study was larger, and we included all adult men aged ≥20 years for the analysis, whereas the studies of Jee et al 15 , 18 only recruited young individuals aged 20–39 years or 20–29 years.…”

Trajectory of smoking and early bladder cancer risk among Korean young adult men

“…Even-numbered and odd-year births have been provided health examination by National Health Insurance Service (NHIS). The characteristics of this study can be found in the previously reported Korean Cancer Prevention Study (KCPS) [ 14 , 15 ]…”

“…Even-numbered and odd-year births have been provided health examination by National Health Insurance Service (NHIS). The characteristics of this study can be found in the previously reported Korean Cancer Prevention Study (KCPS) [14,15] For this study, 430,951 individuals (307,652 males, 123,299 females) aged 20-39 years were selected based on their ages in 1992 and 1993. Among them, the smoking rate in women was extremely low (0.2%), and they were excluded.…”

“…Third, the study subjects were mostly middle-aged and elderly. However, in fact, a rapid increase in the smoking rate is observed in young people in their 20s and 30s [13,14].…”

Substance Abuse and Public Health: A Multilevel Perspective and Multiple Responses

“…In this special issue, Zubak et al [21] examined the effects of scholastic factors-for example, grade point averages, school and other unexcused absences and poor behavior-in relation to illicit drug misuse (IDM) and its initiation among adolescents in Bosnia and Herzegovina. Jee et al [22] investigated the trajectories of different smoking groups of young South Korean male adults and the implication of the habit in their atherosclerotic cardiovascular disease (ASCVD) in middle age. However, substance takers are never restricted to any specific social groups; they can be found in communities of professionals, social talents, elders and university students.…”