title: Effects of Disease Detection on Changes in Smoking Behavior.
abstract: OBJECTIVE
  This study was conducted to investigate the effect that detection of chronic disease via health screening programs has on health behaviors, particularly smoking.
  
  
  METHODS
  We analyzed national health insurance data from 2007 and 2009. Subjects who were 40 years of age in 2007 and eligible for the life cycle-based national health screening program were included. The total study population comprised 153,518 individuals who participated in the screening program in 2007 and follow-up screening in 2009. Multiple logistic regression analyses were conducted by sex, with adjustment for health insurance type, socioeconomic status, body mass index, diabetes, hypertension, hyperlipidemia, and family history of cardiovascular and/or neurovascular disease.
  
  
  RESULTS
  Among men with smoking behavior changes, those newly diagnosed with hyperlipidemia were more likely to show a positive health behavior change, such as smoking cessation, and were less likely to have a negative behavior change (e.g., smoking initiation). Additionally, men newly diagnosed with diabetes showed lower rates of negative health behavior changes compared to those without disease. Body mass index (BMI)≥25, compared to BMI<23, showed higher rates of positive health behavior changes and lower rates of negative health behavior changes. Newly diagnosed chronic disease did not influence smoking behavior in women.
  
  
  CONCLUSIONS
  Smoking behavior changes were only detected in men who participated in health screening programs. In particular, those newly diagnosed with hyperlipidemia were more likely to stop smoking and less likely to start smoking.
authors.affiliation: National Cancer Control Institute, National Cancer Center, Goyang, Korea.
authors.forename: Jeoung A
authors.initials: JA
authors.lastname: Kwon
authors.affiliation: National Health Insurance Services, Seoul, Korea.
authors.forename: Wooman
authors.initials: W
authors.lastname: Jeon
authors.affiliation: Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.; Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Eun-Cheol
authors.initials: EC
authors.lastname: Park
authors.affiliation: Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Korea.; Department of Public Health, Graduate School, Yonsei University, Seoul, Korea.
authors.forename: Jae-Hyun
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Health Administration, Namseoul University, Cheonan, Korea.
authors.forename: Sun Jung
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Healthcare Management, Eulji University, Seongnam, Korea.
authors.forename: Ki-Bong
authors.initials: KB
authors.lastname: Yoo
authors.affiliation: Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
authors.forename: Minjee
authors.initials: M
authors.lastname: Lee
authors.affiliation: Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Korea.; Department of Hospital Management, Graduate School of Public Health, Yonsei University, Seoul, Korea. leevan@yuhs.ac.
authors.forename: Sang Gyu
authors.initials: SG
authors.lastname: Lee
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D015438:Health Behavior; D006306:Health Surveys; D006801:Humans; D006949:Hyperlipidemias / Q000175:diagnosis; D006973:Hypertension; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D009042:Motivation; D012044:Regression Analysis; D012907:Smoking / Q000453:epidemiology / Q000523:psychology*; D016540:Smoking Cessation / Q000523:psychology* / Q000706:statistics & numerical data; D012923:Social Class
keywords: Smoking; behavior change; life cycle-based; national; screening program