Eon Sook Lee

Cognitive Behavioral Therapy (CBT) is a commonly used intervention for smoking cessation. This PROSPERO-registered systematic review and meta-analysis (CRD42024581823) evaluated the long-term effectiveness of CBT in achieving abstinence for six months or longer. Sixteen randomized controlled trials (RCTs) involving 2,531 adults were included. Studies comparing CBT to minimal care and published in English or Korean were selected; those focusing on Acceptance and Commitment Therapy (ACT) or mindfulness were excluded. Results indicate that CBT significantly improves long-term cessation rates. Subgroup analyses showed that both CBT alone and CBT with pharmacotherapy were effective compared with minimal care. In particular, CBT demonstrated greater effectiveness among patients with smoking-related conditions such as COPD and cardiovascular disease. Risk of bias was generally rated as “some concerns,” and the certainty of evidence was moderate. These findings support CBT’s clinical utility, especially when integrated with pharmacological treatments or tailored to high-risk populations.

Seo YB, et al. J Korean Med Sci. 2025 Oct;40(39):e299. https://doi.org/10.3346/jkms.2025.40.e299

Soo Hyun Park, Eon Sook Lee, Jieun Kwon, Lina Kim, Yeonsoo Kim, Tae Kyung Kim, Nayoung Ahn, Young Kill Yun, Sun Joo Lee, Young Sun Lee, Hyo Jeong Lee, Suk Ha Jeon, Tae Im Yi. KJSM 2024;42:247-53. https://doi.org/10.5763/kjsm.2024.42.4.247

Yoo Bin Seo, Eon Sook Lee. JKSRNT 2024;15:107-14. https://doi.org/10.25055/JKSRNT.2024.15.3.107

Introduction Dual use of e-cigarettes and cigarettes is a growing usage pattern in adults, but little is known about the motivations underlying this trend. We investigated the reasons for e-cigarette use among adults who smoke, considering variation in sociodemographic subgroups. Methods This repeated cross-sectional study analysed adults who smoked at least weekly and vaped at any frequency. Data were from the International Tobacco Control Korea Surveys conducted in 2016 (n=164) and 2020 (n=1088). Fourteen reasons for e-cigarette use were assessed in both waves. Subgroup analyses were performed by age, sex and educational level. Results The top reasons for e-cigarette use in 2020 were curiosity (62.8%), less harmful than smoking (45.4%) and taste (43.2%). Curiosity was the most cited across age, sex and education subgroups. Significant differences were observed in 2020 compared with 2016, with lower percentages in goal-oriented reasons: helping quit smoking (36.3% vs 48.9%; p=0.017), helping cut down smoking (35.3% vs 52.7%; p=0.001), less harmful to others (39.0% vs 54.6%; p=0.003) and more acceptable (31.6% vs 61.2%; pConclusions E-cigarette use for curiosity and pleasure predominated among adults who smoked. The reasons for dual use in adults have shifted from goal-oriented to non-goal-oriented.

Background: Cigarette smoking is the leading preventable cause of death, with smoking cessation representing the most effective strategy to reduce the risk of smoking-related diseases. Pharmacotherapeutic interventions for smoking cessation such as nicotine replacement therapy, bupropion, and varenicline aim to manage the symptoms of nicotine cravings and withdrawal. Evidence-based practice guidelines for pharmacotherapy in smoking cessation have been recently developed in Korea.Current Concepts: Among the general population, varenicline is the recommended first-line therapy for smoking cessation, surpassing nicotine patches and bupropion therapy. Although varenicline is commonly effective, combination therapy with varenicline and a nicotine patches may be considered when varenicline monotherapy is insufficient for managing nicotine cravings and withdrawal symptoms. Extended-duration therapy (>12 weeks) has demonstrated greater efficacy compared to standard therapy (6-12 weeks). Varenicline can promote attempts to quit smoking in smokers who are not yet prepared to quit. In cases of smokers with comorbid psychiatric conditions, varenicline is preferred over nicotine patches. The efficacy and safety profiles of smoking cessation medications have been well established in patients with cardiovascular diseases.Discussion and Conclusion: Smoking is a chronic condition associated with a high risk of relapse, emphasizing the crucial role of pharmacotherapy in increasing the success rates of smoking cessation. In accordance with evidence-based smoking cessation guidelines, the careful selection of pharmacotherapeutic agents tailored to individual smokers is pivotal.

Although major countries, such as South Korea, have developed and disseminated national smoking cessation guidelines, these efforts have been limited to developing individual societies or specialized institution-based recommendations. Therefore, evidence-based clinical guidelines are essential for developing smoking cessation interventions and promoting effective smoking cessation treatments. This guideline targets frontline clinical practitioners involved in a smoking cessation treatment support program implemented in 2015 with the support of the National Health Insurance Service. The Guideline Development Group of 10 multidisciplinary smoking cessation experts employed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE)-ADOLOPMENT approach to review recent domestic and international research and guidelines and to determine evidence levels using the GRADE methodology. The guideline panel formulated six strong recommendations and one conditional recommendation regarding pharmacotherapy choices among general and special populations (mental disorders and chronic obstructive lung disease [COPD]). Strong recommendations favor varenicline rather than a nicotine patch or bupropion, using varenicline even if they are not ready to quit, using extended pharmacotherapy (>12 weeks) rather than standard treatment (8–12 weeks), or using pharmacotherapy for individuals with mental disorders or COPD. The conditional recommendation suggests combining varenicline with a nicotine patch instead of using varenicline alone. Aligned with the Korean Society of Medicine’s clinical guideline development process, this is South Korea’s first domestic smoking cessation treatment guideline that follows standardized guidelines. Primarily focusing on pharmacotherapy, it can serve as a foundation for comprehensive future smoking cessation clinical guidelines, encompassing broader treatment topics beyond medications.

Jun Hyung Lee, Yoo Bin Seo, Eon Sook Lee. JKSRNT 2023;14:91-100. https://doi.org/10.25055/JKSRNT.2023.14.3.91