Korean J Fam Pract 2019; 9(2): 239-244  https://doi.org/10.21215/kjfp.2019.9.2.239
The Association between the Stress Relief Method and High-Risk Alcohol Drinking: The 2005 Korea National Health and Nutrition Examination Survey
Woo-seok Choi1, Min-Ok Jung1, Yu-Jin Kwon2,*
1Department of Family Medicine, Yonsei University College of Medicine, Seoul; 2Department of Family Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Korea
Yu-Jin Kwon, Tel: +82-31-331-8816, Fax: +82-31-3462-8209, E-mail: digda3@yuhs.ac, ORCID: http://orcid.org/0000-0002-9021-3856
Received: August 29, 2017; Revised: September 19, 2017; Accepted: September 19, 2017; Published online: April 20, 2019.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Background: The importance of stress relief methods is becoming an important issue in developed societies. However, no studies have examined the effects of stress relief methods on the risk of engaging in high-risk alcohol consumption. Therefore, we aimed to investigate the association between stress relief methods and high-risk alcohol consumption.
Methods: This study included a total of 5,313 subjects who participated in the 2005 Korean National Health and Nutritional Examination Survey. To evaluate high-risk alcohol consumption, we used the alcohol use disorders identification test (AUDIT-K). Regarding the stress relief method, participants were divided into three groups as follows: 1) those who were non-smokers and relieved stress using methods other than smoking (Group A), 2) those who were smokers but relieved stress using methods other than smoking (Group B), and 3) those who relieved stress by smoking (Group C). Multiple logistic regression analysis was conducted to examine the association between the stress relief method and high-risk alcohol consumption.
Results: The mean scores of AUDIT-K were 5.7 for Group A, 10.0 for Group B, and 11.4 for Group C (P-value<0.001). Compared to Group A, the odds ratio and 95% confidence intervals for high-risk alcohol consumption were 3.91 (1.96–7.80) for Group B and 6.26 (2.99–13.10) for Group C after adjusting for age, sex, body mass index, household income, education levels, residential area, marital status, stress levels, hypertension, diabetes, and dyslipidemia.
Conclusion: We found that the participants who relieved stress by smoking had a significantly higher risk of engaging in high-risk alcohol consumption.
Keywords: Stress; Alcohol; Smoking
  1. Cho JJ. Stress and disease: evidence based review. J Korean Med Assoc 2013;56: 460-1.
  2. Watson D, Pennebaker JW. Health complaints, stress, and distress: exploring the central role of negative affectivity. Psychol Rev 1989; 96: 234-54.
    Pubmed CrossRef
  3. Mohan A, Sharma R, Bijlani RL. Effect of meditation on stress-induced changes in cognitive functions. J Altern Complement Med 2011; 17: 207-12.
    Pubmed CrossRef
  4. Deshpande RC. A healthy way to handle work place stress through yoga, meditation and soothing humor. Int J Environ Sci 2012; 2: 2143-54.
  5. Choi S, Kim Y, Park S, Lee J, Oh K. Trends in cigarette smoking among adolescents and adults in South Korea. Epidemiol Health 2014; 36: e2014023.
    Pubmed KoreaMed CrossRef
  6. Gandini S, Botteri E, Iodice S, Boniol M, Lowenfels AB, Maisonneuve P, et al. Tobacco smoking and cancer: a meta-analysis. Int J Cancer 2008; 122: 15564.
    Pubmed CrossRef
  7. Brinton LA, Schairer C, Haenszel W, Stolley P, Lehman HF, Levine R, et al. Cigarette smoking and invasive cervical cancer. JAMA 1986; 255: 3265-9.
    Pubmed CrossRef
  8. Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years’ observations on male British doctors. BMJ 2004; 328: 1519.
    Pubmed KoreaMed CrossRef
  9. U.S. Office of the Surgeon General, U.S. Office on Smoking and Health. The health consequences of smoking: a report of the Surgeon General. Rockville: U.S. Department of Health & Human Services; 2004.
  10. Lee EH, Park SK, Ko KP, Cho IS, Chang SH, Shin HR, et al. Cigarette smoking and mortality in the Korean Multi-center Cancer Cohort (KMCC) study. J Prev Med Public Health 2010; 43: 151-8.
    Pubmed CrossRef
  11. Higenbottam T, Clark TJ, Shipley MJ, Rose G. Lung function and symptoms of cigarette smokers related to tar yield and number of cigarettes smoked. Lancet 1980; 1: 409-11.
  12. Lee KM. Body fat distribution and serum leptin levels according to amount of cigarette smoking in Korean middle-aged men. J Korean Acad Fam Med 2003; 24: 524-31.
  13. Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG; World Health Organization. AUDIT: the alcohol use disorders identification test: guidelines for use in primary health care. 2nd ed. Geneva: Geneva World Health Organization; 2001.
  14. World Health Organization, Management of Substance Abuse Unit. Global status report on alcohol and health, 2014. Geneva: World Health Organization; 2014.
  15. Joe KH, Chun YM, Chai SH, Kim DJ. Alcohol and cognitive disorder. Korean J Psychopharmacol 2009; 20: 5-14.
  16. Hong SW, Linton JA, Shim JY, Kang HT. High-risk drinking is associated with a higher risk of diabetes mellitus in Korean men, based on the 20102012 KNHANES. Alcohol 2015; 49: 275-81.
    Pubmed CrossRef
  17. Yang S, Kim W, Choi KH, Yi YG. Influence of occupation on lumbar spine degeneration in men: the Korean National Health and Nutrition Examination Survey 2010-2013. Int Arch Occup Environ Health 2016; 89: 1321-8.
    Pubmed CrossRef
  18. Seong JH, Lee CH, Do HJ, Oh SW, Lym YL, Choi JK, et al. Performance of the AUDIT Alcohol Consumption Questions (AUDIT-C) and AUDIT-K question 3 alone in screening for problem drinking. Korean J Fam Med 2009; 30: 695-702.
  19. Kwon YJ, Kim SE, Park BJ, Bae JW, Kang HT. High-risk drinking is associated with dyslipidemia in a different way, based on the 2010-2012 KNHANES. Clin Chim Acta 2016; 456: 170-5.
    Pubmed CrossRef
  20. Lee KW, Park BJ, Kang HT, Lee YJ. Alcohol-drinking patterns and metabolic syndrome risk: the 2007 Korean National Health and Nutrition Examination Survey. Alcohol 2011; 45: 499-505.
    Pubmed CrossRef
  21. Lee KH, Chung WJ, Lee SM. Association of stress level with smoking. J Korean Acad Fam Med 2006; 27: 42-8.
  22. Diehl A, Scherbaum N. [Nicotine dependence as comorbidity of alcohol dependence--epidemiology, etiology and therapy]. Fortschr Neurol Psychiatr 2008; 76: 14-20.
    Pubmed CrossRef
  23. Le Strat Y, Ramoz N, Gorwood P. In alcohol-dependent drinkers, what does the presence of nicotine dependence tell us about psychiatric and addictive disorders comorbidity? Alcohol Alcohol 2010; 45: 167-72.
    Pubmed CrossRef
  24. Joe KH, Kim DJ. The comorbidity of alcohol dependence and nicotine dependence. Korean J Psychopharmacol 2008; 19: 85-93.

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