Smoking in South Korea has decreased overall for both men and women in the past decades. However, a high prevalence of tobacco use is still observed, especially with the rise of novel tobacco products such as e-cigarettes and heat-not-burn tobacco products. There are socioeconomic inequalities in smoking prevalence according to gender, income, education, and occupational class. Advocates call for measures to reduce the smoking rates and address smoking inequalities using a combination of monitoring and tobacco control policies. These measures include significant price hikes, mandatory warning photos on cigarette packs, advertising bans, financial incentives, medical help for quitting, and complete smoking bans in public places.
History
Smoking arrived in Korea through the introduction of tobacco in the early 1600s from Japan and quickly became a widespread and popular activity among the people regardless of gender, social class, and age. This was due to the appealing characteristics of tobacco in the context of Korea at that time. Namely, the favorable climate and soil for tobacco cultivation created a profitable economic sector, and smoking was thought to be a health-promoting, social, and cultural activity. Although smoking was common amongst all people, the quality of tobacco used differed across the established classes of the hierarchical system.
Men and women both smoked until around 1880, when stigmas against women, especially young and middle-aged women, started to arise.
Prevalence of smoking
Cigarettes
Adults
According to the 2017 World Health Organization (WHO) report on the global tobacco epidemic, smoking prevalence was estimated to be 49.8% among males and 4.2% among females in 2015, when both daily and non-daily smokers were included. Another survey by the Organization for Economic Cooperation and Development (OECD), which included only daily smokers, indicated a smoking prevalence of 31.1% among males and 3.4% among females in 2015.
The Korea National Health and Nutrition Examination Survey (KNHANES) tracks smoking behavior in Korean adults (aged 19 years or older). KNHANES aims to represent the Korean population through surveying approximately 10,000 individuals aged 1 year and older from 3,840 households. In this survey, adult smokers were defined as those who smoked at least five packs of cigarettes in their lifetime and currently smoke everyday or on somedays. In 2016, the cigarette smoking prevalence was 40.7% among male adults and 6.4% among female adults.
Adolescents
The Korea Youth Risk Behavior Web-based Survey (KYRBWS) annually tracks smoking behavior in Korean adolescents, defined as individuals between the ages 12 and 18. In this survey, adolescent smokers are defined as those who had smoked on more than one day during the past 30 days. In 2015, adolescent cigarette prevalence was measured to be 7.8%. In 2013, the cigarette smoking prevalence was 14.4% among male adolescents and 4.6% among female adolescents. When the adolescent group was divided, high school students had a higher prevalence rate (20.7% males, 6.3% females) compared with middle school students (7.9% males, 2.8% females).
E-cigarettes
E-cigarettes were introduced in the South Korean market in 2007. Whereas other countries have seen a dramatic rise in e-cigarette use among adolescents, it has remained at a stable low level in Korea. According to the 2015 KYRBWS, e-cigarette prevalence among adolescents was 4%. Adolescents make up less than 3% of e-cigarette users.
Other tobacco products
IQOS, a heat-not-burn tobacco product from company Philip Morris International (PMI), was introduced in South Korea in May 2017 in two stores in Seoul. A month later in June, IQOS was sold by other retail outlets including CU (a convenience store chain) and Electromart (an electronics store chain).
Cultural environment
General attitudes
Compared with the past, smoking has become substantially less prevalent. Still, South Korea has a high smoking prevalence, but tobacco control measures may be a strategy to depict smoking as an undesirable or socially unacceptable activity in public places. Research has shown that smoke-free policies help to change attitudes towards smoking bans in public places. Specifically, through a process called denormalization, smoke-free policies may shift attitudes of smokers and non-smokers from smoking acceptance to regarding it as an atypical behavior.
There is a cultural reluctance to seek treatment such as medical or psychological support. 87.8% of Korean male smokers indicated that they would rather try to quit smoking by themselves than seek out smoking cessation tools.