Tobacco Use in Korea: Current Epidemiology and Public Health Issues

Tobacco control efforts in Korea began nearly three decades ago with the enactment of the National Health Promotion Act in 1995. Monitoring smoking prevalence is crucial for evaluating the effectiveness of tobacco control measures, as reductions in smoking rates reflect the impact of anti-smoking policies. This review aims to provide an updated overview of the epidemiology of tobacco use in Korea, outline the nation's advancements in tobacco control, and emphasize emerging challenges in tobacco use. The data sources included statistics and reports from the World Health Organization (WHO) and the Organization for Economic Co-operation and Development (OECD), the Korea National Health and Nutrition Examination Survey, as well as various national statistics and reports on tobacco use and control in Korea. Over the past quarter-century, there was a notable 49.6% reduction in the prevalence of cigarette smoking among Korean adults, with a particularly pronounced decline among men (1998: 66.3% vs. 2022: 30.0%; a 54.8% decrease). However, the reduction among women was more modest, with only a 1.5 percentage point decrease (1998: 6.5% vs. 2022: 5.0%; a 23.1% decrease), and an increase in smoking prevalence was observed among women in their 20s and 30s. Overall use of any tobacco product, including cigarettes, heated tobacco products, electronic nicotine delivery systems, and others, was 6.6 percentage points higher among males and 2.2 percentage points higher among females compared to cigarette smoking alone. In 2019, there were 58,036 deaths attributed to direct smoking in Korea, with an estimated socioeconomic cost of smoking amounting to 12,191.3 billion Korean won. Furthermore, critical issues in tobacco use persist in Korea, including significant disparities in tobacco use related to age, gender, and disability, the growing use of novel tobacco and nicotine products among adolescents and younger adults, and regulatory blind spots. The reduction in smoking rates in Korea reflects the impact of expanded tobacco control policies and public health initiatives. However, for Korea to advance to the next level in tobacco control policies, it is essential to implement the WHO Framework Convention on Tobacco Control's MPOWER measures more thoroughly.