Cigarette Smoking in South Korea: A Narrative Review

Although the prevalence of cigarette smoking has declined in Western countries over the past few decades, a comparable decline among males has not been observed in Asian countries, especially in South Korea, where approximately 40%–50% of men and 4%–8% of women have been identified as smokers, and there is a pressing need to understand the background of cigarette smoking in these populations. The present study is a narrative review of the research literature on cigarette smoking in South Korea. First, we describe the social, economic, and cultural factors that impact cigarette smoking in South Korea. The paper also reviews the available peer-reviewed literature comprising observational studies and interventional studies, including randomized controlled trials. The extant literature on smoking in Korean Americans is also reviewed. Cigarette smoking in South Korea has been relatively understudied, and this review identifies priority areas for future research, including the use of mobile interventions.

The prevalence of and factors associated with the use of smoking cessation medication in Korea: trend between 2005-2011

Background

In Korea, nicotine replacement therapy (NRT) has been widely used in government-led, public health center-based smoking cessation services since 2004 and varenicline has become available from 2007 but without reimbursement. In this study which used a series of nationwide cross-sectional surveys in Korea performed from 2005 to 2011, we examined the prevalence of smoking cessation medication use and factors associated with it.

Methods

We analyzed data from the third to fifth waves of Korean National Health and Nutrition Examination Survey (2005–2011). Prevalence of each smoking cessation method use was calculated for each year, and its secular trend was tested by multivariate logistic regression.

Results

Among smokers who made quit attempt during the previous year, 15.7% had used smoking cessation medications,15.3% had used NRT, and 0.7% had used prescription medication. There was a significant increasing trend for NRT use (P<0.001) during the study period, but use of prescription medication did not show any increase over time (P = 0.654) Education on smoking prevention and cessation was associated with smoking cessation medications use (OR 2.08, 95% CI 1.58–2.75).

Conclusions

While the use of NRT has increased over years through government-sponsored smoking cessation programs, use of prescription drugs remained very low and flat probably due to lack of reimbursement. Education of smokers about effective smoking cessation methods and change in reimbursement policy are suggested to stimulate evidence-based smoking cessation practice.