DOI QR코드

DOI QR Code

The Status and Future Challenges of Tobacco Control Policy in Korea

  • Cho, Hong-Jun (Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • Received : 2014.03.13
  • Accepted : 2014.05.08
  • Published : 2014.05.31

Abstract

Tobacco use is the most important preventable risk factor for premature death. The World Health Organization (WHO) Framework Convention on Tobacco Control (FCTC), the first international public health treaty, came into force in 2005. This paper reviews the present status of tobacco control policies in Korea according to the WHO FCTC recommendations. In Korea, cigarette use is high among adult males (48.2% in 2010), and cigarette prices are the lowest among the Organization for Economic Cooperation and Development countries with no tax increases since 2004. Smoke-free policies have shown incremental progress since 1995, but smoking is still permitted in many indoor public places. More than 30% of non-smoking adults and adolescents are exposed to second-hand smoke. Public education on the harmful effects of tobacco is currently insufficient and the current policies have not been adequately evaluated. There is no comprehensive ban on tobacco advertising, promotion, or sponsorship in Korea. Cigarette packages have text health warnings on only 30% of the main packaging area, and misleading terms such as "mild" and "light" are permitted. There are nationwide smoking cessation clinics and a Quitline service, but cessation services are not covered by public insurance schemes and there are no national treatment guidelines. The sale of tobacco to minors is prohibited by law, but is poorly enforced. The socioeconomic inequality of smoking prevalence has widened, although the government considers inequality reduction to be a national goal. The tobacco control policies in Korea have faltered recently and priority should be given to the development of comprehensive tobacco control policies.

Keywords

References

  1. World Health Organization. WHO report on the global tobacco epidemic 2013; 2013 [cited 2014 Feb 20]. Available from: http://www.who.int/tobacco/global_report/2013/en/.
  2. World Health Organization. WHO global report: mortality attributable to tobacco; 2012 [cited 2014 Feb 20]. Available from: http://whqlibdoc.who.int/publications/2012/9789241564434_eng.pdf.
  3. Khang YH, Lynch JW, Jung-Choi K, Cho HJ. Explaining age-specific inequalities in mortality from all causes, cardiovascular disease and ischaemic heart disease among South Korean male public servants: relative and absolute perspectives. Heart 2008;94(1):75-82. https://doi.org/10.1136/hrt.2007.117747
  4. World Health Organization. WHO framework convention on tobacco control; 2005 [cited 2014 Feb 21]. Available from: http://whqlibdoc.who.int/publications/2003/9241591013.pdf.
  5. World Health Organization. Tobacco: fact sheet N°339; 2013 [cited 2014 Feb 22]. Available from: http://www.who.int/mediacentre/factsheets/fs339/en/.
  6. Korean Center for Disease Control. 2010 National health statistics: Korea National Health and Nutrition Examination Survey (KNHANES) V-1. Seoul: Korean Center for Disease Control; 2011, p. 82-83 (Korean).
  7. Jung-Choi KH, Khang YH, Cho HJ. Hidden female smokers in Asia: a comparison of self-reported with cotinine-verified smoking prevalence rates in representative national data from an Asian population. Tob Control 2012;21(6):536-542. https://doi.org/10.1136/tobaccocontrol-2011-050012
  8. Khang YH, Cho HJ. Socioeconomic inequality in cigarette smoking: trends by gender, age, and socioeconomic position in South Korea, 1989-2003. Prev Med 2006;42(6):415-422. https://doi.org/10.1016/j.ypmed.2006.02.010
  9. Ministry of Health and Welfare. 2013 Community integrated health promotion program guide: tobacco control section. Sejong: Ministry of Health and Welfare; 2013, p. 131 (Korean).
  10. Centers for Disease Control and Prevention. Best practice for comprehensive tobacco control program 2014. Atlanta: US Department of Health and Human Services; 2014, p. 138.
  11. Chalopka FJ, Hu T, Warner KE, Jacobs R, Yurekli A. The taxation of tobacco products. In: Jha P, Chaloupka FJ, editors. Tobacco control in developing countries. Oxford: Oxford University Press; 2000, p. 237-272.
  12. World Health Organization. Global health observatory data repository [cited 2014 May 26]. Available from: http://apps.who.int/gho/data/node.main.1300?lang=en.
  13. Callinan JE, Clarke A, Doherty K, Kelleher C. Legislative smoking bans for reducing secondhand smoke exposure, smoking prevalence and tobacco consumption. Cochrane Database Syst Rev 2010;(4):CD005992.
  14. Albers AB, Siegel M, Cheng DM, Biener L, Rigotti NA. Relation between local restaurant smoking regulations and attitudes towards the prevalence and social acceptability of smoking: a study of youths and adults who eat out predominantly at restaurants in their town. Tob Control 2004;13(4):347-355. https://doi.org/10.1136/tc.2003.007336
  15. Korean Center for Disease Control. 2013 Korea Youth Risk Behavior Web-based Survey results. Seoul: Korean Center for Disease Control; 2013, p. 60-63 (Korean).
  16. National Health Promotion Act. Law No. 11973, Article 9-4 (Jul 30, 2013).
  17. Son HJ, Cho HJ, Kim HJ. Outdoor smoking bans in South Korea: current situation and public health implication. In: Society for Nicotine and Tobacco Research. Proceedings of 20th Annual Meeting: RAPIDS; 2014 Feb 5-8; Seattle, USA. Society for Nicotine and Tobacco Research; 2014, p. 4.
  18. Chapman S. Going too far? Exploring the limits of smoking regulations. William Mitchell Law Rev 2008;34(4):1605-1620.
  19. Durkin S, Brennan E, Wakefield M. Mass media campaigns to promote smoking cessation among adults: an integrative review. Tob Control 2012;21(2):127-138. https://doi.org/10.1136/tobaccocontrol-2011-050345
  20. Seo HG, Cheong YS, Myung SK, Kim Y, Lee WB, Fong GT. Smoking-related characteristics in Korean adult smokers: findings from the 2005 International Tobacco Control Policy Evaluation Survey-Korea. J Korean Acad Fam Med 2008;29(11):844-853 (Korean).
  21. Quentin W, Neubauer S, Leidl R, König HH. Advertising bans as a means of tobacco control policy: a systematic literature review of time-series analyses. Int J Public Health 2007;52(5): 295-307. https://doi.org/10.1007/s00038-007-5131-0
  22. Lovato C, Watts A, Stead LF. Impact of tobacco advertising and promotion on increasing adolescent smoking behaviours. Cochrane Database Syst Rev 2011;(10):CD003439.
  23. Cancer Council Victoria. Plain packaging of tobacco products: a review of the evidence [cited 2014 Feb 20]. Available from: http://www.heartfoundation.org.au/SiteCollectionDocuments/Evidence-Paper-Plain-Packaging.pdf.
  24. Korea Health Promotion Foundation. Truth about cigarette package. Health Promot Ser 2013;2(11):26-31 https://doi.org/10.4103/2277-9531.112703
  25. Public Health Service. Treating tobacco use and dependence: 2008 update. Clinical practice guideline. Rockville: US Department of Health and Human Services; 2008, p. 77-128.
  26. Stead LF, Lancaster T. Interventions for preventing tobacco sales to minors. Cochrane Database Syst Rev 2005;(1): CD001497.
  27. Feighery E, Altman DG, Shaffer G. The effects of combining education and enforcement to reduce tobacco sales to minors. A study of four northern California communities. JAMA 1991;266(22):3168-3171. https://doi.org/10.1001/jama.1991.03470220084032
  28. Ministry of Health and Social Welfare. 3rd National Health Promotion Plan (2011-2020). Seoul: Ministry of Health and Welfare; 2011, p. 96-119 (Korean).
  29. Khang YH, Yun SC, Cho HJ, Jung-Choi K. The impact of governmental antismoking policy on socioeconomic disparities in cigarette smoking in South Korea. Nicotine Tob Res 2009; 11(3):262-269. https://doi.org/10.1093/ntr/ntn036
  30. Cho HJ, Jung-Choi K, Yang YS. Did Korean smoking cessation clinic reduce smoking inequalities?; 2013 [cited 2014 Feb 20]. Available from: http://www.uknscc.org/uknscc2013_poster_221.php.

Cited by

  1. Association between secondhand smoke exposure and blood lead and cadmium concentration in community dwelling women: the fifth Korea National Health and Nutrition Examination Survey (2010–2012) vol.5, pp.7, 2014, https://doi.org/10.1136/bmjopen-2015-008218
  2. The importance of the belief that “light” cigarettes are smoother in misperceptions of the harmfulness of “light” cigarettes in the Republic of Korea: a nationally representative cohort study vol.16, pp.1, 2014, https://doi.org/10.1186/s12889-015-2472-0
  3. Health Performance and Challenges in Korea: a Review of the Global Burden of Disease Study 2013 vol.31, pp.suppl2, 2014, https://doi.org/10.3346/jkms.2016.31.s2.s114
  4. 한국인에서 흡연과 우울증상의 연관성 vol.33, pp.2, 2016, https://doi.org/10.14367/kjhep.2016.33.2.57
  5. Is a Price Increase Policy Enough for Adolescent Smokers?: Factors Affecting the Effectiveness of Increasing Cigarette Prices Among Korean Adolescent Smokers vol.18, pp.10, 2014, https://doi.org/10.1093/ntr/ntw122
  6. Decreases in Smoking-Related Cancer Mortality Rates Are Associated with Birth Cohort Effects in Korean Men vol.13, pp.12, 2014, https://doi.org/10.3390/ijerph13121208
  7. Factors associated with stage of change in smoker in relation to smoking cessation based on the Korean National Health and Nutrition Examination Survey II-V vol.12, pp.5, 2014, https://doi.org/10.1371/journal.pone.0176294
  8. Effectiveness of government anti-smoking policy on non-smoking youth in Korea: a 4-year trend analysis of national survey data vol.7, pp.7, 2014, https://doi.org/10.1136/bmjopen-2016-013984
  9. Effect of Viewing Smoking Scenes in Motion Pictures on Subsequent Smoking Desire in Audiences in South Korea vol.3, pp.3, 2014, https://doi.org/10.2196/publichealth.7093
  10. Differences in Adolescent E-cigarette and Cigarette Prevalence in Two Policy Environments: South Korea and the United States vol.20, pp.8, 2014, https://doi.org/10.1093/ntr/ntx198
  11. Tobacco Control Policies in the Republic of Korea and the Methods of the ITC Korea Surveys vol.9, pp.suppl1, 2014, https://doi.org/10.25055/jksrnt.2018.9.s1.s1
  12. Smoking cessation services provided by the National Health Insurance Service vol.61, pp.3, 2018, https://doi.org/10.5124/jkma.2018.61.3.157
  13. Situation, Impacts, and Future Challenges of Tobacco Control Policies for Youth: An Explorative Systematic Policy Review vol.10, pp.None, 2019, https://doi.org/10.3389/fphar.2019.00981
  14. Vapor Compounds Released from Nicotine-Free Inhalators as a Smoking-Cessation Aid vol.9, pp.11, 2019, https://doi.org/10.3390/app9112232
  15. Gender differential secular trend in lifetime smoking prevalence among adolescents: an age-period-cohort analysis vol.19, pp.1, 2014, https://doi.org/10.1186/s12889-019-7735-8
  16. Convenience store visitors recall cigarette advertisements even if they do not purchase cigarettes vol.41, pp.4, 2019, https://doi.org/10.1093/pubmed/fdy166
  17. Setting the policy agenda for graphic health warning labels: An analysis of online news media coverage in South Korea, 2016 vol.18, pp.8, 2020, https://doi.org/10.18332/tid/125108
  18. Gender differences in the perceived effectiveness of female-focused graphic health warnings against smoking in South Korea vol.79, pp.1, 2014, https://doi.org/10.1177/0017896919862308
  19. The effect of outdoor smoking ban: Evidence from Korea vol.29, pp.3, 2014, https://doi.org/10.1002/hec.3979
  20. Effects of an 80% cigarette price increase on quit attempts, successful quitting and smoking intensity among Korean adult smokers: results from nationally representative longitudinal panel data vol.30, pp.3, 2014, https://doi.org/10.1136/tobaccocontrol-2019-055518
  21. Effect of usual source of care on receiving smoking cessation advice: Korean National Health Panel data analysis vol.38, pp.3, 2021, https://doi.org/10.1093/fampra/cmaa108
  22. Trends in the Socioeconomic Inequalities Related to Second-Hand Smoke Exposure as Verified by Urine Cotinine Levels Among Nonsmoking Adults: Korea National Health and Nutrition Examination Survey 2008 vol.23, pp.9, 2014, https://doi.org/10.1093/ntr/ntab051
  23. Exposure to Secondhand Smoke: Inconsistency between Self-Response and Urine Cotinine Biomarker Based on Korean National Data during 2009-2018 vol.18, pp.17, 2014, https://doi.org/10.3390/ijerph18179284