South Korea: A decline in smoking is hampered by the rise of heated tobacco and vaping

A survey conducted in 2025 showed that the rate of traditional cigarette smoking in South Korea had declined to 17.9 per 100,000 people (down 1 percentage point in one year), while e-cigarette use had increased to 9.3 per 100,000 people (up 0.6 percentage points). Overall, 22.1 per 100,000 adults reported using a nicotine-containing product (manufactured cigarettes, heated tobacco, or vaping products), a slight decrease since 2019, and the limited capacity of current policies to sustainably reduce nicotine consumption in the population.

The survey was conducted by the Korea Disease Control and Prevention Agency (KDCA) between May and July 2025, among more than 230,000 adults over the age of 19, as part of its national health survey. Participants were questioned about the use of nicotine products, including traditional cigarettes, and electronic devices such as heated tobacco and e-cigarettes.[1].

A very marginal decrease in smoking, largely offset by the increase in heated tobacco and vaping.

While the 2025 survey reports a slight decline in combustible tobacco use, falling to 17.9 per 1,000 people (%), this decrease remains extremely marginal and cannot be interpreted as a significant improvement in the health situation. According to the results published, this rate has decreased by only one percentage point compared to the previous year. At the same time, the use of e-cigarettes and the associated heated tobacco continues to increase, reaching 9.3 per 1,000 people (%), representing a rise of 0.6 percentage points in one year. This opposing trend leads to a near-stagnation in the total proportion of adults consuming a nicotine product: all uses combined (combustible cigarettes, heated tobacco, and e-cigarettes, including heated tobacco) have decreased by only 0.5 percentage points, settling at 22.1 per 1,000 people (%).

Data published in 2024 confirms this structural trend: the growth of heated tobacco is hindering the decline in smoking. Philip Morris International's market share of heated tobacco products reached 8.1% in 2024 (compared to 7.1% the previous year), while these products accounted for 16.5% of total tobacco sales in the first half of 2023. These developments show that the decline in traditional smoking is largely offset by the rapid growth of alternative nicotine products, which are reshaping the market rather than leading to a genuine exit from nicotine addiction, and do not constitute any reduction in risks for consumers. [2].

The dynamism of the e-cigarette, flavored liquid, heated tobacco device, and nicotine analog product markets reinforces this shift. Often marketed as more modern or less harmful, these products attract smokers, ex-smokers, and non-smokers alike, maintaining regular nicotine consumption in various forms. Their appeal, linked to a diverse range of products and still insufficient regulation, fosters patterns in which nicotine remains omnipresent.

The continued high level of overall nicotine use, combined with the ongoing growth of alternative products, demonstrates that current policies are not yet succeeding in sustainably reducing nicotine dependence within the population. This underscores the need for a stronger regulatory framework and increased monitoring of all emerging products to prevent a renormalization of use and to effectively support harm reduction through complete cessation of tobacco use in all its forms.

An accumulation of risk factors in the Korean adult population

The Korean survey shows that several health risk factors remain highly prevalent among the adult population. Besides tobacco and e-cigarettes, alcohol consumption remains high and stagnant, while the obesity rate has reached 35.4 per 100,000 adults, and physical activity indicators continue to decline: only 26 per 100,000 adults report engaging in moderate to vigorous physical activity, and the proportion of people who walk regularly has fallen to 49.2 per 100,000 adults. All of these trends highlight the significant influence of commercial determinants of health—that is, the influence of the tobacco, nicotine, alcohol, food, and digital industries—which shape behaviors through the availability, promotion, attractiveness, and normalization of harmful products.

In this context, strengthening regulations appears essential to reduce the population's exposure to these products and limit the impact of marketing strategies that maintain high levels of consumption. Only a comprehensive approach, explicitly integrating the commercial determinants of health and the environment in which these behaviors occur, will effectively protect the public, particularly young people who are most exposed to the practices of these companies.

©Generation Without Tobacco

AE

[1] Kim Hyunjeong, Conventional Cigarette Smoking Declines but E-Cigarette Use Rises... Obesity Rate Continues to Increase, The Asia Business Daily, published on December 8, 2025, accessed on the same day

[2] Tobacco-free generation, In South Korea, decline in traditional smoking slowed by heated tobacco and new nicotine products, Published on October 22, 2025, accessed on December 9, 2025