South Korea assesses efforts needed to quit smoking

Adopting specific regulations and strengthening tobacco control research are two of the avenues suggested by researchers to achieve a tobacco-free generation in South Korea. A study compares the failed attempt at a tobacco-free generation in this country with the successes achieved in three other countries recognized as leaders in tobacco control.

With a smoking prevalence of 21,% and after a first failed attempt in 2019, South Korea plans to become a tobacco-free country, i.e. a smoking prevalence of less than 5,% of the population, by 2030.

To assess the steps still to be taken to achieve this goal, a study published by a team of Korean researchers compared South Korea's progress in the fight against smoking with that of three countries considered to be at the forefront in this area: Australia, New Zealand and Finland.[1].

Three countries taken as references by South Korea

This comparison between the four countries allows us to distinguish several key elements in the implementation of a tobacco-free generation. The regulatory and research aspects appear particularly decisive in reference to the World Health Organization's (WHO) MPOWER program.[2] and more generally of the Framework Convention on Tobacco Control (FCTC).

Setting a deadline and target prevalence rates are also essential steps, as Australia, New Zealand, and Finland have implemented in their Tobacco-Free Generation programs. This was not the case in North Korea when the idea of a total ban on tobacco sales was floated in 2019 in its Comprehensive Plan for Tobacco Control and the Eradication of Induced Smoke into the Environment. A study conducted at the same time among 1,500 South Korean adults indicated that 70% of those surveyed supported a complete ban on tobacco sales. However, this measure was not debated by parliamentarians and was shelved after the National Assembly was dissolved in April 2020.

An exploration of the pitfalls of creating a tobacco-free generation

The experience of the three countries considered as models also shows that including tobacco control in its own law is not only a way to formalize this area, but also allows for subsequent changes to these regulations. In South Korea, this legislation is split between two pieces of legislation that hinder its full implementation. The fact that there is still a Korean tobacco manufacturer – KT&G – also constitutes a permanent threat to the implementation of effective regulation, through the interplay of influence and lobbying. Strict compliance with Article 5.3 of the FCTC, which stipulates that tobacco manufacturers must be kept away from public health policies, must be observed here, in order to guarantee effective regulation.

The research component is an equally essential aspect of the fight against smoking. It allows anti-smoking proposals to be based on a scientific basis, which is essential for defending legislative proposals to legislators and supporting a project as ambitious as the Tobacco-Free Generation. The three reference countries have each established a research center specifically dedicated to tobacco studies, and can thus produce data useful for legislators' decision-making. Such an organization is called for by the authors of the Korean study, even if research alone is not enough to counter the influence of the tobacco industry. Finally, the establishment of a tobacco-free generation is only conceivable if a country's prevalence rates are low enough to achieve this, which requires, in particular, monitoring changes in consumption. Added to this is the essential implementation of proven measures recognized as effective internationally, brought together in the FCTC treaty ratified by the country.

Meeting all of these conditions appears essential to achieving a tobacco-free generation. South Korea's research and efforts to achieve this goal should also enable other countries to avoid certain mistakes and more easily achieve the goal of a tobacco-free generation.

Keywords: South Korea, Australia, New Zealand, Finland, tobacco-free generation.

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[1] Kang H, Cheon E, Kim HK, et al. Vision for tobacco endgame in Korea: suggestions for countries with endgame aspirations. Tobacco Control Published Online First: 05 May 2023. doi: 10.1136/tc-2022-057691

[2] The MPOWER program is structured around six dimensions: Monitoring tobacco use and prevention policies; Protecting people from tobacco smoke; Offering help to quit tobacco use; Warning about the dangers of tobacco; Enforcing bans on tobacco advertising, promotion and sponsorship; Raising taxes on tobacco.