Original article
Electronic Cigarette Use Among Korean Adolescents: A Cross-Sectional Study of Market Penetration, Dual Use, and Relationship to Quit Attempts and Former Smoking

https://doi.org/10.1016/j.jadohealth.2013.11.003Get rights and content

Abstract

Purpose

As elsewhere, in South Korea electronic cigarettes (e-cigarettes) are marketed, in part, as a smoking cessation aid. We assessed the prevalence of e-cigarette use among Korean adolescents and the relationship between e-cigarette use and current (past 30-day) smoking, cigarettes/day, attempts to quit conventional cigarettes, and ceasing to use cigarettes.

Methods

Data from the 2011 Korean Youth Risk Behavior Web-based Survey of 75,643 students aged 13–18 years were analyzed with logistic regression.

Results

A total of 9.4% (8.0% ever–dual users who were concurrently using e-cigarettes and smoking conventional cigarettes and 1.4% ever–e-cigarette only users) of Korean adolescents have ever used e-cigarettes and 4.7% were current (past 30-day) e-cigarette users (3.6% dual users and 1.1% e-cigarettes only). After adjusting for demographics, current cigarette smokers were much more likely to use e-cigarettes than were nonsmokers. Among current cigarette smokers, those who smoked more frequently were more likely to be current e-cigarette users. The odds of being an e-cigarette user were 1.58 times (95% confidence interval, 1.39–1.79) higher among students who had made an attempt to quit than for those who had not. It was rare for students no longer using cigarettes to be among current e-cigarette users (odds ratio, .10; confidence interval, .09–.12).

Conclusions

Some Korean adolescents may be responding to advertising claims that e-cigarettes are a cessation aid: those who had made an attempt to quit were more likely to use e-cigarettes but less likely to no longer use cigarettes. E-cigarette use was strongly associated with current and heavier cigarette smoking.

Section snippets

Data

The KYRBWS is an anonymous, Internet-based, self-administered questionnaire administered in class to a nationally representative cross-section of middle and high school students [15]. The 2011 sample consisted of 79,202 students age 13–18 years in 2,400 classrooms (secondary sampling units), consisting of all students in three classes from each of 400 middle and 400 high schools (primary sampling units) from 129 strata identified using a stratified multistage cluster sampling method. The first

Results

Sample demographics appear in Table 1.

A total of 85.5% of seventh-grade students (age 13 years) were never-users of conventional cigarettes or e-cigarettes, compared with 66.5% of 12th-grade students (Table 2). Among 12th graders, 16.9% currently smoked cigarettes (past 30 days) and 5.9% currently used e-cigarettes, including 5.0% who were currently dual users of conventional cigarettes and e-cigarettes.

E-cigarette use was significantly higher for boys (7.8% vs. 1.8% for girls; p < .001), older

Discussion

The findings of high dual use of cigarettes and e-cigarettes show that e-cigarettes are not being used as a substitute for cigarettes among Korean adolescents. Furthermore, the significant association between current e-cigarette use and higher levels of cigarette consumption compared with ever– and never–e-cigarette users suggests that e-cigarettes do not have a role in reducing harm among these teens, and in fact may be increasing harm.

Although e-cigarettes have rapidly become widely

Funding Sources

This research was funded in part by the National Cancer Institute, by United States National Institutes of Health Grant CA-113710, by University of California Tobacco Related Diseases Research Program Grant 21FT-0040, and by the Hellmann Family Fund. The sponsors had no role in study design, the collection, analysis, and interpretation of data, the writing of the report or the decision to submit the paper for publication.

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    Conflicts of Interest: The authors have no conflicts of interest or financial disclosures to report.

    1

    Current address: National Evidence-Based Healthcare Collaborating Agency, Seoul, Republic of Korea.

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