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Heated tobacco product use among Korean adolescents
  1. Heewon Kang1,
  2. Sung-il Cho1,2
  1. 1 Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul, Korea
  2. 2 Institute of Health and Environment, Seoul National University, Seoul, Korea
  1. Correspondence to Dr Sung-il Cho, Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea; persontime{at}


Background Heated tobacco products (HTPs) may compromise decades-long efforts to marginalise the tobacco industry. Their appeal to adolescents imposes a risk of a new tobacco epidemic. Empirical evidence on the behavioural patterns of HTP use among adolescents is required. We investigated the prevalence of HTP use and the association between use of HTPs and e-cigarettes and attempts to quit smoking cigarettes.

Methods Nationally representative cross-sectional survey data of South Korean adolescents aged 12–18 years (mean age: 15 years) were used. The survey was conducted 1 year after the introduction of HTPs in Korea. A total of 59 532 adolescents were identified. Descriptive statistics and multiple logistic regression results are presented.

Results In all, 2.8% of South Korean adolescents were ever HTP users. Among these, 75.5% were current cigarette users, 45.6% were current e-cigarette users and 40.3% were concurrent users of cigarettes and e-cigarettes. Unlike ever use of e-cigarettes, which was associated with a higher likelihood of cigarette quit attempts (adjusted OR (aOR)=1.35, 95% CI: 1.16 to 1.58), no difference in cigarette quit attempts was found for ever use of HTPs (aOR=1.07, 95% CI: 0.91 to 1.26).

Conclusion Considering the recent introduction of HTPs to the Korean market and less than 1% prevalence of e-cigarette when first introduced, the prevalence of ever HTP use among Korean adolescents is an important concern. The results showing high polytobacco use and the lack of an association between HTP use and cigarette quit attempts call for a ban on HTP advertisements with modified harm claims.

  • non-cigarette tobacco products
  • denormalisation
  • priority/special populations
  • surveillance and monitoring

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

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  • Contributors HK conducted data analyses and wrote the manuscript. S-iC advised on data analyses. Both authors designed the study, interpreted the findings, reviewed and approved the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was exempt from review by the Seoul National University Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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