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Prevalence and predictors of heated tobacco product use and its relationship with attempts to quit cigarette smoking among Korean adolescents
  1. Seo Young Kang1,
  2. Sungkyu Lee2,
  3. Hong-Jun Cho3
  1. 1 International Healthcare Center, Asan Medical Center, Seoul, Republic of Korea
  2. 2 National Tobacco Control Centre, Korean Health Promotion Institute, Seoul, Republic of Korea
  3. 3 Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
  1. Correspondence to Professor Hong-Jun Cho, Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea; hjcho{at}


Introduction Heated tobacco products (HTPs) have been available in the Korean market since June 2017. In this study, we examined the prevalence and predictors of HTP use among Korean adolescents and the association between HTP and electronic cigarette (EC) use and attempts to quit conventional cigarette (CC) smoking.

Methods We analysed the data of a representative sample (n=60 040) of 13–18-year-old middle-school and high-school students in Korea who had participated in the 14th Korea Youth Risk Behavior Web-based Survey in 2018.

Results The prevalence of ever HTP use among Korean adolescents was 2.9% (men: 4.4%, women: 1.2%), a year after the introduction of HTPs in the Korean market. Furthermore, 81.3% of the 1568 ever HTP users were triple users of HTPs, ECs and CCs. Multivariate analysis revealed that ever HTP use was greater among men, higher-grade students, current CC and/or EC users and risky alcohol drinkers. Among current CC smokers, ever users of ECs (28%–30%) and ever HTP users and current EC users (48%) were more likely to have attempted to quit CC smoking than those who had never used HTPs and ECs. However, there were fewer HTP and/or EC ever users among ever CC smokers who successfully quit smoking.

Conclusions Many adolescents, especially CC and EC users, had already used HTPs shortly after the introduction of HTPs in Korea. The use of newer types of tobacco products is associated with lower odds of abstinence from CCs; therefore, it is important to protect adolescents from them.

  • cessation
  • non-cigarette tobacco products
  • prevention

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  • Contributors H-JC designed the study and critically revised the manuscript. SYK designed the study, analysed the data and drafted the manuscript. SL critically revised the manuscript. All authors read and approved the final 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 No, there are no competing interests.

  • Patient consent for publication Not required.

  • Ethics approval This study used the data collected in the 14th KYRBWS (2018). The KYRBWS was approved by the Institutional Review Board of the Korea Centers for Disease Control and Prevention (2014-06EXP-02-P-A), and all the study participants and their parents or legal guardians provided informed consent to participate in the KYRBWS.

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

  • Data availability statement Data are available in a public, open access repository. We used the data from the Korea Youth Risk Behavior Web-based Survey. The data are publicly available in the KCDC website ( Details about the survey design and methodology have been previously published (Int J Epidemiol 2016;45(4):1076–1076e).