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Current Use of Heated Tobacco Products and Its Association with Socioeconomic Factors in Korean Adults: A Study Using Community Health Survey 2019
J Korean Soc Res Nicotine Tob 2022; 13(4): 140-150
Published online December 30, 2022
© 2022 The Korean Society for Research on Nicotine and Tobacco.

Sung Yeol Son1, Seo Young Kang2, Hong-Jun Cho1*

1Department of Family Medicine, Asan Medical Center, University of Ulsan, College of Medicine, Seoul,
2International Healthcare Center, Asan Medical Center, Seoul, Korea
Correspondence to: 議고솉以
슱궛븰援 쓽怨쇰븰 꽌슱븘궛蹂묒썝 媛젙쓽븰援먯떎
Received September 14, 2022; Revised November 1, 2022; Accepted November 1, 2022.
This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, dis-tribution, and reproduction in any medium, provided the original work is properly cited.
Background: Cigarette smoking is prevalent among adults of low socioeconomic level, which contributes to health inequality in Korea. However, the relationship between the use of heated tobacco products (HTPs) and socioeconomic position is not well known. We investigated the relationship between current HTP use and socioeconomic position in Korean adults.
Methods: We analyzed 193,220 adults from Community Health Survey 2019. The participants were categorized to either current HTP users or nonusers of conventional cigarettes (CCs), electronic cigarettes (ECs), and HTPs. Socioeconomic factors, including income, education, and occupation; marital status; and drinking status were evaluated between each gender. Multivariate logistic regression analysis was performed to evaluate the association between HTP use and socioeconomic positions.
Results: There were 4,572 current HTP users, comprising 985 HTP-only users (20.9%), 2,465 CC/HTP dual users (53.3%), 251 EC/HTP dual users (5.6%), and 871 triple product users (20.1%). The adjusted odds ratios and 95% confidence intervals for males were higher in university graduates and nonmanual workers (AOR 2.97, 95% CI 2.53-3.47). No significant relationship was found between income and current HTP use. For females, the odds were higher in the 1st quartile (AOR 2.68, 95% CI 1.86-3.86), high school graduates (AOR 2.88, 95% CI 2.19-3.79), and manual workers (AOR 2.03, 95% CI 1.54-2.67). Males and females showed higher odds in the young age, separated/bereaved/divorced, and binge drinker groups, but differed in other socioeconomic factors.
Conclusion: In males, the prominent use of HTPs in higher socioeconomic class such as higher education and having occupation, demonstrates a new challenge in establishing tobacco regulation policies. In females, socioeconomic inequalities were identified. Therefore, a gender-specific strategy is required.
Keywords : Heated tobacco products; Socioeconomic factors; Community Health Survey 2019
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