search for




KCI

Crossref

Cross mark

Cited-by

Fundref

TDM

View (118) Download (69) CrossRef (1)
Gender-Based Socioeconomic Inequality of Electronic Cigarettes and Heated Tobacco Products in Korea
J Korean Soc Res Nicotine Tob 2024; 15(3): 96-106
Published online September 30, 2024
© 2024 The Korean Society for Research on Nicotine and Tobacco.

Joung Eun Kim, Jung Ah Lee, Hong-Jun Cho*

Department of Family Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Correspondence to: *조홍준
울산대학교 의과대학 서울아산병원 가정의학과
E-mail: hjcho@amc.seoul.kr
ORCID: https://orcid.org/0000-0002-5358-6549
Received August 1, 2024; Revised September 15, 2024; Accepted September 15, 2024.
This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, dis-tribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Background: Conventional cigarettes are commonly used by adults with low educational level and lower income in South Korea. Information on socioeconomic and gender-related disparities associated with the use of electronic cigarettes (EC) and heated tobacco products (HTP) is limited. Therefore, this study aimed at investigating gender differences in relation to socioeconomic inequalities and use of EC and HTP in Korea.
Methods: Data of 226,749 adults from the 2020 Community Health Survey in South Korea were analyzed. Variables associated with socioeconomic position included household income and education. Multivariable logistic regression analysis was adjusted for age, household income, education, occupation, marital status, and binge drinking.
Results: Current HTP and EC users were 6,065 (5,414 men and 651 women) and 3,764 (3,432 men and 332 women), respectively. The odds of EC and HTP users were 0.33 (95% confidence interval [CI], 0.24-0.46) and 0.77 (0.63-0.95) in men, and 2.52 (1.46-4.35) and 2.56 (1.57-4.15) in women with educational levels of middle school or lower, compared with those with at least college education, respectively. Income differences were not observed among men. However, women in the first income quartile (lower income) had higher odds of using EC at 2.12 (1.14-3.93) and HTP at 2.78 (1.90-4.08) compared with those in the fourth quartile.
Conclusion: Men with higher educational levels and women with lower income and educational levels were more likely to use EC and HTP. Therefore, regulatory strategies should be designed to control the use of novel tobacco products in South Korea.
Keywords : Tobacco products; Electronic nicotine delivery systems; Socioeconomic factors; Gender equity; Health surveys
References
  1. Grana R, Benowitz N, Glantz SA. E-cigarettes: a scientific review. Circulation. 2014; 129(19): 1972-86.
    Pubmed KoreaMed CrossRef
  2. U.S. Department of Health and Human Services. E-Cigarette Use Among Youth and Young Adults. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2016.
  3. Callahan-Lyon P. Electronic cigarettes: human health effects. Tob Control. 2014; 23 Suppl 2(Suppl 2): ii36-40.
    Pubmed KoreaMed CrossRef
  4. Kulik MC, Lisha NE, Glantz SA. E-cigarettes Associated With Depressed Smoking Cessation: A Cross-sectional Study of 28 European Union Countries. Am J Prev Med. 2018; 54(4): 603-9.
    Pubmed KoreaMed CrossRef
  5. Pearson JL, Richardson A, Niaura RS, Vallone DM, Abrams DB. e-Cigarette awareness, use, and harm perceptions in US adults. Am J Public Health. 2012; 102(9): 1758-66.
    Pubmed KoreaMed CrossRef
  6. Korean Centers for Disease Control and Prevention. Korea Health Statistics 2022: Korea National Health and Nutrition Examination Survey (KNHANES IX-1) [Internet]. [updated 2023 December 12; cited 2024 July 17].
    Available from: https://knhanes.kdca.go.kr/knhanes/sub04/sub04_04_03.do
  7. Lee CM. International regulatory overview of electronic cigarettes and heated tobacco products. J Korean Med Assoc. 2020; 63(2): 112-8.
    CrossRef
  8. Mackenbach JP, Stirbu I, Roskam AJ, Schaap MM, Menvielle G, Leinsalu M, et al. Socioeconomic inequalities in health in 22 European countries. N Engl J Med. 2008; 358(23): 2468-81.
    Pubmed CrossRef
  9. Cho HJ, Song YM, Smith GD, Ebrahim S. Trends in socio-economic differentials in cigarette smoking behaviour between 1990 and 1998: a large prospective study in Korean men. Public Health. 2004; 118(8): 553-8.
    Pubmed CrossRef
  10. Chang Y, Kang HY, Lim D, Cho HJ, Khang YH. Long-term trends in smoking prevalence and its socioeconomic inequalities in Korea, 1992-2016. Int J Equity Health. 2019; 18(1): 148.
    CrossRef
  11. Jang TW, Kim HR, Choi SE, Yim HW, Lee HE, Myong JP, et al. Smoking rate trends in Korean occupational groups: analysis of KNHANES 1998-2009 data. J Occup Health. 2012; 54(6): 452-8.
    Pubmed CrossRef
  12. Khang YH, Cho HJ. Socioeconomic inequality in cigarette smoking: trends by gender, age, and socioeconomic position in South Korea, 1989-2003. Prev Med. 2006; 42(6): 415-22.
    Pubmed CrossRef
  13. Kim YJ, Lee JS, Park J, Choi DS, Kim DM, Lee KH, et al. Trends in socioeconomic inequalities in five major risk factors for cardiovascular disease in the Korean population: a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey, 2001-2014. BMJ Open. 2017; 7(5): e014070.
    Pubmed KoreaMed CrossRef
  14. Hartwell G, Thomas S, Egan M, Gilmore A, Petticrew M. E-cigarettes and equity: a systematic review of differences in awareness and use between sociodemographic groups. Tob Control. 2017; 26(e2): e85-e91.
    Pubmed KoreaMed CrossRef
  15. Vardavas CI, Filippidis FT, Agaku IT. Determinants and prevalence of e-cigarette use throughout the European Union: a secondary analysis of 26 566 youth and adults from 27 Countries. Tob Control. 2015; 24(5): 442-8.
    Pubmed CrossRef
  16. Ooms GI, Bosdriesz JR, Portrait FR, Kunst AE. Sociodemographic Differences in the Use of Electronic Nicotine Delivery Systems in the European Union. Nicotine Tob Res. 2016; 18(5): 724-9.
    Pubmed CrossRef
  17. Chang Y, Cho S, Kim I, Khang YH. Socioeconomic Inequalities in e-Cigarette Use in Korea: Comparison with Inequalities in Conventional Cigarette Use Using Two National Surveys. Int J Environ Res Public Health. 2019; 16(22).
    Pubmed KoreaMed CrossRef
  18. Miller CR, Sutanto E, Smith DM, Hitchman SC, Gravely S, Yong HH, et al. Characterizing Heated Tobacco Product Use Among Adult Cigarette Smokers and Nicotine Vaping Product Users in the 2018 ITC Four Country Smoking & Vaping Survey. Nicotine Tob Res. 2022; 24(4): 493-502.
    Pubmed KoreaMed CrossRef
  19. Igarashi A, Aida J, Kusama T, Tabuchi T, Tsuboya T, Sugiyama K, et al. Heated Tobacco Products Have Reached Younger or More Affluent People in Japan. J Epidemiol. 2021; 31(3): 187-93.
    Pubmed KoreaMed CrossRef
  20. Sung Yeol S, Seo Young K, Cho H-J. Current Use of Heated Tobacco Products and Its Association with Socioeconomic Factors in Korean Adults: A Study Using Community Health Survey 2019. Journal of Korean society for research on nicotine and tobacco. 2022; 13(4): 140-50.
    CrossRef
  21. Kang YW, Ko YS, Kim YJ, Sung KM, Kim HJ, Choi HY, et al. Korea Community Health Survey Data Profiles. Osong Public Health Res Perspect. 2015; 6(3): 211-7.
    Pubmed KoreaMed CrossRef
  22. Turner R. Diffusion of Innovations, 5th edition, Everett M. Rogers. Free Press, New York, NY (2003), 551 pages. Journal of Minimally Invasive Gynecology. 2007; 14: 776.
    CrossRef
  23. Lee ES, Kim H, Ju Y-S, Ock M. Female Smoking Behaviors and Female Smoking Related Social Stigma: Qualitative Research Using Focus Group Discussion. JKSRNT. 2024; 15(1): 8-18.
    CrossRef
  24. Lee JA, Kim SH, Cho HJ. Electronic cigarette use among Korean adults. Int J Public Health. 2016; 61(2): 151-7.
    Pubmed CrossRef
  25. Choi J-E, Cho H-J. Analysis of the Factors Affecting the Support to Regulating Heated Tobacco Devices among South Korean Adults. JKSRNT. 2021; 12(2): 64-73.
    CrossRef
  26. Kim JM, Cho H-J. Reasons for Using Heated Tobacco Products among South Korean Adults. JKSRNT. 2021; 12(2): 53-63.
    CrossRef
  27. Cho H-J. Comparison of the risks of combustible cigarettes, e-cigarettes, and heated tobacco products. Journal of the Korean Medical Association. 2020; 63: 96-104.
    CrossRef
  28. Kim YA, Lee J, Kim J, Kim J, Ko Y-J, Kim S. The characteristics of electronic cigarette user among Korean smokers: The sixth Korean national health and nutrition examination Survey, 2013-2015. Korean Journal of family practice. 2019; 9(4): 324-30.
    CrossRef
  29. Roberts W, Moore KE, Peltier MR, Verplaetse TL, Oberleitner L, Hacker R, et al. Electronic Cigarette Use and Risk of Harmful Alcohol Consumption in the U.S. Population. Alcohol Clin Exp Res. 2018; 42(12): 2385-93.
    Pubmed KoreaMed CrossRef
  30. Kim M, KIM, Dohyung. Gender Inequality in Social Institutions and Gender Differences in Smoking Prevalence: Evidence From OECD Countries. Health and Social welfare review [Internet]. 2022; 42(4): 29-43 [cited 2024 July 22].
    Available from: https://doi.org/10.15709/HSWR.2022.42.4.29
    CrossRef