search for



Cross mark




View (231) Download (272) CrossRef (1)
Qualitative Study on Age and Sex Differences in the Experience of Using Flavored Tobacco
J Korean Soc Res Nicotine Tob 2023; 14(4): 142-153
Published online December 30, 2023
© 2023 The Korean Society for Research on Nicotine and Tobacco.

Kwanwook Kim1, Heejin Kimm2*

1Department of Cultural Anthropology, College of Integrated Global Studies, Duksung Women’s University, Seoul, 2Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
Correspondence to: *김희진
연세대학교 보건대학원
역학건강증진학과 국민건강증진연구소
Received December 12, 2023; Revised December 19, 2023; Accepted December 21, 2023.
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: The popularity of flavored tobacco, especially menthol varieties, is increasing. This use is particularly noticeable among teenagers and young adults under 25.
Methods: This study was conducted using focus group interviews with 42 adolescents and adults, both male and female, from Seoul, metropolitan, and nonmetropolitan areas. The survey took place from May to June 2022 and followed a semistructured guideline.
Results: The findings revealed that teenagers often use strong-tasting and aromatic flavored tobacco as “starter cigarettes,” which plays a critical role in both initiating and maintaining smoking habits. Adults under 25 develop “personal tobacco preferences” influenced by taste and aroma. Users of liquid e-cigarettes often adjust for nicotine concentration and hit sensation with flavor. In contrast, adults over 25 tend to prefer flavored tobacco for “stimulation rather than taste.” Men in this age group favor the throat hit of menthol, while women value reduced odor. The study also found that advertising of flavored tobacco significantly influences youth smoking. Participants believed flavored tobacco could be more harmful than regular cigarettes and that its taste and aroma substantially affect their quitting intentions.
Conclusion: Flavored tobacco impacts various age groups differently regarding smoking initiation, continuation, and cessation. There are also sex-based differences in flavored tobacco preferences. Advertising and specific flavors and aromas have a significant impact on youth. There is a need for further research and routine monitoring on the flavored tobacco.
Keywords : Flavored tobacco; Focus group interview; Youth smoking; Adult smoking experience; Beginner-friendly cigarettes; Nicotine dependence; Smoking initiation
  1. Euromonitor International [Internet]. Euromonitor International. 2021 [cited 2023 Dec 3].
  2. Moon SM. NARS analysis of current issues. Cases and implications of overseas regulations on flavored tobacco. National Assembly Research Service. 2021.
  3. Korea Centers for Disease Control and Prevention. Research on the impact of flavored tobacco products on smoking initiation. Korea Centers for Disease Control and Prevention. 2017.
  4. Paek HJ. Cigarette Packages as Marketing Communication Tools: Predictive Roles of Cigarette Package Elements in Perceptions and Choices of Low-Tar and Flavored Cigarettes. Health and Social Welfare Review. 2018; 38(3): 303-30.
  5. Kimm HJ, Kim KW, Yu HJ, Lee SK, Lee EJ, Na KI, et al. Current Status of Flavored Tobacco Products Use. Public Health Weekly Report. 2023; 16(7): 185-99.
  6. Giovino GA, Sidney S, Gfroerer JC, O’Malley PM, Allen JA, Richter PA, et al. Epidemiology of menthol cigarette use. Nicotine & Tobacco Research. 2004; 6(Suppl_1): S67-S81.
    Pubmed CrossRef
  7. Goldenson NI, Leventhal AM, Simpson KA, Barrington-Trimis JL. A review of the use and appeal of flavored electronic cigarettes. Current addiction reports. 2019; 6: 98-113.
    Pubmed KoreaMed CrossRef
  8. Harrell MB, Weaver SR, Loukas A, Creamer M, Marti CN, Jackson CD, et al. Flavored e-cigarette use: characterizing youth, young adult, and adult users. Preventive medicine reports. 2017; 5: 33-40.
    Pubmed KoreaMed CrossRef
  9. Hersey JC, Ng SW, Nonnemaker JM, Mowery P, Thomas KY, Vilsaint MC, et al. Are menthol cigarettes a starter product for youth?. Nicotine & Tobacco Research. 2006; 8(3): 403-13.
    Pubmed CrossRef
  10. Nonnemaker J, Hersey J, Homsi G, Busey A, Allen J, Vallone D. Initiation with menthol cigarettes and youth smoking uptake. Addiction. 2013; 108(1): 171-8.
    Pubmed CrossRef
  11. Villanti AC, Collins LK, Niaura RS, Gagosian SY, Abrams DB. Menthol cigarettes and the public health standard: a systematic review. BMC public health. 2017; 17: 1-13.
    Pubmed KoreaMed CrossRef
  12. Le TT, Mendez D. An estimation of the harm of menthol cigarettes in the United States from 1980 to 2018. Tobacco Control. 2022; 31(4): 564-8.
    Pubmed KoreaMed CrossRef
  13. Kang SY, Lee S, Cho HJ. Prevalence and predictors of heated tobacco product use and its relationship with attempts to quit cigarette smoking among Korean adolescents. Tobacco Control. 2021; 30(2): 192-8.
    Pubmed CrossRef
  14. Jackson K, Bazeley P, and Bazeley P. Qualitative Data Analysis with NVivo. London: Sage, 2019.
  15. Saldaña J. The coding manual for qualitative researchers. London: Sage, 2021.
  16. Klausner K. Menthol cigarettes and smoking initiation: a tobacco industry perspective. Tobacco control. 2011; 20(Suppl 2): ii12-ii19.
    Pubmed KoreaMed CrossRef
  17. Anderson SJ. Marketing of menthol cigarettes and consumer perceptions: a review of tobacco industry documents. Tobacco control. 2011; 20.Suppl 2: ii20-ii28.
    Pubmed KoreaMed CrossRef
  18. Hiscock R, Silver K, Zatoński M, Gilmore AB. Tobacco industry tactics to circumvent and undermine the menthol cigarette ban in the UK. Tobacco Control. 2020; 29(e1): e138-e142.
    Pubmed KoreaMed CrossRef
  19. Delnevo CD, Ollie G, Renee DG. Banning menthol cigarettes: a social justice issue long overdue. Nicotine and Tobacco Research. 2020; 22(10): 1673-5.
    Pubmed KoreaMed CrossRef
  20. Kim KW, Kimm HJ. Qualitative Study on Youth Smoking and Drinking Patterns in 2019. Journal of the Korean Society for Research on Nicotine and Tobacco. 2023; 14(3): 79-90.
  21. Rossheim ME, Livingston MD, Krall JR, Barnett TE, Thombs DL, McDonald KK, et al. Cigarette use before and after the 2009 flavored cigarette ban. Journal of Adolescent Health. 2020; 67(3): 432-7.
    Pubmed CrossRef
  22. Chung-Hall J, Fong GT, Meng G, Cummings KM, Hyland A, O’Connor RJ, et al. Evaluating the impact of menthol cigarette bans on cessation and smoking behaviours in Canada: longitudinal findings from the Canadian arm of the 2016-2018 ITC Four Country Smoking and Vaping Surveys. Tobacco control. 2022; 31(4): 556-63.
    Pubmed KoreaMed CrossRef
  23. Cadham CJ, Sanchez-Romero LM, Fleischer NL, Mistry R, Hirschtick JL, Meza R, et al. The actual and anticipated effects of a menthol cigarette ban: a scoping review. BMC Public Health. 2020; 20: 1-17.
    Pubmed KoreaMed CrossRef
  24. Ahijevych K, Garrett BE. Menthol pharmacology and its potential impact on cigarette smoking behavior. Nicotine & Tobacco Research. 2004; 6.Suppl1: S17-S28.
    Pubmed CrossRef
  25. Brooks DR, Palmer J R, Strom BL, Rosenberg L. Menthol cigarettes and risk of lung cancer. American journal of epidemiology. 2003; 158(7): 609-16.
    Pubmed CrossRef