BACKGROUND: Adolescent tobacco use poses significant health risks, particularly in relation to respiratory conditions such as asthma, making it a critical public health issue. This study investigates the association between tobacco use behaviors and asthma prevalence among Korean adolescents
METHODS: We analyzed data from the 2022–2024 Korea Youth Risk Behavior Survey (KYRBS), encompassing 159383 middle and high school students. The study examined the relationship between asthma diagnosis within the past 12 months and patterns of tobacco use, including non-use, exclusive use of conventional cigarettes, e-cigarettes, or heated tobacco products (HTPs), and dual or triple product use. A complex sampling design and weighting were applied, and multivariate logistic regression analysis was conducted to calculate adjusted odds ratios (aORs) for asthma prevalence, controlling for gender, age, academic performance, socioeconomic status, and alcohol use.
RESULTS: The proportion of adolescents using at least one tobacco product declined from 5.3% in 2022 to 4.4% in 2024. Among the 159383 participants, 2,715 (1.7%) reported an asthma diagnosis in the past year. Compared to non-users, adolescents who exclusively used conventional cigarettes had an aOR of 1.37 (95% CI: 1.31–1.43) for asthma. The aOR was 4.57 (95% CI: 4.40–4.76) for exclusive e-cigarette use and 10.57 (95% CI: 9.97–11.21) for exclusive HTP use. Dual users of conventional cigarettes and e-cigarettes showed an aOR of 2.38, while dual users of conventional cigarettes and HTPs had an aOR of 3.78. Adolescents using both e-cigarettes and HTPs had an aOR of 16.1, and triple users had an aOR of 5.54.
CONCLUSIONS: Tobacco use in any form was positively associated with asthma prevalence among adolescents, with e-cigarettes and HTPs showing particularly strong links. Regulatory efforts targeting these emerging tobacco products are urgently needed to protect adolescent health.