BACKGROUND: The use of novel tobacco products has increased, leading to the proliferation of multi-tobacco product use. However, there is a lack of research on how multi-tobacco product users recognize the harms of smoking, which may influence their support for tobacco control policies. This study aimed to assess multi-tobacco product users' awareness of smoking harms and to examine its correlation with support for tobacco control policies.
METHODS: This cross-sectional study surveyed 1217 South Korean adults, selected through simple random sampling based on gender, age, and region. Awareness of smoking harms was assessed based on participants’ recognition of the risk of 32 diseases associated with tobacco use. Support for tobacco control policies was measured across five items: two based on MPOWER strategies and three from tobacco endgame policies. Multivariable logistic regression analysis was used to analyze the association between harm awareness and support for tobacco control policies.
RESULTS: The most supported policy among current single users was banning tobacco use near schools(65.8%), while among multi users most supported designating all indoor areas as smoke-free zones and restricting retailers(both 61.5%). The least supported policy for both groups was a total ban on tobacco sales within 10 years(34.3% and 34.2%, respectively). Low awareness of smoking harms was related to lower policy support across all tobacco use patterns. Especially among those aware of smoking harms for lung cancer, single users were less likely to support a total ban on tobacco sales within 10 years(OR 0.192, 95% CI=0.124-0.296) compared to multi users(OR 0.231, 95% CI=0.137-0.388).
CONCLUSIONS: The findings of this study reaffirm the role of awareness of smoking harms in supporting tobacco control policies, while highlighting differences in support levels for certain policies based on tobacco use patterns. These results suggest the need for tailored strategic approaches that consider use patterns for specific tobacco control policies.