BACKGROUND: The emergence of novel tobacco products, such as electronic cigarettes (e-cigarettes), heated tobacco products (HTPs), and nicotine pouches, presents significant challenges to tobacco control policies worldwide, including in South Korea. While attention has largely focused on these new products, conventional cigarettes have also evolved, incorporating flavor capsules and sweet tipping techniques to enhance taste and smell. These changes may contribute to increasing youth smoking rates and shifting perceptions of tobacco harm.
METHODS: From July 9 to 30, 2024, an online survey was conducted with 2.581 South Korean adolescents aged 13-18.
RESULTS: Among the respondents, 8.0% (206 participants) reported current use of at least one tobacco product, including conventional cigarettes, e-cigarettes, or HTPs. Notably, 96.5% (2,421 participants) reported exposure to tobacco advertisements in convenience stores, the primary retail outlets for tobacco in South Korea. Among those who had seen these advertisements, 41.2% identified flavor-related promotions as the most common ad content.
Among current youth smokers, 43.6% (134 participants) stated that flavor-related advertisements triggered their urge to smoke, followed by capsule-related features (17.9%, 55 participants). Additionally, 78.4% of all respondents reported direct or indirect experiences with flavored conventional cigarettes, and 73.7% believed that flavors in cigarettes could encourage youth smoking initiation. Alarmingly, approximately 28% perceived flavored cigarettes as less harmful to health compared to non-flavored ones.
CONCLUSIONS: This study highlights that not only novel tobacco products but also flavored conventional cigarettes contribute to youth smoking initiation. The widespread promotion of flavors creates misconceptions about tobacco harm and facilitates smoking uptake. These findings underscore the urgent need to implement and strengthen regulations banning flavor additives in all tobacco products to protect public health effectively.