Estimated prevalence and trends in smoking among adolescents in South Korea, 2005–2021: a nationwide serial study

Hyoin Shin, Sangil Park, Hyunju Yon, Chae Yeon Ban, Stephen Turner, Seong Ho Cho, Youn Ho Shin, Jung U. Shin, Ai Koyanagi, Louis Jacob, Lee Smith, Chanyang Min, Young Joo Lee, So Young Kim, Jinseok Lee, Rosie Kwon, Min Ji Koo, Guillaume Fond, Laurent Boyer, Jong Woo HahnNamwoo Kim, Sang Youl Rhee, Jae Il Shin, Ho Geol Woo, Hyeowon Park, Hyeon Jin Kim, Yoonsung Lee, Man S. Kim, Eléa Lefkir, Vlasta Hadalin, Jungwoo Choi, Seung Won Lee, Dong Keon Yon, Sunyoung Kim

Research output: Contribution to journalArticlepeer-review


Background: Although smoking is classified as a risk factor for severe COVID-19 outcomes, there is a scarcity of studies on prevalence of smoking during the COVID-19 pandemic. Thus, this study aims to analyze the trends of prevalence of smoking in adolescents over the COVID-19 pandemic period. Methods: The present study used data from middle to high school adolescents between 2005 and 2021 who participated in the Korea Youth Risk Behavior Web-based Survey (KYRBS). We evaluated the smoking prevalence (ever or daily) by year groups and estimated the slope in smoking prevalence before and during the pandemic. Results: A total of 1,137,823 adolescents participated in the study [mean age, 15.04 years [95% confidence interval (CI) 15.03–15.06]; and male, 52.4% (95% CI 51.7–53.1)]. The prevalence of ever smokers was 27.7% (95% CI 27.3–28.1) between 2005 and 2008 but decreased to 9.8% (95% CI 9.3–10.3) in 2021. A consistent trend was found in daily smokers, as the estimates decreased from 5.4% (95% CI 5.2–5.6) between 2005 and 2008 to 2.3% (95% CI 2.1–2.5) in 2021. However, the downward slope in the overall prevalence of ever smokers and daily smokers became less pronounced in the COVID-19 pandemic period than in the pre-pandemic period. In the subgroup with substance use, the decreasing slope in daily smokers was significantly more pronounced during the pandemic than during the pre-pandemic period. Conclusions: The proportion of ever smokers and daily smokers showed a less pronounced decreasing trend during the pandemic. The findings of our study provide an overall understanding of the pandemic’s impact on smoking prevalence in adolescents. [MediaObject not available: see fulltext.].

Original languageEnglish
JournalWorld Journal of Pediatrics
Publication statusAccepted/In press - 2023

Bibliographical note

Funding Information:
This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HV22C0233) and the National Research Foundation of Korea (NRF) grant funded by the Korea government (NRF2021R1I1A2059735). The funders had no role in study design, data collection, data analysis, data interpretation, or writing of the report.

Publisher Copyright:
© 2023, Children's Hospital, Zhejiang University School of Medicine.

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health


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