Trends of Electronic-Cigarette and Heated Tobacco Product Use Among Korean Adults From 2013 to 2023: A Cross-Sectional Study

초록

Background: While awareness and use of electronic cigarettes and heated tobacco products (EC/HTP) have increased in Korea over the past decade, studies on the yearly prevalence of such use are limited, as are those identifying factors associated with their use. Methods: In this study, we analyzed the prevalence, trends, and factors associated with EC/ HTP use over a 10-year period (2013-2023) using the Korea National Health and Nutrition Examination Survey. The yearly prevalence of EC/HTP use was assessed, and factors related to EC/HTP use were identified. Results: Over the study period, EC/HTP use increased, especially use by males and younger study subjects, to 7.3% in 2023. While conventional cigarette use declined consistently from 24.1% in 2013 to 18.7% in 2023, EC/HTP use fluctuated; however, the overall trend was increasing, particularly among individuals in their 20s and 30s. Groups associated with EC/ HTP use as identified on multivariable analyses were former smoking (adjusted odds ratio [aOR], 66.01; P < 0.001), current smoking (aOR, 152.43), younger age (aOR, 7.34 for ages 20-29 years; P < 0.001 and aOR, 7.42 for ages 30-39 years; P < 0.01; the reference group was those 60 years or older), higher body mass index (aOR, 1.30; P < 0.001), unmarried (aOR, 1.53; P < 0.001), and employed in managerial/professional and service/sales positions (aOR, 2.66 and 2.63, respectively; P < 0.001 for both). Conclusion: EC/HTP use in Korea has risen significantly, particularly among younger males, and conventional cigarette use has declined. Key factors include ever-smoking status, younger age, male, elevated BMI, unmarried, and specific occupational roles. These trends highlight the need for targeted interventions and public health strategies to address shifting modes of tobacco use.

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