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Effectiveness of government anti-smoking policy on non-smoking youth in Korea: a 4-year trend analysis of national survey data
  1. Jueun Kwak1,
  2. Hyunsuk Jeong2,
  3. Sungha Chun3,
  4. Ji Hoon Bahk1,
  5. Misun Park4,
  6. Youngseol Byun1,
  7. Jina Lee1,
  8. Hyeon Woo Yim2,5
  1. 1 Catholic Medical Center, Seoul, Republic of Korea
  2. 2 Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
  3. 3 College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
  4. 4 Clinical Research Coordinating Center, Catholic Medical Center, Republic of Korea
  5. 5 Clinical Research Coordinating Center, Catholic Medical Center, Republic of Korea
  1. Correspondence to Dr Hyeon Woo Yim; y1693{at}


Objectives Since the Health Promotion Act was introduced in Korea in 1995, anti-smoking policies and regulations have undergone numerous revisions, and non-smoking areas have gradually been expanded. The purpose of this study was to examine the impact of a partial legislative ban on adolescent exposure to secondhand smoke using objective urinary cotinine levels in a nationwide representative sample.

Methods Urine cotinine levels were measured in the Korea National Health and Nutrition Examination Survey from 2008 to 2011. This study was a trend analysis of 4 years of national survey data from 2197 Korean youth aged 10–18 years. Among non-smokers, the 75th percentile urinary cotinine level was estimated. We also considered the number of household smokers.

Results The 75th percentile urine cotinine level of non-smokers showed a significant decreasing trend from 2008 to 2011, from 15.47 to 5.37 ng/mL, respectively. Urine cotinine did not decline significantly in non-smokers living with smokers during the study period. The results did not show a statistically significant reduction in smoking rate in adolescents from 2008 to 2011, although there was a trend towards a decrease (p=0.081).

Conclusions Based on urine cotinine levels, government-initiated anti-smoking policies have only been effective among highly exposed non-smoking adolescents during the study period. Further study needs to evaluate whether or not the legislative ban affects domestic smoking exposure.

  • vernment-initiated policy
  • cotinine
  • environmental tobacco smoke (ETS)

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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  • Contributors JK conducted the analyses and wrote the manuscript. HWY guided and supervised the writing of the manuscript. HWY, HJ and JK came up with and proposed the basic idea of the study. HJ, JB, YB and JL reviewed the manuscript. MP conducted statistical analysis. All authors contributed editorial comments on the manuscript.

  • Competing interests None declared.

  • Ethics approval This study received approval from the Institutional Review Board of The Catholic University of Korea (MC15EISI0097).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Extra data can be accessed via the Dryad data repository at doi:10.5061/dryad.b7040

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