Modelling the potential impact of a flavour ban on smoking and vaping prevalence in South Korea.

Abstract

Background: The increasing popularity of flavoured cigarettes in South Korea poses a challenge to recent declines in smoking prevalence, particularly among younger populations. This study aimed to estimate the potential impact of implementing a flavoured cigarette ban on smoking and vaping prevalence in South Korea using the Smoking and Vaping Model (SAVM).

Methods: We adapted the SAVM to the Korean context using national demographic data, smoking and vaping prevalence from the Korea National Health and Nutrition Examination Survey (KNHANES) and flavoured cigarette use data from the International Tobacco Control (ITC) survey. To validate the model, we compared the projected smoking prevalence under the status quo scenario from 2016 to 2022 with the smoking prevalence reported in KNHANES. The model assumes implementation of the flavoured cigarette ban beginning in 2025 and projects smoking and vaping prevalence from 2025 to 2034 under both the status quo and flavour ban scenarios. Sensitivity analyses were conducted by varying key parameters by ±10%.

Results: Under the flavour ban scenario, male smoking prevalence is projected to further decline by 2.0% point and female prevalence by 0.5% point within 1 year of policy implementation, compared with the status quo. Flavoured cigarette use is expected to drop substantially, with partial substitution to unflavoured cigarettes and flavoured nicotine vaping products. Vaping prevalence is projected to increase by approximately 1.0% point in both sexes, compared with the status quo. Sensitivity analysis indicated the robustness of these projections.

Conclusions: A comprehensive flavour ban could significantly reduce smoking prevalence in South Korea, but may lead to increased use of alternative tobacco products. To maximise public health benefits, policies should address flavoured products across all tobacco products and anticipate potential substitution behaviours.