Citation

Chun, H., Fong, G.T., Gravely, S., Xu, S.S., Quah, A.C.K., Kang, H., Yoon, W., Seo, H.G., Kim, Y., Lee, S., Kim, G., Kim, S.-Y., Lim, S., Yan, M., Cho, S. (2025). An examination of the relationship between perceptions that cigarette smoking increases the severity of COVID-19 illness and reduction in smoking during the COVID-19 pandemic: Findings from the 2021 ITC Korea Survey. Tobacco Induced Diseases.doi: 10.18332/tid/205468.

Abstract

Introduction: This study examined whether Korean adults who smoked cigarettes during the COVID-19 pandemic decreased their smoking because of COVID-19, with a focus on whether perceptions of susceptibility and severity of COVID-19 disease were associated with reduced smoking.

Methods: Data came from 1506 Korean adults (aged =19 years) who exclusively smoked cigarettes (weekly) and participated in the 2021 International Tobacco Control (ITC) Korea Survey. Weighted analyses assessed pandemic-related changes in smoking and whether reductions in smoking were related to: 1) perceived susceptibility to contracting COVID-19; 2) perceiving that smoking increases the severity of COVID-19 disease; and 3) general worry about getting a smoking-related disease.

Results: Korean adults were significantly more likely to have reduced their smoking because of COVID-19 (18.9%) than increased their smoking (6.3%) (p<0.001); 74.8% made no changes to their smoking. Reducing smoking was associated with being very worried about contracting COVID-19 (adjusted odds ratio, AOR=4.25; 95% CI: 1.65-10.99) and believing that smoking increases COVID-19 severity (AOR=2.34; 95% CI: 1.19-4.61). General worry about getting smoking-related diseases was not associated with smoking reduction (p=0.53). We also found an interaction between perceived severity and worry about getting COVID-19; those who were very worried about getting COVID-19 and perceive smoking as increasing its severity, were more likely to reduce smoking (p=0.049).

Conclusions: In response to the COVID-19 pandemic, Korean adults who smoked were much more likely to reduce than increase their smoking, unlike in most countries where there was no net change. The higher smoking reduction rate in Korea may reflect successful and strong communication by the Korean government regarding the importance of reducing smoking during the pandemic, compared to the general future threat of health risks from smoking.