Socioeconomic Inequalities in e-Cigarette Use in Korea: Comparison with Inequalities in Conventional Cigarette Use Using Two National Surveys.

Youngs Chang,Sanghyun Cho,Ikhan Kim,Young-Ho Khang

doi:10.3390/ijerph16224458

Abstract

Socioeconomic inequalities in conventional cigarette smoking are well established in developed countries. The aim of this study was to investigate socioeconomic inequalities in e-cigarette use in Korea, in comparison with inequalities in conventional cigarette use. Data from the Korea National Health and Nutrition Examination Survey (KNHANES) and the Korea Community Health Survey (KCHS) were analyzed. The years of data collected were 2013 to 2016 for the KNHANES and 2014 to 2016 for the KCHS, respectively. The age-adjusted prevalence of ever and current e-cigarette use and conventional cigarette use was calculated according to socioeconomic status indicators, including education, occupation, and income. The prevalence of ever e-cigarette use in men increased from 12.1% in 2013 to 19.2% in 2016 in the KNHANES, and from 13.4% in 2014 to 17.9% in 2016 in the KCHS. Ever and current e-cigarette use was concentrated among current smokers and was much more prevalent among men and also more common among younger age groups in men and women. There was higher prevalences of conventional cigarette use among men and women with less education, manual occupational class and lower income, with the differences more pronounced for women. There was higher ever and current use of e-cigarettes among women with less education, manual occupational class and lower income, but among men there was much less difference in e-cigarette use by these indicators of socio-economic status.

Highlights

The electronic cigarette (e-cigarette), a device through which the user inhales vapor containing electronically vaporized liquid nicotine, was initially developed in China in the 2000s [1]
Considering the relatively expensive price of e-cigarettes, it is notable that the prevalence of ever and current use of e-cigarettes among men in the high-income group was relatively similar to the prevalence of e-cigarette use among men in the low-income group, whereas the prevalence of conventional cigarette smoking was significantly different according to income groups
This study examined socioeconomic inequalities in the prevalence of ever and current e-cigarette use and conventional cigarette smoking in Korea using two nationally representative surveys

Summary

Introduction

The electronic cigarette (e-cigarette), a device through which the user inhales vapor containing electronically vaporized liquid nicotine, was initially developed in China in the 2000s [1]. E-cigarettes may contain nicotine as well as other chemical substances observed in conventional cigarettes. Previous studies have reported that e-cigarettes, whilst likely to be less hazardous than conventional smoked cigarettes, are very unlikely to be harmless, of particular note, e-cigarette use has been associated with an increased use of conventional cigarettes among youth [2,3,4,5]. The prevalence of e-cigarette use has increased worldwide in recent years. A study conducted in the US showed an increase in the prevalence of ever-use of e-cigarettes among adults from 1.8% in

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