South Korea’s nicotine policies are costing lives: New report
Major new research by international health experts shows South Korea’s negative approach to smoke-free nicotine products is sabotaging the fight against smoking, which kills more than 68,000 people in the country every year.
A new Smoke Free Sweden report compares South Korea’s tobacco-control strategy with Sweden’s world-leading harm reduction model and concludes that Korea’s refusal to distinguish between cigarettes and lower-risk nicotine products is slowing progress against smoking and denying smokers access to life-saving alternatives.
The report, Tale of Two Nations: South Korea v Sweden, finds that South Korea’s daily smoking rate remains stuck at 15.3% – almost three times higher than Sweden’s 5.3% rate.
While Sweden has cut smoking by 46% since 2015 and is on the verge of becoming fully smoke-free, South Korea’s decline has slowed dramatically despite decades of conventional tobacco-control measures.
The report identifies one of the clearest examples of policy failure in South Korea’s treatment of nicotine pouches. Under current regulations, nicotine pouches are taxed at KRW 12,736 per 20 pouches – more than four times the tax burden applied to a pack of 20 cigarettes.
Smoke Free Sweden leader Dr Delon Human said the comparison exposed the dangers of regulating smoke-free products as if they were cigarettes.
“South Korea’s progress against smoking is stalling because policymakers continue to treat all nicotine products as equally harmful,” said Dr Human.
“That approach ignores both science and common sense. Cigarettes kill because tobacco is burned and inhaled. Products such as nicotine pouches, snus and vapes eliminate combustion entirely. When governments refuse to tax and regulate these products less harshly than cigarettes, they make it harder for smokers to switch.”
The report notes that smoking caused 68,536 deaths in South Korea in 2023 and continues to impose an enormous economic burden, with smoking-attributable healthcare costs reaching about KRW 5 trillion (almost US$3.4 billion) annually.
Dr Human, a former secretary-general of the World Medical Association, said: “Sweden has shown the world how to defeat smoking. Instead of declaring war on nicotine itself, Sweden focused on eliminating the smoke. Safer alternatives were made accessible, acceptable and affordable, and millions switched.
“The result is Europe’s lowest smoking rate, the lowest tobacco-related disease burden and one of the most remarkable public-health success stories of modern times.
“South Korea cannot expect Swedish results while taxing, restricting and stigmatising safer alternatives. Every year that policymakers delay adopting a risk-proportionate approach means thousands more preventable deaths and billions more in avoidable healthcare costs.”
The report calls on South Korea to adopt risk-proportionate regulation, reform its nicotine pouch taxation system and improve public awareness of lower-risk alternatives to encourage adult smokers to switch away from combustible cigarettes.
“South Korea has the opportunity to dramatically accelerate its decline in smoking,” said Dr Human. “But that will require abandoning outdated policies that treat every nicotine product the same and embracing the evidence that has already delivered extraordinary results in Sweden.”
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