Social, Educational, and Psychosocial Correlates of Lifetime Tobacco/Nicotine Initiation Status Among Adolescents in the 2019-2023 Korean Youth Health Behaviour Panel Survey
Hoang Le Tu, Jin-kyoung OhBackground
This study examined the prevalence and correlates of lifetime tobacco/nicotine initiation status, defined as having ever initiated or used at least one tobacco/nicotine product among adolescents in South Korea.
Methods
We analyzed 22,843 adolescent-year observations from the 2019-2023 Korean Youth Health Behaviour Panel Survey. Survey-weighted prevalence estimates and sequential survey-weighted logistic regression models were used to examine associations of lifetime initiation status with socioeconomic indicators, academic performance, peer and household smoking, peer pressure, depressive feelings, access-related factors, and media/commercial exposure.
Results
Overall, 647 adolescent-year observations (2.8%) were classified as having lifetime tobacco/nicotine initiation status. Weighted prevalence was 0.35% in 2019 and 9.07% in 2023, although the 2023 estimate should be interpreted cautiously because of outcome construction and missingness. In the fully adjusted model, lifetime initiation status was strongly associated with having one, two, or three close friends who smoked (AOR = 6.13, 11.07, and 22.31, respectively). Lower academic performance, depressive feelings, peer pressure to smoke, and male sex were also positively associated. Household economic status showed a non-monotonic pattern in the primary categorical analysis, while pocket money adequacy, access-related factors, and media/commercial exposure showed weaker or less consistent associations after full adjustment.
Conclusions
These findings highlight peer social context, educational vulnerability, and adolescent mental health as potentially relevant considerations for prevention.