Directions and Challenges in Smoking Cessation Treatment

Abstract

Raising the tax on tobacco-related products is the most effective and most sustainable intervention for smoking cessation. The 2015 tobacco tax increase resulted in a decreased smoking rate among Korean adult men. However, the governmentsponsored smoking cessation programs, developed after the 2015 tobacco tax increase, have been experiencing a sharp decrease in participation since 2018. The popularity of electronic cigarettes (e-cigarettes) seems to be an important factor in this decline. Indeed, the market share of e-cigarettes has increased steadily since 2007, when the e-cigarette was introduced in Korea as a vaporizer. The introduction of the tobacco-heating device IQOS in 2017 resulted in the skyrocketing popularity of e-cigarettes, especially among the young generation of Koreans. The US Food and Drug Administration (FDA) authorized marketing of IQOS as a "reduced exposure" tobacco product on July 7, 2020, which has complicated smoking cessation efforts further. The agency announced that IQOS produces fewer or lower levels of some toxins compared with combustible cigarettes. However, the US FDA authorization does not mean that these products are safe. There is no evidence that reducing the harmful chemical components leads to health benefits. Clinicians need to maintain the position that those who smoke, 2 regardless of tobacco product type, should be counseled for smoking cessation and prescribed proven pharmacologic agents for smoking cessation.

Factors related to the success of smoking cessation: A retrospective cohort study in Korea

“…Varenicline is currently the most used treatment in smoking cessation clinics in South Korea. However, despite the implementation of smoking cessation programs using varenicline, and an annual budget dedicated to smoking cessation clinics, the smoking rate in South Korea has not decreased as expected 8 . Therefore, it is necessary to investigate the factors that impact smoking cessation success, such as smoking habits and health-related risks, in addition to pharmaceutical treatment.…”

Sex differences in chronic obstructive pulmonary disease characteristics: the Korea National Health and Nutrition Examination Survey 2007–2018

“…However, COPD is gradually becoming an important factor affecting women’s mortality and quality of life [ 11 ]. In general, the smoking rate is lower in women than men [ 12 , 13 ], but women generally experience a greater decline in lung function than men at the same smoking exposure. There may be sex differences in lung damage susceptibility associated with cigarette smoking [ 14 ], and women who have never smoked may have prolonged exposure to organic dust [ 8 ].…”

Nicotine Dependence and Stress Susceptibility in E-Cigarette Smokers: The Korea National Health and Nutrition Examination Survey 2013–2017

“…However, it did not decrease further and remained at almost the same level in subsequent years. This could be attributed to the increased popularity of e-cigarettes 3 . It has been established that many smokers seek ways to continue smoking even in the face of increased cigarette prices either reducing other expenses to spare money for originally preferred products or switching to cheaper products 4 .…”