BACKGROUND AND IMPLEMENTATION CHALLENGES: E-cigarette use among youth is a significant public health concern globally. In South Korea, e-cigarettes are the most popular tobacco product among adolescents. In 2024, the prevalence of e-cigarette use among boys and girls was 3.7% and 2.2%, respectively—a slight increase from 2023 but a sharp decline from 2014, when the prevalence among high school boys reached 12.3%.
INTERVENTION OR RESPONSE: This reduction is closely tied to South Korea’s regulatory measures, particularly taxation.
RESULTS AND IMPACT: E-cigarettes entered the Korean market in 2007 and were marketed as safer alternatives to cigarettes and smoking cessation aids. Their popularity surged, with youth prevalence rising ninefold between 2008 and 2011, reaching 4.5%. During this period, e-cigarettes were largely unregulated, contributing to the rapid increase in use. In 2011, the government implemented a tax of 400 KRW (USD 0.30) per millilitre of nicotine liquid, equivalent to the tax on 12.5 conventional cigarette sticks. A Health Promotion Contribution was also introduced, aligning e-cigarette taxation with conventional cigarettes. These measures led to a sharp decline in youth e-cigarette use, dropping from 7.3% in 2011 to 4.7% in 2013. In 2015, further tax increases on e-cigarettes, tied to broader cigarette excise tax hikes, continued to reduce youth prevalence, which fell to 3.7% by 2016. However, the e-cigarette industry adapted by separating nicotine and flavoured liquids to reduce the effective tax, temporarily increasing use.
CONCLUSIONS: Korea’s experience highlights the critical role of taxation in curbing youth e-cigarette use. By aligning e-cigarette taxes with those on conventional cigarettes, South Korea provides a model for countries aiming to address the rise in youth e-cigarette prevalence through evidence-based policies.