South Korea has made substantial progress against smoking over recent decades. Higher tobacco taxes, smoke-free laws, graphic warnings, public education and cessation programmes have all contributed to falling cigarette use. Yet smoking still causes a major burden of preventable disease, and the decline appears increasingly difficult to sustain. The debate is therefore no longer simply about whether South Korea needs stronger tobacco control. It is about which policies will actually reduce smoking fastest without creating damaging unintended consequences.
A case to follow
A study published in The Lancet Regional Health – Western Pacific in 2026 revealed a significant acceleration in the decline of adult smoking beginning in 2018/19, which aligned with a rise in vaping following regulatory changes and government backing for vaping as a smoking cessation tool.
An example cited all too often: Sweden has pursued many conventional tobacco-control policies, but it has also allowed cigarettes to compete with non-combustible alternatives and achieved historic successes as a result. The Smoke Free Sweden report places South Korean daily smoking at around 15.3%, compared with 5.3% in Sweden. Differences in surveys and definitions may mean international comparisons require caution, but the gap remains striking.
Sweden’s experience does not necessarily indicate that snus and nicotine pouches alone caused its low smoking prevalence. Culture, taxation and conventional tobacco-control measures matter too. Nevertheless, Sweden demonstrates something highly relevant to South Korea: widespread use of nicotine does not necessarily require widespread cigarette smoking.
Still, this doesn’t completely address concerns about youth vaping. Other research conducted in New Zealand has pointed out issues regarding adolescent vaping patterns, emphasising the necessity for strong age limits and targeted protections for young individuals. The lesson is not unrestricted nicotine access. It is risk-proportionate regulation.
The prohibition problem
Applied to nicotine, Koumal highlighted an obvious contradiction: cigarettes remain legally available while products expected to pose considerably lower risks are sometimes prohibited or heavily restricted. That matters because prohibition does not necessarily eliminate demand.
Reversing the risk hierarchy
This is particularly relevant to South Korea’s treatment of newer nicotine products. South Korea already has substantial experience with alternatives to cigarettes, especially heated tobacco products. But regulation should increasingly distinguish products by their likely health risks and encourage complete substitution, rather than prolonged dual use.
This balanced approach aligns with Koumal’s “sweet spot”: not a completely hands-off market or outright prohibition but a regulated environment focused on measurable health outcomes. Additionally, South Korea should keep assessing whether these interventions are effective. If tighter restrictions lead to more illegal purchases or higher rates of smoking relapse or cigarette use, regulators ought to be ready to make adjustments instead of measuring success just by how many legal nicotine products are sold.
Smoking, not nicotine, should be the target
No problem, smokers who want and can handle complete nicotine abstinence should receive counselling, NRT and cessation medicines. But those unable or unwilling to quit nicotine should have accurate information and regulated pathways towards substantially lower-risk products.
South Korea has shown the positive outcomes that traditional tobacco control can bring. The next step forward might hinge on blending these policies with harm reduction strategies, striking a balance in regulation: being strict on cigarettes, cracking down on illegal sellers, safeguarding young people, while also being supportive of adults who are trying to quit smoking.
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