ArticleBMJ public health2026
Expansion of smoke-free policies and their associations with observed smoking, policy support and voluntary home bans in South Korea: findings from the 2005-2020 ITC Korea surveys.
Article in BMJ public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: South Korea has progressively strengthened its smoke-free regulations over the past two decades. However, few studies have systematically examined how this expansion has corresponded with changes in observed smoking, support for smoke-free laws, voluntary home smoking bans and motivation to quit smoking. Methods: We analysed nationally representative data from five waves of the International Tobacco Control Korea Surveys (2005: n=991; 2008: n=1733; 2010: n=1552; 2016: n=1989; 2020: n=3763), including 10 028 adults who smoked cigarettes at least weekly. Using a repeated cross-sectional design, we assessed self-reported smoking restrictions in bars/pubs, cafés/restaurants and workplaces, and examined their associations with observed smoking, support for smoking bans, voluntary home smoking bans and motivation to quit smoking. Adjusted associations were estimated using regression models with generalised estimating equations, accounting for survey weights and within-subject correlation. Results: Smoking restrictions expanded substantially across all venues between 2005 and 2020. Over the same period, observed smoking declined markedly (51.4%-97.2% to 5.8%-12.4%), while support for smoking bans (5.3%-17.6% to 78.4%-88.1%), voluntary home smoking bans (29.3% to 60.3%) and motivation to quit smoking (36.3%-38.5% to 57.7%-60.4%) all increased. Both complete and partial bans were inversely associated with observed smoking, with stronger associations for complete bans (adjusted prevalence ratios (aPRs) 0.15-0.44 vs 0.47-0.95). Complete bans were also positively associated with support for smoke-free laws (aPRs 1.82-1.93) and voluntary home smoking bans (aPRs 1.27-1.45), whereas partial bans showed weak or no significant relationships. Only workplace smoking bans were associated with greater motivation to quit smoking (aPRs 1.92). Conclusions: The expansion of smoke-free policies in South Korea has coincided with lower observed smoking, stronger public support and wider adoption of home smoking bans, highlighting that comprehensive bans are more effective than partial bans in strengthening smoke-free norms and advancing tobacco control efforts.
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