Smoking in North Korea
Tobacco smoking is popular and, at least for men, culturally acceptable in North Korea. As of 2014[update], some 45% of men are reported to smoke daily, whilst in contrast only 2.5% of women smoke daily, with most of these being older women from rural areas. Smoking is a leading cause of death in North Korea, and as of 2010[update] mortality figures indicate that 34% of men and 22% of women die due to smoking-related causes, the highest mortality figures in the world. There are tobacco control programs in North Korea, and although smoking is not prohibited in all public spaces, the smoking rates have declined since their peak in the 2000s.
All three leaders of North Korea—Kim Il-sung, Kim Jong-il, and Kim Jong-un; have been smokers and the country has struggled to balance their public image with its anti-smoking efforts. In general, North Koreans tend to prefer strong tobacco and different classes of quality range from homegrown to sought-after foreign brands that are considered status symbols. As a percentage of the available arable land compared to consumption, the tobacco crop is over-represented in North Korean agriculture.
Over 4,569,000 adults and 167,000 children in North Korea are believed to consume tobacco daily. It is estimated by the World Lung Foundation and American Cancer Society's The Tobacco Atlas (2014 data) that 45% of men, 2.5% of women, nearly 16% of boys and <1% of girls (aged <15) are daily smokers, with the average smoker (data is likely skewed towards males due to the higher prevalence of smoking in this group) smoking an average of 609 cigarettes per person per year. World Health Organization (WHO) data is roughly comparable, with 44% of men classified as smokers (only 33% are classed as "daily smokers"), whilst North Korean anti-smoking authorities put the figure even higher, saying that some 54% of men are smokers.
Overall, the average smoker consumes 12.4 cigarettes per day, with this figure rising slightly to 15 per day when just male smokers are considered. The average smoker starts smoking at the age of 23 and the percentage of the population that smokes increases with age until the 55–64 age group, after which it declines. On average, people who live in urban areas tend to smoke more cigarettes per day than rural farmers.
Data indicates that the prevalence of smoking in North Korea is on par with South Korea, although South Korean men pick up the habit earlier and smoke more cigarettes per day. The high rate of smoking in South Korea is possibly due to it being a capitalist society, where marketing is prevalent and consumption is uncontrolled. 
However, much of the current information regarding the smoking habits of North Koreans is obtained by studying North Korean defectors who now live in South Korea and may not be totally representative of the true picture. One study of defectors found that smoking is even more common than anticipated, but nicotine dependence was not as severe as predicted. Defectors are reported as often being very interested in quitting smoking.
Tobacco first arrived in Korea in the early-1600s from Japan and until around 1880, both men and women smoked. Today, North Koreans consider smoking to be a normal activity for men, but female smoking has become a social taboo.
All of North Korea's three leaders—Kim Jong-un, his father Kim Jong-il and grandfather Kim Il-sung; have been smokers. Kim Jong-il has called smokers one of the "three main fools of the 21st century", along with people who do not understand music or computers. The current leader Kim Jong-un is often seen smoking in public, including in university classrooms, subway carriages, and in the presence of his pregnant wife Ri Sol-ju, facts that "might make the life of the North Korean health educators more complicated." While discussing any negative aspects of the leaders has normally been rare, some North Koreans have recently raised the issue of the apparent contradiction between anti-smoking measures and Kim's public image with foreigners.
Women and smoking
Female smoking is a taboo in North Korea and is considered even more disgraceful than heavy drinking. Women are said to "react with shock if you joke that maybe they secretly smoke in bathrooms". Smoking by older women, above the age of 45 to 50 is more tolerated, particularly in rural areas. In comparison, for men smoking is considered such an important social activity that men who do not smoke can become socially isolated at workplaces.
Even though most consumer items are in short supply in North Korea, there is a considerable variety of cigarettes available. In general, strong tobacco is preferred, and filters are rare. Western brands, particularly American, but also Chinese, Russian and Japanese are popular with the elite and preferred over domestic cigarettes. Foreign cigarettes and the domestic 727 brand, whose name stands for 27 July, the date of the Korean Armistice Agreement; are veritable status symbols. Menthol cigarettes are virtually non-existent, but there is competition among tobacco companies to introduce other attractive products, such as fruit-flavored balls inside the filter to give the cigarette a more distinct flavour.
Those who have hard currency can easily buy imported cigarettes from hard currency shops, although these will also stock the best domestic brands (such as Pak Ma, comparable in quality to makhorka) to convince tourists of the quality of North Korean tobacco. Cigarettes are popular gifts, and tourists are recommended to give Western brands of cigarettes to tour guides. Within the country, cigarettes are used as form of currency in bribery.
Those who roll their own tobacco prefer to use sheets of Rodong Sinmun—the organ of the Central Committee of the ruling Workers' Party of Korea—as rolling paper. One piece of the paper can be used to roll some 40–50 cigarettes. According to one defector, when a North Korean "starts to smoke the Rodong Sinmun tobacco, he cannot smoke other kinds of tobacco. I used to smoke the Rodong Sinmun tobacco, and after defection, couldn't smoke with Chinese paper tobacco due to the poor taste." Because the Rodong Sinmun is in limited circulation, most North Koreans roll their cigarettes with some other paper.
The health impacts of smoking are well documented and in North Korea the high prevalence of smoking has a significant impact on the health of the population. Some 34.3% of men and 22.3% of women are reported to die as a result of smoking, the highest smoking mortality figures in the world, and in total tobacco-caused illness kills 55,600 North Koreans annually.
Tobacco is only sold at designated shops at a fixed price set by the government.[a] As of 2014[update], a 20-pack of the most common cigarette brand costs 246.38 KPW North Korean won (£0.21, US$0.27), whilst the cheapest 20-pack sells for as little as 7.47 won (£0.01, US$0.0083).
North Korea has set up specific government objectives for tobacco control and there is a national agency to implement them, with eight full-time staff members. Although there is no free of charge smoking cessation quitline that smokers could phone and discuss their problems, most healthcare facilities offer support in cessation, including cessation programs and nicotine replacement therapy. Costs are covered for the patient partially, or in full by the state. In addition to regular healthcare clinics, there are eleven specialized anti-smoking centers in the country where consultation is free, but medicine is not. Of medicines, bupropion and varenicline are not legally available in North Korea, but herbal medicines are used as smoking cessation aids.
There have been attempts at anti-smoking movements "across the generations" in the country, with the earliest major campaign taking place in 2004. While early campaigns had little effect, they have become more frequent in the 2010s and restrictions on smoking have been observed more closely in recent years; consequently, since the early-2000s; smoking rates have started to decline. There are signs that the North Korean government takes anti-smoking campaigns more seriously than they did in the past. According to the WHO, North Korea now "keenly celebrates World No Tobacco Day (WNTD) every year and disseminates information about tobacco use and its effect on health. The Government persuades public health institutions and the media to spread the information about the health effects of tobacco and its adverse impact on environmental protection and economic development."
Smoking legislation in North Korea has tightened in recent years, although it is still relatively lax and has not had any really meaningful effect on curtailing smoking rates. The rules on where people can or cannot smoke are complex, with smoking prohibited on pavements, ferries, aircraft and at stations, in healthcare and educational facilities, pre-schools and nurseries, shops, theaters, cinemas, culture halls and conference rooms, historic and battle sites, and hotel lobbies.[b] However, smoking is not prohibited in either private or work vehicles or on-board trains, at bus stops, near entrances to buildings, in universities, government offices, workplaces, restaurants, cafes, bars, or nightclubs.
Some of the legislation is observed with high levels of compliance, but not uniformly throughout the country. There are not mandatory fines for smoking transgressions, although the newest 2016 anti-smoking campaign has seen fines issued and offenders threatened with images of them being broadcast on TV. Tobacco packaging warning messages are required on all types of packaging, but their appearance is not regulated in any way. They are usually printed in small print on the side of the package and only state that smoking is harmful to health. However, the descriptions must state the nicotine and tar content,[c] must not be misleading and do need to be approved by local authorities. Graphic warning images that are now common worldwide have never appeared on packaging in North Korea.
There are no restrictions on tobacco advertising, although there are no advertising campaigns of any kind in North Korean media. Tobacco may not be sold to minors [d] (those under the age of seventeen) and Cigarette machines are banned.[e] North Korea imposes no kind of tax at all on tobacco, including specific excise, ad valorem excise, value-added tax, sales tax, or import duty. Electronic cigarettes are legal.
The tobacco industry in North Korea is substantial, with 53,000 hectares (2.3% of its arable land) dedicated to tobacco cultivation. This is the fourth-highest percentage of arable land dedicated to tobacco in the world, with the annual output exceeding 80,000 tonnes, making North Korea one of the top 25 tobacco producers worldwide. This is despite 31% of North Koreans being malnourished. The best, strongest and most expensive tobacco comes from the north of the DPRK near the border with China.
There are many North Korean tobacco companies, making some 30 different types of cigarettes, with the biggest tobacco company being the North Korea General Tobacco Corporation. Some companies export tobacco to the Middle East and elsewhere, sometimes in partnership with foreign firms. For example, the Taedong River Tobacco Company and the Rason Shinhung Tobacco Company, both operating in the Rason Special Economic Zone, are partnered with the Chinese Jilin Tobacco. British American Tobacco also has business in the country, but it has reduced its involvement due to political pressure and public relations reasons. During the Cold War, North Korea paid for goods it imported from the Soviet Union with poor quality tobacco. Later, during the years of the Sunshine Policy, high-end Pyongyang brand cigarettes were exported to South Korea where they were popular among South Koreans who wanted to express a pro-reunification stance. There are some privately owned tobacco factories, some of which are known to produce counterfeit brand cigarettes for export as part of North Korea's illicit activities to earn hard currency. North Korea is one of the largest producers of counterfeit cigarettes in the world.
Leaf tobacco is cheap and can be bought from markets to roll one's own cigarettes. Many rural farmers produce homegrown tobacco on their own plot of land, while others steal tobacco from co-operative farms for sale.
- Law of the Democratic People's Republic of Korea on Tobacco Control 2009, Articles 22 and 23
- Law of the Democratic People's Republic of Korea on Tobacco Control 2009, Articles 27 and 28
- Law of the Democratic People's Republic of Korea on Tobacco Control 2009, Article 12
- Law of the Democratic People's Republic of Korea on Tobacco Control 2009, Article 24
- Law of the Democratic People's Republic of Korea on Tobacco Control 2009, Article 22
- "Country Fact Sheet: DPR Korea". The Tobacco Atlas. World Lung Foundation. 2015. Retrieved 27 May 2016.
- "Cigarette Use Globally". The Tobacco Atlas. 2014. Retrieved 27 May 2016.
- WHO Country Profile 2015, p. 2.
- "Smokers' Paradise: North Korea is Now Urging People to Quit, though Kim Jong-un Sets a Poor Example". South China Morning Post. Associated Press. 6 July 2016. Retrieved 25 October 2016.
- "STEPwise Approach to Chronic Disease Risk Factor Surveillance" (PDF). World Health Organization. 2007. p. 7.
- WHO 2009, p. 13.
- Khang 2013, p. 926.
- Khang 2013, p. 927.
- Kim et al. 2016, p. 685.
- Lankov 2007, p. 107.
- Lankov 2007, p. 109.
- Lee, Michelle (4 December 2015). "North Korea's Halting Anti-smoking Efforts". NK News. Retrieved 28 July 2016.
- Oppenheim, Maya (3 July 2016). "A South Korean Spy Agency Claims They've Worked Out How Much Weight Kim Jong Un Has Put On". The Independent. Retrieved 18 August 2016.
- "Smoking in Pyongyang". chosonexchange.org. Choson Exchange. 30 June 2016. Retrieved 25 October 2016.
- Macdonald, Hamish (6 July 2016). "Mixed Messages on Smoking Restrictions in North Korea". NK News. Retrieved 25 October 2016.
- Seol Song Ah (27 June 2016). "Smoking Ban by Cigarette-loving Kim Riles Residents". Daily NK. Retrieved 25 October 2016.
- Hokkanen 2013, p. 97.
- Lankov 2007, p. 108.
- "North Korea Travel Rules and Tips". New Korea Tours. 2014. Retrieved 18 August 2016.
- "Who Reads North Korea's Rodong Sinmun Newspaper?". NK News. 13 October 2015. Retrieved 24 March 2016.
- Hokkanen 2013, p. 98.
- "Smoking's Death Toll". The Tobacco Atlas. World Lung Foundation. 2010. Retrieved 31 May 2016.
- Eriksen et al. 2015, pp. 14–15.
- WHO 2011, p. 22.
- WHO Report on the Global Tobacco Epidemic 2015, p. 137.
- WHO Report on the Global Tobacco Epidemic 2015, p. 149.
- WHO Country Profile 2015, p. 1.
- WHO Country Profile 2015, p. 4.
- "Quitting". The Tobacco Atlas. World Lung Foundation. 2012. Retrieved 31 May 2016.
- WHO Country Profile 2015, p. 3.
- WHO 2012, p. 88.
- WHO Country Profile 2015, pp. 5–6.
- WHO 2012, p. 80.
- "Warnings & Packaging". The Tobacco Atlas. World Lung Foundation. 2015. Archived from the original on 6 September 2015. Retrieved 31 May 2016.
- WHO Country Profile 2015, p. 8.
- WHO 2009, p. 68.
- WHO 2011, p. 23.
- WHO Country Profile 2015, p. 9.
- WHO Report on the Global Tobacco Epidemic 2015, p. 192.
- "Growing Tobacco". The Tobacco Atlas. World Lung Foundation. 2012. Retrieved 31 May 2016.
- Eriksen et al. 2015, p. 47.
- Eriksen et al. 2015, p. 46.
- "Tobacco Companies". The Tobacco Atlas. World Lung Foundation. 2014. Retrieved 31 May 2016.
- Lankov, Andrei (2015). The Real North Korea: Life and Politics in the Failed Stalinist Utopia. Oxford: Oxford University Press. p. 76. ISBN 978-0-19-939003-8.
- Cha, Victor (2012). The Impossible State: North Korea, Past and Future. London: Random House. p. 8. ISBN 978-1-4481-3958-3.
- Eriksen, Micahel; Mackay, Judith; Schluger, Neil; Gomeshtapeh, Farhad Islami; Drope, Jeffery (2015). The Tobacco Atlas (PDF) (Fifth ed.). Atlanta: American Cancer Society. ISBN 978-1-60443-235-0.
- Hokkanen, Jouni (2013). Pohjois-Korea: Siperiasta itään [North Korea: East of Siberia] (in Finnish). Helsinki: Johnny Kniga. ISBN 978-951-0-39946-0.
- Khang Young-Ho (2013). "Two Koreas, War and Health". International Journal of Epidemiology. 42 (4): 925–929. doi:10.1093/ije/dyt134. PMID 24062281.
- Kim Sei Won; Lee Jong Min; Ban Woo Ho; Park Chan Kwon; Yoon Hyoung Kyu; Lee Sang Haak (2016). "Smoking Habits and Nicotine Dependence of North Korean Male Defectors". Korean Journal of Internal Medicine. 31 (4): 685–693. doi:10.3904/kjim.2015.114. PMC 4939500. PMID 26951917.
- Lankov, Andrei (2007). North of the DMZ: Essays on Daily Life in North Korea. Jefferson: McFarland. ISBN 978-0-7864-5141-8.
- "Law of the Democratic People's Republic of Korea on Tobacco Control" (PDF). Pyongyang: Legislation Press. 2010 .
- WHO (2009). WHO Country Cooperation Strategy: Democratic People's Republic of Korea 2009–2013 (PDF). World Health Organization Regional Office for South-East Asia.
- WHO (2011). "Profile on Implementation of WHO Framework Convention on Tobacco Control in the South-East Asia Region" (PDF). World Health Organization Regional Office for South-East Asia.
- WHO (2012). 2012 Global Progress Report on Implementation of the WHO Framework Convention on Tobacco Control (PDF). Geneva: World Health Organization. ISBN 978-92-4-150465-2.
- WHO Country Profile (2015). WHO Report on the Global Tobacco Epidemic, 2015: Country Profile: Democratic People's Republic of Korea (PDF). World Health Organization.
- WHO Report on the Global Tobacco Epidemic (2015). WHO Report on the Global Tobacco Epidemic, 2015: Raising Taxes on Tobacco (PDF). World Health Organization. ISBN 978-92-4-069460-6.
|Wikimedia Commons has media related to Tobacco of North Korea.|
- North Korea at The Tobacco Atlas
- "North Korean Site Lists Cigarette Addiction Cure" at NK News
- "Meet Azalea the Smoking Chimp, New Star at Pyongyang Zoo" at ABC News