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Smoking in North Korea

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A man smokes at a shop selling cigarettes.

Tobacco smoking is popular and culturally acceptable in North Korea, especially for men. Some 45.81 percent of men smoke daily. In contrast, only 2.57 percent of women are daily smokers, and smoking is reserved primarily for older women who live in the countryside.

Smoking has a significant negative effect on the health of North Koreans. 34.3 percent of men and 22.3 percent of women in North Korea die because of smoking. Both figures are the highest in the world.

Laws restrict the sale and consumption of tobacco, but smoking is not prohibited in all public spaces. There are regular tobacco control programs in North Korea, and smoking rates have gone down from their peak in the 2000s. There is considerable tobacco industry compared to the small amount of arable land in the country.

Consumption

Over 4,569,000 adults and 167,000 children consume tobacco daily.[1] Smokeless tobacco consumption is negligible, making virtually all tobacco consumers in North Korea smokers.[2] Smoking increases with age until the age group of 55–64, when it starts to decline.[3]

According to World Lung Foundation and American Cancer Society's The Tobacco Atlas (2014 data), the adult population (ages 15 and older) smoke on average 609.67 cigarettes per person per year.[4] 45.81 percent of men smoke daily, in contrast to only 2.57 percent of women. 15.8 percent of boys and 0.7 percent of girls smoke daily (2013 data).[1]

The World Health Organization (WHO) gives the figure for men as 32.6 percent of men being daily smokers and 43.9 percent of men being current smokers overall (2013 data, ages 17 and older),[5] and notes that recent and representative data is only available for adults.[6] North Korean anti-smoking authorities put the figure even higher, saying that some 54 percent of men are smokers.[7]

Daily smokers smoke 12.4 cigarettes per day on average;[3] the average for men is 15.[8] The urban working population smokes slightly more than farmers.[8] Smokers pick up the habit at the age of 23 years on average.[8] Tobacco is only sold at designated shops at a fixed price set by the government.[9][a] A 20-pack of the most sold brand of cigarettes costs 246.38 North Korean won.[10] A 20-pack of the cheapest brand costs 7.47 won.[11]

The prevalence of daily smoking men is on par with South Korea, but South Korean men pick up the habit earlier and smoke more cigarettes per day.[12] Current information about smoking habits of North Koreans can be obtained by studying North Korean defectors in the South. A study of defectors found that smoking is more common than anticipated, but nicotine dependence is not as severe as predicted. Defectors are very interested in quitting smoking.[13]

Culture

Cigarettes being sold at a duty-free shop at the Pyongyang Sunan International Airport

Smoking arrived in Korea in the 1610s from Japan and became popular immediately.[14] Until around the 1880, both men and women smoked.[15] Today, North Koreans consider smoking to be a normal activity for men, but female smoking is a taboo. For women it is considered even more disgraceful than heavy drinking,[16] and they "react with shock if you joke that maybe they secretly smoke in bathrooms".[17] Smoking by older women, above the age of 45 or 50,[15] particularly in rural areas, is tolerated more. Smoking is considered an important social activity, and men who do not smoke can become outsiders at workplaces. Smoking in workplaces is common, even indoors.[16]

Even though most consumer items are in short supply in North Korea, there is a considerable variety of cigarettes available.[7] In general, strong tobacco is preferred.[16] Western brands, particularly American, are particularly popular with the elite. These are preferred over even the best domestic cigarettes.[18] Foreign cigarettes and the domestic 727 brand—whose name stands for 27 July, the date of the Korean Armistice Agreement—are status symbols.[18][7] Chinese and Russian cigarettes are also liked,[18] as well as the Japanese Seven Stars.[7]

Menthol cigarettes are virtually non-existent, but there is competition among tobacco companies to introduce attractive products. One brand has fruit-flavored balls inside the filter to give taste, while another features smiley faces on the tip of filters.[7] Those who have hard currency can easily buy imported cigarettes from hard currency shops.[18] Cigarettes are popular gifts,[14] and tourists are recommended to give Western brand cigarettes to tour guides.[19] Within the country, cigarettes are used as form of "currency" in bribery.[14]

The party newspaper Rodong Sinmun is used as rolling paper for roll-your-own cigarettes.

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.[18] One piece of the paper can be used to roll some 40 to 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."[20]

North Korea's first leader Kim Il-sung smoking. All three leaders have been smokers.
North Korea's first leader Kim Il-sung smoking. All three leaders have been smokers.

All of North Korea's three leaders, Kim Jong-un, his father Kim Jong-il and grandfather Kim Il-sung, have been smokers.[21] Kim Jong-il called smokers one of the "three main fools of the 21st century", along with people who do not understand music or computers.[17] The current leader Kim Jong-un is often seen smoking in public[22]—including in university classrooms, subway cars, and in the presence of his pregnant wife Ri Sol-ju[23]—which "might make the life of the North Korean health educators more complicated."[16] While discussing any negative aspects of the leaders is normally rare, some North Koreans have raised the issue of the apparent contradiction between anti-smoking measures and Kim's public image with foreigners.[22]

Health effects

The high prevalence of smoking contributes to the level of non-communicable disease in North Korea.[8]

34.3 percent of men and 22.3 percent of women in North Korea die of smoking (all ages).[24] Both figures are the highest in the world.[25] Tobacco-caused illness kills 55,600 North Koreans annually.[1]

Tobacco control

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.[6]

There is no free of charge smoking cessation quitline that callers could phone and discuss their problems, but most health-care facilities offer support in cessation,[26] including cessation programs and nicotine replacement therapy.[27] Costs are covered for the patient partially or in full by the state.[26] There are 11 specialized anti-smoking centers in the country where consultation is free, but medicine is not.[7] Bupropion or varenicline are not legally available in North Korea,[26] but herbal medicines are used.[7]

There have been largely unsuccessful attempts at anti-smoking movements "across the generations" in the country,[22] but the earliest major campaign was in 2004.[17] While early campaigns had little effect, campaigns have become more frequent in the 2010s and restrictions on smoking have been observed more closely in recent years.[22] Smoking has begun to decline from the early 2000s onward due to these campaigns.[16]

There are indications that the government takes anti-smoking campaigns more seriously than in the past.[22] According to 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."[9]

WHO estimates that implementing the four best tobacco control measures—tax increases, smoke-free policies, packaging warnings, and advertising bans—would cost only 0.04 dollars per capita.[28]

Law

Laws on smoking in North Korea are relaxed,[22] and have not had meaningful effect,[23] though restrictions have been tightened in recent years.[22] North Korea imposes no specific excise, ad valorem excise, value-added tax, sales tax, import duty or any other kind of tax on tobacco.[10]

A smoking lounge at the Grand People's Study House in Pyongyang

Smoking is prohibited at sidewalks, aboard public ground transport, ferries, airplanes and at stations, in health-care and educational facilities, kindergartens and nurseries, shops, theaters, cinemas, culture halls and conference rooms, historic and battle sites, and hotel lobbies.[29][30][9][22][b] 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.[29][30][22] Some of the existing restrictions are observed with high compliance,[29] but not uniformly throughout the country.[22] No special funds are allocated to enforcement of smoking bans. There are no mandatory fines associated with breaches,[29] but the newest 2016 anti-smoking campaign has seen fines issued and offenders threatened with images of them being broadcast on television.[23]

Tobacco packaging warning messages are required on all types of packaging, but their appearance is not regulated.[31] They are usually printed in small print on the side of the package and only state that smoking is harmful to health.[7] Descriptions however must indicate the nicotine and tar content,[9][c] and may not be misleading.[32] They need be approved by local authorities.[32] Graphic warning images have never appeared on packaging.[33] There are no restrictions on tobacco advertising,[34] but there are no advertising campaigns in North Korean media either.[35] Cigarette machines are banned,[34][d] but electronic cigarettes are legal.[36] Tobacco may not be sold to minors[37][e] (those under the age of 17).[7]

North Korea signed the WHO Framework Convention on Tobacco Control on 17 June 2003 and ratified it on 27 April 2005.[38] The Law of the Democratic People's Republic of Korea on Tobacco Control was adopted by decree no. 1200 of the Presidium of the Supreme People's Assembly on 20 July 2005, and amended by decree no. 537 on 22 December 2009.[9]

Tobacco industry

Tobacco is a large industry in North Korea.[17] North Korea devotes 53,000 hectares,[39] 2.3 percent of its arable land, to tobacco cultivation, the fourth highest share in the world.[40] Some 30 different types of tobacco are made.[14] Despite being one of the top 25 tobacco producers in the world with 80,000 tonnes annual output 31 percent of the population of North Korea is undernourished.[41] There are many North Korean tobacco companies.[17] The biggest one is North Korean General Tobacco Corporation.[42] Some companies export tobacco to the Middle East and elsewhere, sometimes in partnership with foreign firms. For example, the Taedong River Tobacco Coompany and the Rason Shinhung Tobacco Company, both operating in the Rason Special Economic Zone, are partnering 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.[17] The Pyongyang Tobacco Factory produces low quality "tobacco for the masses" without filters in two classes: rolled with imported or domestic paper.[18]

Some tobacco product factories are privately owned. Young girls are usually employed for what is manual rolling of cigarettes due to outdated technology.[43] Some of these factories produce counterfeit brand cigarettes for export as part of North Korea's illicit activities to earn hard currency. Leaf tobacco is cheap and can be bought from markets to roll one's own cigarettes. Many farmers produce it on their own plot of land, while others steal tobacco from cooperative farms for sale.[18] Tobacco is also commonly homegrown.[16]

See also

Notes

  1. ^ Law of the Democratic People's Republic of Korea on Tobacco Control 2009, Articles 22 and 23
  2. ^ Law of the Democratic People's Republic of Korea on Tobacco Control 2009, Articles 27 and 28
  3. ^ Law of the Democratic People's Republic of Korea on Tobacco Control 2009, Article 12
  4. ^ Law of the Democratic People's Republic of Korea on Tobacco Control 2009, Article 22
  5. ^ Law of the Democratic People's Republic of Korea on Tobacco Control 2009, Article 24

References

  1. ^ a b c "Country Fact Sheet: DPR Korea". The Tobacco Atlas. World Lung Foundation. 2015. Retrieved 27 May 2016.
  2. ^ "Smokeless Tobacco". The Tobacco Atlas. World Lung Foundation. 2014. Retrieved 31 May 2016.
  3. ^ a b "STEPwise Approach to Chronic Disease Risk Factor Surveillance" (PDF). World Health Organization. 2007. p. 7.
  4. ^ "Cigarette Use Globally". The Tobacco Atlas. 2014. Retrieved 27 May 2016.
  5. ^ WHO Country Profile 2015, p. 2.
  6. ^ a b WHO Country Profile 2015, p. 1.
  7. ^ a b c d e f g h i "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.
  8. ^ a b c d WHO 2009, p. 13.
  9. ^ a b c d e WHO 2011, p. 22.
  10. ^ a b WHO Report on the Global Tobacco Epidemic 2015, p. 137.
  11. ^ WHO Report on the Global Tobacco Epidemic 2015, p. 149.
  12. ^ Young-Ho Khang (2013). "Two Koreas, war and health". International Journal of Epidemiology. 42 (4): 926. doi:10.1093/ije/dyt134.
  13. ^ Sei Won Kim; Jong Min Lee; Woo Ho Ban; Chan Kwon Park; Hyoung Kyu Yoon; Sang Haak Lee (2016). "Smoking habits and nicotine dependence of North Korean male defectors". Korean Journal of Internal Medicine. 31 (4): 685. doi:10.3904/kjim.2015.114.
  14. ^ a b c d Lankov 2007, p. 107.
  15. ^ a b Lankov 2007, p. 109.
  16. ^ a b c d e f Lee, Michelle (4 December 2015). "North Korea's halting anti-smoking efforts". NK News. Retrieved 28 July 2016.
  17. ^ a b c d e f "Smoking in Pyongyang". chosonexchange.org. Choson Exchange. 30 June 2016. Retrieved 25 October 2016.
  18. ^ a b c d e f g Lankov 2007, p. 108.
  19. ^ "North Korea Travel Rules and Tips". New Korea Tours. 2014. Retrieved 18 August 2016.
  20. ^ "Who reads North Korea's Rodong Sinmun newspaper?". NK News. 13 October 2015. Retrieved 24 March 2016.
  21. ^ 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.
  22. ^ a b c d e f g h i j Macdonald, Hamish (6 July 2016). "Mixed messages on smoking restrictions in North Korea". NK News. Retrieved 25 October 2016.
  23. ^ a b c Seol Song Ah (27 June 2016). "Smoking ban by cigarette-loving Kim riles residents". Daily NK. Retrieved 25 October 2016.
  24. ^ "Smoking's Death Toll". The Tobacco Atlas. World Lung Foundation. 2010. Retrieved 31 May 2016.
  25. ^ Eriksen et al. 2015, pp. 14–15.
  26. ^ a b c WHO Country Profile 2015, p. 4.
  27. ^ "Quitting". The Tobacco Atlas. World Lung Foundation. 2012. Retrieved 31 May 2016.
  28. ^ "Investing in Tobacco Control". The Tobacco Atlas. World Lung Foundation. 2011. Retrieved 31 May 2016.
  29. ^ a b c d WHO Country Profile 2015, p. 3.
  30. ^ a b WHO 2012, p. 88.
  31. ^ WHO Country Profile 2015, pp. 5–6.
  32. ^ a b WHO 2012, p. 80.
  33. ^ "Warnings & Packaging". The Tobacco Atlas. World Lung Foundation. 2015. Retrieved 31 May 2016.
  34. ^ a b WHO Country Profile 2015, p. 8.
  35. ^ WHO 2009, p. 68.
  36. ^ WHO Country Profile 2015, p. 9.
  37. ^ WHO 2011, p. 23.
  38. ^ WHO Report on the Global Tobacco Epidemic 2015, p. 192.
  39. ^ "Growing Tobacco". The Tobacco Atlas. World Lung Foundation. 2012. Retrieved 31 May 2016.
  40. ^ Eriksen et al. 2015, p. 47.
  41. ^ Eriksen et al. 2015, p. 46.
  42. ^ "Tobacco Companies". The Tobacco Atlas. World Lung Foundation. 2014. Retrieved 31 May 2016.
  43. ^ Lankov, Andrei (25 April 2016). "Who works in North Korea's private sector?". NK News. Retrieved 28 July 2016.

Works cited

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