The Gender Politics of Smoking in South Korea: Part 3

( Korea is 4th from right; source )

Apparently, Korea is pretty unique in its huge difference in smoking rates between the sexes: up to 10 times more Korean men smoke than women. Or do they?

In short, probably not: considering that a 2007 Gallup Korea study found that 83.4% of Koreans thought that women should not smoke, then the accuracy of almost all figures are undermined by chronic underreporting by women. Moreover, it is misguided to speak of male or female smoking rates in the first place when those within each gender differ so widely by age, socioeconomic position, and/or marital status. Even unhelpful too, as low perceived rates for women overall have encouraged Korean medical authorities to almost exclusively focus on reducing smoking rates among men instead, overlooking rapidly rising rates among young women especially.

But for all their flaws, it is only natural to want to have some numbers to work with. And so, when I wrote Part 1, my original intention here was to pass on all those provided by 3 recent journal articles on the subject, hopefully providing readers with enough information to get at least a rough idea of the true numbers in the process. Numerous failed drafts later however, I now realize that that approach was a mistake, and should have paid much more attention to the following points by Lee et .al. (2009):

…the limited data available on female smoking prevalence and behaviour in South Korea must be urgently addressed. Data from the Korean National Health and Nutrition Survey (Table 2) suggests female smoking rates have fluctuated significantly between 1980 and 2003, with variations within age groups by year that are difficult to explain. There are also inconsistencies across different data sources which prevent clear understanding of smoking behaviour within specific cohorts by age, location, socio-economic group and other variables.

Instead then, let me do my best to point out broad themes within the various data sources instead, starting with those revealed by the following graph provided by Young-Ho Khang and Hong-Jun Cho, “Socioeconomic inequality in cigarette smoking: Trends by gender, age, and socioeconomic position in South Korea, 1989-2003“, Preventive Medicine Volume 42, Issue 6, June 2006, Pages 415-422:

Based on a huge sample population from 5 Social Statistical Surveys from the Korea National Statistical Office, it does at least provide a good illustration of overall smoking trends for both sexes over the period covered. A quick summary:

Results show that for men, smoking rates decreased in all age groups…For women aged 45+, smoking rates decreased…while those for younger age groups either remained stable (25-44) or increased (20-24). In addition, the decreasing pattern of smoking among women aged 45+ was not the same as that of men. For women aged 45+… reductions began earlier than for men. (p. 418, paraphrased)

And they believe that the decreases were primarily due to legislation; in particular, the 1995 Health Promotion Act, which restricted smoking in public buildings and places. Unfortunately however, it was not very effective on young women, nor on the inverse relationship between educational level and rates of smoking, which was generally true in all age groups and both genders. They speculate that that was partially because:

…most policy efforts have been aimed at the dissemination of information about the hazardous health impacts of smoking while policy efforts on work site smoking cessation programs or economic measures (i.e., taxation) to discourage smoking were minimal. (p. 421)

( Source )

Khang and Cho do provide further details of how women’s smoking rates differ by their socioeconomic position, but to be frank I found that jargon-filled part of the article rather poorly written, and don’t understand it despite several rereadings. Whether that’s my fault or theirs, I’ll have to skip covering that topic here regardless, and instead will focus on the following point that you may already have noticed yourself:

Unlike many developed Western countries, this study showed greater smoking rates in older women compared to younger women. This is consistent with studies conducted in Asian countries such as China, Vietnam, and India….Age differences in power relations by gender and social pressure toward young women may explain the difference in female smoking prevalence between Western countries and less developed Asian countries. However, further studies are needed to elucidate the causes of the difference. (p. 420, my emphasis)

And probably not by coincidence, in Hong-Jun Cho, Young-Ho Khang, Hee-Jin Jun, and Ichiro Kawachi, “Marital status and smoking in Korea: The influence of gender and age“, Social Science & Medicine, Volume 66, Issue 3, February 2008, Pages 609-619, they provided exactly that, from which an intriguing finding was:

…that the difference in the effect of marital status on smoking rate varied according to gender….smoking rates for unmarried women compared with married women were generally much greater than comparable [rates] for men across all age groups, and were particularly high in younger women. This finding differs from many previous Western studies that reported either no gender difference in the influence of marriage on smoking, or greater difference between married versus unmarried rates in married men compared to married women. (pp. 613-14, my emphasis)

Some details:

The smoking rate for unmarried women was approximately 2-8 times higher than for married women depending upon the age group. In contrast, the smoking rate for unmarried men was not higher than the married men for the 25-34 and 65-74 year-old age groups…

…In the 35-54 year-old age range, the smoking rate in divorced women was more than twice that of the widowed women. This difference was smaller for men…

…the present study found that the smoking rate was higher in unmarried compared to married people. This finding is consistent with those of many Western studies of both men and women…(p. 613)

( Businesswoman by the_toe_stubber )

And crucially:

Women’s smoking can be underreported in societies where there is a strong social norm against young women adopting such behavior. Such a reporting bias may have affected the findings of this study. Nonetheless, it is not clear whether reporting bias would have produced the differential patterns of smoking rate according to marital status

…a definite casual relationship between marital status and smoking could not be established [in this study]. Selection is also possible. The divorce rate for smokers is twice that for non-smokers, and men who continue smoking have a lower probability of getting married. But, because the effect of marital status on smoking is stronger in men than women, this cannot explain the gender-related difference in the present study. (p. 616 & 617, my emphases)

And they identify many reasons why unmarried Korean women may smoke more than married ones, and particularly divorced or widowed ones. Some are positive:

…smoking by women, and especially married women, can be restricted by social pressure applied from both inside and outside the family. In such cases, becoming divorced or widowed may release women from the force of sanctions and expectations. (p. 611).

And see here and here for more on those social pressures married women face. Unfortunately however, newly-single women are much more likely to smoke from stress rather than a feeling of liberation:

Higher smoking rates in the unmarried may be a reflection of coping in response to stress brought on my marital disruption. Marital disruption can create two types of stress – that which is directly associated with the disruption, and that which is indirectly associated, such as role change, financial difficulties, and child caring responsibilities. Women suffer greater financial hardship following marital disruption compared to men, especially in societies where the gender age gap is high [James – and Korea’s is among the highest the world; see #10 here]….[in 2002], the income of a woman-headed single-parent family was 83% of a man-headed single-parent family.

Above: “A Woman Smoking” (여자가 담배피는게) by Im Su-bin (임수빈), which according to allkpop “tells of a sad story of how a woman resorts to smoking and drinking after being heartbroken and why there’s nothing wrong with that”.

On a final note however, it is also true that widowed or divorced women also tend to older than average, and in Korea particularly the effects of that are difficult to separate from their marital status because:

…older women may find it easier to smoke due to less social pressure on this age group stemming from the general respect shown for the elderly in Confucian traditions. (p. 611)

With a nod to copyright, if any readers interested in reading the articles for themselves, please email me if you like me to send copies (and thanks again to the reader who sent them to me in the first place!). Meanwhile, as those turned out to be much more closely linked than I first realized (indeed, they even use the same data), then I’ve decided to discuss the third article – Kelley Lee, Carrie Carpenter, Chaitanya Challa, Sungkyu Lee, Gregory N Connolly, and Howard K Koh, “The strategic targeting of females by transnational tobacco companies in South Korea following trade liberalisation”, Globalization and Health 2009, Volume 5, Issue 2) – in a separate post (Part 4) rather than carry on here. The final Part 5 though, will still be a “discussion on the ways in which tobacco companies have (largely successfully) targeted Korean girls and women over the last two decades” from that however!^^

Update 1 - For anyone interested, a recent survey found that Seoul residents endure 50 minutes of passive smoking a day.

Update 2 - A picture that I was reminded of by I’m no picasso’s comment on the connections between coffee-shop culture and female smoking. From Getting Married in Korea: Of Gender, Morality, and Modernity by Laurel Kendall (1996):

(Other posts in the series as they appear: Part 1, Part 2, Newsflash, Part 4, Korea’s Hidden Smokers; Living as a female smoker in Korea)

11 thoughts on “The Gender Politics of Smoking in South Korea: Part 3

  1. Pingback: Tweets that mention The Gender Politics of Smoking in South Korea: Part 3 « The Grand Narrative -- Topsy.com

  2. It was not unusual for me to to choke on cigarette smoke from an adjacent stall while I was using a university restroom. Since women are already in the habit of sneaking smokes, restrictions on smoking in public places won’t impact female smoking rates much.

    My mom struggles with COPD, taking medications twice daily and using a walker when she has to move for more than a few minutes. She’s quit smoking, but the damage is irreversible, and COPD usually progresses on its own. Her lifelong nonsmoking sisters look like they’ll live to 100. I and most of my siblings had low birth weights perhaps because of her smoking during her pregnancies.

    I’d like to see Korean health officials create public awareness campaigns aimed at women and girls, but those campaigns will be effective only if they are created and reviewed by peers – women and girls themselves.

    • Oh, for the sake of restricting passive smoking in general it’s still good that the legislation is there, and I think it has had a real effect on smokers’ behavior, but it also appears to have reached its limits: in the Korean companies I have worked at for instance, the higher-up a guy was in the hierarchy then the more likely he was to not to bother to go to the smoking rooms (sort of both a signifier and a perk of his higher status), and at my university you get so many smoking students clustered around any part of a hallway with more than one window that you it’s impossible not to gag on their smoke anyway while pushing them all out of the way to get through. But yeah, I take your point that restrictions on smoking in public places won’t impact female smoking rates when so few smoke in public anyway, and come to think of it the female smokers at my university do tend to choose the much more secluded smoking areas, with very little chance of their Korean professors seeing them.

      In fairness to Korean health officials, the male smoking rate was so fricking high, and for so long, that I can understand the emphasis on reducing the male smoking rate. But presumably they are fully aware of and can’t deny the increases in the female smoking rate now, so it will be interesting to see what female-specific campaigns they have or will come up with. And like you say, what influence women and girls themselves have in them.

  3. A couple of things I’d like to share my thoughts on.

    Ajumma smoking: I was always under the impression that ajummas had a relatively high rate of smoking compared with younger women. This is essentially for the reasons you mention at the end; that they suffer less from social pressures. Once a woman becomes an older ajumma, she can get away with basically doing what she wants a lot of the time, and this extends to smoking. BUt there are other factors.

    Firstly, rates of smoking all over the world decreased when people became more aware of the health risks. Let’s not forget, there was a time when smoking was even considered to be healthy. Older people, then, were more likely to begin smoking due to less knowledge about the health risks way back when than there is now. It would be interesting to find out exactly when Korea had its first public campaign outlining the health risks of smoking.

    Another related reason is that there is also a geographic misrepresentation of the age groups. The percentage of old people living in the countryside is higher than in big cities. Historically campaigns such as public health campaigns about the risks of smoking have taken longer for their message to reach rural areas than urban areas. Furthermore, being geographically more remote, and populated largely by older generations, rural villages and small towns have been more independent and self-governing than other areas. This would also partly explain why older women have what appear to be unusually high smoking rates.

    As for young women smoking because of stress, I take issue with this idea in part. As I’m sure all non-smokers will attest, when a non-smoker feels stressed, they do not think, “I really want a cigarette.” Smoking only takes on an idea of stress-relieving among people who already smoke, because of the addiction to nicotine. Therefore, stress in itself couldn’t possibly be a cause for young women to smoke. They would have to already be a smoker in order to think that smoking will help relieve their stress. So, one would have to look deeper and further into what the real reasons young women start smoking actually are.

    If I were to venture my opinion, I would say peer pressure – pure and simple – plays a much bigger role than people tend to think in Korea. Ask young female smokers themselves, and I think a lot would say they had their first smoke in school, and usually because an 언니 offered them one or encouraged them. They think it makes them look cool (this is also pretty much the same for men, I think), and they do it. Some never go past this stage, whilst others become addicted without ever intending to or sometimes even realising it.

    I think the fact that it’s more socially acceptable for men to smoke means that they can smoke more regularly in that early stage. Young girls have to do it in secret, and have to rely on being offered cigarettes, usually by older 언니 (because younger girls will find it very difficult to buy cigarettes), so it takes them longer to become addicted, and less of them do. Also, they fall into patterns of only smoking socially much earlier. Young men, on the other hand, find it much easier to buy their own cigarettes, and it’s much more socially acceptable for them to smoke out and about. Therefore, they become addicted quicker and in greater numbers.

    These are just my own thoughts, of course, and I only have anecdotal evidence to offer in support.

    • All good points as always Seamus. Just one possible misunderstanding though: I didn’t say young women smoked because of stress, I said that divorcees and widows often did, but naturally I do still agree that it would be very strange for a divorcee or widow to suddenly start smoking if she never had before marriage (or sneakily during). I also agree with the points you raise about how young women may take it up in the first place, but having said that, I’m often amazed at how many male smokers will tell me they took up smoking during their military service. Not that I can’t understand how boring guard duty must have been (which they usually stressed!), nor do I think that peer pressure is only something teenagers have to deal with…but still, it surprises me that men that withstood peer pressure and other various push factors for their entire adolescence succumb to them at the comparatively mature age of 21 or so.

      Of course that has nothing to do with women, but because of things like that it wouldn’t surprise me to learn that many Korean women similarly take it up at a much later age than most of their Western counterparts, for whatever reasons (slimming effects perhaps?).

    • How young do you mean by ‘young’? High school girls have no trouble getting them from their friends who work in shops or supermarkets. Middle school girls might have a harder time getting them if they don’t have a naughty friend who’s family own a shop. I’m really not sure about your older friend hypothesis since every time I’ve caught or have seen HS girls get caught for smoking it’s been two or more of the same age.

      Interesting read, as usual. I’m pulling these figures out of my ass (though I am a HS teacher), but I’d guess that around 15-20% of high school girls smoke or at some point in their lives have smoked on a daily basis, and in addition to this about same % have tried it from time to time. The rates and smoking culture would also vary a lot between academic HS students and technical / vocational ones.

  4. It would be interesting to look into the correlation between the development of coffee shop culture in Korean and that of the growth rate of female smokers. I’ve seen maybe five women smoking on the street in my nearly two years in Korea, and at least three of those were ducked into telephone booths or alleys. However. When I sit in the smoking rooms of cafes (which I do quite often), they are often (particularly in the afternoon, when the coffee shops are full almost exclusively of women, with no male audience around to balk) overflowing with groups of young women smoking. A commenter above mentioned the lack of public space available for such behavior. The coffee shop seems to have become a safe haven for women smoking openly in public. I would say the growth of the popularity of coffee shops have encouraged women to be seen, at least here, smoking in public. Which has probably had an influence on the acceptance of the behavior in general, which has no doubt increased its popularity.

    • I think that makes a lot of sense. Even though I generally hate Korean coffee shops because of the expensive, crappy coffee (sometimes instant! for 3000 won!); the old furniture which, bizarrely, seems to be the same all over the country, as if it’s passed on from coffee shop to coffee shop as they open and close down; and yes, the smokers(!), it’s very easy to forget how they used to be the place to go to for Koreans not all that long ago (and “Western” ones still are), with men saving up for months to be able to impress a girl by taking her to one and so on. See the picture I’ve added to the text which your comment reminded me of for instance (albeit about arranged meetings), and books about life in Korea in the ’60s to 80s are full of anecdotes like that.

      My point is that if coffee shops have been considered such beacons of class and modernity for so long, then I’d be surprised if people didn’t act out a fantasy life a little on their very rare visits there, and if you’re young then of course that involves breaking all your parents’ and elders’ rules. Probably this feminine, smoking coffee-shop culture developed out of that then, and still underlies it.

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