The Pee Doesn’t Lie: 1 in 4 young Korean women smoke (The Gender Politics of Smoking in South Korea, Part 5)

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When crusty old Confucians will slap them in the face for smoking, then surely women will tend to smoke in private, and keep mum about it if anyone asks. That’s just common sense.

But, as discussed in previous posts in this series (Part 1, Part 2, Part 3, Newsflash, Part 4, Korea’s Hidden Smokers, How Many Teenage Girls Are Smoking?), that still seems to escape many journalists and researchers, who work under the assumption that very few Korean women smoke (officially, just 2.8% in 2010 for instance, against 42.6% of men). Whereas in reality, previous best estimates put the figure at 17% for young women, pointing to a looming health crisis.

So, how to convince the Korean government to take action? Especially when successive administrations have been accused of exaggerating their successes in reducing the male smoking rate, while ignoring the indirect evidence for rising female one?

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What’s needed is irrefutable proof. To get that, one reader suggested installing highly sensitive smoke detectors in the toilets of schools and universities, where many young women hide to smoke, while another, thinking of a rough minimum rate for teenage girls, to simply look at the number that were caught by their teachers (14% at his school). A third, probably most reliable option is to test for nicotine in their urine, via the medical tests given to every middle and high-school student, and, as explained in the recently-released article “Relationship Between BMI, Body Image, and Smoking in Korean Women as Determined by Urine Cotinine: Results of a Nationwide Survey” in the Asian Pacific Journal of Cancer Prevention (Volume 13, 2012; 1003-1010), a group of researchers from various universities have indeed focused on pee, albeit that of women aged 19 and over in the 2008-2009 Korea National Health and Nutrition Examination Survey instead.

Very readable at just 8 pages, half of which are tables or references, I highly recommend downloading the PDF (just email me for a copy if the link stops working). For readers without the time though, let me pass on the abstract here instead (click on it to make it bigger), then some highlights:

— Unfortunately, the sampling method, explained on page 1004, is very poorly explained, and I think has some crucial typos. But in sum, out of 4,600 households in the survey, 5,485 women above the age of 19 “were selected for further analysis because complete data concerning their socioeconomic and health factors and body-related variables were available.” How many 19+ women were in the original household survey though, and how and why extra information about these 5,485 of them was available (e.g., were they randomly selected for further tests?), is not provided.

— Urinary cotinine “is widely used as a biomarker for smoking because of its high sensitivity and specificity,” the level of 50 ng/mL used here being a widely accepted cut-off level for indicating active, rather than passive smokers.

— Here are the figures by age bracket, with their standard errors. Unfortunately, I lack the statistical background to understand the discrepancies between reported and “analyzed” rates sorry (for example, 158 out of 704 is actually 22.4%):

  • 19-29: 158 smokers out of 704 (23.1%, 2.0%)
  • 30-39: 178 smokers out of 1075 (17.3%, 1.3%)
  • 40-49: 134 smokers out of 1046 (13.5%, 1.2%)
  • 50-59: 97 smokers out of 1001 (9.3%, 1.0%)
  • 60-69: 70 smokers out of 919 (7.5%, 1.1%)
  • 70+: 87 smokers out of 740 (12.1%, 1.5%)

— Overall, 14.5% of the participants smoked, just under 1 in 7. Note that the article mentions that the reported rate in 2011 was 7.0%, which arguably more indicates how useless official figures are than a sudden dramatic jump from the 2.8% of 2010 (both figures are from the OECD).

— The article does an excellent job of breaking the figures down by age, income, occupation, and marital status, demonstrating that the notion of an “overall” or “average” female (or male) smoking rate is misguided and unhelpful anyway. Please see previous posts in the series for more discussion of that.

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— Finally, the focus of the article is on the relationship between smoking rates and the difference between subjects’ Body Mass Index (BMI) and Subjective Body Perception (SBP), and found that that was indeed:

…the most important factor determining female smoking behavior. Women with low BMI who perceived themselves as normal or fat were most likely to smoke; these results suggested that subjective body recognition plays as important a role as objective physical measures such as BMI in smoking behavior. Moreover, in women who were never married, divorced or widowed, underweight BMI was highly correlated with smoking. Thus, it is necessary to educate the public to have a correct self-body perception and a good understanding or the relationship between smoking and weight issues in order to reduce female smoking. In particular, women who were never married and had low BMI were especially susceptible to smoking and require special attention and preventative care (p. 1009).

Unfortunately, those educators will have their work cut out for them: Korea is the only developed country in the world where women in their 20s and 30s are getting thinner rather than more obese (and, accordingly, are the slimmest), yet a 2010 study would find that 2/3rds of female university students still overestimated their own weight (and, tellingly, all of those 2/3rds were actually either normal or underweight).

Update: Interestingly, the notion that cigarettes put off hunger was once used to sell cigarettes to men as well as women. I wonder when and why that stopped?

10 thoughts on “The Pee Doesn’t Lie: 1 in 4 young Korean women smoke (The Gender Politics of Smoking in South Korea, Part 5)

  1. my guess? about the time the collective subconscious (or whatever the heck drives these societal randominities) decided men weren’t allowed to be *visibly* concerned about their weight. Men are supposed to want to work out to become stronger, not thinner. I’ve noticed that most men aren’t comfortable talking about being on diets unless it’s because a doctor made them. If a man does talk about a diet, the assumption that he isn’t straight is fairly common. Admittedly, these are only the observations of one 29 year old woman, but I could poll my friends again if you’d like ;)

    • Agreed. And another interesting question to pursue is when – or if – smoking stopped being advertised as a weight loss method to women. Clearly, it was in the Twiggyesque late-60s and early-70s that you start to get all those slims ads, but those much much earlier Lucky Strikes ones are the first ones I’ve seen from an earlier period (and much earlier at that).

      Not that they’re not necessarily out there of course – it’s just yet another subject I need to read much more about. Although I do know about the “Torches of Freedom” of course! :)

      Update: Seeing as I’m already on Wikipedia, I see that it was 1968 that Virginia Slims came on the market, albeit possibly originally advertised more as a “feminine” cigarette than a weight-loss method per se.

        • Thanks: that does indeed more than cover it!

          I don’t trust Wikipedia for anything even remotely controversial either, but it’s a good reference guide. Being a complete geek, I probably spend about 2 hours each week just browsing things there, just like my idea of a good time as a 13 year-old was going through our family’s encyclopedia. (Even though they were the same age as me!)^^

            • I beg to differ: geeks just get really into something, whereas nerds are socially awkward. I wouldn’t say I was that socially awkward as a teenager (no more than any other that is), but being a geek, having big glasses and wild curly hair, and being dragged around 6 high schools in 3 countries by my parents didn’t exactly help with making friends either…

              • Huh, that’s interesting. In my circle of friends it is considered that geeks are the more socially awkward. Of course, there’s a high population of Aspies in many of my circles, so that might have something to do with it.

  2. Is there any reason why they couldn’t release rates for females under 19? 25% for women in their 20s is about what I would have guessed. I’d also guess that the number for 15-19-year-olds is very similar. I have little doubt that, contrary to government claims, smoking is actually on the increase.

    In any event, as I’ve mentioned before, the data on teens is out there somewhere, since all high school students get annual medicals. Who’s concealing it and why one can only guess.

    I was suprised a few months ago to read that the number of smokers in grades 10 to 12 in Canada was only ten percent, according to a survey – http://www.vancouversun.com/news/todays-paper/Fewer+teens+smoke+study+finds/6712401/story.html . For some reason I’m more inclined to believe a survey of Canadian students than Korean ones on this matter. If that’s true then Korea’s youth smoking rate may well be three times or more that of Canada’s. Of course it will be some time before Korean kids overtake them in pot consumption.

    I wonder if this report will get any attention in the mainstream Korean press.

    • I don’t see any reason why the data for under-19s wasn’t released either. Also agreed that the data is out there, and that, seeing as presumably there are active programs targeting teens in Canada, the rate for girls would be much lower there.

      Unfortunately, I doubt it will get any attention in the media: almost everything I’ve read in English for previous posts, and/or translated in Korean, just lazily repeats the adage that the average rate for women is very low (one slight exception would be this Korea Times article). That’s despite just a 2 minute Naver or Google search providing dozens of sources that seriously question both (let alone this blog!).

      As always though, media reports that do may still be out there, and I just haven’t found them yet.

  3. Korean girls who smoke very often work in the bars and clubs.. (they pick up the smoking habits there). Women who work there often are in their 20s, are from the poor family background, and need to keep a slim figure to keep their job. It’s no surprise that the slim girls are those who smoke the most… But not for the reasons mentioned in the article thus ;).

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