Smoking in North Korea

Over 5,355,658 adults and 4% of the youth 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 (2019 data) that 43.6% of men, 4.5% of women, nearly 2.4% of boys and 5.1% 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 indicate 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 free 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. ==History==

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. 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. ==Culture==

Women and smoking Female smoking is a taboo in North Korea Within the country, cigarettes are used as a 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. ==Health effects==

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. As of 2021 mortality figures indicate that 14.2% of North Koreans die due to smoking-related causes, which is the 6th highest rate after China, Greenland, Kiribati, Denmark and Micronesia. ==Tobacco control==

Tobacco is sold only at designated shops at a fixed price set by the government. , a 20-pack of the most common cigarette brand costs 246.38 KPW (US$2.51), whilst the cheapest 20-pack sells for as little as 7.47 won (US$0.08). 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. 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. 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. Since the creation of the smoking prohibition act in 2020, there are now posters at smoking places displaying graphic images of the effects of smoking, including images of gangrene and lip cancer. 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 (those under the age of seventeen) ==Tobacco industry==

The tobacco industry in North Korea is substantial, 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. 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, Some companies export tobacco to the Middle East and elsewhere, sometimes in partnership with foreign firms. For example, the Taedong River Tobacco Company (대동강담배합영회사) and the Rason Shinhung Tobacco Company (라선신흥담배회사), 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. 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. ==See also==