The Gender Politics of Smoking in South Korea: Part 3

James Turnbull's picture
( 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!^^

(Links to other posts in the series as they appear: Part 1, Part 2, Part 4, Part 5)

(Posted at The Grand Narrative)

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