Smoking in North Korea

Consumption

Over 4,569,000 adults and 167,000 children in North Korea consume tobacco daily. Since smokeless tobacco consumption is negligible, virtually all tobacco consumers in the country are smokers.

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. Of men, 45.81 percent are daily smokers, in contrast to only 2.57 percent of women. For children, these figures are lower: 15.8 percent of boys and only 0.7 percent of girls smoke daily (2013 data).

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), and notes that recent and representative data is only available for adults. North Korean anti-smoking authorities put the figure even higher, saying that some 54 percent of men are smokers.

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 aged 23 and the percentage of the population that smokes increases with age until the 55–64 age group, after which it declines. On average urban smokers tend to smoke more cigarettes per day than rural farmers.

Tobacco is only sold at designated shops at a fixed price set by the government, where a pack of 20 cigarettes of the most sold brand costs 246.38 North Korean won. In comparison, a 20-pack of the cheapest brand costs as little as 7.47 won.

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. Current information about smoking habits of North Koreans can be obtained by studying North Korean defectors who live 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 also very interested in quitting smoking.

Culture

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

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

Menthol cigarettes are virtually non-existent, but there is competition among tobacco companies to introduce other attractive products. One brand has fruit-flavored balls inside the filter to give taste, while another features smiley faces on the tip of filters. Those who have hard currency can easily buy imported cigarettes from hard currency shops. They also stock the best domestic brands—such as Pak Ma, comparable in quality to makhorka—to convince tourists of the quality of North Korean tobacco. Cigarettes are popular gifts, and tourists are recommended to give Western brand cigarettes to tour guides. Within the country, cigarettes are used as 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 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." Because the Rodong Sinmun is in limited circulation, most North Koreans roll their cigarettes with some other paper.

All of North Korea's three leaders—Kim Jong-un, his father Kim Jong-il and grandfather Kim Il-sung—have been smokers. 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. The current leader Kim Jong-un is often seen smoking in public—including in university classrooms, subway cars, 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 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.

Health effects

The high prevalence of smoking contributes to the level of non-communicable disease in North Korea: 34.3 percent of men and 22.3 percent of women die of smoking (all ages). Both percentages are the highest in the world. All in all, tobacco-caused illness kills 55,600 North Koreans annually.

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.

Although there is no free of charge smoking cessation quitline that callers could phone and discuss their problems, most health-care 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. There are 11 specialized anti-smoking centers in the country where consultation is free, but medicine is not. Bupropion and varenicline are not legally available in North Korea, but herbal medicines are used as smoking cessation aids.

There have been largely unsuccessful attempts at anti-smoking movements "across the generations" in the country, but the earliest major campaign was in 2004. 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. Smoking has begun to decline from the early 2000s onward due to these campaigns.

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

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

Law

Smoking laws in North Korea are considerably relaxed, and have not had meaningful effect on curtailing smoking, although restrictions have been tightened in recent years. North Korea imposes no kind of tax at all on tobacco, including specific excise, ad valorem excise, value-added tax, sales tax, or import duty.

Smoking is prohibited on 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. 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. Some of the existing restrictions are observed with high compliance, but not uniformly throughout the country. No special funds are allocated to enforcement of smoking bans. There are no mandatory fines associated with transgressions, but the newest 2016 anti-smoking campaign has seen fines issued and offenders threatened with images of them being broadcast on TV.

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

North Korea signed the WHO Framework Convention on Tobacco Control on 17 June 2003 and ratified it on 27 April 2005. The Law of the Democratic People's Republic of Korea on Tobacco Control was adopted by decree number 1200 of the Presidium of the Supreme People's Assembly on 20 July 2005, and amended by decree number 537 on 22 December 2009.

Tobacco industry

Tobacco is a large industry in North Korea. The country devotes 53,000 hectares, 2.3 percent of its arable land, to tobacco cultivation, which is the fourth highest share in the world. Despite being one of the top 25 tobacco producers in the world with 80,000 tonnes of annual output, 31 percent of the population of North Korea is undernourished. The best, and strongest, tobacco comes from the north of the country near the border with China and is said to contain twice as much nicotine as milder varieties cultivated in the south. This variety also costs more than the others.

There are many North Korean tobacco companies. The biggest one is North Korean General Tobacco Corporation. Some 30 different types of cigarettes are made. 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. High-end Pyongyang brand cigarettes were exported to South Korea during the years of the Sunshine Policy and they were popular among South Koreans who wanted to express a pro-reunification stance.

The Pyongyang Tobacco Factory produces low quality "tobacco for the masses" without filters in two classes: rolled with imported or domestic paper. Some tobacco product factories are privately owned. Young girls are usually employed for what is manual rolling of cigarettes due to outdated technology. 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. Tobacco is also commonly homegrown.