Gender-Based Socioeconomic Inequality of Electronic Cigarettes and Heated Tobacco Products in Korea

Background: Conventional cigarettes are commonly used by adults with low educational level and lower income in South Korea.Information on socioeconomic and gender-related disparities associated with the use of electronic cigarettes (EC) and heated tobacco products (HTP) is limited.Therefore, this study aimed at investigating gender differences in relation to socioeconomic inequalities and use of EC and HTP in Korea.Methods: Data of 226,749 adults from the 2020 Community Health Survey in South Korea were analyzed.Variables associated with socioeconomic position included household income and education.Multivariable logistic regression analysis was adjusted for age, household income, education, occupation, marital status, and binge drinking.Results: Current HTP and EC users were 6,065 (5,414 men and 651 women) and 3,764 (3,432 men and 332 women), respectively.The odds of EC and HTP users were 0.33 (95% confidence interval [CI], 0.24-0.46)and 0.77 (0.63-0.95) in men, and 2.52 (1.46-4.35)and 2.56 (1.57-4.15) in women with educational levels of middle school or lower, compared with those with at least college education, respectively.Income differences were not observed among men.However, women in the first income quartile (lower income) had higher odds of using EC at 2.12 (1.14-3.93)and HTP at 2.78 (1.90-4.08)compared with those in the fourth quartile.Conclusion: Men with higher educational levels and women with lower income and educational levels were more likely to use EC and HTP.Therefore, regulatory strategies should be designed to control the use of novel tobacco products in South Korea.