Differential predictors of smoking quit attempts between single- and poly-tobacco-using adolescents: a Korean national survey analysis

Background: Despite the rapid rise in adolescent poly-tobacco use, evidence on what drives quit attempts in this high-risk group remains limited compared to single-product users. This study identifies these differential predictors using a socio-ecological framework to inform tailored tobacco control strategies. Methods: This study performed a cross-sectional analysis using complex sample logistic regression on pooled data from the 2023-2024 Korea Youth Risk Behavior Survey (KYRBS), a nationwide survey conducted in South Korea. Participants included a total of 5,127 current adolescent smokers, of whom 40.8% were single-product users and 59.2% were poly-tobacco users. The primary outcome was self-reported quit attempts within the past 12 months. Predictors included user type and individual, interpersonal, organizational, and community/policy factors based on the socio-ecological model. Results: < 0.001). Notably, anti-smoking media campaigns were associated with quit attempts exclusively among poly-tobacco users (aOR = 1.29, 95% CI [1.09-1.52]), showing no significant effect on single-product users. Conclusion: Predictors of adolescent quit attempts differ significantly by tobacco use complexity. Although a higher-risk group, poly-tobacco users showed a stronger association between quit attempts and both school-based education and media campaigns. This highlights the need for tailored tobacco control strategies that account for varying levels of receptivity among different user groups.