In Korea, as students move up in grade, experiences with smoking and drinking increase, while healthy habits such as eating breakfast and exercising gradually decline.
According to the results of the 7th-year follow-up of the Youth Health Panel Survey released by the Korea Disease Control and Prevention Agency on the 3rd, overlapping use of tobacco products, including e-cigarettes, increased, and overall health behaviors such as diet and physical activity worsened.
This survey is a 10-year (2019–2028) follow-up project in which the Korea Disease Control and Prevention Agency built a panel of 5,051 6th-grade elementary school students nationwide in 2019 to identify changes in youth health behaviors and related factors. The released materials are the cumulative analysis results of changes in health behaviors—smoking, drinking, physical activity, diet, and mental health—among 3,756 participants who took part in all 1st–7th rounds.
The survey found that experiences with tobacco products increased sharply with higher grade levels. The lifetime experience rate of using tobacco products rose from 0.35% in 6th grade to 11.93% in 12th grade, an increase of 11.58 percentage points over six years. The rate was 16.02% for male students and 7.64% for female students.
The current use rate of tobacco products—defined as using tobacco on at least one day in the past 30 days—also increased from 0.01% in 6th grade to 5.30% in 12th grade. By product in 12th grade, conventional cigarettes (combustible) were highest at 4.41%, followed by pod-type e-cigarettes at 3.61% and heated tobacco products at 1.59%.
In particular, overlapping use—using multiple types of tobacco products together—stood out more than single-product use. Among current conventional cigarette smokers in 12th grade, the solo use rate was 32.6%, while overlapping use with pod-type e-cigarettes was 32.8%, overlapping use with heated tobacco products was 5.3%, and triple use of conventional cigarettes, pod-type e-cigarettes, and heated tobacco products was 29.3%.
Drinking experience also increased with higher grade levels. The share of adolescents who had taken even a sip of alcohol rose from 36.4% in 6th grade to 68.4% in 12th grade. The lifetime drinking experience rate based on a full glass also increased from 7.5% to 43.2% over the same period. The current drinking rate rose from 0.7% in 6th grade to 11.2% in 12th grade.
An analysis of new-onset drinking by grade transition found that the largest number of adolescents first encountered alcohol when moving from 11th to 12th grade. The new-onset drinking rate during that transition was 18.1%, higher than during other grade transitions.
Diet indicators worsened with higher grade levels. From 6th to 12th grade, the breakfast skipping rate—skipping breakfast on five or more days in a week—increased by 14.9 percentage points, from 17.9% to 32.8%.
Meanwhile, the share consuming fruit at least once a day fell by 19.1 percentage points, from 35.4% to 16.3%, and the share consuming vegetables three or more times a day dropped from 18.0% to 5.6%. The share consuming milk and dairy products at least once a day also decreased from 45.7% to 16.8%.
By contrast, the rate of engaging in physical activity declined. The share doing at least 60 minutes of physical activity on five or more days a week fell by 18.4 percentage points, from 29.8% in 6th grade to 11.4% in 12th grade. In 12th grade, the rate was 16.7% for male students and 5.8% for female students.
Mental health indicators showed gender differences. Among 12th-grade students, the experience rate of generalized anxiety disorder of moderate severity or higher was 8.3%, with female students at 11.4%, more than twice the rate for male students (5.3%).
The experience rate of smartphone overdependence was also higher among female students. Among 12th-grade students, the overall smartphone overdependence experience rate was 31.9%, with 28.8% for male students and 35.2% for female students, it was found.
Im Seung-gwan, commissioner of the disease control agency, said, "The deterioration in adolescent health behaviors is not an individual problem but a challenge the whole society must address together," adding, "Tailored policies are needed for new risk factors such as e-cigarettes, high caffeine, and digital overdependence."