Developmental trajectories of smoking susceptibility among Korean adolescents: A five-year longitudinal study using latent class growth analysis.
Changmin Yoo ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001
This study tracked smoking susceptibility among Korean adolescents aged 11-16 over five years using annual surveys. Researchers identified three distinct patterns: most adolescents remained at low risk, but about 12% showed either increasing or decreasing-but-persistently-high susceptibility to smoking. Adolescents in the higher-risk groups were significantly more likely to use cigarettes, e-cigarettes, and heated tobacco products by age 16. Key protective factors included strong parental disapproval of smoking, perception of harm, and better academic performance.
Key points
88.4% of adolescents maintained low and stable smoking susceptibility over five years
Both increasing and high-decreasing groups had significantly higher lifetime use of cigarettes, e-cigarettes, and heated tobacco products
Lower parental disapproval, lower perceived harm, greater media exposure, male gender, and lower academic performance predicted higher-risk trajectories
Parental attitudes, harm perceptions, and media exposure identified as modifiable prevention targets
Limitations
The study is observational and cannot establish causation. Results are specific to Korea and may not generalise to other cultural or economic contexts.
Abstract
BACKGROUND: Smoking susceptibility predicts subsequent tobacco use, yet most research has treated it as static, measured at a single time point. How susceptibility develops over adolescence and how distinct patterns relate to multi-product tobacco use remain unclear in East Asian contexts. METHODS: Five annual waves (2019-2023) of the nationally representative Korean Youth Health Behaviour Panel Survey (n = 5045) were analyzed, following adolescents from grade 6 (age 11-12) to grade 10 (age 15-16). Susceptibility was assessed with a four-point willingness-to-smoke measure. Latent class growth analysis was applied to the five repeated susceptibility measures to identify trajectory classes. Associations with wave 5 lifetime use of cigarettes, e-cigarettes, and heated tobacco products (HTPs) were examined using the Bolck-Croon-Hagenaars method. Multinomial logistic regression identified baseline predictors, including peer smoking, parental disapproval, household smoking, perceived harm, media exposure, gender, academic performance, and socioeconomic status. RESULTS: Three trajectory classes emerged: low-stable (88.4 %), increasing (5.6 %), and high-decreasing (6.0 %); entropy was 0.812. Both the increasing and high-decreasing classes showed significantly higher lifetime use of cigarettes, e-cigarettes, and HTPs than the low-stable class. Lower parental disapproval, lower perceived harm, greater media exposure, male gender, and lower academic performance distinguished these two trajectories from the low-stable trajectory. CONCLUSIONS: Smoking susceptibility follows heterogeneous developmental trajectories during adolescence, and a small but identifiable subgroup shows escalating susceptibility associated with elevated risk for multi-product tobacco use. Findings highlight parental attitudes, harm perceptions, and media exposure as modifiable targets for early prevention.
Findings the Hub has extracted
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