In Korea, even daytime drinking on the job can be considered normal depending on where you work. Interestingly, however, when it comes to smoking, the same laissez-faire attitude is not adopted.

However, they are both labeled as Group 1 carcinogens by the World Health Organization (WHO). Still, only one is widely socially accepted which makes all the difference in the way society treats it.

Imagine saying there will be no alcohol at a New Year’s party versus no smoking allowed at that same party. One feels like an obvious statement while the other might sound ludicrous as people generally associate a good time with alcohol.

In an opinion poll conducted on Instagram with 91 participants to determine which vice people considered more dangerous, 57.1 percent thought both were equally dangerous, 35.1 percent responded smoking and the remaining 7.6 percent answered drinking.

Lately, more attention has been drawn to this issue and sparked a recent National Assembly debate facilitated by the Korea Health Promotion Institute (KHEPI) on ways to prevent alcohol harm in Korea.

Nam In-soon, a member of the National Assembly’s Health and Welfare Committee, said, "Although alcohol is a representative Group 1 carcinogen designated by the World Health Organization (WHO) like tobacco and causes various diseases that threaten public health, alcohol harm prevention policy is relatively lukewarm compared to the anti-smoking policy, and the marketing methods of the liquor industry are deeply penetrating daily life."

Korea’s drinking culture

Understanding Korea’s culture would help provide some context. In some countries, drinking alcohol is generally used for celebratory purposes. But in other places like Korea, it comprises a bigger part of the culture. Drinking is a “daily norm” in after-school and after-work gatherings called hoesik, which makes it an integral part of life for most Koreans. According to 2020 data from Statistica, 83 percent of the male population and 65.3 percent of the female population consumed at least one drink for the year.

A 27-year-old foreign resident in Seoul explained that she started drinking more in Korea than back home in Spain. “I started in university to fit in because it felt like the only way to make Korean friends because that’s what they like.”

She was not the only one. One other foreign university graduate and company worker both living in Seoul also voiced similar opinions,

“It’s definitely a double standard. Both are bad for your health but Korea encourages you to drink. The social life here is one of the reasons, or the main reason, that I started drinking. Drinking is the way to socialize with Koreans and sometimes, there is pressure, not just between friends, but with work colleagues and professors too,” said the 29-year-old university graduate.

A worker from Thailand in her 30s compared the situation in her country. “Back home, people can freely reject a drinking invitation at work. It’s weird if a boss forces you to attend a gathering for drinking and bonding which can simply be done through chatting and coffee in the office. People are just more relaxed and don’t need alcohol to break the ice,” she said.

However, a Korean in her 30s who regularly smokes noted that she thinks this culture is slowly changing in some places. “It used to be mandatory to drink but now many workplaces don’t really force you to drink.”

It appears to be culturally influenced as it starts from an early age. The legal age for smoking and drinking is both 19 years old but two Koreans in their 30s explained how their smoking and drinking habits started.

Both said they were neither peer pressured but nevertheless influenced by their peers around them. “It's a bit of a shame. I started smoking from a young age because it felt like the ‘cool’ thing to do but now it’s a habit I can’t break,” he said.

However, for drinking, his answer was different, “Ever since I was a child, we always drank when we ate something after turning 20, so I naturally became addicted.”

However, as a regular smoker, he expressed unfairness.

“Smoking is usually approached very hatefully compared to alcohol but even if we smoke, we try to have consideration for others. For example, in apartments, you have to vote whether or not to remove the smoking place but the same consideration is not shown for us as we often have to walk for 10 minutes or more to find a suitable smoking place,” he explained.

Alcohol vs Smoking Regulations (The National Health Promotion Act)

Every two years, the warning pictures plastered on cigarette boxes to discourage smokers, are changed in accordance with the WHO framework convention for tobacco control guidelines to prevent familiarity and strengthen the expression of health risks. Since this system was implemented on December 23, 2016, the adult male smoking rate has continuously decreased from 40.7 percent in 2016 to 34 percent in 2020.

They are both Group 1 carcinogens but one is seen as a socializing factor at events and is thus more widely accepted socially. 

This is the reason why celebrities, and usually the most influential ones, parade on alcohol bottles, while cigarette boxes are covered in very distasteful pictures to dissuade smokers. It’s easy to glamorize alcohol because it has been culturally entrenched for years across the globe. Although alcohol can be just as detrimental, the health consequences of smoking are more glaring and this is why alcohol is sometimes referred to as the silent killer.

Quantity matters?

According to a study published in September, even small quantities drunk frequently can still be very harmful to health. The study conducted by researchers at the Seoul National University College of Medicine revealed that in men particularly, those who drank alcohol five times a week or more and less than 40g ethanol per day were associated with a 46 percent greater risk of gastric cancer than those who drank less than five times a week and less than 40g ethanol per day.

At the National Assembly debate, Professor Sohn Ae-ree of the Department of Health Management at Sahmyook University mentioned some models to follow to curb the lenient alcohol advertising regulations in Korea.

For example, the U.S., the EU, and the U.K. prohibit the use of models influential to young people in alcohol advertisements. In particular, the U.K. bans the use of famous models or characters under the age of 18. France also strictly reviews the content of alcohol advertisements, while Germany, regulates the time, place, and content of alcohol advertisements and bans celebrity alcohol advertisements.

Changes being made in Korea and who should spearhead this?

Even if equivalent pictures of liver cirrhosis or gastric cancer were placed on alcohol bottles, would it have the same effect? Very likely it would not be sufficient to dissuade users who already have the habit like chain smokers but it might be enough to persuade others from starting.

So, what are the preemptive measures being taken to restrict this mildly regulated environment for alcohol? 

The good news is that health officials are aware of Korea’s growing issue. Last week, it was mentioned that the National Assembly is reviewing a bill related to strengthening regulations on liquor advertisement. 

Nam said, "As the harmful effects of drinking are growing, we need legislation to help solve this problem."

The National Health Promotion Act regarding liquor advertising was last amended in June 2021 restricting periods for alcoholic beverage advertisements for data broadcasting, IPTV, and DMB in addition to TV, prohibiting attachment of alcoholic beverage advertisements inside and outside public transportation, and prohibiting alcohol advertisement when holding events targeting children and teenagers.

Aside from this, the Ministry of Health and Welfare (MOHW) together with KHEPI produced an alcohol consumption guide which was published in May this year. This guideline outlines some major amendments to the community drinking harm prevention project. This includes plans for adding an in-depth curriculum on alcohol harm, revising major violations in the national health promotion act to protect more youth, and amending the liquor advertisement act, to name a few.