The Seocho-gu's Anti-Smoking Policy

A. Problem Analysis

 1. What was the problem before the implementation of the initiative?
Secondhand smoke poses a major threat to public health Smoking was regarded as a matter of personal taste in the past. Today, it is widely condemned as a threat to the health of not only smokers, but people in their vicinity as well. The Seocho district is home to some of the busiest transportation centers in Seoul and includes the Gangnam Central Express Terminal and the Nambu Bus Terminal, through which hundreds of thousands of visitors pass as they traveling nationwide by bus. It is also home to Gangnam-daero (boulevard), by far the nation’s most popular commercial street, visited by at least a million people daily. These popular venues, sadly, were where innocent passersby most likely experienced secondhand smoke. Indeed, the number of complaints to the Seocho-gu District Office related to secondhand smoke has been increasing rapidly, from 42 in 2009 to 72 in 2010 and to 101 in 2011. As South Korea is party to the World Health Organization (WHO)’s Framework Convention on Tobacco Control (FCTC), it bears the responsibility of protecting current and future generations against the harmful effects of secondhand smoke. Acknowledging this responsibility, the Seocho-gu District Office took decisive action. A high ratio of tobacco retailers to district population There were 1,901 tobacco retailers in the Seocho district, or one for every 412 residents, while the average number of tobacco retailers per district nationwide in Korea was 389. Compared to the United States (one retailer per 1,071 residents) and Spain (one retailer per 3,206 residents), and even to the neighboring Songpa district (one retailer per 566 residents), Gwanak district (one per 560 residents), and Dongjak district (one per 465 residents), the ratio of tobacco retailers to population in Seocho was alarmingly high. According to the Korea Health Promotion Foundation (KHPF), exposure to tobacco products and tobacco ads at retailers, such as convenience stores, can double the likelihood of children and teenagers becoming smokers. Teens exposed to the harms of smoking The online survey titled The Health-Related Behavior of Youth 2011, released by the Korean government (co-conducted by the Ministry of Education and the Centers for Disease Control and Prevention), states that 17.2 percent of male students and 6.5 percent of female students had smoked at least once over the 30 days prior to being surveyed. Although the Juvenile Protection Act forbids the sale of tobacco products to children and teens, 80.9 percent of male students and 81.4 percent of female students had no difficulty in purchasing cigarettes from convenience stores and other retailers. It is critical for the nation to protect its youth against the harms of smoking, but the nature of the commercial environment in Korea still tends to encourage teens to take up smoking.

B. Strategic Approach

 2. What was the solution?
First, stricter tobacco regulation was needed for the authorization of tobacco retailers, thus preventing them from spreading, along with the designation of smoke-free zones in public areas to protect non-smokers. Second, to prevent teenagers from taking up smoking, anti-smoking education and environments were provided. Third, more smokers were encouraged to quit by extending the opening times of the anti-smoking clinic and hiring more anti-smoking counselors.

 3. How did the initiative solve the problem and improve people’s lives?
Powerful tobacco regulation 1. Designating smoke-free zones to minimize the harms of secondhand smoke Determined to reduce the scourge of secondhand smoke that threatens the health of locals, the Seocho-gu District Office decided to introduce a number of new regulatory measures that controlled and minimized the use of tobacco. Having first established the legal ground for designating smoke-free zones in July 2011 in the form of the Borough Bylaw and Enforcement Rules on Preventing the Harms of Secondhand Smoke, the Seocho-gu District Office designated Gangnam-daero (Boulevard) as a smoke-free street in March 2012. That made Seocho the first municipality in Korea to designate an entire street as a smoke-free zone. 2. Creating stricter criteria for the authorization of tobacco retailers In an effort to discourage the spread of tobacco retailers, the Seocho-gu District Office amended the Rules on the Authorization of Tobacco Retailers and increased the minimum distance between tobacco retailers from 50 meters to 100 meters beginning in October 2016, thus setting an example for the other districts in Seoul. As a result, the number of tobacco retailers decreased from 1,089 in 2016 to 1,074 in 2017, as did the number of applications to open new tobacco outlets. Anti-smoking efforts to discourage teenagers 1. Community-Wide Tobacco Mapping for Teens (since 2013) This innovative program enlists the participation of teens themselves to identify and improve harmful environments that encourage smoking. The program, which applies a mobile mapping technology to the improvement of public health, invites teens to identify and discuss solutions to such environments in their vicinity via mobile and web platforms. As a community-based program, it allows teens to play a leading role in the progress of anti-smoking efforts in their area. 2. Anti-smoke Monitoring for Teens (since 2011) A volunteering teenager is paired up with an adult to monitor local activities that encourage smoking among teens, such as the illegal sales of tobacco products to teens and the failure to check teen IDs when they attempt to purchase tobacco products. The Seocho-gu District Office was the first municipality in Korea to adopt this program, and it publishes the results of its monitoring campaign regularly to provide information to the public and gain feedback. 3. The Nineteen⑲ Campaign (since 2013) Middle- and high-school student volunteers, health clubs, local community service centers, and residents’ associations participate together in this campaign to ensure that retailers check IDs and do not sell tobacco and liquor to teenagers. The campaign involves distributing Nineteen⑲ stickers and the Manual for Tobacco Retailers developed by the Seocho-gu District Office to the proprietors of tobacco stores. 4. Health Youth Program (Tobacco Industry Expose) This participatory program was designed to raise teens’ awareness of the harms of smoking and to encourage them to think about smoking in a critical manner. The program conducts eight classes, each with a different topic, at middle schools and alternative schools. Active support for quitting smoking Improving the capabilities and services of the anti-smoking clinic Statistics show that over 50 percent of smokers treated at anti-smoking clinics return to smoking within six months of completing clinic programs. The Seocho-gu District Office thus extended the length of its clinic service program from six months to one year and increased the number of clinic sessions from nine to 15. The district also hired three more anti-smoking counselors to add to the existing four. The district’s clinic now provides not only counseling to quit smoking, but also an overall assessment of smokers’ health, including a body composition analyses.

C. Execution and Implementation

 4. In which ways is the initiative creative and innovative?
Teen-oriented and teen-participation initiative (1) Community-Wide Tobacco Mapping for Teens: using mobile technology for anti-smoking efforts for the first time in Korea The tobacco mapping program broke free of the mold of merely lecturing teens on the harms of smoking, and instead actively sought the participation of teens and local communities to use mobile technology to map environments that encourage smoking. The results of volunteers’ work were relayed to the Seocho-gu District Office to improve its anti-smoking awareness and regulatory programs for teens. (2) Health Youth Program (Tobacco Industry Expose): the first-ever program in Korea to make smoking “abnormal” to students The Health Youth Program (Tobacco Industry Expose), the first of its kind ever tried in Korea, was introduced out of a need for a new paradigm in anti-smoking education that could achieve “a smoke-free next generation.” The program intends to show students how smoking and the tobacco industry are “abnormal” by exposing the marketing tricks and lobbying efforts of tobacco industries, thus enlightening them on what tobacco companies do to try to keep people hooked on smoking.

 5. Who implemented the initiative and what is the size of the population affected by this initiative?
An extensive and effective network of cooperation led by public healthcare clinics The Seocho-gu District Office’s anti-smoking policy is implemented along an extensive and effective network of cooperation led by public healthcare clinics and various departments of the district office. Health promotion teams at public healthcare clinics oversee anti-smoking efforts for teens, such as the Community-Wide Tobacco Mapping for Teens Program and the Health Youth Program (Tobacco Industry Expose). They relay feedback from participants of the Community-Wide Tobacco Mapping for Teens Program to various responsible departments of the district office, including the Urban Planning, Roads, and Public Hygiene Administration Divisions. Smoker management teams at public healthcare clinics oversee the prohibition of smoking in smoke-free zones, while the Job Creation & Economy Divisionis responsible for minimizing the creation of new tobacco retailers. And the Nineteen⑲ Campaign has been carried out with the ongoing cooperation of the district’s community service centers. Freeing over a million citizens daily from the harms of secondhand smoke While public healthcare clinics are officially in charge of designating smoke-free zones and keeping them smoke free, citizens’ own participation in various district programs and campaigns forms the core of the Seocho-gu District Office’s anti-smoking efforts. Gangnam-daero is the busiest and most crowded commercial street in Korea, visited by over a million Koreans and international tourists every day. Seocho’s designation of the boulevard as a smoke-free zone thus frees a million people from the harms of secondhand smoke daily. Greater support for smokers The Seocho-gu District Office’s anti-smoking clinic, which opened its doors in 2005, helps 2,000 to 4,000 smokers (three to six percent of all local smokers) quit smoking annually. The clinic also runs the Anti-Smoking Clinic on the Go program, which conducts over 100 visits a year to local businesses, university campuses, military posts, and police stations.
 6. How was the strategy implemented and what resources were mobilized?
Pre-designation public opinion polls on smoke-free zones In an effort to minimize the public controversy and resistance to the designation of smoke-free zones in public areas, the Seocho-gu District Office surveyed locals for their opinions (with respect to secondhand smoke, the designation of smoke-free zones, and the creation of smoking booths, etc.) to identify policy needs and strengthen support for the policy. Research on anti-smoking efforts In developing the Health Youth Program (Tobacco Industry Expose) to enlighten teens of the dubious activities of tobacco companies and present smoking as “abnormal,” the Seocho-gu District Office contracted the research service of Inje University’s Industrial-Academic Collaboration Group, and hired anti-smoking counselors from Seocho’s anti-smoking clinic as instructors for school class presentations. The Seoul National University’s Institute for Health and the Environment was also commissioned to analyze the air quality inside the airtight smoking booths at Gangnam Central Express Bus Terminal and elsewhere in March 2013. The analysis revealed that smokers in airtight booths were exposed to concentrations of PM2.5 fine particles in the range of 453.9 ± 412.2㎍/㎥, almost 3.5 times higher than was the case for smokers in open booths. As a result, Seocho-gu installed ventilated smoking booths at Sadang Subway Station and elsewhere to better protect the health of smokers. Effective cooperation with local communities Local communities actively participated in the Seocho-gu District Office’s anti-smoking campaigns, with local police precincts, education offices, convenience stores and residents volunteering for the Nineteen⑲ Campaign, students of Baekseok Arts University designing an anti-smoking mascot and organizing street performances for smoke-free zones, and the Korean Association on Smoking and Health and other NGOs organizing diverse ceremonies and events toward fostering a smoke-free street culture. Korea’s first-ever municipal anti-smoking task force In an effort to enhance the effectiveness of its anti-smoking policy, the Seocho-gu District Office assembled a task force in March 2012, the first of its kind in Korea. It also hired 18 anti-smoking monitoring agents, all on full-time regular government service contracts, to monitor smoking in smoke-free zones day and night. Efficient fiscal management: Using donations from businesses, collected fines, and public healthcare clinic budgets Under an agreement with the JW Foundation to provide incentives for people to quit smoking, the Seocho-gu District Office awards 16 participants in the Seocho Anti-Smoking Retreat Program every year with KRW 10 million each. It has also hired 18 anti-smoking monitoring agents (amounting to KRW 460.72 million in annual labor costs), without increasing its fiscal burden, by drawing upon the monetary fines collected (totaling KRW 698.17 million in 2016) for their salaries. Other funds from the surplus public healthcare clinic budget are used for the display of anti-smoking messages on billboards, banners, and signboards and to produce community maps showing where smoke-free zones are located. Seocho Smoke-Free Zone App Under an agreement with Seoul National University, the Seocho-gu District Office developed the Seocho Smoke-Free Zone App in November 2012. The mobile application sends out sound and text to alert a user if she or he is 20 meters away from a smoke-free zone and it also provides a map on the 298 smoke-free zones in Seocho, while warning users against smoking in those zones.

 7. Who were the stakeholders involved in the design of the initiative and in its implementation?
Public healthcare clinics and departments of the Seocho-gu District Office The anti-smoking campaign first began with public healthcare clinics participating as sole actors. Over time, however, an extensive system of interdepartmental collaboration was developed, connecting all related departments in the district office. The Job Creation & Economy Divisionhandles rule changes for reducing the number of tobacco retailors; the City Planning, Roads, and Cleaning Administration Divisions, deal with feedback from the community-wide mapping program; the Informatization Support Division, connects the community-wide tobacco maps to the Seocho Map, a ubiquitous community app; the local community service centers and the Resident Administration Division, manage the Nineteen⑲ Campaign and its promotion; and the Seniors and Youth, as well as the Jobs and Economy divisions, crack down on illegal tobacco sales by taking appropriate administrative actions. Local residents, civil organizations, and communities The Seocho-gu District Office’s anti-smoking campaign for teens crucially depends upon local communities’ participation. The Community-wide Tobacco Mapping for Teens Program involves the participation of schools and youth centers; the Nineteen⑲ Campaign involves local police precincts, the education office, convenience stores, and local residents. Moreover, the Seocho-gu District Office enlisted the participation of Inje University’s Graduate School of Health as well as the Industrial-Academic Collaboration Group to design, operate, and monitor the Health Youth Program (Tobacco Industry Expose), with students of medical administration from Baekseok University also involved as assistants. Also, to ensure effective anti-smoking education for teens in school, the Seocho-gu District Office has held multiple discussions, meetings, and workshops with education support offices, school nurses, and classroom anti-smoking trainers. Finally, the district’s anti-smoking clinic assisted smokers who repeatedly failed to quit smoking by referring them to nicotine addiction clinics for formal medical opinions, or to the anti-smoking camp of the Seoul Non-Smoking Support Center for in-depth addiction treatment.

 8. What were the most successful outputs and why was the initiative effective?
Fostering a non-smoking culture in the streets The Seocho-gu District Office’s designation of Gangnam-daero as a smoke-free zone has induced positive change in the behavior of smokers, who used to see smoking as a natural part of walking down the street. The district now has 1,208 smoke-free zones, including Gangnam-daero, the Central Express Bus Terminal Plaza, and the areas around nurseries and kindergartens. The district’s anti-smoking agents caught and fined 78,703 smokers from 2012 to 2016. Keeping Gangnam-daero and the Central Express Bus Terminal, by far the two most crowded locations in Korea, smoke-free had a significant effect on fostering and spreading a non-smoking culture, encouraging non-smoking not only in Seoul, but also nationwide. Boasting the lowest smoking rate across Korea The adult smoking rate in the Seocho district was 16.5 percent in 2015, well below Seoul’s citywide average of 19.4 percent and the nationwide average of 22.2 percent. A youth health survey conducted in 2015 also revealed that Seocho had a lower smoking rate among teens (6.1 percent) than the nationwide average (7.8 percent). Eliminating the harms of smoking with smoke-free environments Surveys on tobacco products being illegally sold to teenagers in Seocho revealed that the rate of such illegal sales dropped from 60.6 percent in 2012 to 37.6 percent in 2015, a decline of 23 percentage points. Meanwhile, the ratio of convenience stores displaying anti-smoking signs increased from 60.9 percent in 2011 to 83.6 percent by 2015, helping foster an environment that discourages teens from smoking. In 2016, the Community-Wide Tobacco Mapping for Teens Project revealed that there were 159 harmful environments in need of improvement. The responsible departments of the Seocho-gu District Office completed necessary improvements at 42 of these environments, or 26 percent of the total. They also reinforced monitoring and campaigns against the illegal disposal of garbage and cigarette butts at 68 of the environments, or 43 percent. Ensuring compliance with the FCTC As South Korea has been a signatory of the FCTC since 2005 and thereby pledges to the international community to work toward reducing smoking, the Seocho-gu District Office decided to actively carry out anti-smoking efforts that have included non-price measures (designating and expanding smoke-free zones) and demand-reducing measures (banning tobacco sales to minors and reducing the number of new tobacco retailers). In fact, Seocho is the first municipality in Korea to specifically develop and implement policies that comply with the FCTC.

 9. What were the main obstacles encountered and how were they overcome?
Smokers’ resistance to the designation of smoke-free zones In the early days of the smoke-free zones, there were many occasions when smokers openly complained about and refused to comply with the enforcement of the anti-smoking law, as they lacked awareness of the new anti-smoking policy. The Seocho-gu District Office sought to minimize smokers’ resistance by creating smoking booths around the Gangnam Subway Station. In addition, there was a trial period of three months before fines were actually levied on smokers, so that the public would be more aware of the introduction of the new anti-smoking law. A total of 2,067 volunteers participated in 162 monitoring sessions, warning 4,391 smokers against the new regulation in total. Tobacco retailers’ resistance The amendment to the Rules on the Authorization of Tobacco Retailers, with the goal of reducing the number of new tobacco retailers, incurred resistance from tobacco and retail industries. The Seocho-gu District Office therefore comprehensively educated the public on why public health had a priority over the freedom of business. It highlighted that tobacco retailers were not ordinary commercial enterprises whose ownership could be transferred or sold, and that the Tobacco Business Act was not designed to protect tobacco retailers. Thanks to the district office’s continued campaign in the media and press, most residents in Seocho today are even aware that a distance of at least 100 meters is mandatory between any two tobacco retailers.

D. Impact and Sustainability

 10. What were the key benefits resulting from this initiative?
Pleasant streets, with a strong anti-smoking culture The designation of Gangnam-daero and other street environments as smoke-free zones, as well as ongoing law enforcement, has contributed significantly to the protection of non-smokers’ health and rights. Keeping Gangnam-daero smoke-free alone protects over a million passersby against the harms of secondhand smoke, particularly little children who might otherwise be exposed to both secondhand smoke and the risk of cigarette burns. The Seocho-gu District Office enforces its smoke-free zone policy with 18 anti-smoking monitoring agents. Hiring these agents presented new job opportunities for retirees who are better suited to the position than people from other age groups. Reducing the number of tobacco retailers The amended Rules on the Authorization of Tobacco Retailers makes it more difficult for tobacco retailers to open new businesses. Thus, it has significantly helped to reduce the concentration of tobacco retailers in the Seocho district. The reduced number of tobacco retailers, in turn, has reduced smokers’ access to tobacco products and thereby it is expected to decrease the smoking rate, making Seocho a healthier environment for teens and the public. Health Youth Program and other teen-centered projects As part of the evaluation of the Health Youth Program (Tobacco Industry Expose) in 2016, the Seocho-gu District Office selected two groups to survey, a test group of 173 teenagers and a control group of 250 middle-school students. Surveying them involved having teenagers from both groups fill out questionnaires, both before and after participating in the program. The evaluation revealed that the program was quite effective in gaining teenagers’ support for tobacco regulation. The program increased their knowledge of tobacco regulation and reduced any favorable inclination toward the tobacco industry. Community-Wide Tobacco Mapping for Teens Program This project launched an active grassroots campaign with the participation of 155 locals from local schools and neighborhood groups. The volunteers together mapped 257 harmful environments in their respective communities, including 31 smoking-encouraging spots, 23 drinking-encouraging spots, 25 areas conducive to aberrant behavior, 66 areas posing physical risks, and 44 areas with other harms to health. The volunteers officially requested that the Seocho-gu District Office and its organizations make visible improvements in 159 of these harmful areas. Enhanced anti-smoking clinic support In an effort to help people who have quit smoking to remain smoke free, the Seocho-gu District Office’s anti-smoking clinic provides in-depth counseling and training programs, including the Anti-Smoking Clinic on the Go that visits businesses, university campuses, military posts and police stations. The Seocho-gu District Office also hired additional counselors specialized in helping teens and women to quit smoking so that they can receive more effective, customized support.

 11. Did the initiative improve integrity and/or accountability in public service? (If applicable)

 12. Were special measures put in place to ensure that the initiative benefits women and girls and improves the situation of the poorest and most vulnerable? (If applicable)
Program tailored to women smokers The Seocho-gu District Office has sought to help women smokers quit in ways customized to their needs. In September and October of 2015, a special anti-smoking clinic of eight weekly sessions was held, with 22 women in attendance. In addition to in-depth anti-smoking counseling and education, the participating women were taught the Lung-Strengthening Exercise (known to lower the urge to smoke), had herbal teas and snacks, experienced forest therapy involving a hike through the woods, and engaged in conversations for emotional support. In 2016, a counseling office for women was created as part of the anti-smoking clinic, with specialist counselors assigned to it. The clinic is open on Saturday mornings for women only to further help women smokers quit for good. Providing anti-smoking clinic services and incentives in a lower-income neighborhood The Seocho-gu District Office has additionally set up an anti-smoking clinic and public education center in the Jugong Apartment Complex in Umyeon-dong, a lower-income area, and employs nurses who provide information about the harms of smoking and help area residents quit smoking. The district’s anti-smoking retreat program also offers incentives for participants from lower-income households.

Contact Information

Institution Name:   Seocho-gu
Institution Type:   Local Government  
Contact Person:   Kwang Jun Kim
Title:   Mr  
Telephone/ Fax:   82-2-2155-6378
Institution's / Project's Website:  
Address:   Seocho-gu District Office, 2584 Nambusunhwan-ro, Seocho-gu, Seoul, Republic of Korea
Postal Code:   06750
City:   Seoul

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