Psychological Stress, Smoking, and Hazardous Drinking Behaviors among South Korean Adults: Findings from the Korean National Health and Nutrition Examination Survey.

INTRODUCTION

There is growing attention to mental health as a contributor to behavioral health in South Korea. We investigated the prevalence of psychological stress and its associations with cigarette smoking and drinking behaviors among a nationally representative sample of South Korean adults.

METHODS

Using data from 14,855 adults aged ≥19 years who participated in the 2013 to 2016 Korea National Health and Nutrition Examination Survey (KNHANES), we performed weighted logistic regression to examine the associations between stress and three binary outcome variables: cigarette smoking, heavy episodic drinking and frequent drinking.

RESULTS

27.2% of participants reported high stress. Controlling for sociodemographic covariates, high stress was associated with 1.54 times the odds (p<0.001) of being a smoker, 1.25 times the odds (p<0.001) of being a heavy episodic drinker, and 1.23 times the odds (p<0.001) of being a frequent drinker. There was evidence of effect modification by gender and occupation, such that the effects of stress on these behaviors were particularly stronger among women and pink-collar (service industry) workers (compared to men and white-collar workers).

CONCLUSIONS

Future policies that aim to address smoking and drinking behaviors in South Korea should consider stress reduction and coping strategies, especially among women and pink-collar workers.