Psychosocial Configurations of Smoking Risk Among Korean Adolescents: A Latent Profile Analysis

Although adolescent cigarette use in South Korea has declined to historically low levels, residual use may become concentrated within distinct psychosocial subgroups not adequately reached by universal prevention. We examined psychosocial configurations associated with persistent smoking vulnerability.

A nationwide online panel sample of 2,000 Korean adolescents completed measures of seven smoking-related psychosocial factors. Profiles were estimated using finite Gaussian mixture modeling with full information maximum likelihood. Multinomial logistic regression examined whether campaign exposure, peer smoking, parental support, and mental health were associated with profile membership, and current cigarette use was compared across profiles.

Six profiles were identified. A "Weakly Denormalized" profile (9.1%), characterized by the least negative attitudes toward people who smoke and low perceived risk, showed the highest current cigarette use (21.4% vs. 6.2% overall), whereas two protective profiles showed very low use (0.7% and 1.9%). Comprehension of prevention messages was associated with membership in both protective profiles (RRRs = 3.26 and 2.16), whereas campaign awareness alone was not. Informational and instrumental parental support was associated with the protective profiles, whereas emotional support was not. Higher internalizing distress was associated with two comparatively vulnerable profiles.

In mature tobacco-control settings, heterogeneous psychosocial configurations may warrant attention because screening focused on low refusal self-efficacy or peer exposure may overlook a subgroup marked by weak internalized denormalization and low perceived risk. Prevention strategies that strengthen message comprehension, facilitate practical family support, and address emotional vulnerability may help reach these adolescents.