We were able to find a total of 47 online media contents from the last 5 years published in Korean by the DPRK that were related to the DPRK government’s efforts to control tobacco use among its population. Among the MPOWER measures, three most appeared ones were W-mass media (78.7%), O (76.6%), and P (44.7%), in the descending order. On the other hand, there was no online media content that reported about R (0%). Difference in the appearance rate among the MPOWER measures does not necessarily reflect the different level of efforts of the DPRK’s government to the measures because the media coverage rate is not directly related to the rate of actual activities. Instead, the difference might reflect the level of the reporting agent’s interest in the individual measures. In that sense, the DPRK media’s main messages were that smoking is hazardous to health, seek help to stop smoking, and smoking is not allowed in the public areas.
The true value of the study is that we found new evidence of the DPRK’s compliance to the MPOWER measures from online media resources. These findings not only supported the results of the DPRK’s WHO FCTC MPOWER compliance report in 202118, but also showed that the government might perform better in some aspects. Even though something did not appear in the media, it does not necessarily mean that the thing did not happen. Reversely, if anything appeared in the media, it means that it truly has happened. With this in mind, we found a difference between the MPOWER compliance report and the DPRK government’s implementations that were reported in the online media. Regarding advertising bans (E), in the WHO FCTC MPOWER compliance report, the DPRK’s performance was categorized as ‘Complete absence of ban, or ban that does not cover national television, radio and print media’. However, according to two separate news documents that were published on June 11, 2018, and December 12, 2020 (material number 6 and 25 in Table 2, respectively), advertisement of tobacco products in the DPRK was completely forbidden by any means. Therefore, we believe the DPRK’s performance for the advertising bans should be categorized as the highest level, ‘Ban on all forms of direct and indirect advertising’.
As stated above, there was no online media content about taxation on the tobacco products (R) and the WHO FCTC MPOWER compliance report in 2021 categorized the DPRK’s performance on the subject as ‘< 25% of retail price is tax’, which is the second lowest level of compliance. The lowest level of compliance was ‘Data not reported’. However, one should interpret the report with caution because there is no tax in the DPRK. The DPRK’s 2020 FCTC report answered the question about taxation on tobacco products: “DPR Korea is a tax free country. It has no tax system and all tobacco products are sold at a price set by the government which is being raised gradually over the years.”8
We were able to find some other DPRK government’s efforts than MPOWER measures through the online media content analysis. The media reported that the government has adopted new anti-smoking laws in November 2020 that were stricter than previous ones, limited domestic tobacco production, limited tobacco products sales, developed smoking cessation products, limited import of tobacco products, and provided remote service for smoking cessation. However, it was not possible to evaluate the effectiveness of those efforts because they were reported in short sentences without any further information in detail.
As a limitation of the current study, we did not evaluate the quality of the DPRK’s media, which might affect interpretation of the study results. When the media content analysis is performed, it is important for the media sources to be transparent and accurate. The lack of information about the DPRK’s media industry and business did not allow us to evaluate the quality of the media.
Even though the DPRK’s government made a wide range of efforts to control tobacco use among its population, it did not significantly reduce the prevalence of smoking in adult males.11 A further study will be necessary to investigate the social, cultural, and economic contexts of smoking in the DPRK to find the reasons for the high prevalence. It will also be an interesting study to examine the unusual absence of female smokers in the DPRK from the perspective of gender inequality.