poster in Pyongyang
with the slogan "Let's all vote in agreement!" ("모두다 찬성투표하자!")
It is possible to vote against the proposed candidate, in state-wide elections; the name of the candidate needs to be traced with a special pen. There seems to be no secrecy, so everyone can see who votes against the candidate.
Elections are held in North Korea. People can elect the representatives of their government, as well as the members of city councils, mayors and governors. Elections are held every 4-5 years. In North Korea, people are required to vote, and almost all people vote.