[Opinion] Raising Public Awareness on Tobacco Lawsuits Holding Smokers Accountable for Smoking Harms

April 14, 2014, marks the day when the National Health Insurance Service (NHIS) filed a tobacco lawsuit against the top three domestic tobacco companies by market share, including KT&G, and one manufacturer. This was done to represent the public, hold tobacco companies accountable for concealing the harms of smoking, and prevent financial leakage caused by smoking-related diseases.

The causal relationship between smoking and cancer has been confirmed through numerous research studies. The contribution of smoking to cancer incidence is known to be quite high: 95.4% for small cell lung cancer, 91.5% for squamous cell carcinoma, and 81.5% for laryngeal cancer. Health insurance medical expenses due to smoking amount to 3.8589 trillion KRW, with benefit payments totaling 3.2591 trillion KRW, increasing at an average annual rate of 4.6% over the past five years (2019?2023).

The number of deaths caused by direct smoking reached 58,036 annually (159 per day) as of 2019. Continuous exposure to secondhand smoke can increase health risks, such as reduced lung function, comparable to smoking about 5 to 10 cigarettes per day.

The NHIS claimed tobacco manufacturers’ product liability in the lawsuit, arguing that they did not adopt designs to reduce risks during the manufacturing process and that warnings about the dangers of smoking were insufficient. They also stated that claims for damages and subrogation related to health insurance financial expenditures caused by smoking-related diseases are possible.

However, the first-instance court dismissed all claims by the NHIS on November 20, 2020, reasoning that the NHIS could not directly claim damages on behalf of the parties, the causal relationship between smoking and lung cancer was not clear, and the tobacco companies’ illegal liability was not recognized.

In response, the NHIS filed an appeal on December 10, 2020, and held the ninth hearing on September 11 of this year. Since there have been cases of successful tobacco lawsuits or settlements in countries such as the United States, Canada, and Brazil, it is expected that a satisfactory outcome can be achieved with a more strategic approach.

The NHIS is strengthening its legal arguments by securing expert opinions and research papers on key issues to win the appeal trial, as well as collecting and analyzing foreign case materials.

Additionally, the Tobacco Harm Management Act, which mandates manufacturers to manage tobacco harmfulness, has passed the National Assembly plenary session and is scheduled to be implemented next year, necessitating analysis of related information. Above all, raising public support and changing the judiciary’s perception are crucial, and great efforts are being made to increase public interest.

The author has personal experience of successfully quitting smoking by deliberately spreading the word among acquaintances to motivate himself while treating persistent cough and phlegm that did not improve well even with medication over ten years ago.

The NHIS is also working in solidarity with various civic and social organizations to raise awareness of the causal relationship between smoking and health management and to expand social interest so that the judiciary recognizes the significant public concern.

Just as enduring the hot summer leads to refreshing breezes and abundant harvests, the long tobacco lawsuit over the past decade is expected to bear fruit, allowing all citizens to look forward to a healthier and more vibrant future for the Republic of Korea.

Deputy General Manager Ji-hwan Lee, Changwon Jungbu Branch, National Health Insurance Service.

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