"Tobacco Companies Must Be Held Accountable for Nicotine Addiction"... Spotlight on 12-Year Lawsuit Outcome

National Health Insurance Service's 50 Billion Won Lawsuit Against Three Tobacco Companies Heads to Final Appeal Hearing
First Trial Ruled "No Causal Link Between Smoking and Lung Cancer"
Medical Community Asserts "Harm to Public Health and Addictiveness Fully Proven"

As the National Health Insurance Service's damages lawsuit against tobacco companies enters its twelfth year, calls are growing to recognize the direct causal relationship between smoking and lung cancer. Medical evidence continues to emerge confirming that smoking, rather than genetic factors, is the primary cause of diseases such as lung cancer and laryngeal cancer.

According to the National Health Insurance Service on May 19, the final hearing in the appellate trial of the damages lawsuit filed by the Service against KT&G, Philip Morris Korea, and BAT Korea will be held at the Seoul High Court on May 22.

In April 2014, the Service filed a damages lawsuit against tobacco companies, seeking 53.3 billion won to cover the medical expenses incurred in treating smokers who developed cancer. The claimed amount corresponds to the medical benefits paid by the Service for 3,465 patients who had smoked for at least 20 pack-years (one pack per day for 20 years) or 30 years and were diagnosed with lung cancer or laryngeal cancer.

Six years later, in the first trial verdict in November 2020, the court sided with the tobacco companies, stating, "Lung cancer can develop due to causes other than smoking, so there is no causal relationship, and the tobacco companies did not minimize or conceal the addictive nature of their products." The court determined that additional evidence was needed to prove that there were no other risk factors besides smoking, such as the period and extent of the patients' exposure to smoking, lifestyle habits, or family history. The Service immediately appealed, leading to more than five years of protracted legal battles.

Ahead of this hearing, 26 cancer-related academic societies, including the Korean Association for Lung Cancer and the Korean Cancer Association, issued a statement saying, "This lawsuit is not simply about damages, but a forum for making decisions to protect public health and realize social justice," and called for a just ruling for the health of the people. Seventeen healthcare institutions, including the National Cancer Center and the National Medical Center, also stated, "Tobacco contains more than 7,000 chemicals, over 250 of which are harmful substances and more than 70 are carcinogens, making smoking the leading cause of lung and laryngeal cancer." They added, "Nicotine, in particular, reaches the brain within 10 seconds of inhalation, stimulates dopamine receptors, and causes strong dependence, so smoking is not a matter of personal freedom but the result of addiction intentionally engineered by tobacco companies."

The National Social Security Union Alliance pointed out, "More than 3 trillion won is spent annually on medical benefits for smoking-related diseases," and added, "With South Korea's health insurance coverage rate at 64.9%?the lowest among OECD countries?financial outflows due to tobacco are hindering both the sustainability and the strengthening of coverage of the national health insurance system."

As research continues on the health harms and addictive nature of smoking, the medical community also believes that the causal relationship between smoking and cancer has already been sufficiently proven. The World Health Organization (WHO) has announced that smoking accounts for about 85% of lung cancer cases and about 90% of laryngeal cancer cases. In a study conducted by the Health Insurance Policy Research Institute of the National Health Insurance Service and the Graduate School of Public Health at Yonsei University, which tracked 136,965 participants at 18 private health screening centers nationwide from 2004 to 2013, it was found that, when general characteristics and genetic factors such as gender, age, and alcohol consumption were the same, those who had smoked for at least 30 years and 20 pack-years had a 54.49 times higher risk of small cell lung cancer, a 21.37 times higher risk of squamous cell lung cancer, and an 8.30 times higher risk of squamous cell laryngeal cancer compared to non-smokers.

A representative of the National Health Insurance Service emphasized, "At this final hearing, Jeong Ki-seok, the Service's president and a respiratory medicine specialist, will attend and directly present his opinion," and added, "Tobacco companies, which have intentionally concealed the strong addictiveness and harmfulness of nicotine, must bear at least some responsibility for the harm caused by smoking."