The National Health Insurance Service has issued a statement of support regarding a 50 billion won damages lawsuit filed against tobacco companies KT&G, Philip Morris Korea, and BAT Korea. The medical community argues that tobacco companies induce nicotine addiction and that the effects of smoking have caused serious harm, including cancer.
The National Health Insurance Service filed a lawsuit against tobacco companies in April 2014 to seek reimbursement for medical expenses incurred in treating smokers diagnosed with cancer. In the first trial, the National Health Insurance Service lost, and the second trial is currently ongoing. The first trial court found it difficult to recognize a direct causal relationship between smoking and cancer, ruling in favor of the tobacco companies.
◇Medical community: 'Tobacco companies control nicotine levels… intensifying addiction'
Eighteen health care organizations, including the National Cancer Center, the National Medical Center, the Korean Medical Association, the Korean Hospital Association, and the Korean Pharmaceutical Association, recently issued a joint statement supporting the National Health Insurance Service’s lawsuit against tobacco. They stated, "Tobacco companies have intentionally designed nicotine addiction." Just one cigarette causes nicotine to enter the bloodstream and reach the brain within 10 seconds. There, nicotine elevates dopamine levels, a neurotransmitter that enhances mood. Over time, smokers desire nicotine again and develop a craving to smoke.
The medical community noted in their joint statement that "tobacco companies adjusted nicotine levels to enhance addiction and manipulated filter designs to allow (tobacco) smoke to penetrate deeply into the body," describing it as "a deliberate act that encourages addiction, independent of the smoker’s will."
They further stated that "smoking can lead to heart attacks, strokes, and peripheral vascular diseases, and non-smokers are also at a 2 to 4 times higher risk of developing cancer and cardiovascular diseases due to secondhand smoke," emphasizing that despite the scientific evidence linking smoking to cancer, tobacco companies deny the causal relationship between smoking and diseases while evading responsibility. Yang Han-gwang, director of the National Cancer Center, expressed hope that tobacco companies would clarify their responsibilities and reduce harm to public health.
The Korean Society of Lung Cancer and the Korean Cancer Society, among 26 other cancer organizations, also issued a similar statement. They asserted, "Tobacco companies that knowingly concealed the strong addictiveness and harmfulness of nicotine must be held accountable," and added, "This lawsuit is not merely a matter of damages but a platform for protecting public health and achieving social justice."
The Korean Liver Cancer Society also supported the tobacco lawsuit, stating that "smoking is a cause of lung cancer and laryngeal cancer." They emphasized that "the causal relationship between smoking and diseases has been scientifically established," and noted that tobacco companies have minimized or concealed their products' addictiveness and harmful effects without providing adequate warnings. The probability that smoking is the cause of a smoker's lung cancer (squamous cell carcinoma/small cell lung cancer) is 96.4% to 97.5%, and for laryngeal cancer, it is 85.3%.
◇Lawsuit eligibility and the causal relationship between smoking and cancer are also issues
Despite the support from the medical community, it remains uncertain whether the appeals court will rule in favor of the National Health Insurance Service. The main issue is the eligibility to file a lawsuit. In April 2014, the National Health Insurance Service filed a 53.3 billion won damages lawsuit against tobacco companies, demanding repayment for the medical expenses incurred in treating 3,465 patients diagnosed with lung cancer and laryngeal cancer over a 10-year period from 2003 to 2013.
The tobacco companies contended that the National Health Insurance Service did not have the standing to file a lawsuit. They argued that while patients with cancer caused by smoking could file a lawsuit, it is difficult to understand why the National Health Insurance Service could do so.
The National Health Insurance Service maintained that it had the right to file a lawsuit. According to the National Health Insurance Act, the National Health Insurance Service manages and pays for insurance benefits. As it incurred expenditures due to tobacco companies, recovering damages (medical expenses) also falls under its duties.
The Seoul Central District Court's Civil Division 22 (Presiding Judge Hong Gi-chan), which handled the first trial, ruled in November 2022 that while the National Health Insurance Service had the standing to file a lawsuit, it was difficult to recognize a direct causal relationship between smoking and cancer. The ruling suggested that factors such as family history, personal habits, environmental influences, and other elements could have contributed to the development of cancer, indicating that tobacco companies might not be liable for damages.
The decision of the appeals court is expected to be announced soon. The Seoul High Court’s Civil Division 6-1 (Presiding Judge Kim Je-wook) will hold a hearing for the second trial on the 22nd. The court is expected to finalize the ruling date after concluding the hearing on that day. This will lead to the final verdict of the second trial of the tobacco lawsuit, which has lasted for 11 years.