The National Health Insurance Service has received support from the medical community ahead of the second trial date in the 50 billion won damages lawsuit filed against tobacco companies KT&G, Philip Morris Korea, and BAT Korea. The medical community noted that tobacco companies induced nicotine addiction, and the resulting smoking has led to serious consequences such as cancer among the populace.
In April 2014, the National Health Insurance Service filed a lawsuit against tobacco companies, seeking reimbursement for medical costs incurred in treating smokers who developed cancer. In the first trial, the NHIS lost, and the second trial is currently underway. The first trial court ruled that it was difficult to acknowledge a direct causal relationship between smoking and cancer, thus siding with the tobacco companies.
◇Medical community says tobacco companies control nicotine levels, enhancing addiction
Eighteen health and medical organizations, including the National Cancer Center, National Medical Center, Korean Medical Association, Korean Hospital Association, and Korean Pharmaceutical Association, recently issued a joint statement supporting the NHIS's lawsuit against tobacco companies, stating, "Tobacco companies have intentionally designed nicotine addiction." It takes only one puff of a cigarette for nicotine to enter the bloodstream and reach the brain within 10 seconds. This nicotine increases the levels of dopamine, a neurotransmitter that creates feelings of pleasure, for a certain period. Over time, smokers develop a desire for nicotine again.
The medical community stated in the joint statement that "tobacco companies have adjusted nicotine levels to enhance addiction and manipulated filter designs to allow (tobacco) smoke to infiltrate deeply into the body," adding that "this is a planned act that promotes addiction regardless of the will of the smoker."
They also noted that "smoking can lead to heart attacks, strokes, and peripheral vascular diseases, and non-smokers face 2 to 4 times higher risks of cancer and cardiovascular diseases due to secondhand smoke," and emphasized that "despite scientific evidence linking smoking to cancer, tobacco companies deny the causal relationship between smoking and disease and evade responsibility." Yang Hang-kwang, head of the National Cancer Center, remarked, "I hope this will prompt tobacco companies to clarify their responsibilities and reduce harm to public health."
The Korean Association for Lung Cancer and the Korean Cancer Association, along with 26 other cancer societies, also issued a similar statement. They asserted, "Tobacco companies, aware of the strong addictive nature and harms of nicotine yet intentionally concealing this information, must be held accountable," adding, "This lawsuit is not simply about damages; it is a platform for safeguarding public health and realizing social justice."
The Korean Liver Cancer Society also supported the tobacco lawsuit, stating that "smoking is a cause of lung and laryngeal cancers." They noted, "Scientific evidence has established the causal relationship between smoking and diseases," adding that "tobacco companies have downplayed or concealed the addictiveness and harms of their products without sufficient warnings." The probability that smoking causes lung cancer (squamous cell carcinoma and small cell carcinoma) is 96.4% to 97.5%, while for laryngeal cancer, it is 85.3%.
◇Lawsuit eligibility and the causal relationship between smoking and cancer are also points of contention
Despite support from the medical community, it remains uncertain whether the second trial court will rule in favor of the NHIS. The main issue is the eligibility for the lawsuit. In April 2014, the NHIS filed a 53.3 billion won damages lawsuit against tobacco companies, seeking reimbursement for the medical expenses incurred while treating 3,465 patients diagnosed with lung and laryngeal cancers between 2003 and 2012.
Tobacco companies contended at that time that the NHIS did not have the standing to bring the lawsuit. While patients who developed cancer due to smoking could sue, it was argued that the NHIS's decision to do so was difficult to justify.
The NHIS maintained that it had standing to file the lawsuit. According to the National Health Insurance Act, the NHIS is responsible for disbursing and managing insurance benefit costs. Since it expended funds for insurance benefits due to tobacco companies, reclaiming these damages (medical expenses) is part of its duties.
The Seoul Central District Court's Civil Division 22 (presiding Judge Hong Gi-chan) ruled in November 2022 that while the NHIS had the legal standing to file the lawsuit, it found it difficult to acknowledge a direct causal relationship between smoking and cancer. The rationale was that the cancer incidence might be influenced not only by smoking, but also by family history, personal habits, surrounding environments, or other factors, suggesting that tobacco companies should not be liable for damages.
The second trial ruling is expected to be announced soon. The Seoul High Court's Civil Division 6-1 (presiding Judge Kim Je-wook) will hold the second trial date on the 22nd. The court plans to set a date for the ruling after concluding the hearing on that day. If so, the final conclusion of the second trial in the tobacco lawsuit, which has continued for 11 years, will be reached.