In this blog post, we’ll examine why cigarettes are still legally sold despite causing health damage comparable to that of some illegal drugs, and why strong regulations are necessary.
When people think of drugs, they usually conjure up intense and dangerous images. Furthermore, since drugs are legally prohibited, social awareness of their dangers is relatively well-established. In contrast, although cigarettes can cause serious harm to health just like drugs, they do not elicit the same level of alarm. In fact, while drug users are relatively rare, smokers are easy to find all around us. The fact that cigarettes are harmful to health has already been proven by countless studies, and many people are aware of this. Some public health experts even point out that tobacco causes greater harm to society as a whole than certain illegal drugs. As a nonsmoker who had previously paid little attention to tobacco, I, too, began to wonder—upon learning these facts—whether tobacco might require a level of regulation similar to that of narcotics.
When you stand at the checkout counter of a convenience store, you can see a wide variety of cigarettes on display. Products with different flavors, scents, and thicknesses are constantly being released to cater to consumer preferences. In this way, cigarettes have established themselves as a luxury item through brand differentiation strategies. However, one fact consumers must be aware of is that they are paying for a substance that can harm their health.
Cigarettes are often described as “all harm, no benefit.” This is because they contain a great many harmful substances. Nicotine, for example, acts on the central nervous system, causing strong dependence and addiction. Within seconds of inhalation, nicotine reaches the brain and stimulates the release of dopamine, leading to dependence with repeated use. It also increases heart rate and blood pressure and affects various organs in the body. Tar is a general term for particulate matter in cigarette smoke and contains numerous carcinogens and toxic substances. Carbon monoxide, a major harmful gas component, binds to hemoglobin in the blood, reducing its ability to carry oxygen and, as a result, can lead to a lack of oxygen supply to body tissues. In addition, cigarette smoke contains numerous other harmful chemicals, such as benzene, arsenic, cadmium, and formaldehyde. Ultimately, tobacco can be considered a major risk factor that threatens human health through the combined effects of various toxic substances.
The diseases caused by tobacco are also extremely diverse. Smoking is known to be a major cause of various respiratory diseases, such as chronic obstructive pulmonary disease (COPD), emphysema, and chronic bronchitis. In particular, the causal relationship between lung cancer and smoking has been established through decades of research. The World Health Organization (WHO) and health authorities around the world have identified smoking as the most significant preventable risk factor for lung cancer. Furthermore, smoking increases the risk of various cardiovascular diseases, such as heart attacks and strokes, by raising blood pressure, increasing heart rate, damaging blood vessels, and promoting blood clotting. It is also known to be closely linked to several other diseases, including oral cancer, laryngeal cancer, esophageal cancer, and periodontal disease.
Tobacco is one of the leading causes of reduced life expectancy and increased risk of premature death. According to the World Health Organization, millions of people worldwide die each year due to smoking and secondhand smoke. It is a regrettable reality that, despite these clearly established risks, tobacco continues to be consumed as a luxury item. Tobacco companies generate profits based on nicotine’s addictive properties, and in the past, they also employed strategies such as using additives like menthol to make the smoking experience more pleasant. Given this situation, there are clear limitations to viewing tobacco merely as a luxury item.
It is already well known that tobacco is a major factor harming public health. Nevertheless, unlike most narcotics, tobacco is legally manufactured, distributed, and sold.
The debate over whether it is appropriate to legally permit tobacco—which poses significant health risks and is highly addictive—continues to this day.
The World Health Organization identifies the characteristics of substances capable of causing drug dependence as strong cravings, repeated use, the development of tolerance, withdrawal symptoms, and harm to individuals and society. Based on these criteria, nicotine also qualifies as a substance that induces dependence. Of course, while tobacco and illegal drugs differ in their legal status and the nature of their risks, nicotine dependence also imposes a significant burden on individual health and society. Although South Korea’s smoking rate has been on a long-term downward trend, a significant number of adults still smoke, and concerns about nicotine dependence continue to be raised.
One of the biggest problems with tobacco is its addictiveness. Nicotine acts on the brain’s reward circuitry to induce repeated use, and in this respect, it shares commonalities with various addictive substances. Once nicotine dependence is established, the body tends to maintain a constant level of nicotine, and withdrawal symptoms such as anxiety, difficulty concentrating, headaches, insomnia, and irritability may occur during the process of quitting smoking. Because of these characteristics, many smokers report difficulty in quitting.
There is also a historical context behind the widespread global adoption of tobacco. After Christopher Columbus and his crew encountered the smoking culture of Native Americans in 1492, tobacco spread to Europe. Subsequently, tobacco rapidly gained popularity, initially perceived as a medicinal or luxury item. It is believed to have been introduced to Korea via Japan during the mid-Joseon Dynasty, at a time when the health risks associated with it were not yet fully understood.
For a long time, South Korea has had a relatively high smoking rate among OECD countries and has implemented various anti-smoking policies to reduce it. These include raising tobacco taxes, expanding smoke-free zones, requiring graphic health warnings, and providing smoking cessation support services. While these policies have achieved some success, the social costs resulting from smoking remain significant. Therefore, from a public health perspective, there are calls for more proactive policies, such as further restricting tobacco advertising and marketing and strengthening warning labels.
While there are voices advocating for smoking cessation, there are also opinions emphasizing smokers’ right to choose and their freedom. Some smokers’ groups argue that a social environment should be created where smokers and nonsmokers can coexist. However, the view that a certain level of restriction is necessary when an individual’s freedom directly harms the health of others is also gaining traction. In particular, within the public health sector, there is a consistent call for the government to intervene actively to protect public health.
Secondhand smoke is especially significant because it directly threatens the health of others. It is well established that people exposed to secondhand smoke also face an increased risk of lung cancer, cardiovascular disease, and respiratory diseases. Since the effects can be even more severe for children and pregnant women, policy efforts are needed to reduce secondhand smoke.
Finally, it is necessary to assess whether sufficient information about tobacco is being conveyed. This is because individuals can only make rational choices if they are provided with accurate information about the risks and addictive nature of smoking. If there is a lack of understanding regarding these risks, the decision to smoke or not may not be considered a choice based on sufficient information.
As examined in this article, tobacco is a substance with strong addictive properties and various health risks. Of course, immediately outlawing tobacco or treating it the same as narcotics is not a realistic solution. However, from a public health perspective, efforts to strengthen regulations on tobacco and more clearly inform the public about its risks must continue. Social discourse and policy approaches aimed at reducing tobacco use and minimizing health harms must also be pursued on an ongoing basis.
