It is an 8.5 centimeter-long and 0.8 centimeter-thick dried herb stick wrapped in white paper, slim enough to fit between your second and third fingers. But it contains at least 250 harmful chemicals, more than 50 of which cause cancers of the mouth, head, lung, breast, bladder, stomach and other parts of the body. It is also linked to coronary heart disease and many other fatal disorders. It is suspected of causing infertility in women and raises the risk of fetal deformity during pregnancy.
The World Health Organization said it killed 5 million people worldwide a year, equivalent to one person dying every six seconds. The organization warned that the death toll could rise to more than 8 million by 2030 unless urgent actions are taken.
One possible solution is that its distribution and manufacture would be banned. However, it is one of the best-selling items in Korea, still luring hundreds of thousands of people every day.
In Korea, about 90 billion Pall Mall cigarettes, or some 4.5 billion packs, were sold in 2010, giving more than 4 trillion won ($3.57 billion) in revenue to tobacco companies.
According to figures from the Ministry of Health and Welfare, 39.6 percent of adult males and 2.2 percent of adult females were smokers last year. This portion is one of the highest among OECD member states.
“The number has been fluctuating for the past couple of years. But one thing that is clear is that while adult males are ditching cigarettes, more underage people are starting to smoke them. The trend is eminent among girls,” said Kim Eun-ji, secretary general of the Korean Association of Smoking and Health.
“Every year, 50,000 people die of diseases related to their smoking habit (in Korea). Adding up the possible number of people who died of passive smoking (there is no exact data dedicated to the issue yet), the number of people dying from smoking-related diseases could go much higher,” she said.
According to the National Health Insurance Corporation, the amount of socioeconomic costs related to smoking reached 5.6 trillion won as of 2007. “It means nonsmokers, too, are paying for the treatments and other living costs caused by smokers. The amount must have gone up in 2010,” an institute spokesman said.
However, it isn’t easy to get away from: Many of those addicted say they cannot quit though they are aware of the threats.
The government and civic groups have held a series of antismoking campaigns but have failed to deter 7.1 percent of middle and high school students from taking up the habit.
On the exterior of the packaging, there is a warning on the damage caused by smoking. Cigarette companies are banned from advertising in newspapers and other media outlets.
A total of 340,638 spots nationwide, including Seoul, Gwanghwamun and Cheonggye plazas in central Seoul, are designated as smoke-free areas. Those who violate the rule are fined up to 300,000 won.
The Health Ministry provides consulting programs to the would-be quitters, with around-the-clock telephone counselors as well as local public health care center doctors checking their conditions on a daily basis.
More and more people have come to understand the damage of smoking. Furthermore, a recent slew of litigation filed against Korea’s dominant cigarette maker KT&G, as well as the government, which owned it until 2002, has served to enhance public awareness of the issue.
Antismoking activists say that cigarettes are too accessible to underage students, who are allured by the “cool and sexy” image of smoking advertised by tobacco companies.
“When you go to supermarkets or convenience stores, cigarettes are displayed right next to the cashiers with billboards and other signs drawing their attention,” Kim said.
Park Jae-gahb, chief director of the National Medical Center, blamed the “sly” marketing strategies of cigarette companies, especially KT&G, which takes up 60 percent of tobacco sales in Korea.
“KT&G have brainwashed the customers, especially the youngsters, with cultural and sports events,” he said. The company sponsors a male basketball team, as well as female volleyball, male ping-pong and female badminton teams.
“Just imagine the little students shouting out, ‘KT&G!’ while cheering, vowing themselves to buy the product to support the teams they like. That’s a horrible indoctrination,” he said.
Park, who refers to cigarettes as “the drug,” or “the poison,” said KT&G and other tobacco firms bear responsibility.
“Instead of asking teenagers not to smoke or stop smoking, the firm has been advising the kids to smoke ‘later,’ when they become adults. This just delays the occurrence of all the problems instead of preventing them,” he said.
Civic activists have been requesting that tobacco firms disclose the list of additives in cigarettes, but the company remains silent.
They have disclosed about 150 additives to the court, which is far less than U.S. manufacturers’ disclosure of 599. The judges, however, showed leniency in sealing the rest of the list, citing business confidentiality.
Activists are now asking the U.S. Food and Drug Administration to show them KT&G’s report of additives. The tobacco company exports 40 percent of its products and the U.S. is one of its main export markets. In order to win the American authorities’ approval, the company has reportedly submitted the list to the USFDA.
The government, however, seems less than enthusiastic about eradicating smoking.
Currently, the Ministry of Strategy and Finance looks over cigarette companies. The ministry hasn’t suggested a single policy regulating cigarette products by far. The government collects about 7.5 trillion won from tobacco firms every year for health promotion, but in reality, the Health Ministry spends less than 25 billion won for the actual smoke-free campaigns and pertinent projects.
For this reason, the government’s attempt to raise cigarette prices by 500 won has been marred by public antipathy. “If they would use it to improve the health and welfare status of the smokers, we would understand. But the cigarette price hike seems to be an easy way to rake in more tax revenue at this point,” Kim said.
Moreover, the Health Ministry has taken a rather inconsistent stance toward cigarettes.
The administration joined the WHO Framework Convention on Tobacco Control, which requires all participating parties to consider taking legislative action or promoting their existing laws, where necessary, to deal with criminal and civil liability, including compensation where appropriate. It is also to restrain and regulate all promotional actions on cigarette consumption.
The Health Ministry will even host a meeting of the convention members next year to show off the progress in its anticigarette campaigns and policies.
On the other hand, the ministry has been promoting the industry. The National Pension Service, an affiliate of the ministry, managing 300 trillion won fund, has been investing a substantial amount of money in tobacco firms.
According to Rep. Jeon Hyun-heui of the main opposition Democratic Party, the NPS has invested a total of $114 million in domestic and international tobacco firms. The NPS poured 2.43 trillion won in KT&G between 2006 and 2010, earning 106 billion won in profit.
“We are trying to reduce the amount in the near future. However, we will not cut it out, because it may pose a huge blow to the market and the company,” a ministry official said.
What are solutions?
Experts and industry insiders claim that the fastest and the most effective way to achieve a smoke-free society is to cease cigarette manufacturing completely.
Park, who has submitted a relevant bill to the National Assembly three times only to be rejected, said no politician will ever vote to destroy one of their largest sponsors. “Tobacco firms are among the largest and the most powerful lobbyists in Yeouido, the political hub of Korea. They have sponsored various events and occasions,” he said.
Park said the second-best idea would be for the administration to entrust cigarette-related policies to the Health Ministry and exclude the Finance Ministry. “The Korea Food and Drug Administration could take care of it since most components of cigarettes are carcinogens and toxins,” he said.
Park said he had suggested this plan last year to President Lee Myung-bak, who didn’t seem impressed with his idea. But later some officials expressed sympathy with his efforts. “Some ministers said I was speaking for them. It seems that many high-ranking officials understand that the socioeconomic costs of smoking exceed the tax income,” he said, adding that antismoking campaigns could be an effective way to bolster the drying up national health insurance fund.
Both Park and Kim stressed that the government needs to cover antismoking programs with the public health insurance. Currently, the program requires more than 200,000 won per 12-week session, which drives away many smokers.
“These days, varenicline-based smoke-addiction treatments such as Champix (Chantix in the U.S.) have proven quite effective ― about 25 percent of smokers have succeeded in maintaining smoke-free status for more than six weeks after finishing the medication,” Park said.
Inserting pictures of skeletons or photos of smokers’ lungs covered with various cancers and dirt on the cigarette packaging are recommended, too. The WHO also finds the method effective.
“We still have a lot to do,” Choi Seung-hee, a ministry official, admitted. “But we are moving toward becoming a smoke-free society,” she added.