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Tobacco and epidemiology in Korea: old tricks, new answers?
  1. Alex Broadbent1,
  2. Seung-sik Hwang2
  1. 1Department of Philosophy, University of Johannesburg, Auckland Park, Gauteng, South Africa
  2. 2Department of Social and Preventive Medicine, Inha University School of Medicine, Incheon, South Korea
  1. Correspondence to Professor Alex Broadbent, Department of Philosophy, University of Johannesburg, P.O. Box 524, Auckland Park, Gauteng 2006, South Africa; abbroadbent{at}

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The National Health Insurance Service (NHIS) of Korea provides health insurance for over 90% of the population. The prevalence of smoking among Korean men is one of the highest in developed countries, and cancer incidence and mortality rates are the highest among all Asian countries.1 The NHIS has taken legal action against Korean and international tobacco companies and recently suffered a blow at the Supreme Court.2 This has attracted comment in Korean epidemiology journals.3 ,4 The familiarity of the issues from the history of epidemiology in Europe and America make the case disturbing and deserving of international attention. In particular, three aspects of the judgement (all identified as problematic in ref.4) deserve emphasis.

First, tobacco companies successfully argued that, beyond statutory warning labels, they had no duty to warn smokers of the dangers of smoking. Legislation obliges manufacturers to place specific warnings on packets, but the question concerned whether the statutory labels satisfied a duty to warn of the dangers of smoking. The court found no further duty, on the basis that the dangers of smoking are already widely known.

Even if the dangers of smoking are better known than they used to be, it is hard to accept that education is sufficient in this regard, especially given the relation between age of starting smoking, difficulty of stopping, duration of smoking habit, and risk of smoking-related diseases. Moreover, even if the present notoriety of smoking is deemed sufficient, it is largely because of the efforts of epidemiologists and others involved in public health. The Korean Supreme Court's decision implies that the efforts of epidemiologists and others involved in public health to raise awareness of the dangers of smoking have relieved tobacco companies operating in Korea of the cost of doing so, thus effectively improving the …

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