Despite setbacks, public action against the tobacco industry remains possible and necessary.

The tobacco industry has won a legal victory against a lawsuit brought by a public body[1]. On January 15, 2026, a South Korean appeals court upheld a 2020 ruling rejecting the National Health Insurance Service of Korea's (NHIS) claim for 53.3 billion won (31 million euros) in damages against KT&G and the Korean subsidiaries of Philip Morris International (PMI) and British American Tobacco (BAT). The public body announced its intention to appeal to the Supreme Court, although the likely outcome is unfavorable. However, globally, legal action against manufacturers is an integral part of the provisions of the WHO Framework Convention on Tobacco Control (FCTC) and is among the most effective ways to reduce tobacco consumption.

A major health and financial issue in Korea, despite the legal setback

The legal action brought by the public body concerned a request for reimbursement of the cost of treatments paid by the NHIS between 2003 and 2012 to 3,465 patients with lung or laryngeal cancer, 90 of whom have since died. These patients had smoked the equivalent of more than 20 pack-years over a 30-year period. Some studies have shown that more than 90% of these cancers are linked to smoking.

More broadly, over 40,000 South Koreans contract lung cancer each year, according to Jung Ki-suck, a pulmonologist and president of the National Health Insurance Service of South Korea, in a country where a quarter of adult men still smoke, and where 16.31% of male deaths were attributable to smoking in 2023.[2].

Furthermore, the NHIS complaint focused on the fact that harmful substances like tar and addictive substances like nicotine are present in large quantities in cigarettes, and that misleading advertising reassures customers about their supposedly low content. Added to this are cigarette filters (whose protective effect has not been scientifically proven) which falsely reassure smokers. Finally, the NHIS emphasized that tobacco manufacturers had not properly affixed health warnings to cigarette packs.[3], specifically aimed at alerting consumers.

However, the court did not recognize a "significant" causal link between the industry's activities and the expenses incurred. It ruled that the epidemiological links between smoking and cancer were insufficient to establish a direct causal link in the given sample, requiring proof of the complete absence of other risk factors and the conduct of larger-scale research.

She also pointed to the individual responsibility of smokers, who are supposed to be aware of the health risks of tobacco.

She further stressed that the payment for care resulted from its legal obligations, including if this entails financial losses, ultimately concluding that the public health insurance body could not demonstrate direct harm attributable to tobacco companies.

Despite this setback, NHIS is expected to appeal to the Supreme Court. Jung Ki-suck stated that he will continue the legal battle and strengthen his legal strategy in order to establish a precedent and hold cigarette manufacturers accountable, at least partially. He argued that legal action against the tobacco industry cannot be abandoned, as smoking-related illnesses place a heavy burden on public finances while tobacco companies continue to generate substantial profits.[4].

The amounts claimed in this procedure represented a minimal part of tobacco-related health expenditure in South Korea, estimated at around $30 billion (€25 billion) between 2014 and 2024 according to The Lancet.

Sungkyu Lee, director general of the Korea Center for Tobacco Control Research and Education, said that if the court had recognized that even some of the lung cancer cases were due to smoking, it would have opened the door to further legal action.

The fact that this was not the case is disappointing, given the importance of legal precedents in South Korea.« If decisions of this type continue to accumulate, they could eventually discourage future generations from pursuing similar lawsuits. »" he warned.

Recurring legal obstacles for governments, which could rely on Article 19 of the UNFCCC

Since the agreements reached in the late 1990s between US states and major tobacco companies, obliging the latter, among other measures, to reimburse the costs of medical treatments attributable to years of misinformation about the risks of cancer and other harms of cigarettes, at least 60 national, regional or local governments in 21 countries have undertaken similar actions to recover the costs of care related to smoking.

With the notable exception of Canada, where some provinces began collecting compensation in 2024, almost all of these lawsuits have been dismissed, abandoned, or remain stalled. According to an analysis by The Examination, no government has yet won a court case to recover medical expenses from the tobacco industry.[5].

Although the lawsuits have failed for various reasons, one of the recurring challenges for governments has been convincing the courts that they have standing to bring a legal action, conditional on having suffered direct harm and being able to hold tobacco companies accountable.

In at least eight cases, the courts ruled that the losses suffered by governments, in the form of medical bills paid to treat illnesses contracted by smokers, were too far removed from the actions of the companies.

In other cases, judges found that governments had not presented sufficient evidence to demonstrate that the industry's wrongdoing had increased smoking rates, or that healthcare costs had increased as a result of smoking.

Other lawsuits against tobacco manufacturers have failed on procedural grounds or have progressed slowly due to multiple delaying tactics employed by the manufacturers to prevent such actions from succeeding.

Many governments and smokers have thus abandoned their lawsuits when their success seemed unlikely, or when they ended up lacking the financial means to continue the action undertaken.

However, countries party to the WHO Framework Convention on Tobacco Control could rely on one of its provisions, specifically concerning recourse to legal action (Article 19). Last November, during COP11, Countries have adopted a number of international measures to address the civil, criminal, administrative, environmental, and human rights liability of the tobacco industry. These measures are intended to be transposed into national laws or directly enforced by mobilizing all available administrative and fiscal resources and tools to hold the industry accountable for the health and environmental damage it causes. This approach is part of a broader, growing international trend aimed at preventing the industry from shifting the burden of damage and costs associated with its products onto the community and its citizens.

The Canadian example proves that it is possible to strengthen one's legal strategy against tobacco manufacturers.

Canada is currently the only country outside the United States where governments have received compensation from tobacco companies for healthcare costs and reparations for victims. In 2024, after 26 years of litigation, its provinces and territories reached an agreement with the Canadian subsidiaries of Philip Morris International, British American Tobacco, and Japan Tobacco.

Two smokers and an anti-smoking association paved the way for this agreement by successfully filing class-action lawsuits against the Canadian subsidiaries. Following the smokers' victory, the subsidiaries quickly filed for bankruptcy protection and sought to resolve other disputes by negotiating a comprehensive settlement.

The out-of-court settlements, totaling $23.1 billion (€19 billion), included $17.6 billion (€14.6 billion) for governments, $2.9 billion (€2.4 billion) for smokers participating in class-action lawsuits, and $712 million (€594 million) to fund a foundation focused on tobacco-related illnesses. The remainder covered other potential creditors and legal fees.

While tobacco control advocates criticized the agreement, faulting it for not including measures to reduce smoking and for not requiring companies to publish internal documents, Rob Cunningham of the Canadian Cancer Society said that this victory could be replicated elsewhere: according to him, the key to the success of Canadian governments lay in adopting laws before any prosecution, which made it possible to overcome the obstacles that blocked other countries.

These laws thus guaranteed the provinces the right to bring lawsuits and established the presumption that professional misconduct by companies, such as false advertising, caused illnesses.

They also enabled governments to use population data to prove harm, thus avoiding the need to demonstrate that smoking was the cause of the disease in each patient.

According to Rob Cunningham, beyond the financial aspect, winning lawsuits or obtaining out-of-court settlements also helps to reveal hidden wrongdoing by forcing companies to disclose documents, and this can curb smoking rates by changing their behavior.

According to Daniel Dorado, director of the tobacco campaign at Corporate Accountability and Public Participation Africa (CAPPA), a non-profit human rights organization, "« This is the industry's biggest fear. […] When an anti-smoking measure is successfully implemented, the domino effect continues. ".

Recently, The Canadian province of British Columbia has also extended these legal actions to vaping, by filing a lawsuit against JUUL., under the new provincial Vaping Product Damages and Health Care Costs Recovery Act.

©Generation Without Tobacco

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[1]Yejin Gim, Jason McLure and María Pérez, Tobacco companies win — again — in South Korean lawsuit over costs to treat sick smokers, The Examination, published on January 22, 2026, accessed on January 28, 2026

[2]Drope J, Hamill S, Country profile: Republic of Korea, Tobacco Atlas, New York: Vital Strategies and Economics for Health, updated in 2025, accessed January 28, 2026

[3]Kim Eun-gyeong, NHIS Loses Appeal in Tobacco Compensation Case, The Chosun Daily, published January 15, 2026, accessed January 28, 2026

[4]Lim Jae-seong, Court again rejects Korean insurer's claim against tobacco firms, The Korea Herald, published January 15, 2026, accessed January 28, 2026

[5]María Pérez, Smoking costs countries billions in health care. Just two have forced tobacco companies to pay up., The Examination, published on October 22, 2025, accessed on January 28, 2026

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