A New Regulatory Strategy Against Smoking –
Weekly Lotteries and Increasing Credit Balance as
Incentives to Modify Behavior
Gerrit M. Beckhaus*
Tobacco use still is the leading global cause of premature death, killing
nearly 6 million people worldwide each year, 1 not to mention its dramatic
social and economic consequences. In the United States alone, smoking
accounts for 443,000 deaths per year, approximately 49,000 of these deaths
being the result of secondhand smoke exposure. 2 The number of smokers is
estimated at more than one billion worldwide, roughly one third of the
world’s adult population. 3 Seven hundred million children are exposed to
secondhand tobacco smoke, particularly at home. 4 Despite the
implementation of extensive tobacco control strategies within the last
decades—such as, increasing prices through taxation, information
campaigns, advertisement bans, or the regulation of smoking in public
areas, particularly in high income countries (HIC)— tobacco’s threat to
global health remains far from being solved. 5 In the United States, one
could observe a dramatic drop of the number of smokers over the last fifty
years from the peak of 42.4% of all adults in 1965 to 19.3% in 2010.6
* Attorney in Hamburg, Germany; LL.M., Yale Law School, Ph.D. (Dr. iur.), EMBA,
University of Muenster, Germany. I gratefully acknowledge the insights, reflections or
comments of Ronald Bayer, Gesa Beckhaus, Lennart Beckhaus, Thomas Pogge, and Jennifer
1. WORLD HEALTH ORG.WHO REPORT ON THE GLOBAL TOBACCOEPIDEMIC, 2011 –
WARNING ABOUT THE DANGERS OF TOBACCO 8 (2011).
2. Ctr. for Disease Control and Prevention, Smoking-Attributable Mortality, Years of
Potential Life Lost, and Productivity Losses – United States, 2000-2004, 57 MORBIDITY &
MORTALITY WEEKLY REP. 1226, 1226-1227 (2008); See also Ali H. Mokdad, James S.
Marks, Donna F. Stroup & Julie L. Gerberding, Actual Causes of Death in the United States,
2000, 291 J. AM. MED. ASS’N 1238 passim (2004) (Errata, 293 J. AM. MED. ASS’N 298
3. INST. OF MED., PROMOTING CARDIOVASCULAR HEALTH IN THE DEVELOPING WORLD:
A CRITICAL CHALLENGE TO ACHIEVE GLOBAL HEALTH 72 (2010).
4. Why is Smoking an Issue for Non-Smokers?, WORLD HEALTH ORG.,
http://www.who.int/features/qa/60/en/index.html (last visited Jan. 17, 2013).
5. World Health Org. supra note 1, passim.